Inspection visit
Health inspection
3 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 3 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview, and record review the facility failed to ensure 1. one newly admitted resident (#161)
out of 11 new admissions sampled received physician ordered medications for pain and chronic obstructive
pulmonary disease (COPD) the night of admission, and 2. failed to ensure three low air loss mattresses for
residents (#90, #76 & #82) were set according to the residents' needs and manufacturer's instructions for
three of four days observed of sixteen residents with air mattresses.
Residents Affected - Few
Findings included:
1. During an interview with Resident #161 on 9/28/21 at 9:27 a.m. the resident stated on Thursday, 9/23/21
he arrived at the facility at 5:45 p.m. and did not receive any pain medication or breathing treatments for his
COPD until 8:00 a.m. the next morning (9/24/21). The resident stated he had back surgery and lifted his left
hand that was in a splint and stated these are the reason he had pain. Resident #161 was observed with
oxygen at 3 liters and stated he needed his breathing treatments around the clock and did not get them the
night he came in. He stated he went all night without pain medications or Albuterol until 8:00 a.m. the next
morning.
During an interview with Resident #161 on 9/29/21 at 9:20 a.m. the resident stated he was still upset that
he did not get his medication the night of his admission on [DATE] for pain and COPD and his friend had
called the police for him, which did not help and he received his medication the next morning around 8:00
a.m. Resident #161 said the nurse did not come back in to check on him that night after the police left until
8:00 a.m. the next morning.
During an interview with Staff E, Licensed Practical Nurse (LPN) on 9/29/21 at 9:23 a.m. he stated new
residents should receive medications the night they are admitted and the facility has an emergency drug kit
(EDK) that includes pain medication and breathing treatments. If they are not in the EDK the pharmacy has
a 10:00 p.m. delivery depending on when the medications are put in the computer. Staff E, LPN confirmed
a resident admitted at 5:45 p.m. should be able to get meds (medications) at 9:00 p.m. or on the 10:00 p.m.
delivery if entered timely. If they need to, they can use the EDK and should not have to wait until morning.
An interview on 9/29/21 at 11:04 a.m. with Staff F, LPN confirmed the pharmacy delivers the EDK twice a
week and replaces the box. The EDK kit on the third floor contains non narcotics such as Albuterol which
Staff F, LPN confirmed was available in the box and confirmed Resident #161 did not have medications
removed from the box. Staff F, LPN said the EDK with controlled substances was on the third floor and
stated the pharmacy delivers medication three times daily around 3 or 4 p.m., 10 p.m. to midnight and 6
a.m. so the resident should not have to wait until 8:00 a.m. to get medications if they were admitted at 5:45
p.m.
(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 7
Event ID:
105422
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
105422
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
09/30/2021
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Pinellas Park FL Opco, LLC
8701 49th St N
Pinellas Park, FL 33782
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)
F 0684
Level of Harm - Minimal harm
or potential for actual harm
An interview with Staff A, LPN on 9/29/21 at 11:32 a.m. stated the process would be to call the pharmacy
and get a code to pull the narcotic. The narcotic would be pulled by two nurses and signed off. Staff A, LPN
confirmed the EDK was not used to provide Percocet 5/325 mg (milligram) which was available in the EDK
for Resident #161 on 9/23/21. Staff A, LPN confirmed the last entry to the narcotic EDK was on 9/2/21.
Staff A, LPN confirmed all Controlled Substance logs were observed and no other entries were found.
Residents Affected - Few
During an interview with Staff C, LPN on 9/29/21 at 4:28 p.m. he stated the resident's (#161) priorities are
his breathing treatments and he wants them on time for his COPD and his pain medication.
Review of admission Record revealed Resident #161 was admitted on [DATE] at 5:45 p.m. for COPD
exacerbation.
