Inspection·June 21, 2023

F 0660 Plan the resident's discharge to meet the resident's goals and needs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to provide an appropriate discharge plan for 1 of 3 sampled residents (Resident #3). Residents Affected - Few The findings included: Record review revealed Resident #3 was admitted to the facility on [DATE]. A comprehensive assessment dated [DATE] documented the resident was cognitively intact, and required extensive to total two-person assist with activities of daily living. The assessment further documented the resident did not have a pressure ulcer, but was at risk for the development of a pressure ulcer. A review of Resident #3's physician orders revealed an order dated 11/30/22 for a wound care consult for coccyx excoriation. A skin/wound progress note dated 12/06/2022 at 12:05 PM documented: Resident was seen by wound care on 12/5/22 related to Stage II wound on the coccyx that she was admitted with. The wound measurement are: 5.0 x 3.0 x 0.1 (centimeters) and is being treated with Hydrophilic paste. Will be followed by the wound NP (Nurse Practitioner) weekly. A Social Service (SS) progress note dated 12/13/22 at 11:57 AM documented: Care plan meeting held today 12/13/22. Resident and her son and daughter in law participated in meeting in person. IDT (interdisciplinary team) reviewed care plans, medications, advance directives, nursing care, therapy services and discharge plan. She is here for short term stay and goal is to return with services to the ALF (assisted living facility). A Social Service progress note dated 12/30/2022 at 4:39 PM documented: SS spoke with resident family -son and daughter-in-law today regarding her discharge plan which is tentatively scheduled for Fri 01/06/23 to return to ALF. SS reviewed discharge plan and protocol and services that will be set up for resident upon discharge home. Resident was here for short term rehab stay and has met her goals in rehab. MD will review the need for Home Health services for PT (physical therapy), OT (occupational therapy) and Nursing. Resident owns wheelchair, rolling walker, commode and shower chair. Resident will be discharge with her medications and 1823 form and family will coordinate transportation. SS will continue to provide services and assist with discharge plan. A review of Resident #3's Wound Care Progress Notes revealed a note dated 01/03/23 documented: wound measurements 7.0 x 2.0 x 0.8 centimeters. Wound coccyx tissue depth has changed, wound stage has changed from stage 2 to unstageable. Recommendation for wheelchair cushion and sharp debridement of non-viable, necrotic, devitalized tissue and accumulation debris to establish the margin of viable (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: 105335 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 105335 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Cascades Health and Rehabilitation Center 2105 SW 11th Court Delray Beach, FL 33445 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)