Health inspection·January 24, 2024

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 observation, review of the medical record and interview with the staff and resident, the facility failed to ensure Resident #5 had his fingernails trimmed and Resident #8 was shaved. This affected two residents ( Resident #5 and #8) of 12 residents who required assistance by staff for activities of daily living (ADLS). The facility census was 61. Residents Affected - Few Finding included: 1. Review of the medical record revealed Resident #5 was admitted to the facility on [DATE]. Diagnoses included protein-calorie malnutrition, cerebral infarction, dysphagia, transient ischemic attack, ataxia, arthritis, epilepsy, spastic paraplegia, Huntington's disease, need for assistance with personal care, major depressive disorder, and aphasic. Review of the plan of care dated 08/10/22 with a revision date of 12/18/23 revealed Resident #5 had a self-care deficit, and ADL decline may be expected related to his disease process. Resident #8 required extensive to total assistance for most ADLs and he required staff assist for feeding. Review of the quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed resident #5 had moderately impaired cognition. He required substantial assistance with personal hygiene. Review of the progress notes from 12/24/23 to 01/24/24 revealed no documentation Resident #5 refused to have his fingernails trimmed. Review of the facility shower schedule revealed Resident #5 was to receive a shower on Monday and Thursdays on midnight shift. Observation on 01/23/24 at 9:30 A.M. revealed the fingernails of Resident #5 were long and jagged. On 01/23/24 at 9:40 A.M. an interview with Licensed Practical Nurse (LPN) #100 revealed nails were trimmed as needed. On 01/23/24 at 10:10 A.M. an interview with State Tested Nursing Assistant (STNA) #101 revealed nails were trimmed with showers. Observation on 01/24/23 at 8:50 A.M. revealed the fingernails of Resident #5 were long and jagged. This was verified at this time by STNA #101. Resident #5 stated at this time they were too long and he would like them trimmed. Page 1 of 2 366391 366391 01/24/2024 Astoria Skilled Nursing and Rehabilitation 3537 12th Street, NW Canton, OH 44708

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 2. Review of the medical record revealed Resident #8 was admitted to the facility on [DATE]. Diagnoses included hypertension, diabetes, osteoarthritis, hypothyroidism, transient ischemic attack, myocardial, cerebral infarction, and frontotemporal neurocognitive disorder. Review of the plan of care dated 02/19/23 with a revision date of 09/18/23 revealed Resident #8 had an ADL self-care performance deficit. Resident #8 required extensive assistance of one staff member for personal hygiene and oral care. Review of the quarterly MDS 3.0 assessment dated [DATE] revealed Resident #8 had intact cognition. He required substantial assistance with personal hygiene. Review of the progress notes from 11/01/23 to 01/23/24 revealed no documentation of Resident #8 refusing to be shaved. Observation on 01/23/24 at 9:35 A.M. revealed Resident #8 was unshaven. His beard was scruffy and uneven. An interview at this time with Resident #8 revealed he would like to be shaven but the staff does not do it for him. On 01/23/24 at 9:37 A.M. an interview with Registered Nurse #102 verified Resident #8 needed to be shaved. This deficiency represents non-compliance investigated under Complaint Number OH00149493. 366391 Page 2 of 2