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Deficiency Category | Inspection Date: 8/30/24 Complaint Reporting Period: 3/1/24 - 2/28/25 | Inspection Date: 10/20/22 Complaint Reporting Period: 3/1/23 - 2/29/24 | Inspection Date: 2/18/21 Complaint Reporting Period: 3/1/22 - 2/28/23 |
---|---|---|---|
Freedom from Abuse, Neglect, and Exploitation Deficiencies | |||
Quality of Life and Care Deficiencies | |||
Infection Control Deficiencies | |||
Resident Assessment and Care Planning Deficiencies | |||
Nursing and Physician Services Deficiencies | |||
Resident Rights Deficiencies | |||
Nutrition and Dietary Deficiencies | |||
Pharmacy Service Deficiencies | |||
Environmental Deficiencies | |||
Administration Deficiencies |
Date of last standard health inspection: | 8/30/24Read the full report (PDF) |
Date(s) of complaint inspection(s) between 3/1/24 - 2/28/25 | 1/14/25Read the full report (PDF) 12/13/24Read the full report (PDF) 10/23/24Read the full report (PDF) 8/30/24Read the full report (PDF) 6/25/24Read the full report (PDF) |
Date(s) of infection control inspection(s) between 3/1/24 - 2/28/25 | No infection control inspections |
Total number of Health Deficiencies for this nursing home: | |
Average number of Health Deficiencies in Florida: | |
Average number of Health Deficiencies in the United States: |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Develop and implement policies and procedures to prevent abuse, neglect, and theft. | 10/23/24 | 11/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | 10/23/24 | 11/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | 10/23/24 | 11/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
No Infection Control Deficiencies were found during this inspection period. |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Some |
Ensure each resident receives an accurate assessment. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | 12/13/24 | 1/15/25 | 2 - Minimal harm or potential for actual harm | Few |
PASARR screening for Mental disorders or Intellectual Disabilities | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | 12/13/24 | 1/15/25 | 2 - Minimal harm or potential for actual harm | Few |
No Nursing and Physician Services Deficiencies were found during this inspection period. |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Ensure that residents are fully informed and understand their health status, care and treatments. | 10/23/24 | 11/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
No Nutrition and Dietary Deficiencies were found during this inspection period. |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | 6/25/24 | 7/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Ensure that residents are free from significant medication errors. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Make sure that a working call system is available in each resident's bathroom and bathing area. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | 12/13/24 | 1/15/25 | 2 - Minimal harm or potential for actual harm | Some |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Some |
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | 1/14/25 | 1/15/25 | 2 - Minimal harm or potential for actual harm | Few |
Date of last standard health inspection: | 10/20/22Read the full report (PDF) |
Date(s) of complaint inspection(s) between 3/1/23 - 2/29/24 | 2/15/24Read the full report (PDF) 6/14/23Read the full report (PDF) |
Date(s) of infection control inspection(s) between 3/1/23 - 2/29/24 | No infection control inspections |
Total number of Health Deficiencies for this nursing home: | |
Average number of Health Deficiencies in Florida: | |
Average number of Health Deficiencies in the United States: |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Develop and implement policies and procedures to prevent abuse, neglect, and theft. | 2/15/24 | 3/15/24 | 2 - Minimal harm or potential for actual harm | Some |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | 2/15/24 | 3/15/24 | 2 - Minimal harm or potential for actual harm | Few |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Provide safe and appropriate respiratory care for a resident when needed. | 10/20/22 | 11/28/22 | 2 - Minimal harm or potential for actual harm | Few |
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | 10/20/22 | 11/28/22 | 2 - Minimal harm or potential for actual harm | Few |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | 10/20/22 | 11/28/22 | 2 - Minimal harm or potential for actual harm | Few |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Ensure each resident receives an accurate assessment. | 10/20/22 | 11/28/22 | 2 - Minimal harm or potential for actual harm | Some |
No Nursing and Physician Services Deficiencies were found during this inspection period. |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | 10/20/22 | 11/28/22 | 2 - Minimal harm or potential for actual harm | Some |
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide. | 10/20/22 | 11/28/22 | 2 - Minimal harm or potential for actual harm | Many |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | 10/20/22 | 11/28/22 | 2 - Minimal harm or potential for actual harm | Some |
Have a policy regarding use and storage of foods brought to residents by family and other visitors. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Some |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | 10/20/22 | 11/28/22 | 2 - Minimal harm or potential for actual harm | Few |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Administer the facility in a manner that enables it to use its resources effectively and efficiently. | 2/15/24 | 3/15/24 | 2 - Minimal harm or potential for actual harm | Some |