Review of the admission note dated 9/23/21 at 5:45 p.m. documented the resident was admitted for COPD
exacerbation. Oxygen 96% on 3 liters, blood pressure 113/85 and pulse of 20. Resident is alert and
oriented times three. All medications to continue as ordered at time of admission.
Review of the physician orders to start on 9/23/21 at 9:00 p.m. revealed:
*Ipratropium-albuterol four times a day for COPD; order entered on 9/24/21 at 12:04 a.m. and discontinued
on 9/24/21 at 10:08 a.m. A review of the Medication Admin Audit Report dated 9/29/21 revealed this
medication was given for first time on 9/24/21 at 8:07 a.m. Review of the EDK kit revealed this medication
was available on 9/23/21.
*Ipratropium-albuterol inhale orally every four hours for COPD order entered on 9/24/21 at 10:08 a.m.
treatment started at noon on 9/24/21.
*Lidoderm patch 5% - apply to back topically two times a day for pain entered on 9/24/21 at 12:05 a.m. first
treatment given on 9/24/21 at 8:05 a.m.
*Prednisone 5 mg one tablet at bedtime related to COPD entered on 9/24/21 at 12:08 a.m. discontinued on
9/24/21 at 9:13 a.m. A review of the Medication Admin Audit Report dated 9/29/21 revealed this medication
was not given. This medication was available in the EDK kit on 9/23/21.
*Prednisone 5 mg one tablet at bedtime related to COPD entered on 9/24/21 at 9:13 a.m.
*Percocet tablet 5-325 mg one tablet every 6 hours as needed for pain middle finger, back pain related to
spinal stenosis was entered on 9/23/21 at 5:45 p.m. A review of the Medication Admin Audit Report dated
9/29/21 and the Medication Administration Record for September 2021 revealed this medication was not
given until 9/24/21 at 8:07 a.m. with a pain of 6. The medication was available in the narcotic EDK on
9/23/21.
An interview on 9/29/21 at 12:24 p.m. with the Director of Nursing (DON) about Resident #161 revealed the
resident wanted his pain medications after admission and stated he could not have them when asked due
to the nurse needing to verify the medications with the physician and get the medications entered into the
computer, so the pharmacy would deliver them on the next run. The DON stated the resident was upset
about not getting his pain medications and called the police. The DON stated a night nurse called about
9:30 p.m. on 9/23/21 to update about a fall then gave the phone to Staff C, LPN who then stated the police
were in the building about Resident #161 not getting his medications but
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105422
If continuation sheet
Page 2 of 7
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
105422
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
09/30/2021
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Pinellas Park FL Opco, LLC
8701 49th St N
Pinellas Park, FL 33782
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)
F 0684
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
confirmed he would get them soon. The DON confirmed she was not aware Resident #161 did not receive
any medications until 8:00 am. the next day. The DON stated she came in the next morning and was told in
morning meeting the resident received his medication and felt an investigation to the incident was
unnecessary. The DON stated that residents have to wait until the nurse gets the medication entered in the
computer after verifying with the physician, and was not concerned that the resident had to call the police
and felt the process was followed by the nurse.
Review of facility policy titled, Emergency Pharmacy Service & Emergency Kits, Policy #3.5, revised on
8/20, revealed: Emergency pharmacy service is available 24 hours a day. Emergency needs for medication
are met by using the facility's approved medication supply or by special order for the provider pharmacy. 2.
The facility should ensure there is a physician on call 24/7 and telephone numbers are posted at nursing
stations . 4. The pharmacy supplies emergency or STAT (immediate) medications according to the
pharmacy provider agreement . 6. The emergency supply along with a list of supply contents and expiration
dates are maintained in the medication room, or in accordance with facility policy and state regulations.
Review of facility policy titled, Medication and Treatment Orders, revised on 7/16, revealed: Orders for
medication and treatments will be consistent with principles of safe and effective order writing.
Review of facility policy titled, Administering Medications, revised 4/19, revealed: Medications are
administered in a safe and timely manner, and as prescribed . 7. Medications are administered within one
hour of their prescribed time, unless otherwise specified.
