Inspection·May 14, 2025

F 0694 Provide for the safe, appropriate administration of IV fluids for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of policy and procedure, observation, interview and record review, the facility failed to ensure it obtained a current physician order for an Intravenous (IV) dressing and IV site; and failed to change the Intravenous (IV) dressing to the right upper chest for 1 of 1 sampled resident observed, Resident #4. Residents Affected - Few The findings included: Review of the facility policy and procedure, titled, Dressing Change for Vascular Access Devices, provided by the Director of Nursing (DON), reviewed 2011, documented in the Policy Statement Purpose: To prevent local and systemic infection related to the IV catheter. Policy: A sterile dressing is maintained on all peripheral and central vascular access devices to protect the site, provide a microbial barrier, and to provide vascular access device securement .3. Central venous access device and peripheral midline dressings are changed every 7 days and immediately if the integrity of the dressing is compromised, if moisture, drainage or blood is present, or for further assessment if infection is suspected .Midline and Central Venous Access Device Dressing Change Procedure: .4. Assess site for: Erythema, Induration, Swelling, Drainage .18. Apply label on dressing with date and nurse's initials 20. Suggested charting: Site assessment, Measured external length of the catheter, Prep used, Type of dressing, Catheter securement (integrity of sutures, other devices) and Resident response. Record review revealed Resident #4 was admitted to the facility on [DATE] and re-admitted on [DATE] with diagnoses that included Hemiplegia and Hemiparesis following Cerebral Infarction affecting right dominant side, Diabetes Mellitus Type II, Hypertension, Dementia, Alzheimer's Disease, Chronic Kidney Disease and Hypertensive Heart Disease with Heart Failure. The record documented a Brief Interview Mental Status (BIMS) score of 00, indicative of (severe impairment). During an observation on 05/14/25 at 10:37 AM, Resident #4 was observed sitting in the wheelchair in the hallway. It was noted the resident had an intravenous (IV) chest dressing dated 04/25/25. Closer observation on 05/14/25 at 2:08 PM, with the Director Of Nursing (DON) revealed the dressing was still dated 04/25/25 that was on the resident's right IV subclavian Opti Flow chest port double lumen dressing (for Hemodialysis which was not required at that time) with the nurse's initials. Photographic Evidence Obtained. Review of the physician orders revealed that 04/25/25 was the last and most recent order for: Change IV dressing to right upper chest every seven (7) days as well as needed (PRN) for soiling and/or dislodgement every evening shift every Monday - order date 04/25/25 14:43 [2:43] PM D/C [discontinue] date 05/06/25 at 15:00 PM. (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 3 Event ID: 105572 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 105572 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/14/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pompano Health and Rehabilitation Center 51 W Sample Road Pompano Beach, FL 33064 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)