Health inspection·February 10, 2025

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** During an interview on 2/10/25 at 2:40 PM; the Infection Preventionist (ICP) stated, I have been ICP for two years. I in-service staff weekly on infection control protocols and as needed depending on if I see incorrect practices performed. The last in-service for catheter care was November and December of last year. We in-service staff on ways to prevent Urinary Tract Infections (UTI) through proper catheter care and hydration care .Certified Nursing Assistants are to wash their hands before and during incontinence care when going from a dirty to clean surface. Staff should be washing hands with soap and water in the sink in the bathroom, not in a basin. Staff should use the soap provided by the facility when cleaning the perineal area. When emptying the urinary drainage bag, The port is to be cleaned with an alcohol pad, not sanitizing wipes. On 2/10/25 at 1:45 PM, The Director of Nursing (DON) stated, Protocols we have in place to help prevent UTIs are keeping residents, performing routine labs for all residents which include a urine analysis and practice routine peri-care. The CNAs are to clean resident's perineal area every shift with soap and water using the fragrant free soap provided by the facility and report any abnormalities to the nurse. Fragrant soaps can irritate the perineal area and lead to an infection. We also change the indwelling catheter and drainage bags bi-monthly. When a resident is admitted with an indwelling urinary catheter, we verify if there is a pertinent diagnosis. If there is no pertinent diagnosis, we receive an order from the doctor to remove it. Based on observations, record review and interviews the facility failed to provide catheter care according to professional standards for two (Residents #2 and Resident #3) out of two residents sampled for indwelling urinary catheter care as evidenced by two observations of incorrect indwelling urinary catheter care being provided. The findings included: On 02/10/25 at 11:09 AM, during observation of Resident #2 's indwelling urinary catheter care performed by Staff D, Certified Nursing Assistant (CNA) and Staff C, Registered Nurse (RN), it was noted that Staff C, RN did not perform handwashing before the procedure started. Staff D,CNA drained the catheter bag and cleansed the tip of the catheter bag with [Germicidal Disinfectant Wipes]. Staff D, CNA washed her hands at the bedside with the residents soap [brand body wash] that was personally selected by Staff D, CNA to be used. Staff D, CNA cleaned the outer perineum area first, then the inside labia and lastly the catheter in a top to bottom motion. Review of the medical records for Resident #2 revealed the resident was admitted to the facility on [DATE]. Clinical diagnoses included but not limited to: Urinary Tract Infection (UTI) and (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 6 Event ID: 105172 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 105172 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Fountain Manor Health & Rehabilitation Center 390 NE 135th St North Miami, FL 33161 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)