Inspection·October 18, 2023

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, staff and resident representative interviews, the facility failed to ensure 1 (Resident #8) of 7 sampled residents was treated with dignity and respect in that the facility failed to ensure the resident was properly dressed when transported to an outside provider's appointment. The findings included: On 10/17/23 at 11:55 a.m., Resident #8 was observed in a reclining wheelchair in the lobby with her sister. She was partially covered with a blanket, and was wearing a long, short sleeved T-shirt. Resident #8's sister lifted the blanket which showed the resident was dressed in a T-shirt and incontinent brief. The shirt was not long enough to cover the brief. She was not wearing any bottoms, socks, or shoes. An orthopedic boot was observed on the resident's right lower leg. Resident #8's sister was visibly upset and speaking to the staff in a loud voice saying, I should call the police. My sister had plenty of warm clothing and you sent her out to the doctor's office with just a shirt and a diaper. It was 57 degrees this morning. On 10/17/23 at 12:10 p.m., Resident #8's sister who was her Power of Attorney said Resident #8 had been at the facility for about two weeks. She said, My sister had an appointment with her orthopedist scheduled this morning and I was concerned it would be chilly. I could not go with her to the appointment so yesterday I came with warm clothing specifically for this morning's appointment. I brought long pajamas, socks and sneakers anticipating it was going to be 57 degrees. I asked a friend to meet her at the appointment. The friend called me saying she was dressed inappropriately in just a T-shirt and incontinent brief. My sister is not cognitively intact after her stroke, but she can say if she is cold. She did say to our friend and to me that she was cold. They put something on her that wasn't even hers and sent her out to the appointment. People should not be treated that way. It was so upsetting to see her dressed like that when she came back to the facility. She can't fight for herself. I need to do it for her. Review of clinical records revealed Resident #8 was admitted to the facility on [DATE]. Diagnoses included Alzheimer's disease, and aphasia (language disorder affecting ability to communicate). The resident's care plan initiated on 10/17/23 noted the resident needs assistance with activities of daily living (ADLs). Staff was to encourage and assist with all ADLs. Review of the AccuWeather website at https://www.accuweather.com/en/us/north-port/34287/october-weather/347853 showed on 10/17/23 the weather in North Port Florida had a low of 59 degrees Fahrenheit (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: 105523 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 105523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/18/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE North Port Rehabilitation and Nursing Center 6940 Outreach Way North Port, FL 34287 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)