Health inspection·April 1, 2021

F 0565 Honor the resident's right to organize and participate in resident/family groups in the facility. Level of Harm - Minimal harm or potential for actual harm Based on interviews and record review, the facility failed to honor each resident's right to organize and participate in resident groups in the facility. No Resident Council meetings were held between March 2020 and April 1, 2021. The most recent meeting documented by the Activities Director was dated 2/25/2020. This practice impacted four residents who were identified by the Activities Director as active Resident Council members (Residents #63, #22, #48 and #37) with the potential to affect more residents who may have had an interest in participating. Residents Affected - Few The findings include: During an interview with Employee A, Activities Director, on 3/29/2021 at 2:00 p.m., she stated from March 2020 through March 2021, there were no group or individual council meetings held. On 3/29/2021 at 2:31 p.m., she provided documentation dated 1/12/2021, which she identified as a one to one council meeting held with Resident #63. Per the documentation, the resident denied any concerns with resident care. The documentation listed Employee A as the only department head/staff member present in the meeting and was unsigned by the resident. She stated she was not aware that she needed to meet with any other residents or the frequency for any such meetings. An interview was conducted with Residents #63, #22, #48 and #37 on 3/30/2021 at 11:15 a.m., who were selected by the Activities Director and identified as active members of Resident Council. During the interview, the residents denied having a Resident Council President. They also denied participating in a resident group or council meeting in the facility to discuss concerns about care, or to review resident rights, suggestions or grievances. The residents also denied participating in any one to one meetings in their rooms or any other location with staff members to discuss these topics. During the interview, Resident #63 was specifically asked about the documentation dated 1/12/2021, provided by Employee A. She denied meeting with Employee A and/or any other staff members regarding her care/stay in the facility on the date listed or any other date, and stated she did have some concerns which she voiced during the interview. During an interview with Employee B, Assistant Director of Activities, on 3/30/2021 at 11:57 a.m., she confirmed that there had been no group or one to one in-room council meetings held with the residents from March 2020 through March 2021. She stated she spoke with the residents when she delivered the daily newsletter, and if a resident voiced concerns, she would report them to nursing or the therapy department. She stated there was no documentation verifying whether or when residents were asked about their care, resident rights, suggestions or grievances, which they may have had from March 2020 through march 2021. On 3/31/2021 at 11:07 a.m., Employee A provided a copy of the minutes from what she stated was the last Resident Council meeting, held on 2/25/2020. She again confirmed that there had been no group Page 1 of 3 105470 105470 04/01/2021 Fernandina Beach Rehabilitation and Nursing Center 1625 Lime Street Fernandina Beach, FL 32034

F 0565 or one to one in-room meetings. Level of Harm - Minimal harm or potential for actual harm A review of the facility's Welcome Packet (#190301), provided on 4/1/2021 at 1:03 p.m. by the Administrator, and which he stated was given to all residents and/or their family representatives read: The resident has a right to organize and participate in resident groups in the facility. It further read: Resident Council Meetings are held monthly and open to all Residents. These meetings are to promote Resident involvement in their care; to ensure resident' rights and to provide a forum for residents to discuss any concerns or issues. All residents are encouraged to participate, which is coordinated by the Director of Activities. Residents Affected - Few . 105470 Page 2 of 3 105470 04/01/2021 Fernandina Beach Rehabilitation and Nursing Center 1625 Lime Street Fernandina Beach, FL 32034

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observations, interviews and record reviews, the facility failed to serve food in accordance with professional standards for food service safety, by failing to maintain appropriate dishwasher temperatures for dishwasher sanitation. This impacted all residents who were served food prepared in the facility's kitchen. The findings Include: On 3/29/21 at 9:45 AM, Employee F, Kitchen Staff, was observed using the dishwasher machine to clean breakfast dishes. The dishwasher temperature was observed at 150°F (Fahrenheit) for the wash cycle. The high-temperature machine had a manufacturer's sticker on it stating the minimum temperature to meet was 160°F for the wash and 180°F for the rinse cycle. On 3/29/2021 at 9:47 AM, the Certified Dietary Manager (CDM) and the Administrator verified that the dishwasher temperature did not meet the minimum wash temperature of at least 160°F. At the time of the observation, when he verified that the dishwasher was not reaching the minimum wash temperature, the Administrator texted the Maintenance Director. The CDM instructed Employee F to continue running the dishwasher to try and get a higher temperature before continuing to clean any more dishes. Employee F continued to run the dishwasher, but it never reached the minimum temperature of 160°F. Two additional visits were made to the kitchen on 3/29/21 at 10:00 AM and 10:30 AM, revealing no increase in the temperature of the dishwasher while running a wash cycle. Observations of temperatures made at these times were each between 150°F and 152°F. The dishwasher temperature log for the month of March 2021 was reviewed. All dates for the month were filled in with appropriate temperatures above or at 160 °F for the wash cycle. On 3/29/21 from 12:30 PM to 1:00 PM, an observation of the lunch meal was made. The food was being served to the residents on disposable dinnerware. On 3/31/21 at 1:15 PM, after the dishwasher had been serviced, the wash cycle temperature was observed to be 168°F. On 4/1/21 at 10:36 AM, during an interview with Employee F, he stated the temperature of the dishwasher should be 160°F for the wash cycle and 180°F for the rinse cycle. Employee F stated if dishwasher wash and rinse cycles did not meet the minimum temperatures, he would tell a supervisor. During an interview with the CDM on 4/1/2021 at 10:44 AM, she stated the employees logged temperatures for the dishwasher midway through washing dishes. She further stated if she were doing dishes, she would run it a couple of times to make sure temperatures were up before starting the dishwashing. The CDM verified during the interview that the temperatures should be at 160°F for the wash and 180 °F for the rinse when using the dishwasher. She further stated if temperatures were not reaching the correct temperature, she would call the dishwasher machine representative to come and check the machine. Then I would hand wash dishes until I could get the problem resolved. . 105470 Page 3 of 3