Inspection·April 11, 2025

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 Based on record review and interview, it was determined, the facility failed to appropriately assess 1 of 2 sampled residents experiencing changes in condition, Resident #1, as evidenced by the lack of monitoring signs and symptoms of a bowel obstruction, that included vomiting, diarrhea, bradycardia / tachycardia and fever. Residents Affected - Few The findings included: Clinical record review conducted on 04/10/25 revealed Resident #1 has been a long-term care resident at the facility since 08/29/22. Review of the Minimum Data Set (MDS) quarterly assessment, with reference date 01/16/25, documents Resident #1 was assessed as severely impaired for skills of daily decision making; is always incontinent of bladder and bowel; has active diagnoses of dementia; and is dependent on staff for activities of daily living (ADLs). Revie of the Care plan titled, At risk for constipation related to decrease self-mobility, last revised 01/22/25, documents interventions as: observe for and report to medical doctor complications related to constipation: change in mental status, new onset confusion, sleepiness, inability to maintain posture, agitation, bradycardia, abdominal, distension, vomiting, small loose stools, fecal smearing, decreased bowel sounds, diaphoresis, abdominal tenderness, guarding, rigidity and fecal compaction. The electronic record revealed a nurse's note communicating to the physician via fax dated 03/04/25. The nurse advised the physician that Resident #1 was vomiting, and the nurse requested antiemetic medication. The physician replied with an order for Zofran 4 milligrams every six hours as needed. Review of the Progress notes dated 03/05/25 documents, Resident remains in bed at this time and will not allow staff to get her up. Resident did not eat breakfast this morning and would not allow staff to feed her. Vital signs stable. Resident fought this nurse when the blood pressure cuff was applied but ultimately allowed vitals to be obtained. Afebrile. Resident continues to sleep but is responsive and easily roused. Review of the Advance Practitioner Registered Nurse (APRN) notes dated 03/05/25 documents, Seen in bed lethargy, vital signs stable. Patient not eating, won't get out of bed which is not her norm. Patient did vomit one episode yesterday. Review of the APRN notes dated 03/10/25 documents, the resident was seen in the hallway, lethargy has resolved, chest x-ray and urine tests were negative. The resident refused intravenous fluids 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 3 Event ID: 105277 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 105277 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/11/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Stuart Rehabilitation and Healthcare 1500 SE Palm Beach Rd Stuart, FL 34994 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)