Health inspection·October 10, 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 interview and record review for one of three sampled residents (Resident 1), the facility failed to follow their policy in providing Activities of Daily Living (ADLS) when personal hygiene was not provide as needed and failing to notify responsible party (RP) of Resident 1 ' s shower refusals. Residents Affected - Few This failure has potential in putting Resident 1 ' s health and safety at risk when hygiene needs were not met. Findings: During review of Residents 1 ' s admission Record (general demographics), the document indicated Resident 1 was admitted to the facility on [DATE], with diagnoses to include: cerebral infarction (blood blocked to brain, causing tissue death), Benign Prostatic Hyperplasia (enlarged prostate) Neurogenic Bladder (bladder retention), Urinary tract infection, schizoaffective disorder (hallucination s, delusions), hypertension (high blood pressure). During a concurrent interview and record review of Resident 1 ' s Medical Record with the Director of Nursing (DON), reviewed are as follows: 1. Task ALDs Shower /Bath self from September 11, 2024- October 09, 2024, 22 bed baths recorded, only 2 showers: September 01, 2024, Hair washed, skin moisturized marked Yes (Nails trimmed and shaved marked No) September 05, 2024, hair washed, skin moisturized shaved marked, shower and skin check marked Yes, nails trimmed marked No. 2. Careplan (No documentation of shower refusals). 3. No Progress Notes of documentation of shower refusals. 4. No Change in Condition for shower refusals, No responsible party notification. During an interview on October 10, 2024, with the Director of Staff Development (DSD), the (DSD) stated, For showers, we were told to chart it down, we go back 3 times after they refuse to see if the resident changes their mind in taking a shower. The charge nurse and the Certified Nursing Assistant (CNA) documents shower refusals. I printed out the bed baths provided, but I only have 2 shower sheets since September 1, 2024, until now. I don ' t know what happened. I ' m not sure for this Page 1 of 2 555089 555089 10/10/2024 Meadows Ridge Care Center 1700 E Washington St Colton, CA 92324

F 0677 resident what happened, there is no documentation. Level of Harm - Minimal harm or potential for actual harm During an interview on October 10, 2024, with the Director of Nurses (DON), the (DON) stated, If Resident 1 is not showering, he needs a bed bath. Showers should be as schedule if he doesn ' t refuse. The charge nurses will be the one to notify me of his refusals. For Refusals we do a Change of Condition of behaviors refusal of Care. Responsible Party and doctor will be notified. I can agree, no records on careplan, there are no refusals for showers. I did not know about the refusals of showers, I never knew of his refusals, it would have been part of his behaviors. Residents Affected - Few During a review of the facility ' s policy and procedure titled, Activities of Daily Living ADL, supporting revised March 2018, the policy and procedure indicated, Residents will be provided with care, treatment, and services as appropriate to maintain or improve their ability to carry out activities of daily living (ADLs). Residents who are unable to carry out activities of daily living independently will receive the services necessary to maintain good nutrition, grooming and personal and oral hygiene .(3) refuses care and treatment to restore or maintain functional abilities and (a) the resident and or representative has been informed of the risk and benefits of the proposed care or treatment .(c) the refusal and information are documented in the residents clinical record. 555089 Page 2 of 2