Health inspection·February 9, 2023

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 an order was obtained to check for wander guard functioning and placement for 1 of 3 sampled residents reviewed (Resident #134); failed to ensure physician orders were followed regarding checking for wanderguard (a device designed to help protect memory care residents against elopement) functioning for 2 of 3 sampled residents reviewed for wanderguards (Residents #151 and #161); and failed to ensure a policy was in place for elopement and wanderguard maintenance. Residents Affected - Few The findings included: 1. Review of Resident #134's record revealed the resident was admitted on [DATE] and diagnoses that included the following: Bipolar disorder, current episode manic with psychotic features; History of Urinary Tract Infection (UTI); Hypertension (HTN); Cognitive Communication Deficit; Adjustment Disorder with Anxiety; and Dementia with Behavioral Disturbance. Review of the resident's Minimum Data Set (MDS) last quarterly assessment completed on 11/01/22 revealed the resident had a Brief Interview for Mental Status (BIMS) of 03, which is consistent with severe impairment. The resident is ambulatory and required supervision and is not steady but can stabilize herself without assistance and the resident wears a wanderguard daily for wandering / exit seeking behaviors. Review of the resident's progress notes revealed the resident wandered in the secured unit frequently going in and out of other resident rooms, requiring frequent redirection. On 02/06/23 at 12:05 PM, an observation of Resident #134 revealed the resident was wearing a wanderguard on her ankle. The resident appeared confused and stated she was scared. On 02/07/23 at 3:19 PM, the resident was observed lying in her bed with her eyes closed. On 02/08/23 at approximately 10:30 AM, the resident was observed in activities. Record review for Resident #134 revealed an order, dated 09/20/22, for a wanderguard bracelet for safety related to wandering, every shift related to dementia with behavioral disturbance. The resident was care planned for wandering with no purpose, with an intervention to wear a wanderguard bracelet for safety related to wandering behaviors. Further review of the record did not reveal any monitoring of the resident's wanderguard for placement and functioning by the nursing staff. 2. Record review of Resident #151 revealed the resident was admitted on [DATE] and had diagnoses including, in part: Epilepsy; Dementia, Anxiety, Major Depressive Disorder, Tremor, Insomnia, Alzheimers Disease and Drug Induced Subacute Dyskinesia. Review of the MDS, dated [DATE], revealed the resident had a BIMS score of 0, consistent with severe impairment. The MDS revealed the resident was (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 5 Event ID: 105484 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 105484 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Okeechobee Health Care Facility 1646 Highway 441 N Okeechobee, FL 34972 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)