Health inspection·May 20, 2021

F 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, review of facility policy and procedures, resident and staff interview, the facility failed to implement necessary restorative care to prevent the decline in range of motion or mobility for 1 (Resident #17) of 3 residents reviewed with limited range of motion. The findings included: The facility policy,10-1140 (4/23/18) for Nursing Services Restorative/Maintenance Program specified, the facility shall have a Restorative/Maintenance Program for the purpose of restoring and maintaining optimum level of function for residents at risk. The policy specified the Restorative Care Coordinator shall attend weekly Minimum Data Set (MDS) (a clinical assessment of all residents to assess a resident's functional capabilities) meeting to maintain current communication relating to resident mobility or related problems. Maintain ongoing communication with the interdisciplinary team. Review of the clinical record revealed Resident #17 had a history of cerebral infarction (stroke) with hemiparesis (weakness) affecting the right side. The MDS (Minimum Data Set) admission assessment completed on 3/9/21 noted Resident #17 had functional limitation in range of motion of both upper extremities. Resident #17 required extensive physical assistance of 1 for activities of daily living. Review of the functional maintenance program dated 3/19/21 revealed instructions to provide range of motion (ROM) to bilateral upper and lower extremities during activities of daily living and to keep a rolled cloth in hand for skin integrity. The Certified Nursing Assistant (CNA) [NAME] (provides direction for care) noted to keep a rolled cloth in hand for skin integrity. On 5/17/21 at 2:18 p.m., 5/18/21 at 9:02 a.m., 5/18/21 at 1:42 p.m., and 5/19/21 at 1:42 p.m., Resident #17's right hand's fingers were observed curled toward his palm. Resident #17 did not have the rolled cloth in his hand. On 5/18/21 at 9:02 a.m., in an interview Resident #17 said he could not remember the last time anyone placed the rolled cloth in his hand. On 5/19/21 review of the daily charting revealed the CNAs placed their initials from 5/1/21 through 5/19/21 indicating the rolled cloth was in place in the resident's hand for skin integrity. Page 1 of 3 106053 106053 05/20/2021 Sunnyside Nursing Home 5201 Bahia Vista Street Sarasota, FL 34232

F 0688 Level of Harm - Minimal harm or potential for actual harm On 5/19/21 at 3:00 p.m., Registered Nurse (RN) Staff A verified Resident #17 did not have a rolled cloth in his hand. She said the nurses and CNAs were responsible to place the rolled cloth in the resident's hand and she checked to ensure it was in place. RN Staff A said although she oversaw the restorative program, she did not have set meetings to review the residents' progress. She said she also participated in stand-up meetings in the morning but did not discuss or review residents on a restorative program. Residents Affected - Few 106053 Page 2 of 3 106053 05/20/2021 Sunnyside Nursing Home 5201 Bahia Vista Street Sarasota, FL 34232

F 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm Based on observation, review of facility policy and procedure, resident and staff interview, the facility failed to store continuous positive airway pressure (CPAP) machines masks in a sanitary manner for 1 (Resident #37) of 1 resident who use a CPAP machine (helps you breathe more easily when you sleep). This has the potential to cause respiratory infection. Residents Affected - Few The findings included: A review of the clinical record documented a Physician order for the care of Resident #37's CPAP machine. The order specified, wash CPAP weekly with soap and water and obtain new storage bag every day shift every Tuesday for infection control. On 5/17/21 at 11:58 a.m., during an observation, Resident #37's CPAP mask and tubing were stored uncovered in the open drawer of the nightstand with other personal items. **Photographic Evidence Obtained** Observations on 5/18/21 at 9:00 a.m., and 5/19/21 at 9:07 a.m., Resident #37's CPAP mask remained uncovered in the opened nightstand drawer. **Photographic Evidence Obtained** On 5/19/21 at 10:12 a.m., in an interview, Licensed Practical Nurse (LPN) Staff B said the nurse was responsible to place the CPAP mask in a plastic bag when not in use. On 5/19/21 at 10:24 a.m., during an observation and interview, Registered Nurse (RN) Unit Manager Staff A confirmed the CPAP mask for Resident #37 was in the open nightstand drawer and was uncovered. RN Staff A verified the CPAP mask should be in a plastic bag and not in contact with other items in the drawer. On 5/19/21 at 11:12 a.m., in an interview, the Director of Nursing said the facility had no policy on the care of CPAP machines. 106053 Page 3 of 3