2. During an observation of Resident #90 on 9/27/21 at 11:40 a.m. the resident was observed sitting up on
a low air loss mattress with bolsters. Observation of the mattress settings included no cycling, comfort set
at 900 pounds, therapy setting on static, and auto firm.
An observation of Resident #90 on 9/28/21 at 9:30 a.m. revealed the resident sitting up on the air mattress
with bolsters. An observation of the mattress settings included no cycling, comfort set at 900 pounds,
therapy setting on static, and auto firm.
Review of the admission Record for Resident #90 revealed an admission date of 8/30/21 and diagnoses to
include COPD, pain in right hip, dementia and severe sepsis without septic shock. The care plan initiated on
9/9/21 documented a focus of [Resident #90] has a potential for skin impairment/pressure ulcers r/t (related
to): impaired mobility, requires staff assist to turn and reposition, incontinence of bowel & has a indwelling
catheter. The interventions included to turn and reposition to promote offloading of pressure.
During an interview with the Maintenance Director on 9/29/21 at 4:04 p.m. he stated Staff H, orders the air
mattress and should be completing the settings on the beds. The Maintenance Director confirmed his
department inflates the mattress on the highest setting since they take so long to blow up and then the
mattress is set automatically after that but they are not in charge of changing the settings once they inflate
the mattress.
Observation of Resident #90's mattress setting on 9/29/21 at 4:40 p.m. with Staff H, she stated Resident
#90's bed is Hard and confirmed the mattress setting of 900 pounds and reduced the mattress setting to
270 pounds for the resident and left the mattress set on static. Staff H, Certified Nursing
Assistant(CNA)/Medical Records stated she has maintenance put the mattresses on the beds and
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105422
If continuation sheet
Page 3 of 7
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
105422
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
09/30/2021
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Pinellas Park FL Opco, LLC
8701 49th St N
Pinellas Park, FL 33782
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)
F 0684
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
inflate them as the facility owns the mattresses. Staff H, confirmed she did not have the manufacturer's
instructions for use on any of the low air loss mattresses and could not confirm who set the mattresses for
the resident's needs.
Observations of Resident 76's mattress were conducted on 9/28/21 at 12:25 p.m. and 9/29/21 at 9:37 a.m.
and the setting was on static (no movement) for therapy for both observations.
A review of the admission Record for Resident #76 revealed an admission date of 8/5/2020 with diagnoses
of dementia, and chronic pain syndrome.
Observations of Resident #82's mattress were conducted on 9/28/21 at 8:32 a.m., 9/29/21 at 12:21 p.m.
and 9/29/21 at 6:40 p.m. and the setting was on static (no movement) for therapy for all observations.
A review of the admission Record for Resident #82 revealed an admission date of 7/29/21 with diagnoses
to include COPD, sepsis, and anoxic brain damage.
During an interview on 9/29/21 at 4:49 p.m. Staff G, LPN/Wound Care Nurse, stated she was unsure who
enters the settings on the mattress after its set up and stated she looks to make sure the mattress is
functioning but does not verify the settings. Staff G, LPN confirmed that the low air loss mattress should
have an order to check settings and function and will include them for all resident's with a low air loss
mattress.
During an interview with the Director of Nursing (DON) on 9/29/21 at 5:35 p.m., she stated Staff G, LPN
would complete the Braden Scale, an assessment on every admission, and look at preadmission wounds
to determine the need for an air mattress. Staff G, LPN would add an air mattress if the resident needed
one. The DON stated the low air loss mattresses are all the same. Central supply usually orders the air
mattresses which belong to us (facility). The DON confirmed the air mattress set at 900 pounds for a
resident about 136 pounds was really hard with bolsters and was not appropriate for the resident.
