Inspection·January 29, 2026

F 0687 Provide appropriate foot care. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview and record review, the facility failed to provide a resident with foot care. This applies to 1 of 3 residents (R1) reviewed for foot care in a sample of 3. The findings include:R1's Face sheet, dated 1/28/26, shows R1's diagnoses included Type 2 hemiplegia/hemiparesis, epilepsy, and Parkinson's disease. MDS (Minimum Data Sheet) dated 1/2/26, shows R1's cognition was severely impaired and R1 was dependent on staff for putting on and taking off footwear, lower body dressing, and showering/bathing and R1 required substantial/maximum assistance for personal hygiene. The MDS shows R1 had no skin problems at the time of assessment. Physician Order Sheet, dated 1/28/26, shows R1 had physician orders for daily skin check every night shift for prevention if moderate to high risk based on Braden scale and perform daily skin check if any skin issues are identified and a weekly skin check every Monday for his skin assessment. R1 also had physician orders for betadine paint/foam daily to be applied to his right foot daily and an order to apply house stock moisturizing lotion to both lower extremities as needed for dry skin. Podiatry note, dated 11/20/25, shows R1's right and left foot/ankle had dry/thin skin. The note shows R1's feet were to be kept clean and lotion was to be utilized daily. On 1/28/26 in R1's room, V3 (Nurse) stated R1 had no skin concerns or open areas on his feet. V3 removed R1's bilateral pressure relieving boots and socks. R1 had a brownish-orange waxy crust covering the majority of the bottom of his feet and spotty areas of the brownish-orange waxy crust were observed on the sides and top of his feet as well as his ankles and shins of his legs. There was also a large amount of brownish-orange waxy crust buildup between all of R1's toes and some of the areas were peeling away from R1's skin leaving pink, intact skin underneath. V3 examined R1's feet and stated she would clean R1's feet and call the wound nurse to examine the areas. V3 called the facility wound nurse and began to wipe R3's feet with a wet towel. Several small chips of the brown/orange waxy substance broke off and fell on the bed revealing intact, pink, dry skin. At 10:53 AM, V2 (Director of Nursing/DON) entered R1's room, examined R1's feet, and stated the waxy crust was not typically present on R1's feet and R1's feet looked very dry. V2 stated R1's feet should not appear to have the brownish-orange waxy substance and staff should be moisturizing R1's feet daily to prevent dryness. On 1/28/26 at 10:56 AM, V4 (Wound Nurse) arrived and examined R1's feet. V4 stated she applied cream earlier that morning. V4 examined R1's feet and stated his feet should be cleaned and lotions/creams should be applied. V4 stated the brownish-orange waxy substance was present on R1's feet for a long time prior and was not new. On 1/28/26 at 11:20 AM with V5 (Certified Nursing Assistant/CNA), V3 (Wound Nurse) washed R1's feet and chips of the brownish-orange waxy substance chipped off of R1's feet as she washed. V3 stated approximately 10-15% of the brownish-orange waxy substance was removed. V3 stated facility staff were expected to apply cream and ointment every day to R1's feet and wash his feet when providing a scheduled bed bath. V5 stated she did not wash R1's feet or apply lotion during AM care that morning. On 1/28/26 at 11:30 AM, V6 (CNA) stated the brown-orange waxy crust appeared on R1's feet intermittently. On 1/28/26 at 11:32 AM, V3 (Nurse) stated R1's feet were sometimes a bit dry, but she had Residents Affected - Few (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 2 Event ID: 145980 Printed: 05/15/2026 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 145980 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/29/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pearl of St Charles, The 850 Dunham Rd St Charles, IL 60174 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)