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, record review, and interviews, the facility failed to ensure that a resident who was unable to
carry out activities of daily living (ADLs), received necessary services to maintain good grooming and
personal hygiene for one (Resident #294) of a total survey sample of 19 residents by not providing
adequate fingernail care.
Residents Affected - Few
The findings include:
On 10/07/2024 at 10:59 AM, Resident #294 was observed in his room, sitting up in a wheelchair with
elongated, jagged fingernails with brown matter underneath. (Photographic evidence obtained). The
resident was asked how long it had been since his fingernails had been trimmed. He stated, It's been a
while.
On 10/08/2024 at 9:58 AM, the resident was observed lying in bed with elongated, jagged fingernails with
brown matter underneath. (Photographic evidence obtained) The resident was asked if any staff had offered
to trim or clean his fingernails and he stated, No. The resident was asked if he wanted his fingernails
trimmed and he stated, Yes. The resident was asked if staff offered to trim his nails today would he allow it
and he stated, Yes.
A record review was conducted on 10/08/2024 at 11:40 AM which revealed that Resident #294 was
admitted to the facility on [DATE] with diagnoses/needs including a need for assistance with personal care,
cognitive/communication deficit and diabetes mellitus type II.
A review of the resident's admission MDS (minimum data set) assessment, dated 9/29/2024, revealed that
the assessment was incomplete (in progress).
A review of the resident's care plan, dated 9/24/2024, revealed the following Focus Area: Resident has ADL
decline related to status post amputation from gangrene infection to left foot, hyperlipidemia, diabetes
mellitus type II, a history of stomach cancer, atrial fibrillation, and other comorbidities. Goal: The resident
will receive assistance to be kept clean, dry, and comfortable through the next 30 days, and resident's ADL
needs will be met and independence potential maximized within constraints of disease through next review.
On 10/08/2024 at 1:26 PM, an interview was conducted with Certified Nursing Assistant (CNA) A. She was
asked who was responsible for providing fingernail care to the residents. She stated, The CNAs. She was
asked how often nail care was provided. She stated, As needed or whenever we see that it needs to be
done. She was asked if she provided fingernail trimming for residents with diabetes. She stated, Yes, but we
have to be careful at all times not to make the nails bleed. She was asked if
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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 2
Event ID:
106124
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
106124
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
10/08/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Pruitthealth - Fleming Island
2040 Town Center Blvd
Fleming Island, FL 32003
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
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
she'd had training/education for abuse/neglect. She stated, Yes, when we do [web-based training] and we
have different subjects every month. The CNA was accompanied to Resident #294's bedside to assess the
status of his fingernails. She was asked if she thought the resident needed fingernail care. She stated, Yes.
The resident's fingernails were elongated and jagged with brown matter underneath.
On 10/08/2024 at 1:31 PM, an interview was conducted with Registered Nurse (RN) B who was asked who
was responsible for providing fingernail care for the residents. She stated, The CNAs unless its a diabetic
resident, then the nurses have to do it. She was asked when fingernail care was provided. She stated, I
wanna say as needed. She was asked if she'd had training/education for abuse/neglect. She stated, Yes,
recently. RN B was then accompanied to Resident #294's bedside to assess the status of his fingernails.
She was asked if she thought the resident needed fingernail care. She stated, Yes, he needs it. The
resident's fingernails were elongated and jagged with brown matter underneath.
On 10/08/2024 at 3:58 PM, a policy and procedure for ADL care was requested from the Director of
Nursing who reported that the facility did not have a policy and procedure for ADL care.
.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
106124
If continuation sheet
Page 2 of 2