During an interview with Staff H, CNA/Medical Records on 9/30/21 at 4:30 p.m. she provided the revised
low air loss mattress list for the residents and confirmed the settings were corrected for all of them (to
include #76 and #82). She confirmed that Resident #90 was not a candidate for a low air loss mattress and
was placed on a different mattress.
Review of the facility policy for Support Surface Guidelines revised September 2013, revealed: The purpose
of this procedure is to provide guidelines for the assessment of appropriate pressure reducing and relieving
devices for residents at risk of skin breakdowns. 3. Support surfaces are modifiable. Individual resident
needs differ. 4. Elements of support surfaces are critical to pressure ulcer prevention and general safety
include pressure redistribution, moisture control, shear reduction, heat dissipation/temperature control,
friction control, infection control, flammability and life expectancy.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105422
If continuation sheet
Page 4 of 7
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
105422
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
09/30/2021
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Pinellas Park FL Opco, LLC
8701 49th St N
Pinellas Park, FL 33782
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)
F 0698
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Level of Harm - Minimal harm
or potential for actual harm
Based on interview and record review the facility failed to provide care and services consisted with
professional standards of practice related to the provision of hemodialysis when they failed to ensure
communication with the dialysis facility regarding care and services for one resident (#5) out of seven
facility residents receiving hemodialysis.
Residents Affected - Few
Findings included:
Resident #5 was interviewed on 09/29/21 at 12:09 p.m. She confirmed that she received hemodialysis
treatments three times a week at an outpatient treatment center and confirmed that she had received
treatment as scheduled the day before (09/28/21).
Review of the medical record for Resident #5 revealed an admission Record with diagnoses including end
stage renal disease, dependence on renal dialysis, and type 2 diabetes. Review of physician orders for
September 2021 revealed an order for hemodialysis treatment at an outpatient provider every Tuesday,
Thursday, and Saturday. Physician orders also revealed the resident received daily insulin for diabetic
management. Her care plan, initiated on 11/4/19, revealed a focus area for the potential for complications
related to hemodialysis treatment, and interventions to include, Complete dialysis communicate tool on
dialysis days and review upon return from dialysis.
Review of the Dialysis Communication Sheet between the facility and the dialysis provider revealed a
section to be completed by the facility prior to dialysis which included vital signs, most recent blood sugar if
insulin dependent diabetic and time insulin given, medications given prior to dialysis, and any changes or
special instructions since last dialysis. The sheet also included a section to be completed by the dialysis
center which included pre and post treatment weight, vitals, blood sugar, status of access/shunt, any lab
results, medications given, complications if any, dietary instructions for facility, and condition of resident
upon transfer back to facility. Review of the Dialysis Communication Sheets for Resident #5 for August 2021
and September 2021 revealed multiple missing entries for 12 of the 15 scheduled hemodialysis treatments:
9/28/21: incomplete entries by facility nurse, no entry from dialysis center,
9/25/21: no entry from dialysis center,
9/23/21: incomplete entry from dialysis center (vitals only),
9/16/21: no entry from dialysis center,
9/14/21: no entry from dialysis center,
9/11/21: no entry from dialysis center,
9/9/21: no entry from dialysis center,
9/4/21: incomplete entry by facility & no entry from dialysis facility,
8/28/21: incomplete entry by facility & no entry from dialysis facility,
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105422
If continuation sheet
Page 5 of 7
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
105422
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
09/30/2021
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Pinellas Park FL Opco, LLC
8701 49th St N
Pinellas Park, FL 33782
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)
F 0698
8/26/21: incomplete entry by facility & no entry from dialysis facility,
Level of Harm - Minimal harm
or potential for actual harm
8/21/21: no entry from dialysis center,
8/14/21: no entry from dialysis center.
