Health inspection·April 29, 2021

F 0676 Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews, and record reviews, the facility failed to ensure it provided restorative services for one (Resident #40) resident sampled for restorative care provided, from a total sample of 44 residents. This placed Resident #40 at risk for functional decline. Residents Affected - Few The findings include: During an interview with Resident #40 on 4/26/21 at 11:36 AM, he was observed using a wheelchair as a mobility aid. He reported that he was supposed to be on restorative programs for stand-to-sit and for walking, but it was not happening. During another interview with Resident #40 on 4/28/21 at 09:30 AM, he revealed that he spoke with the Physical Therapy Manager/Therapist who told him his services would start on 5/03/21. A record review for Resident #40 revealed he was admitted to the facility on [DATE]. His diagnoses included, but were not limited to, coronary artery disease, heart failure, hypertension, diabetes mellitus, arthritis, osteoporosis, and morbid obesity. A review of Resident #40's Significant Change Minimum Data Set assessment, dated 3/6/21, revealed a Brief Interview for Mental Status (BIMS) score of 15, indicating intact cognitive response. The assessment was documented that he required extensive assistance of 2 people with bed mobility and transfers, and 1-person extensive assistance to walk in his room and in the corridors. His balance during transitions and walking was not steady, and he used a walker and a wheelchair as mobility aids. The care plan for Resident #40 was reviewed and documented that Resident #40 was a fall risk and non-compliant with waiting for assistance and using his walker for transfers and ambulation. Approaches included refer to physical therapy as needed. A review of Resident #40's physician's orders dated 4/19/21 read: Discontinue skilled PT services and continue with RNP (restorative nursing program). A review of the RNP Occupational Therapy Functional Maintenance Program for Resident #40, dated 4/16/21, revealed the goal: Sit to stand transfers x 5 repetitions at the hall rail or parallel bars with minimal assistance and cues for hand/foot placement, scoot to edge of chair. (Photographic evidence obtained) A review of the CNA [NAME] for Resident #40, asking how Resident #40 ambulated in corridors and his Page 1 of 3 105145 105145 04/29/2021 Parkside Health and Rehabilitation Center 451 S Amelia Ave Deland, FL 32720

F 0676 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few room revealed many of the fields over the last 30 days were marked not applicable. The [NAME] section titled Nursing Rehab: Transfers: Sit to stand transfers x 5 repetitions at hall rail and cues for hand/foot placement, scoot to edge of chair for staff to fill in was left blank for the past 30 days. The Nursing Rehab: Walking, assist to toilet using 2 WW (wheeled walker) from elevated EOB (edge of bed), 3 x's a week as tolerated section for staff to complete was also blank for the past 30 days. (Photographic evidence was obtained) An interview was conducted with Employee A, Restorative Certified Nursing Assistant, on 4/29/21 at 10:27 AM. She stated that Resident #40 was put on restorative services a week ago and his goals are to walk to the bathroom and move from sitting to standing position for 5 repetitions. During the interview, Employee A revealed that due to short staffing and restorative department having to finish monthly weights, they had not been able to provide Resident #40's restorative services. . 105145 Page 2 of 3 105145 04/29/2021 Parkside Health and Rehabilitation Center 451 S Amelia Ave Deland, FL 32720

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observations and staff interviews, the facility failed to store dishware, covered or inverted, in a location where it was not exposed to splash, dust and other contamination. This deficient practice potentially affected all residents in the facility who took their meals from the facility's kitchen. The findings include: During a kitchen visit on 04/28/21 at 11:31 AM, the plate dispenser was observed next to the stove and partially under the vent hood. The plates were stored face-up and were not covered in a manner to prevent food, grease splatters, or dust and debris from landing on the face or lip of the plates. A second kitchen visit and interview with Employee C, Dietary [NAME] was conducted on 04/29/21 at 09:45 AM. The plate dispenser was once again observed full of plates partially under the vent hood with plates face-up not inverted. The Dietary [NAME] acknowledged the potential for cross-contamination of the eating surface of the plates and confirmed they should be stored face down or covered. During an interview with the Certified Dietary Manager on 4/29/21 at 10:00 AM, he acknowledged the potential for contamination of the eating surfaces of the plates. . 105145 Page 3 of 3