Inspection·August 8, 2024

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 Based on observation, review of facility policy and procedure, review of the clinical record and resident and staff interview, the facility failed to provide the necessary care and services to maintain personal hygiene for 3 (Resident # 899, #800 and #7) of 3 residents reviewed for ADL's (activities of daily living). Residents Affected - Some The findings included: The facility policy Activities of Daily Living (ADL's) implemented 11/2020 (revised 11/22/21) documented Residents who are unable to carry out activities of daily living independently will receive the necessary services to maintain good nutrition, grooming and personal and oral hygiene. 1. Review of the clinical record revealed Resident #899 had a readmission date of 5/5/24 with diagnoses including cerebral palsy, contracture of hands and left leg, and muscle wasting. The Quarterly Minimum Data Set (MDS) (standardized assessment tool that measures health status in nursing home residents) dated of 5/10/24 documented the resident was dependent on staff assistance for personal hygiene, dressing and bathing. The MDS noted Resident #899's cognitive skills for daily decision making were intact. The care plan initiated on 4/18/24 noted Resident #899 had an ADL self-care deficit due to cerebral palsy, weakness and contractures. The goal for Resident #899 was to have bathing, grooming, toileting, and ADL needs met with assistance from staff through next review. On 8/7/24 at 10:15 a.m., during observation and interview Resident #899 was observed in his room in bed. He was unshaven with approximately four days of facial hair growth. He said no one had shaved him in days and he was not receiving his scheduled showers. Resident #899 said he did not like facial hair, would like to be shaved and showered. He said had not received oral care in a week or so and when they do brush his teeth, they do it very quickly and harsh. Resident #899 said he was incontinent. He said he gets up and spends five hours sitting in his wheelchair every day. He said no one changes his incontinent briefs when he's up in the wheelchair for five hours. On 8/7/24 at 10:00 a.m., in an interview Certified Nursing Assistant (CNA) Staff A said Resident #899 required the use of a mechanical lift for transfers and the assistance of two for turning and incontinent care. Staff A said Resident #899 refuses showers. When asked about incontinent care, Staff A declined to say how often she provided incontinent care to the resident. On 8/7/24 at 10:45 a.m., in an interview Licensed Practical Nurse (LPN) Staff B said staff are (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: 105439 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 105439 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Naples Health and Rehabilitation Center 2900 12th Street N Naples, FL 34103 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)