Inspection·April 30, 2025

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 provide splints for 1 of 3 residents reviewed for range of motion (ROM), of a total sample of 36 residents, (#75). Residents Affected - Few Finding: Resident #75 was admitted to the facility on [DATE] with diagnoses of hemiplegia and hemiparesis following an intracranial hemorrhage affecting his left non-dominant side, atrophy and type 2 Diabetes Mellitus. Resdient #75 was able to express simple needs and answer questions appropriately. On 4/27/25 at 12:30 PM, resident #75 was observed in bed, his left arm and hand were contracted. The resident stated he had a stroke and was supposed to wear a splint everyday. He stated no one helped him with the splint, and added, I can't put them on myself. Review of the of the Occupational Therapist Discharge summary dated [DATE], noted resident #75 met the goal of wearing a left upper extremity elbow extension splint and a resting hand splint. The discharge instructions noted resident #75 would remain in the facility as a long term care resident with an updated splinting program in place. Review of the resident's current Activities of Daily Living (ADL) Care Plan noted, Apply left Elbow extension for Contracture Management or Maintenance up to 6 hours or as tolerated. Not to be worn at the same time with the left resting splint . On 4/28/25 at 1:02 PM, and 4/29/25 at 12:59 PM, the resdient was observed in bed eating lunch. The resident did not have the elbow extension or the resting hand splint on. On 4/29/25 at 3:45 PM, resident #75 was observed lying in bed, his left arm was bent at the elbow and his left hand was at his chest. The resident used his right hand to grasp his left hand, trying to move/extend the left arm. He stated he was not able to straighten out his left arm. He said a Certified Nursing Assistant (CNA) used to put the splints on him, but she no longer worked at the facility. He pointed to the chest of drawers at the end of his bed. He stated the splints were in the second drawer from the top. The resident gave permission to open the drawer and both the elbow extension and resting hand splint were in the drawer. The resident explained he had not worn the splints for the past 4 months. The 200 Wing Unit Manager (UM) entered the resident's room and was informed resident #75 had not been seen wearing splints for the past 3 days. The resident told her he wanted to wear the splints. On 4/29/25 at 4:02 PM, the UM explained the nurses and the CNAs were responsible for placing the (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 2 Event ID: 105539 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 105539 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Healthcare and Rehab of Sanford 950 Mellonville Ave Sanford, FL 32771 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)