Health inspection·November 21, 2024

F 0554 Allow residents to self-administer drugs if determined clinically appropriate. Level of Harm - Minimal harm or potential for actual harm Resident #118 Residents Affected - Few An observation of Resident #118 was conducted on 11/19/24 at 2:36 PM. The resident was in bed and a bottle of Osteo Biflex (a Glucosamine Chondroitin supplement) was observed on his over bed table. An interview was conducted with Resident #118 on 11/20/24 at 10:35 AM. Resident #118 stated he ordered the Osteo Biflex online, administers the medication to himself, and had previously discussed it with his physician. The bottle of medication remained on the over bed table. (Photographic evidence was obtained.) A review of Resident #118's EMR revealed no assessment for the resident to self-administer medications and no care plan for self-administration of medications. An interview was conducted with Employee G, an agency LPN, on 11/20/24 at 10:25 AM. She stated unless the physician approved otherwise, the facility should be administering and storing the Osteo Biflex. She did not know if Resident #118 had been assessed to self-administer medications. An interview was conducted with the Director of Nursing (DON) on 11/20/24 at 10:37 AM. She stated Resident #118 was not assessed to self-administer medications and he should not have the medication at bedside. She expected the staff to observe for medications at bedside and report to the nurse so the facility can screen the resident to determine if they are safe to self-administer medications. A review of the policy on Self Administration of Medication revealed, A resident may not be permitted to administer or retain any medications in his/her room unless so ordered, in writing, by the attending physician and approved by the Interdisciplinary Care Plan Team. Should the resident's attending physician permit resident to administer his/her medication(s), the following conditions will apply: The Physician's order must be given prior to self-administration Storage of medications in the resident's room must be such that it will prevent access by other residents. Only the medications permitted for self-administration shall be left at the bedside. The Interdisciplinary Care Plan Team must record in the resident's medical record that self-administration has been authorized and shall identify the name, strength, and quantity of each medication retained at the bedside. (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 4 Event ID: 105532 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 105532 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/21/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Arcadia Health and Rehabilitation Center 10095 Hillview Road Pensacola, FL 32514 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)