Health inspection·July 12, 2023

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - 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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record review the facility failed to provide monitoring and care according to professional standards of practice related to urinary catheter care for one resident (#1) out of 3 residents sampled for catheter care. Findings included: Resident #1 was admitted to the facility on [DATE] and readmitted to the facility on [DATE] after a hospitalization. Resident #1 diagnoses include but are not limited to, Bacteremia, Stage 3 Chronic Kidney Disease, candidiasis, need for assistance with personal care, obstructive and reflux uropathy, dementia without behavioral disturbances, and dysphagia. A review of Resident #1's Minimum Data Set (MDS), dated [DATE], revealed in Section H: Bladder and Bowel, Resident #1 had a urinary catheter. Section C: Cognitive Patterns, revealed the resident had a Brief Interview for Mental Status (BIMS) score of 5 out of 15, indicating severe cognitive impairment. A review of Resident #1's Certified Nursing Assistant (CNA) documentation from 7/3/23-7/12/23 revealed documentation that identified Resident #1 as having an indwelling urinary catheter. An observation was conducted of Resident #1 on 7/12/23 at 3:00 p.m. The resident was observed to be in bed sitting upright with the head of the bed elevated, watching television. A urinary catheter bag was observed to be hanging on her bed frame, empty and off of the floor. A review of Resident #1's Physician orders did not reveal any orders related to Resident #1 having a urinary catheter, care of a urinary catheter, or monitoring of a urinary catheter. A review of Resident #1's July 2023 Medication Administration Record (MAR) and Treatment Administration Record (TAR) did not reveal any documentation a urinary catheter was being monitored or cared for by nursing. A further MAR and TAR review from June 2023, revealed Resident #1 had not had a urinary catheter monitored or cared for by nursing since June 12th, 2023. An interview was conducted on 7/12/23 at 2:00 p.m. with the facility's Director of Nursing (DON). She confirmed there were no urinary catheter orders in place for Resident #1 and she stated, The resident has been in and out of the hospital so the orders must not have been reordered when she came back. (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 2 Event ID: 105271 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 105271 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/12/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Boca Ciega Center 1414 59th St S Gulfport, FL 33707 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)