Inspection visit
Inspection
3 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 3 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0550
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or
her rights.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, staff and residents' interview, the facility failed to promote the resident's rights to make choices
related to dining location for 3 (#44, #6, #11) of 10 residents reviewed for choices.
The findings included:
1. On 12/5/22 at 12:51 p.m., during observation of the lunch service, residents were noted to have trays
being delivered to their rooms and eating at the bedside table in their rooms. No residents were in the
dining room.
The same observation was made for the lunch meal of 12/6/22, 12/7/22, and 12/8/22.
On 12/5/22 at 12:47 p.m., the Certified Dietary Manager (CDM) said communal dining never resumed since
the COVID pandemic. She said residents had been dining in their rooms for the past 2-3 years. She said
they had begun discussing going back to using the dining room, but it has not happened.
2. On 12/5/22 at 12:57 p.m., Resident 44 said he didn't know why they ate in their rooms. He said he would
prefer to eat in the dining room to be able to talk with people. He said they just redid the dining room, and it
was a waste of money to not use it.
On 12/7/22 at 9:18 a.m., the Administrator said the residents have not dined in the dining room in at least
three years. The Administrator said he was aware pandemic restrictions on communal dining were lifted
over a year ago. He said initially the pandemic shut the dining room down and then they did a renovation
which the pandemic caused issues with getting supplies. He said the renovation was completed shortly
after Hurricane [NAME] which occurred on 9/28/22. He said they had not had servers for the dining room in
at least three years and they needed to get the dining room in order with staff, but had no specific date or
plans when the dining room would be reopened for dining.
3. On 12/6/22 at 09:32 a.m., Resident #6 said she has been a resident at the facility for several years and
always ate her meals in the dining room. She said she is very social and likes talking to people. Resident #6
said dining in her room was terrible, she did not like it.
On 12/7/22 at 9:08 a.m., in a telephone interview, Resident #6' Health Care Surrogate said the resident told
her she wants to eat in the dining room. She said Resident #6 told her it was disappointing she had to eat
Thanksgiving dinner in her room.
On 12/07/22 at 12:04 p.m., Resident #6 said she has been telling the staff she wants to dine in 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 6
Event ID:
105584
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
105584
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/08/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Sarasota Memorial Nursing & Rehabilitation Center
5640 Rand Blvd
Sarasota, FL 34238
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)
F 0550
dining room. She said there were other residents who do not like eating in their rooms either.
Level of Harm - Minimal harm
or potential for actual harm
4. On 12/6/22 at 11:00 a.m., Resident #11 said she misses having her meals in the dining room. She
misses the social aspect of dining in the dining room.
Residents Affected - Few
On 12/6/22 at 2:05 p.m., Certified Nursing Assistant (CNA) Staff N said all residents dine in their rooms and
have been doing it since COVID-19 began. She said some residents don't like it, but that's the way it is.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105584
If continuation sheet
Page 2 of 6
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
105584
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/08/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Sarasota Memorial Nursing & Rehabilitation Center
5640 Rand Blvd
Sarasota, FL 34238
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)
F 0554
Allow residents to self-administer drugs if determined clinically appropriate.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, staff and resident interview and record review, the facility failed to ensure an assessment for
clinically appropriate self-administration of medications and a care plan was completed for 3 (Residents
#301, #303 and #11) of 20 residents reviewed for medications left at the bedside.
Residents Affected - Few
The findings included:
The Self-administration policy provided by facility revised 5/9/22 indicated, Residents have the right to
self-administer medications if the interdisciplinary has determined that it is clinically appropriate and safe
for the resident to do so. As part of their overall evaluation .2-The Nursing Assessment of Self-Medication
tool is completed which identifies the resident's ability to read and understand medication labels .
1. Resident #301 was admitted on [DATE] with diagnoses of unspecified glaucoma, hypertension, and
major depression.
On 12/5/22 at 11:24 a.m., observation revealed a bottle of artificial tears, a bottle of Timolol Maleate 0.5 %
ophthalmic solution, and a bottle of Alphagan 0.1% ophthalmic solution stored on Resident #301's
nightstand.
Resident #301 said she has been self-administering her drops since her admission on [DATE].
