Health inspection·October 20, 2022

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few stated she had been working at the facility for six years as an Agency CNA, and more recently (over the last three weeks) she had been working here more often. She stated orientation training was conducted at the facility which included resident hygiene, documentation of tasks, appointments, CPR (cardiopulmonary resuscitation), falls, and personal hygiene. When asked about resident showers, she said showers were generally conducted on the 7A-3P and 3P-11P shifts, and shower sheets had to be signed and filled out to show the task had been completed. When asked to talk through the process of cleaning the residents, she said she would first wake the resident, help if needed to brush their teeth and get them ready to eat breakfast. She would wait for approximately 30 minutes after the meal so they could digest their food, and then she would shower the resident which usually occurred between 9:00 AM and 9:30 AM. During the showering process, she said she would look for skin redness, signs of injury, skin tears or anything abnormal, and she would notify the nurse of such things. She added that she would make sure the residents were clean shaven, toe nails and fingernails were trimmed and clean, and ensure the residents' eyes were clean. If the nails did need trimming, she would let the nurse know, because CNAs could not trim or cut the nails, only clean them. An interview was conducted with Licensed Practical Nurse (LPN) B, Unit Manager, on 10/20/2022 at10:43 AM, who stated personal hygiene training was provided, and she expected the CNAs to attempt to shower the residents as cleanliness was important. She continued, stating she expected residents not to have soiled hair, and for the CNAs to do their best to keep the residents clean paying close attention to perineal care, washing and cleaning fingernails, have podiatry trim toenails, and make a full-body observation from head to toe. She stated if toenails need trimming, this need was placed in the Podiatry book. When asked who trimmed residents' fingernails, she stated fingernails were done by the Activities Department staff. They had what was called a manicure day every Tuesday and on an as needed basis. When she was asked how it was known whether or not a resident needed fingernail or toenail care, she said she would know based on a visual assessment, if the resident verbalized it themselves, or through notification by the CNA. Activities Director C was interviewed on 10/20/2022 at 11:08 AM in reference to residents' fingernail and toenail care. she stated she had been employed by the facility for 15 years. She had a CNA license and would help with tasks such as fingernail care. She stated the facility had what they called Fancy Fingers activities on Thursdays, and this consisted of manicures, fingernail cleaning, nail trimming and filing, and if the resident wished, the nails would be polished. When asked about toenail care, she said her team would place information inside the Podiatrist book and the Podiatrist came to the facility on Fridays to take of the residents' feet. On 10/20/2022 at 11:24 AM, an interview with the Director of Nursing (DON) revealed that if residents needed assistance with ADLs, it would be listed on the [NAME] (brief paper-based summary of a resident's needs). If a resident needed or wanted a bath/shower, there were shower sheets that would indicate who needed showers on certain days. When asked about her expectations of staff for the provision of ADL care and personal hygiene, she said she expected showers to be given in a timely manner and CNAs to do a minimum of two-hour rounds, change residents in a timely manner, assist with brushing teeth, washing faces, combing hair, and skin observation. She further stated along with the skin observation, there should be no new bruising or skin tears/lacerations, and if something like that was observed, the CNA should report it to the nurse or herself (DON). When asked about CNA roles and capabilities when providing personal hygiene as it relates to fingernails, she stated, CNAs can clean, file, and paint fingernails but no cutting or trimming. Nurses are allowed to cut/trim fingernails, and toenail care is left for the podiatrist. She further stated her nurses should be observing as well That's their job and they should be doing weekly checks. When asked if this was just for women, she (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106064 If continuation sheet Page 2 of 3 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 106064 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/20/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Life Care Center of Jacksonville 4813 Lenoir Avenue 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)

F 0677 replied, Nno, men get their nails cleaned and filed, and they get shaved. Level of Harm - Minimal harm or potential for actual harm A review of the facility's Assisted Daily Living Policy stated for Fingernail Care: Ensure fingernails are clean and trimmed to avoid injury and infection; Explain importance of fingernail care to the resident; assemble all necessary equipment, which may include fingernail clipper, nail file, orange sticks, wash basin, towel, and any other necessary equipment; report any abnormalities to the nurse. Residents Affected - Few . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106064 If continuation sheet Page 3 of 3