Health inspection·December 9, 2025

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure complete and accurate records for 1 of 4 residents, Resident #6, reviewed for intravenous medication management.Findings include: Review of Resident #6's nursing admission assessment dated [DATE] read, Section 12. Intravenous Access Devices: 1. Does the resident have a vascular device in place? Yes. What type of device is present? a) PICC [peripherally inserted central catheter] Line. Review of Resident #6's physician order dated 11/06/2025 read, PICC line can be removed at the end of IV [intravenous] [NAME] [antibiotics]. Review of Resident #6's physician order dated 11/6/2025 read, Piperacillin Sod-Tazobactam [antibiotic] solution reconstituted 3-0.375 GM [gram] use 3.375 gram intravenously [IV] every 6 hours for ESBL [extended-spectrum beta-lactamase] Pseudomonas until 12/05/2025 05:59. Review of Resident #6's care plan dated 11/05/2025 read, Focus: [Resident #6's name] is at risk for complications r/t [related to] receiving IV therapy. Currently has (central) IV line located (LUE) [left upper extremity]. Is receiving (IV ABX) [intravenous antibiotics] for the treatment of: (ESBL/Pseudomonas). Interventions: Administer IV (fluids/meds) as ordered, observe for effectiveness and for adverse SEs [side effects]. Perform IV flushes as ordered. Change IV tubing per protocol. Perform IV site care as ordered, observe site for sx/sx [signs/symptoms] of infection/infiltration; notify physician if noted. Labs as ordered; report findings to physician and pharmacy prn [as needed]. Vital signs as ordered and PRN. Encourage resident to notify staff of pain at IV site upon onset. Observe for sx/sx of fluid volume overload; report to physician if noted. Review of Resident #6's health status note dated 12/07/2025 read, Removed IV at 1700 [5:00 PM] on 12/7/25. Review of Resident #6's physician orders revealed there were no orders for PICC line dressing changes. Review of Resident #6's medication administration record and treatment administration record for November 2025 and December 2025 revealed there was no documentation that PICC dressing changes were completed. During an interview on 12/09/2025 at 3:24 PM, Staff A, LPN [licensed practical nurse] Unit Manager reviewed Resident #6's admission Summary and physician orders with the surveyor, and stated, [Resident #6's name] had a PICC line when she came in. We have to select the orders when residents come in with a PICC line. It's not an automatic order, but we go to the batch orders to select which ones we need. Normally I would order to change the dressings, order flushes, and observe for signs and symptoms of infection. If there is an order for a PICC dressing change, it would be on the MAR [medication administration record] for the nurse to document. Nurses do the PICC line dressing changes. I would expect the nurses to look at the date on the PICC dressing when they are assessing it. I expect the nurses to know that PICC dressings should be changed every seven days. If there is no order, I expect the nurses to put in an order and document that they changed the dressing. I do try to check on the nurses' documentation. I can't say I did or didn't forget to put in the order for the PICC dressing change. Review of the policy and procedure, titled, PICC IV Line, with an issue date of 4/01/2022, read, Page 1 of 2 105434 105434 12/09/2025 Plaza Health and Rehab 4842 SW Archer Road Gainesville, FL 32608

F 0842 Level of Harm - Minimal harm or potential for actual harm Policy: It will be the policy of this facility to adhere to IV/PICC line administration guidelines as set forth by infection control, state and at federal regulations. Licensed nurses shall provide care according to state and federal law. Dressing changes: 1. Sterile dressing change using transparent dressing is performed: At least weekly. 2. Dressing changes will be documented in the clinical record. Residents Affected - Few 105434 Page 2 of 2