Health inspection·September 21, 2024

F 0676 Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to provide residents weekly showers for two of three residents (R2 and R3) reviewed for showers in the sample 11. Residents Affected - Few Findings include: The facility's Shower and Hygiene Policy dated 8/19/24 documents, It is the policy of this facility to ensure that resident showers/hygienic care is provided by the nursing staff to promote cleanliness, provide comfort to the resident and observe the condition of the resident's skin. Administer resident shower once weekly and/or as often as necessary. Documentation: Date and shift the shower was performed. The name/title of the nursing staff who assisted the resident with the shower/bath. 1. R2's MDS (Minimum Data Set) assessment dated [DATE] documents R2 needed staff assistance for hygiene and showers. R2's Shower/Bathing and Skin Monitoring Report dated 6/29/24 (Admission) through 7/31/24 documents R2 only received two showers within this timeframe on 7/10/24 and 7/27/24. On 9/20/24 at 4:40 PM V4 (R2's Family Member) stated, (R2) no longer resides at the facility. Whenever I would visit (R2) he was dirty, and his hair was greasy. (R2) was not getting showers. 2. R3 was re-admitted from the (Local Hospital) on 9/4/24. R3's MDS dated [DATE], documents R4 has a memory problem, is moderately impaired for daily decision making, is unable to ambulate, and requires maximum to dependent staff assistance with ADL's (Activities of Daily Living). R3's Shower/Bathing and Skin Monitoring Report dated 9/4/24 through 9/19/24 documents R3 only received one shower within this timeframe on 9/16/24. On 9/20/24 at 8:45 AM R3 was lying in bed. R3 did not respond to verbal stimuli. R3's hair was unkempt and all R3's fingernails were long, jagged, and had brown matter underneath. R3 was still in a facility gown and had a putrid smell. On 9/20/24 at 9:30 AM V17 (Certified Nursing Assistant) verified R3's long nails with black matter underneath them. V17 stated, I am getting ready to give (R3) a bed bath now and I will clip and clean her nails. Page 1 of 2 145701 145701 09/21/2024 Bella Terra Streamwood 815 East Irving Park Road Streamwood, IL 60107

F 0676 Level of Harm - Minimal harm or potential for actual harm On 9/2/204 at 2:00 PM V2 (Director of Nursing) verified R2 and R3 (according to shower reports) did not receive at least one shower per week. V2 stated, According to facility policy they should at least receive one shower per week. The staff should also be clipping and cleaning residents' fingernails on shower days at least. Residents Affected - Few 145701 Page 2 of 2