Health inspection·May 10, 2023

F 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews, observations and record and policy reviews, the facility failed to provide appropriate supervision to prevent an elopement which resulted in a missing resident for 1 of 3 sampled elopement risk residents of 16 elopement risk residents in the facility (Resident #1). The deficient practice allowed Resident #1 to exit the facility undetected on 05/04/23 between 3:47 PM and 5:00 PM. It is not known what direction the resident took, or what exit he took to leave the facility. The resident is still missing. There were 80 residents in the facility at the time of the survey. The facility's Administrator was notified of Immediate Jeopardy on 05/10/23 at 4:00 PM. The findings included: The facility's policy on elopements titled Elopements, and revised February 2014, revealed Staff shall investigate and report all cases of missing residents. The policy interpretation and implementation revealed Staff shall promptly report any resident who tries to leave the premises or is suspected of being missing to the Charge Nurse or Director of Nursing. Resident #1, an elderly male was initially admitted to the facility on [DATE] and readmitted on [DATE]. The resident's diagnoses included Diabetes, Vascular Dementia, Mood swings, Delusions, Hypertension and Cerebral Vascular Accident (stroke). On 04/21/23, the documented Brief Interview for Mental Status (BIMS) score was 4 indicating the resident was cognitively impaired. He was on medication for Diabetes which was Metformin 500 milligrams (mg) daily at 9 AM. Other pertinent medications included Clonazepam 1mg BID (twice daily) 9 AM and 5 PM for Anxiety, Losartan 50mg once daily at 9 AM for Hypertension and Mirtazapine 45mg one table at night for Depression. There was no history of falls, and his gait was slow but steady. On 05/09/23 at 11:15 AM, a walking tour was conducted of the inside of the facility with the Director of Nurses (DON). The front door is a glass door and is unlocked and not alarmed and someone is at the desk until 8:30 PM. This door is locked from 8:30 PM to 10:45 PM. At 10:45 PM, it is unlocked for the night shift to come in and the supervisor sits at the desk. When all the staff is in, the door is locked until the receptionist comes in the morning. The door from the reception area to the patient care area was alarmed and the keypad code was changed post elopement. The alarm is shut off with a button located on the top of the doorway. The door did alarm and was locked at the time of the tour. In the dining room, there are 2 doors alarmed and locked that lead to the smoking patio. They (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: 105296 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 105296 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Westlake Nursing and Rehab Center 440 Phippen Waiters Road Dania Beach, FL 33004 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)