Health inspection·December 15, 2022

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, staff and resident interviews, medical record review and facility policy review, the facility failed to provide assistance with activities of daily living (ADLs), specifically nail care, for one dependant resident (#73) in a sample of 30 residents. Residents Affected - Few The findings include: On 12/12/22 at 12:40 PM, Resident #73 was observed lying in bed, awake. His right hand was out of his bed covers and all fingernails were observed to be elongated with brown debris under each nail. The resident was asked if he could show his left hand. He pulled his covers back and picked up his left hand with his right hand to show his left hand. The nails were also elongated with brown debris under each nail. On 12/13/22 at 10:27 AM, Resident #73 was observed lying in bed, awake. Both hands had elongated nails with brown debris under the nails. The resident was asked if he preferred his nails to be trimmed and clean. He stated Yes, they used to trim my nails but no one has trimmed or cleaned them in months. He was asked if he had asked the staff to trim and clean his nails during that time frame. He stated, Yes, I have, many times, but no one has come back to do it. On 12/14/22 at 9:50 AM, Resident #73 was observed lying in bed, awake. Both hands had elongated nails with brown debris under the nails. He was asked when he last had a shower. He stated, This week. Yesterday. He was asked if staff tended to his nails during his shower. He stated No, they used to come by and trim my nails, but no one does that anymore; it's been months now. On 12/14/22 at 2:12 PM, Resident #73 was observed lying in bed, awake. He put his right hand out to show that his nails were trimmed and clean. He was asked if he was happy with the length of the nails. He stated yes. A medical record review revealed that Resident #73 was admitted on [DATE] with diagnoses including CVA (cerebral vascular accident) affecting the left non-dominant side, and contracture of the left hand. In a record review for Resident #73, it was revealed that a doctor's order, dated 11/28/22, read, Restorative nursing: Check and complete skin and nail hygiene as tolerated. Complete nails and skin hygiene to promote skin integrity. A review of the Minimum Data Set (MDS) quarterly assessment, dated 11/18/22, revealed a Brief Interview for Mental Status (BIMS) score of 9 out of 15, indicating moderately impaired cognition. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 3 Event ID: 105145 Printed: 05/28/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 105145 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkside Health and Rehabilitation Center 451 S Amelia Ave Deland, FL 32720 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)