Photographic evidence obtained.
The physician's order for Resident #301 included Timolol Maleate 0.5 % eye drops, one drop by ophthalmic
(eye) route in left eye two times per day and Alphagan 0.1 % eye drops, one drop by ophthalmic (eye) route
in left eye two times per day.
On 12/5/22 at 11:35 a.m., a review of the clinical record failed to reveal documentation the interdisciplinary
determined it was clinically appropriate and safe for the resident to self-administer the Timolol Maleate, the
artificial tears or the Alphagan.
On 12/7/22 at 8:10 a.m., review of the Medication Administration Record (MAR) for Resident #301 revealed
Registered Nurse (RN) Staff C signed administration of the timolol on 12/3/22 at 8:00 a.m. RN Staff C said
Resident #301 told her she had already done it and she signed. She said, I don't necessarily observe her
doing so.
On 12/7/22 at 9:04 a.m., Licensed Practical Nurse (LPN) Unit Manager Staff I said it was her understanding
Resident #301 has been self-administering her eye drops since her admission and the nurses have been
signing off the administration of the eye drops on the MAR. Staff I said, we did not have a
self-administration tool until 12/5/22.
On 12/8/22 at 9:12 a.m., LPN Staff G said Resident #301 mentioned wanting to administer her eye drops
and could not remember if she had told the management or followed up.
2. On 12/5/22 at 12:57 p.m., observation revealed a bottle of Nyamyc powder (antifungal) stored on
Resident #303's nightstand. Resident #303 said she came with the medication from the hospital and
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105584
If continuation sheet
Page 3 of 6
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
105584
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/08/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Sarasota Memorial Nursing & Rehabilitation Center
5640 Rand Blvd
Sarasota, FL 34238
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)
F 0554
has been using it since admission on a small area on her abdomen.
Level of Harm - Minimal harm
or potential for actual harm
Photographic evidence obtained
Residents Affected - Few
On 12/5/22 at 1:18 p.m., a review of Resident #303's clinical record revealed an admission date of
11/14/22. The physician's order did not include the use of Nyamyc powder to the resident's abdomen.
On 12/8/22 at 9:58 a.m., Registered Nurse Minimum Data Set Coordinator said Resident #303 did not have
a care plan for self -administration of medication or a self-administration assessment.
On 12/7/22 at 9:04 a.m., Licensed Practical Nurse (LPN) Unit Manager, Staff I said she was told Resident
#303 had an ointment in her possession. She said Resident #303 came with it from the hospital, and she
did not know she was using it.
On 12/8/22 at 12:01 p.m., the Director of Nursing (DON) said she was aware medications were left at
bedside and facility protocols were not followed.
3. Review of Section C of the Minimum Data Set (MDS) for Resident #11 dated 11/1/22 revealed a Brief
Interview for Mental Status (BIMS) score of 13, indicating intact cognition.
Review of the Medication Administration Records (MARs) for Resident #11 dated December 2022 revealed
a physician's order for antacid, 2 tablets, two times a day with food at 9:00 a.m. and 5:00 p.m. starting
8/2/22. The antacid was signed off each day from 12/1/22 through 12/8/22 at 9:00 a.m., indicating the nurse
gave the medication.
On 12/06/22 at 11: 00 a.m. and 12:15 p.m., Resident #11 was observed in her room sitting up in a chair,
tray table in front of the resident. There were two round tablets in a plastic medication cup on the tray table
in front of her. Resident #11 confirmed they were the antacid the nurse gives her at 9:00 a.m. with meals to
prevent gas. She said the nurse gives them to her in the cup and she takes them when she wants to. She
said if she does not take them, she puts them in her drawer.
On 12/08/22 at 9:47 a.m., Unit Manager Staff M said there is no medication self-administration assessment
for Resident #11. Staff M said before a resident can self-administer medications on their own at the facility,
they must pass an assessment indicating it is a safe thing for the resident to do. The Unit Manager said if
the resident passes the assessment, an order is obtained from the physician, and it is documented in the
care plan. Staff M said she was not aware staff was allowing Resident #11 to take the antacid on her own.
