Inspection·August 3, 2023

F 0569 Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to convey within 30 days the resident's funds and a final accounting of those funds to the residents, or in case of death, the individual or probate jurisdiction administering the resident's estate, in accordance with State law, for 2 of 3 sampled residents reviewed, that are due refunds (Resident#1 and Resident#2). Residents Affected - Few The findings included: 1). Review of Resident #1's record revealed the resident was admitted to the facility on [DATE] and expired on [DATE]. Further review revealed during her stay at the facility, she was on Medicare and Medicaid, and on Hospice Medicaid at the time of her death. Review of Resident#1's accounting records from the business office revealed that she has a credit in her account in the amount of $2436.38. This is 315 days since the resident expired. 2). Review of Resident #2's record revealed the resident was initially admitted to the facility on [DATE], with a readmission on [DATE] and expired on [DATE]. Further review revealed during her stay at the facility, she was on Medicare and Medicaid, and Hospice Medicaid at the time of her death. Review of this Resident #1's accounting records from the business office revealed that she has a credit in her account receivable in the amount of $463.20. This is 195 days since the resident expired. During an initial interview on [DATE] at 11:27 AM with the Business Office Manager (BOM), she stated that she began working for the company on [DATE]. She stated that Resident #1's credit is $2,436.38, she then stated that this was not correct, and the accounting is off. She further stated that Resident #1's balance is $1,904.86 and doesn't believe this is a correct amount either. At 12:43 PM, the BOM stated after she recalculated the monies, Resident #1 now has an account credit in the amount of $992.84. Upon request, the Surveyor asked the BOM for Resident#1's monthly bills and inquired who the bills were given to. She stated Resident #1's brother received the bills but was not the Power of Attorney. She went on to state that corporate takes care of the refunds. She acknowledged that the monies owed to family or probate should have been refunded within 30 days of the residents passing away. She further stated that the current company does not have a process for submitting refunds. She stated that sends an email to corporate requesting refunds. The Surveyor asked to see if an email was sent to corporate requesting for Resident #1's refund and she stated, I looked in my emails and I don't see one for her. During an interview on [DATE] at 1:10 PM with the Director of Accounts Receivable form the corporate office, she stated that our sister company is in charge of the accounts payable and receivable, which was taken over July/August of this year. She stated that Resident #1's refund should have been (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: 105300 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 105300 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Martin Coast Center for Rehabilitation and Healthc 9555 SE Federal Hwy Hobe Sound, FL 33455 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)