Health inspection·August 4, 2022

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review and policy review, the facility failed to accurately assess and reassess the efficacy of interventions for skin rash for 1 of 1 sampled resident, reviewed (Resident #92); and failed to provide post-op surgical care for 1 of 1 sampled resident, reviewed (Resident #82). Residents Affected - Few The findings included: 1. During the initial screening of residents on 08/01/22 at 1:50 PM, Resident #92 was observed to have a reddened raised rash on both his arms, as well as linear scratches in the same areas. Record review on 08/02/22 revealed Resident #92 was admitted on [DATE] with a primary diagnosis of Osteomyelitis, non-healing pressure ulcers, Diabetes, and the relevant diagnosis of Pruritis. The admission comprehensive assessment documented the BIMS (Brief Interview of Mental Status) exam score of 15/15 showing no cognitive decline. Known allergies to heparin, penicillin and sulfa were also noted. The admission summary, dated [DATE] at 11:54 PM, noted a general body rash and multiple dry scabs to both legs. On 07/18/22 at 2:55 PM, a progress note read: Torso and upper back covered in hives, with associated itching, presenting as an allergic response to something. Legs clean, no hives, Communicated with Attending physician, awaiting feedback regarding treatment plan. Evening nurse to follow. (Written by Staff C, a Registered Nurse). No follow up documentation or new orders were found. Review of the resident's physician orders showed a previous order for an 'as-needed' antihistamine from 07/01/22 to 07/15/22. The ketoconazole cream 2% was originally ordered on 07/05/22 to apply to groin/peri area every day and evening shift. A different order, dated 07/02/22, read: 'cleanse generalized area with normal saline and dry area. Apply antifungal cream to affected area. Reapply twice a day, treat rash for 14 consecutive days even if rash has improved, every day and evening shift for wound healing for 14 days. If no improvement in 14 days, consider treatment change.' The treatment began on 07/05/22 and continued until it was discontinued on 08/02/22 after surveyor intervention. No documentation reassessing the efficacy of the treatment at any time over the 28 days was found in the medical record. Review of the resident's care plan revealed a focus area of RASH: The resident has Rash to groin/peri/generalized body, (not initiated until 07/26/2022) with the following interventions: 1) The resident's rash will heal by review date; 2) Administer medication as ordered by MD. Monitor/document side effects and effectiveness; 3) Avoid scratching and keep hands and body parts from (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 5 Event ID: 105039 Printed: 05/28/2026 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 105039 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/04/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rehabilitation Center of the Palm Beaches, The 301 Northpointe Parkway West Palm Beach, FL 33407 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)