On 12/08/22 at 9:57 a.m., Minimum Data Set (MDS) Registered Nurse (RN) Staff L confirmed there was no
assessment, physician's order, or care plan indicating Resident #11 was deemed safe to take her own
antacid while at the facility.
On 12/8/22 at 10:22 a.m., the Unit Manager said Resident #11 confirmed with her staff was allowing her to
self-administer the antacid.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105584
If continuation sheet
Page 4 of 6
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
105584
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/08/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Sarasota Memorial Nursing & Rehabilitation Center
5640 Rand Blvd
Sarasota, FL 34238
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)
F 0761
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted
professional principles; and all drugs and biologicals must be stored in locked compartments, separately
locked, compartments for controlled drugs.
Based on observation, record review and resident and staff interview, the facility failed to ensure proper
storage of medications left at the bedside for 2 (Residents #301, and #303) of 20 residents reviewed for
medication storage. The facility failed to remove expired medications in 1 ( South Unit Medication Cart A) of
3 medication carts reviewed for proper storage and labeling of medications.
The findings included:
The facility's Medication Storage and Disposal/Destruction policy revised on 5/23/22 noted medications and
biologicals including treatments items are secured in a locked cart which is inaccessible to residents or
visitors. Medications with expiration dates will not be kept stored and will be disposed of as per appropriate
procedure. Facility should dispose of discontinued medication, outdated medications or medications left in
facility after a resident has been discharged in a timely fashion.
1. On 12/5/22 at 11:24 a.m., observation revealed a bottle of artificial tears, a bottle of Timolol Maleate 0.5
% ophthalmic solution, and a bottle of Alphagan 0.1% ophthalmic solution stored on Resident #301's
nightstand.
Resident #301 said she did not have a locked box to store the bottles of eye drops.
Photographic evidence obtained.
On 12/7/22 at 11:50 a.m., Certified Nursing Assistant (CNA) Staff B said Resident #301 kept the bottles of
eye drops on the table.
On 12/8/22 at 9:12 a.m., Licensed Practical Nurse (LPN) Staff G said Resident #301 mentioned wanting to
administer her eye drops and could not remember if she had told the management or followed up.
2. On 12/5/22 at 12:57 p.m., observation revealed a bottle of Nyamyc powder (antifungal) stored on
Resident #303's nightstand. Resident #303 said she came with the medication from the hospital and has
been using it since admission on a small area on her abdomen.
Photographic evidence obtained
On 12/7/22 at 9:04 a.m., Licensed Practical Nurse (LPN) Unit Manager, Staff I said she was told Resident
#303 had an ointment in her possession. She said Resident #303 came with it from the hospital, and she
did not know she was using it.
3. On 12/5/22 at 12:02 p.m., observation of South Unit medication cart A with Registered Nurse Staff F
revealed one bottle of Nitroglycerin 0.4 milligram (mg) with an expiration date of 11/2022, and two bottles of
Nitroglycerin 0.4 mg with an expiration date of 9/11/22.
On 12/5/22 at 12:12 p.m., RN Staff F said the expired Nitroglycerin should not be in the cart and should
have been sent to pharmacy
.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105584
If continuation sheet
Page 5 of 6
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
105584
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/08/2022
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Sarasota Memorial Nursing & Rehabilitation Center
5640 Rand Blvd
Sarasota, FL 34238
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)
F 0761
On 12/8/22 at 12:01 p.m., the Director of Nursing (DON) said she was aware medications were left at
bedside and facility protocols were not followed.
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
105584
If continuation sheet
Page 6 of 6
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Back to topCitations
3 citations recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F761 - Labeling of Drugs and Biologicals
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
F550 - Resident Rights
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
F554 - The right to self-administer medications if the interdisciplinary team, as
Allow residents to self-administer drugs if determined clinically appropriate.
FAQ · About this visit
Common questions about this visit
What happened during the December 8, 2022 survey of SARASOTA MEMORIAL NURSING & REHABILITATION CENTER?
This was a inspection survey of SARASOTA MEMORIAL NURSING & REHABILITATION CENTER on December 8, 2022. The surveyor cited 3 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at SARASOTA MEMORIAL NURSING & REHABILITATION CENTER on December 8, 2022?
Yes, 3 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional princip..."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.