Residents Affected - Few
An interview was conducted with Staff A, Licensed Practical Nurse (LPN) on 09/29/21 at 12:32 p.m. She
confirmed she was the assigned nurse that day for Resident #5, and cares for her often. The Dialysis
Communication Sheets were reviewed with Staff A including those for dates 9/28, 9/25, 9/23, and 9/16
which she confirmed had been prepared and signed by her. She confirmed the sheets were missing entries
from the dialysis center and/or had incomplete entries. She said that it was hit or miss whether the dialysis
center completed their section of the form. She could not provide a concrete response for what the facility
expectation was when she received an incomplete form, but did confirm she was supposed to call the
dialysis center and get the information if it was missing. Regarding the incomplete sheet from 09/28/21 she
said, I called yesterday, and they said they would send the sheet with the next one.
An interview was conducted with the Director of Nursing (DON) on 09/29/21 at 4:03 p.m. The incomplete
Dialysis Communication Sheets were reviewed with her, and she confirmed they were not complete and
said that was not acceptable. She said the expectation was that if a nurse received an incomplete form,
they were to call the dialysis enter and ask for the information via verbal report or via fax. She said that a
nurse's signature on the bottom section of the form titled facility to complete this section upon return from
dialysis meant they were attesting that the form was reviewed and complete. She said she had not been
made aware sheets were not being completed, and said, All the nurses have been trained and oriented on
what to do, and said, Unit managers should be auditing the sheets the day after for completion.
Review of facility policy titled, End-Stage Renal Disease, Care of a Resident with, revised September 2010,
revealed that education and training of staff included specifics on the type of assessment data that must be
gathered about the resident's condition on a daily or per shift basis. The policy outlined that agreements
between the facility and contracted dialysis providers included how information would be shared between
facilities about resident's care.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105422
If continuation sheet
Page 6 of 7
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
105422
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
09/30/2021
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Pinellas Park FL Opco, LLC
8701 49th St N
Pinellas Park, FL 33782
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)
F 0761
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted
professional principles; and all drugs and biologicals must be stored in locked compartments, separately
locked, compartments for controlled drugs.
Based on observation, interview and facility policy review, the facility failed to store a medication in a
sanitary manner for one resident (#262) of eight residents sampled during the task of medication
administration.
Findings included:
An observation of a medication administration was performed on 09/29/21 at 9:38 a.m. Staff A, Licensed
Practical Nurse (LPN) brought the manufacturer's external packaging box for Spiriva Respimat from the
medication cart into Resident 262's room. Staff A placed the packaging on a bedside table while she
withdrew the medication to administer the dose. Staff A, LPN then placed the medication back into the box,
picked it up and went into the bathroom where she placed the medication box down on top of the toilet tank
to perform hand hygiene. She then picked up the box, exited the room and returned the box to the
medication cart amongst the other medications.
A review of the facility's policy titled, Storage of Medications, revised in November of 2020, revealed under
Policy Interpretation and Implementation Section, 3. The nursing staff is responsible for maintaining
medication storage and preparation areas in a clean, safe, and sanitary manner.
The Consultant Regional Director of Clinical Services confirmed during an interview on 09/30/21 at 5:30
p.m. the Storage of Medications policy does not address contamination mitigation related to multi-use
medication containers, and stated the nurse should place the medication on a barrier in the room, or simply
not take the external packaging into the resident's room.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105422
If continuation sheet
Page 7 of 7
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Back to topCitations
3 citations recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F698 - Dialysis
Provide safe, appropriate dialysis care/services for a resident who requires such services.
F761 - Labeling of Drugs and Biologicals
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
F684 - Quality of care
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
FAQ · About this visit
Common questions about this visit
What happened during the September 30, 2021 survey of PINELLAS PARK FL OPCO, LLC?
This was a inspection survey of PINELLAS PARK FL OPCO, LLC on September 30, 2021. The surveyor cited 3 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at PINELLAS PARK FL OPCO, LLC on September 30, 2021?
Yes, 3 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Provide safe, appropriate dialysis care/services for a resident who requires such services."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.
Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.
Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.