Inspection·March 13, 2025

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some On 3/10/25 at 11:42 a.m., in an interview Resident #26 said the staff do not always give the showers as scheduled. He said he sometimes does not get his showers. Resident #26's family member was present during the interview and said Resident #26 did not get his scheduled shower on Friday 3/7/25. The resident's family said, He needs to get showers. He wets himself and has a wound on his buttocks. Review of the CNA shower schedule revealed Resident #26's showers were scheduled on the night shift (7:00 p.m., to 7:00 a.m.) on Mondays, Wednesdays and Fridays. Review of the CNA shower documentation for February 2025 and March 2025 failed to reveal Resident #26 received a shower as scheduled on 2/3/25 (Monday), 2/5/25 (Wednesday), 2/7/25 (Friday), 2/10/25 (Monday), 2/12/25 (Wednesday), 2/14/25 (Friday), 2/17/25 (Monday), 2/19/25 (Wednesday), 2/21/25 (Friday), 2/24/25 (Monday), 2/28/25 (Friday), 3/3/25 (Monday), 3/5/25 (Wednesday), 3/7/25 (Friday) and 3/10/25 (Monday). 3. Review of Resident #53's clinical record revealed a Quarterly MDS with an assessment reference date of 12/18/24. The assessment noted Resident #53's cognition was intact with a BIMS of 13. Resident #53 was dependent on staff for personal hygiene and showers. Diagnoses included right hemiplegia (paralysis of right side of the body), and Fibromyalgia (widespread body pain). On 3/11/25 at 11:21 a.m., in a telephone interview, a family member said Resident #53 did not speak English but had all her senses. She said Resident #53 calls her at night to tell her she wet herself because no one answered her call light. She spoke to the Unit Manager who said she would take care of it. She said, It is good for a few days then things will go back the way they were. They do not give her showers. She is to get them on Tuesdays, Thursdays and Saturdays. She needs them because she wets herself. Review of the CNA documentation revealed Resident #53's showers were scheduled on Mondays, Wednesdays, and Fridays on the day shift (7:00 a.m., to 7:00 p.m.). Review of the CNA shower documentation for February 2025 and March 2025 failed to reveal Resident #53 received her scheduled showers on 2/3/25 (Monday), 2/5/25 (Wednesday), 2/7/25 (Friday), 2/10/25 (Monday), 2/12/25 (Wednesday), 2/14/25 (Friday), 2/19 25 (Wednesday), 2/21/25 (Friday), 2/24/25 (Monday), 2/26/25 (Wednesday), 2/28/25 (Friday), 3/3/25 (Monday), and 3/5/25 (Wednesday). There was little to no documentation to show Resident #53 received toileting assistance for each shift in February 2025 and March 2025. On 3/10/25 at 11:43 a.m., in an interview CNA staff I said Resident #53 was total care with her Activities of Daily Living and incontinent at night. On 3/12/25 at 9:26 a.m., in an interview CNA Staff D said each unit has a shower schedule in the CNA assignment book and we follow the shower list. If a resident refuses we can ask them on the next day or the next shift. Each resident receives three showers a week. If the resident is always refusing, I let the nurse know, We document the showers in the computer. On 3/12/25 at 9:30 a.m., in an interview CNA Staff E said there was a shower list in the assignment book at the desk. We document the showers in the electronic record. Sometimes the resident will refuse and say we did not offer the shower; we can't always change the shower day because you get behind. Some residents refuse and then will take a shower the next day, if I can do it I will. Sometimes (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105584 If continuation sheet Page 2 of 4 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 03/13/2025 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 0677 we forget to put it in the computer but we gave the shower. Level of Harm - Minimal harm or potential for actual harm On 3/12/25 at 9:39 a.m., in an interview, Unit Manager Registered Nurse (RN) Staff C said, The shower assignments are in the CNA assignment book and staff use electronic charting, there is no paper documentation. RN Staff C said she was working on creating a new sheet for the showers. The Unit Manager said sometimes the residents will refuse showers and the staff go back later in the day or the next day to shower the resident. I understand if it wasn't documented what that means. There are times when the staff give them showers at night instead of the day and they have nowhere to document it. I'm working on changing the way we document the showers so if it is given on a different day the aids can chart it. Residents Affected - Some RN Staff C said, Resident #18 did tell me last week that she wanted showers in the morning but I have not changed it yet, I'm working on a new system. She said, Resident #53 is showered and toileted, but she will tell her daughter she did not get care. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105584 If continuation sheet Page 3 of 4 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 03/13/2025 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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, review of facility policy and procedure and resident and staff interviews, the facility failed to ensure medications were safely stored at the bedside for 1 (Resident #52) of 8 residents observed during medication administration. The facility failed to ensure medications were secured when unattended and properly labeled in 1 (North Unit Medication Cart B) of 2 medication carts observed. This had the potential for residents and others to have access to medications that could create hazardous health consequences for residents in the facility. The findings included: The facility policy Administration of Medications documented Facility staff should avoid touching the medication with bare hands when opening unit dose package. Only prepare medications for one resident at a time. Ensure that medication carts are always locked when out of sight or unattended. On 3/11/25 at 8:53 a.m., during a medication administration with LPN Staff J, a tube of Voltaren Gel was observed on the bedside table of Resident #52. The resident said she puts the gel on her right knee daily for pain relief. Review of the clinical record revealed there was no physician order for the medication and Resident #52 had not been assessed to see if she was able to self-administer the medication. On 3/12/25 at 8:46 a.m., in an interview Registered Nurse (RN) Unit Manager Staff C said Resident #52 had the Voltaren Gel since her admission on [DATE]. Staff C said the resident must have bought it at the store because they were not aware she had it. On 3/11/25 at 9:15 a.m., Licensed Practical Nurse (LPN) Staff F was observed at the North Unit medication cart B with three medication cups containing unidentified pills on top of the cart. LPN Staff F grabbed the three medication cups from the cart and placed them into her right hand. LPN Staff F said she was just going to give them to Resident #98 and #350. LPN Staff F confirmed she prepared the medications for both residents and was going to administer them to the residents. On 3/12/25 at 9:26 a.m., North Unit medication cart B was observed unlocked. The medication cart was against the wall with the drawers facing the hallway. There were residents, staff and visitors in the hall passing by the unsecured medication cart. Three medication cups with unidentified pills were observed in the unlocked, top drawer of the medication cart. One cup containing a white liquid was stacked in one of the cup of pills. Approximately three minutes later, RN Staff H came to the unsecured cart. She verified she left the medication cart unlocked and unattended and the unlabeled medication cups in the top drawer. She said she got interrupted by staff and residents. Photographic evidence obtained. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105584 If continuation sheet Page 4 of 4