Inspection·December 19, 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 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record review, the facility failed to ensure that one (Resident #151) of two residents reviewed for activities of daily living (ADLs) assistance, out of 29 residents in the total survey sample, received necessary services to maintain good grooming and personal hygiene, specifically fingernail care. Residents Affected - Few The findings include: A review of the medical record revealed that the resident was admitted to the facility on [DATE] with diagnoses including the following: Surgical aftercare following surgery on the circulatory system, acute combined systolic and diastolic heart failure, major depressive disorder, muscle weakness (generalized), hypertension, shortness of breath, diabetes mellitus and legal blindness. On 12/16/24 at 9:35 AM, Resident #151 was observed with the fingernails on both of his hands extending approximately 1/4 of an inch beyond the nail bed. When the resident was asked if he preferred having his fingernails at the current length, he replied that he asked facility staff to trim his nails and was told someone would come trim them. He further explained that he was fearful of scratching himself with such long nails. (Photographic evidence obtained) On 12/17/24 at 10:48 AM, Resident #151 was observed with the fingernails on both of his hands extending approximately 1/4 of an inch beyond the nail bed. (Photographic evidence obtained) On 12/19/24 at 10:45 AM, Resident #151 was observed with the fingernails on both of his hands extending approximately 1/4 of an inch beyond the nail bed. (Photographic evidence obtained) A review of the 2/6/24 minimum data set (MDS) assessment for Resident #151, revealed a brief interview for mental status (BIMS) score of 13 out of a possible 15 points, indicating intact cognition. He had had no indicators of psychosis, physical or verbal behaviors directed toward others, rejection of care, or wandering behaviors documented in the assessment. ADLs were documented as his having no impairment to the upper or lower extremities; eating and oral hygiene required set-up or clean-up assistance; toileting hygiene, lower body dressing and putting on/taking off footwear required partial to moderate assistance. The resident was assessed as independent for self-bathing/showering. Upper body dressing required supervision or touching assistance. For mobility, the resident required supervision or touching assistance. He received scheduled and as needed pain medication. On 12/19/24 at 10:56 AM, an interview was conducted with Certified Nursing Assistant (CNA) A, who reported she had worked at the facility for approximately seven and a half years. She explained that she completed rounds to check on residents every two hours and every hour for residents who were (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 4 Event ID: 105820 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 105820 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/19/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE University Crossing 6210 Beach Blvd Jacksonville, FL 32216 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)