Health inspection·November 20, 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 observations, interviews, and record review the facility failed to provide the necessary services for residents who were unable to carry out activities of daily living to maintain good grooming and personal hygiene for 1 (Resident#1) of 6 residents reviewed for ADLs. Residents Affected - Some The facility failed to ensure Resident #1 had his fingernails cleaned and trimmed. This failure could place residents who were dependent on staff for ADL care at risk for loss of dignity, risk for infections, and a decreased quality of life. Findings included: Review of Resident #1's Quarterly MDS assessment dated [DATE] reflected Resident #1 was an [AGE] year-old male with initial admission date to the facility on [DATE]. His diagnoses included fracture of part of neck of left femur (the bone of the thigh), Obstructive uropathy (urine cannot drain through the urinary tract), and Alzheimer's disease. Resident #1 had a BIMS of 99 which indicated Resident #1 was unable to complete brief interview for mental status. Resident #1 required moderate assistance with personal hygiene. Review of Resident #1's Comprehensive Care Plan, revised 07/04/24, reflected the following: Care area: Self-Care Deficit Goal: [Resident #1] Will maintain or improve self-care area of dressing, grooming hygiene and bathing Interventions: . Provide assistance with self-care as needed. An observation on 11/19/24 at 09:47 AM, revealed Resident #1 was laying in his bed. The nails on both hands were approximately 0.3 centimeters in length extending from the tip of his fingers and had black substance underneath the nails and around the nail beds. Resident #1 was unable to answer questions. In an interview on 01/19/24 at 11:00 AM, with CNA A revealed she was assigned to Resident #1. She stated that most ADL's such as hair trimming, nail clipping was completed during shower times. She revealed that since Resident #1 was not a Diabetic resident, CNAs were responsible for clipping and cleaning his nails. CNA A stated that fingernail clipping should be done weekly or as needed and the risk of not cleaning/ trimming fingernails could be increased risk of infection. CNA A stated she did not check Resident #1's nails this morning when she changed him. In an interview with the DON on 11/20/24 at 12:59 PM, revealed her expectation was that nail care should be provided as needed, especially during shower time. She stated that CNAs were responsible for doing nail care unless the resident had a diagnosis of diabetes. She also stated that as the DON, (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 4 Event ID: 675969 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 675969 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/20/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Settlers Ridge Care Center 1280 Settlers Ridge Rd Celina, TX 75009 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)