Inspection·February 23, 2026

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interviews, the facility failed to ensure the physician was notified of blood sugar levels (BSLs) that were outside parameters for one (Resident #2) of two residents sampled.Findings included:Resident #2 was readmitted to the facility on [DATE] with diagnoses to include type 2 diabetes mellitus with hyperglycemia, and type 2 diabetes with diabetic peripheral angiopathy without gangrene and long-term use of insulin.Review of Resident #2's Medication Administration Record (MAR) for January 2026 revealed Novolog FlexPen subcutaneous solution pen-injector 100 UNIT/ML (milliliters) (insulin Aspart). Inject per sliding scale: 150-200 + 4 Units; 201-250 = 6 units; 251-300 = 8 units; 301-350 = 10 units; 351-400 units = 12 units. Notify MD (medical doctor) if BS (blood sugar) less than 70 or greater than 400; 401-450 = 14 units subcutaneously before meals and at bedtime related to type 2 diabetes mellitus with hyperglycemia. Start date 10/29/25. D/C (discontinued) date 1/26/26.The order revealed the physician was to be notified for any BS readings above 400.Review of Resident #2's MAR for January 2026 revealed the following BS readings:On 1/1 at 9:00 p.m. = 420On 1/ 2 at 9:00 p.m. = 423On 1/4 at 9:00 p.m. = 409On 1/6 at 4:30 p.m. = 440On 1/8 at 9:00 p.m. = 450On 1/11 at 9:00 p.m. = 412On 1/18 at 9:00 p.m. = 408On 1/21 at 11:30 a.m. = 413On 1/23 at 4:30 p.m. = 436Review of Resident #2's MAR for December 2025 revealed Resident #2 had BS readings above 400 19 out of 120 tested times.Review of Resident #2's MAR for November 2025 revealed Resident #2 had BS readings above 400 32 out of 120 tested times.Review of Resident #2's medical record from November 2025 to January 2026 did not revealed documentation the physician being notified of BS readings above 400 per orders.On 2/23/2026 at 5:20 p.m. an interview was conducted with the Director of Nursing (DON). The DON reviewed the MARs for Resident #2 and stated the nurses should have been documenting notification of the BS levels that were above 400. She stated sometime in October the physician changed the sliding scale to include higher numbers because the resident was at baseline with the higher numbers. She stated when they changed the order to increase the sliding scale to 450, he did not change the instructions. The DON stated given the way the current orders read, They should have documentation. The DON stated if the numbers were above or below parameters, the physician should be notified.Review of a facility policy titled, Notification of Change, revised 12/16/2020, showed, policy - The Center to promptly notify the Patient/Resident, the attending physician, and the Resident Representative when there is a change in the status or condition.Procedure: The nurse to notify the attending physician and Resident Representative when there is a(n):o Accidentso Significant change in the patient/resident's physical, mental, or psychosocial statuso Need to alter treatment significantly? New treatment? Discontinuation of a current treatment due to but not limited to: Adverse consequences, Acute condition, Exacerbation of a chronic condition.o A transfer or discharge of the Patient/Resident from the Centero Patient/Resident consecutively refuses medication and/or treatment ( i.e. two or more times)o Patient/Resident is discharged without proper medical authority (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: 105394 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 105394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/23/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Aviata at the Palms 2600 Highlands Blvd N Palm Harbor, FL 34684 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)