Health inspection·May 10, 2023

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, and record review, the facility failed to provide care for peripherally inserted central catheters in accordance with professional standards of practice for 1 of 3 residents reviewed with central venous catheters, Resident #3. Residents Affected - Few Findings include: During an observation on 5/10/2023 at 9:05 AM, Resident #3 had a right upper arm PICC (Peripherally Inserted Central Catheter) line with intravenous antibiotic infusing. The transparent dressing was lifting up and pulling away from skin on the side of the dressing closest to the resident and exposing the insertion site. The dressing was dated 4/27/2023. Review of Resident #3's admission record revealed that the resident was admitted to the facility on [DATE] with diagnoses including osteomyelitis (an infection of the bone), paraplegia, sepsis (a life threatening response to infection that can lead to tissue damage, organ failure and death), acute cystitis (an inflammation of the bladder) with hematuria (blood in the urine), essential (primary) hypertension, generalized anxiety disorder, and acquired absence of left leg above the knee. Review of Resident #3's physician orders dated 4/29/2023 reads, Maintain single lumen PICC line to right upper extremity, measure external catheter length every night shift every seven days with dressing change and measure arm circumference every night shift every seven days with dressing change. During an interview on 5/10/2023 at 9:15 AM, Staff B, Licensed Practical Nurse (LPN), stated, I did give [Resident #3's name] his antibiotic this morning. I did not check the date on his PICC line. I don't know if it needs to be changed. Dressings should be changed if they are loose or every 7 days. I should check the date when I give medicine through the PICC line. During an interview on 5/10/2023 at 11:40 AM, Resident #3 stated, Well, I did refuse to have the dressing changed once it was the middle of the night. I told her to come back later and no one ever did after that. I let the director of nursing change it today. If it was such a big deal, they should have asked again. I would have let them change it. During an interview on 5/10/2023 at 12:35 PM, the Director of Nursing stated, That dressing was dated 4/27 and was not changed according to our policy. The dressing was lifting up and should have been changed. But I looked at the MAR [Medication Administration Record] and he refused to have it changed on 5/2/2023. He did let me change the dressing today. I don't see any indication that anyone else tried to change the dressing after that. Nurses should look at the dressing and document if a resident refuses to get the dressing changed and that they were educated on the possible side effects of (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: 105196 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 105196 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Lodge Healthcare and Rehabilitation Center 635 SE 17th Street Ocala, FL 34471 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)