Employ staff that are licensed, certified, or registered in accordance with state laws. | 2/15/24 | 3/15/24 | 2 - Minimal harm or potential for actual harm | Few |
Date of last standard health inspection: | 2/18/21Read the full report (PDF) |
Date(s) of complaint inspection(s) between 3/1/22 - 2/28/23 | 12/29/22Read the full report (PDF) |
Date(s) of infection control inspection(s) between 3/1/22 - 2/28/23 | 12/5/22Read the full report (PDF) 5/26/22Read the full report (PDF) |
Total number of Health Deficiencies for this nursing home: | |
Average number of Health Deficiencies in Florida: | |
Average number of Health Deficiencies in the United States: |
No Freedom from Abuse, Neglect, and Exploitation Deficiencies were found during this inspection period. |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Provide appropriate treatment and care according to orders, resident’s preferences and goals. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Few |
Provide care and assistance to perform activities of daily living for any resident who is unable. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Few |
Provide safe, appropriate pain management for a resident who requires such services. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Few |
Provide appropriate treatment and care according to orders, resident’s preferences and goals. | 12/29/22 | 1/20/23 | 2 - Minimal harm or potential for actual harm | Some |
Provide safe and appropriate respiratory care for a resident when needed. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Few |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Ensure staff are vaccinated for COVID-19 | 12/5/22 | 1/6/23 | 1 - Potential for minimal harm | Many |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Ensure services provided by the nursing facility meet professional standards of quality. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Few |
Ensure each resident receives an accurate assessment. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Few |
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Few |
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Some |
No Nursing and Physician Services Deficiencies were found during this inspection period. |
No Resident Rights Deficiencies were found during this inspection period. |
No Nutrition and Dietary Deficiencies were found during this inspection period. |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Few |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Few |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Keep all essential equipment working safely. | 2/18/21 | 3/19/21 | 2 - Minimal harm or potential for actual harm | Some |
No Administration Deficiencies were found during this inspection period. |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Develop and implement policies and procedures to prevent abuse, neglect, and theft. | 10/23/24 | 11/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | 10/23/24 | 11/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Provide appropriate pressure ulcer care and prevent new ulcers from developing. | 8/30/24 | 9/30/24 | 2 - Minimal harm or potential for actual harm | Few |
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | 10/23/24 | 11/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | 12/13/24 | 1/15/25 | 2 - Minimal harm or potential for actual harm | Few |
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | 12/13/24 | 1/15/25 | 2 - Minimal harm or potential for actual harm | Few |
Ensure that residents are fully informed and understand their health status, care and treatments. | 10/23/24 | 11/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | 6/25/24 | 7/23/24 | 2 - Minimal harm or potential for actual harm | Few |
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | 12/13/24 | 1/15/25 | 2 - Minimal harm or potential for actual harm | Some |
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | 1/14/25 | 1/15/25 | 2 - Minimal harm or potential for actual harm | Few |
Develop and implement policies and procedures to prevent abuse, neglect, and theft. | 2/15/24 | 3/15/24 | 2 - Minimal harm or potential for actual harm | Some |
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | 2/15/24 | 3/15/24 | 2 - Minimal harm or potential for actual harm | Few |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Have a policy regarding use and storage of foods brought to residents by family and other visitors. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Some |
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | 6/14/23 | 7/14/23 | 2 - Minimal harm or potential for actual harm | Few |
Administer the facility in a manner that enables it to use its resources effectively and efficiently. | 2/15/24 | 3/15/24 | 2 - Minimal harm or potential for actual harm | Some |
Employ staff that are licensed, certified, or registered in accordance with state laws. | 2/15/24 | 3/15/24 | 2 - Minimal harm or potential for actual harm | Few |
Provide appropriate treatment and care according to orders, resident’s preferences and goals. | 12/29/22 | 1/20/23 | 2 - Minimal harm or potential for actual harm | Some |
Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
---|---|---|---|---|
Ensure staff are vaccinated for COVID-19 | 12/5/22 | 1/6/23 | 1 - Potential for minimal harm | Many |