Health inspection·July 24, 2025

F 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review, the facility failed to thoroughly investigate a voiced grievance for one resident (#3) out of four sampled residents. Findings included:On 07/24/2025 at 02:35 P. M., a phone interview was conducted with Resident #3's family member. She stated she was unable to speak with the Nursing Home Administrator (NHA), via phone call because she could not be reached. She stated she was able to communicate with the NHA through text messaging. She stated she had concerns about the care her family member was getting and she notified the NHA of her concerns. She stated the NHA was dismissive of her. She stated she never heard from the facility with what happened. Review of Resident #3's medical records revealed she was admitted to the facility on [DATE], with a discharge date of 07/16/2025 to another facility. Diagnoses for Resident #3 included: wedge compression fracture of vertebra, and depression. A review of the progress notes revealed the following: 6/19/2025 12:01 Communication with FamilyNote Text: : On this day writer spoke with [family member]. [Family member] stated that resident's former roommate was screaming and yelling in the background while resident was on the phone with her and provider . [Family member] stated she did not appreciate the other resident's behavior and requested facility to move the other resident from near [Resident #3's] room .An interview was conducted on 07/24/2025 at 01:11 P. M., with the Social Services Director. She stated any needs or wants of residents go through her department and she makes sure grievances are resolved in a timely manner. She stated there were no grievances documented, related to Resident #3 for the month of June. She stated if a concern is raised by a resident, family member, or staff member in relation to a resident, then a grievance needs to be filed. She stated this applies to the Administrator and the Director of Nursing, (DON) as well.A review of grievance logs for the month of June 2025, revealed no grievances were filed related to Resident #3.On 07/24/2025 at 02:00 P. M., an interview was conducted with the Nursing Home Administrator (NHA). She stated in the month of June, around the sixteenth, she spoke with Resident #3's family member. She stated she told the family member she would look into the concerns. She stated she did not file a grievance and had no documentation to support an investigation into the family's concerns. She stated in lots of cases a concern is not considered a grievance unless it happens more than once.On 07/24/2025 the NHA provided the Resident and Family Grievances, policy for review, with a last revision date of 4/21/25, The policy revealed the following: Policy: It is the policy of this facility to support each resident's and family member's right to voice grievances without discrimination, reprisal or fear of discrimination or reprisal. Definitions: Prompt efforts to resolve include facility acknowledgment of a complaint/grievance and actively working toward resolution of that complaint/grievance. Policy Explanation and Compliance Guidelines:1. (Name and Title) has been designated as the Grievance Official and can be reached at (list contact information).2. The Grievance Official is responsible for overseeing the grievance process; receiving and tracking (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: 105323 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 105323 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/24/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Oaks of Clearwater, The 420 Bay Ave Clearwater, FL 33756 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)