Health inspection·May 23, 2023

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few was noted on the west side of the building, they are conducting high speed testing for the new high-speed train that will be going through this area. The tracks are on the immediate west side of Dixie Avenue which borders the west side of the property. A subsequent review of Resident #2's record revealed on 05/06/23 at approximately 3:45 PM Staff C, a registered nurse (RN), was approached by another resident of the facility that he saw Resident #2 go through the east door and was outside. Staff C stated there were various sounds at the nurse's station such as steady beeping and a louder sound which could have been the door alarm. Staff C looked towards the door where the resident was pointing and saw Resident #2 sitting outside. Staff C asked Staff D, a Certified Nursing Assistant (CNA) to come with her to help get the resident back inside the building. Per Staff C cand Staff D, no additional staff went out to the resident to assist in getting him back into the building. Staff C stated the resident was sitting on the curb calmly looking towards the road. When asked, the resident stated he did not fall, and the resident required stand-by assist to get up and back to his wheelchair. The resident was assessed for injuries, blood sugar and vital signs were checked. No irregularities noted. The resident was placed on 1:1 with a CNA and neurological checks were in place for 72 hours. The resident was re-educated on leaving the facility unattended. Review of the Minimum Data Set (MDS) assessment for Resident #2 revealed in the quarterly assessment completed on 03/15/23 that the resident had a Brief Interview for Mental Status (BIMS) of 04, suggesting severe cognitive impairment. On 05/22/23 at approximately 2:00 PM, the east door alarm was tested by the survey team with the administrator. The bar on the door must be pushed for 15 seconds, which did alarm. After 15 seconds, when the door opens, a second, much louder, alarm alerts staff that the door is open. The alarm requires a key and a code to be silenced. An interview was conducted via telephone on 05/22/23 at 1:00 PM with Staff D. Staff D stated on 05/06/23, she was at the nurse's station looking over her assignment when Resident #2 went out of the building through the east door by the kitchen. Staff D stated when she saw him, he was outside sitting down. Staff C had asked her to go outside with her to help bring the resident back inside the building. The two of them helped the resident back into the building. There was no other staff outside. An interview was conducted via telephone on 05/22/23 at 5:50 PM with Staff C. Her written statement with the above information was verified. An interview with the Dietary Manager on 05/23/23 at approximately 10:30 AM revealed on 05/06/23 while she was in the kitchen, she heard the door alarm go off. She went to the kitchen door, that is near the east door of the facility and saw the resident sitting on the curb (Photo Evidence submitted) approximately 15-20 feet in front of the east door. The Dietary Manager further stated by the time she was able to get outside, there were 2 staff members assisting him to try to get him back to his wheelchair, which was sitting outside of the door. Review of Resident #2's care plans revealed in part that on 05/06/23 the resident was to be placed on 1:1 supervision. Documentation for this supervision was not located for 05/06/23 through 05/15/23. An interview on 05/23/23 at 10:10 AM with Staff E, CNA, revealed that the CNAs' document all 1:1 supervision on a paper that is left in the resident's room. This form was observed in the resident's room at this time. The documentation for all 1:1 observation for this resident was requested but was not received prior to exit. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105509 If continuation sheet Page 2 of 3 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 105509 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/23/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Seabranch Health and Rehabilitation Center 4801 SE Cove Rd Stuart, FL 34997 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 0850 Hire a qualified full-time social worker in a facility with more than 120 beds. Level of Harm - Minimal harm or potential for actual harm Based on interview and documentation review, the facility failed to ensure a Social Service Director (SSD) was employed by the 120-bed facility. This has the potential to affect all residents in the facility. Residents Affected - Some The findings included: During the entrance conference with the Administrator and Director of Nursing (DON) on 05/22/23 at 9:05 AM, it was revealed that the facility does not currently have an SSD. The administrator stated they have a social services assistant (SSA) but have not had an SSD for 8 months. In a follow up interview on 05/22/23 at approximately 11:30 AM, the administrator stated the SSA does not have any type of degree in social services and that they have interviewed 4 candidates, but they did not pan out. The administrator provided documentation of advertising printed today, 05/22/23, for an SSD. The job activity associated with the posting stated the job was posted 13 days ago. No other advertising was made available during the survey. An interview conducted on 05/22/23 at 2:25 PM with the SSA revealed he has worked for this facility since 02/23 and there has been no director during the time he has been there. His job includes care plan meetings, discharge planning, grievance revies, and referral for residents for dental, optometry, and podiatry services. The SSA stated he does get assistance from co-workers, so he is not too overwhelmed. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105509 If continuation sheet Page 3 of 3