Health inspection·December 11, 2025

F 0687 Provide appropriate foot care. Level of Harm - Minimal harm or potential for actual harm Based on observation, interviews, and record review, the facility failed to ensure that eight (Residents #1, #2, #3, #4, #5, #6, #7, and #8) of eight residents reviewed for foot care were provided with foot care consistent with professional standards of practice, including assisting residents in making necessary appointments with qualified healthcare providers such as podiatrists. Failure to provide appropriate foot care can result in ingrown toenails, fungal infections, skin infections, and can potentially impact the resident's dignity and sense of self-worth.The findings include:1.On 12/11/25 at 9:45 AM, Resident #1 was observed in her room with Certified Nursing Assistant (CNA) B. When asked if anyone had looked at her feet or if she had seen a Podiatrist, Resident #1, replied, No. CNA B removed the resident's socks. Her toenails were very thick and discolored. The resident then gave permission to photograph her toenails. (Photographic evidence obtained)A review of Resident #1's Physician's orders revealed that no order (current, past, or discontinued) was found for podiatry care/visit/referral.2. On 12/11/25 at 9:48 AM, an interview was conducted with resident #2's daughter in the resident's room. When asked about Podiatry care, she stated her mother had not seen a Podiatrist. When asked to see her mother's toenails, she uncovered her feet. The resident's toenails were long and thick. The daughter gave permission to photograph Resident #2's toenails. (Photographic evidence obtained)A review of Resident #2's Physician's orders revealed that no order (current, past, or discontinued) was found for podiatry care/visit/referral.3. On 12/11/25 at 9:58 AM, Resident #3 was interviewed in his room. The resident was sitting in his wheelchair with his shoes and socks on. When asked about his toenails, he stated they are not cut here. He stated he would like to have them cut because they are very long. A review of Resident #3's Physician's orders revealed that no order (current, past, or discontinued) was found for podiatry care/visit/referral.4. On 12/11/25 at 10:03 AM, Resident #4 was interviewed in his room. The resident was in his bed covered with a blanket. When asked about his care, he stated it was ok. When asked about his toenails, he stated they were very tender and removed the blanket. The resident's toenails were very long and thick. Resident #4 gave permission to photograph his toenails. (Photographic evidence obtained) A review of Resident #4 medical record revealed a Podiatry note: Thick and elongated toenails (Appt time: 2/26/2025 12:30:00 PM) (Arrival time: 9:33 AM) physician removed borders of toenails that were painful on right and left feet. There were no other notes in electronic chart regarding foot/toenail care.5. On 12/11/25 at 12:30 PM, a brief interview was conducted with Resident #5. He stated that he would like to have his nails cut because they bothered him. His toenails were observed to be very long. The resident gave permission to photograph his toenails. (Photographic evidence obtained) A review of Resident #5's Physician's orders revealed that no order (current, past, or discontinued) was found for podiatry care/visit/referral.6. On 12/11/25 at 12:33 PM, a brief interview was conducted with Resident #6. He stated his last podiatry visit was in February, and now he is having transportation difficulties. The resident stated his toenails were hurting his skin and painful and he needed to have them cut. His toenails were observed to be very long. The resident gave permission Residents Affected - Some Page 1 of 2 105262 105262 12/11/2025 Blue Lake Post Acute 991 E New York Ave Deland, FL 32724

F 0687 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some to photograph his toenails. (Photographic evidence obtained) A review of Resident #6's Physician's orders revealed that no order (current, past, or discontinued) was found for podiatry care/visit/referral.7. On 12/11/25 at 12:38 PM, a brief interview was conducted with Resident #7. He stated he would like to have his nails cut because they bothered him. His toenails were observed to be very long. The resident gave permission to photograph his toenails. (Photographic evidence obtained) A review of Resident #7's Physician's orders revealed that no order (current, past, or discontinued) was found for podiatry care/visit/referral.8. On 12/11/25 at 12:41 PM, a brief interview was conducted with Resident #8. She stated she would like to have her nails cut because they bothered her. Her toenails were observed to be very long. The resident gave permission to photograph her toenails. (Photographic evidence obtained) A review of Resident #8's Physician's orders revealed that no order (current, past, or discontinued) was found for podiatry care/visit/referral.On 12/11/25 at 12:49 PM, an interview was conducted with Unit Manager A. When asked about resident assessments and if they look at their feet, she stated yes, but they are only looking for skin issues. She stated she does look at toenails but does not document anything about them. When asked about the nail care policy and procedure, she stated she was not familiar with it. She stated if she has a resident with long or damaged toenails, she will put that resident on a list to see the Podiatrist. She stated social services sets up the appointments. When asked if she would cut a resident's toenails she stated no. When asked about resident's nails causing them pain, she stated that she would call the nurse practitioner for orders.On 12/11/25 at 12:56 PM, an interview was conducted with the Social Services Director (SSD). When asked about podiatry appointments, she stated the facility has used Aria physicians for this, but they only take cash fee-for-service. She stated that she has recently contracted with another Podiatrist that will see anyone in the building, and she hoped they will be able to start this month. The appointment book for previous and current appointments with the Podiatrist was requested. At 1:10 PM, the SSD returned and stated she could not locate the requested appointment book.On 12/11/25 at 1:14 PM, an interview was conducted with CNA B. She stated, If I observe long nails on a resident, I will report it to the nurse. She explained that the staff do not cut the resident's nails.On 12/11/25 at 1:45 PM, an interview was conducted with the DON. When asked about the condition of the residents' toenails, she stated that the new social services director has contracted with a Podiatrist to come to the facility for nail care. She stated they do not have a start date to her knowledge. When asked about the procedure for nail care, she stated she was not familiar with it. 105262 Page 2 of 2