Inspection·March 20, 2025

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interviews, the facility failed to protect the resident(s') right to be free from neglect when it failed: 1) to provide to structural processes necessary to ensure ongoing incontinence care to two residents (#1 and #2); and 2.) to prevent emotional anguish to 1 resident (#2). The findings included: Record Review of Abuse and Neglect-Clinical Protocol Policy last revised in March 2018 stated that neglect is defined as the failure of the facility, it's employees or service providers to provide goods and services to a resident that are necessary to avoid physical harm, pain, mental anguish or emotional distress. The facility management and staff will institute measures to address the needs of residents and minimize the possibility of abuse and neglect. Record Review of ADL Policy, last revised on March 2018 stated, Residents will be provided with care, treatment and services as appropriate to maintain or improve their ability to carry out activities of daily living (ADL's). Residents who are unable to carry out activities of daily living independently will receive the services necessary to maintain good nutrition, grooming and personal and oral hygiene. Appropriate care and services will be provided for residents who are unable to carry out ADL's independently, including Hygiene (bathing, dressing, grooming, and oral care). Resident #1 was admitted to the facility on [DATE] for skilled nursing care. Resident #1 has a diagnosis of Alzheimer's disease, impaired gait and mobility, and generalized muscle weakness. Resident #1 requires staff assistance with hygiene care and transfers in and out of her wheelchair. Record Review of the facility's neglect allegation showed that the facility verified the Certified Nursing Assistant (CNA) who was assigned to this resident did not provide incontinent care during breakfast service or lunch service resulting in the resident sitting in a puddle of urine at breakfast and lunch time on 2/20/25. Record review of staff training logs for neglect at the time surrounding the incident involving Resident #1 showed facility lacked ongoing training for staff regarding the incident, and that the only staff trained on neglect at the time of the incident were the 24 staff working at the facility on 2/26/25. Record review of facility's Quality Assurance Performance Improvement (QAPI) agenda shows that the incident involving Resident #1 was included on the agenda dated 3/19/25. (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: 105538 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 105538 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harbour Health Center 23013 Westchester Blvd Port Charlotte, FL 33980 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)