Health inspection·September 1, 2022

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, record review and interview, the facility failed to provide showers per residents' request and preference, for 1 of 2 sampled residents reviewed for preferences (Resident #94). The findings included: Record review for Resident #94 documented an admission date of 04/09/21 with diagnoses that included Stroke with Left Sided Paralysis, Chronic Kidney Disease, Hypertension and Diabetes. A Minimum Data Set (MDS), dated [DATE], documented the resident as cognitively intact and requiring extensive assistance for all activities of daily living except eating which required limited assistance. A care plan, dated 04/12/21, documented Resident #94 needed assistance for Activities of Daily Living (ADL) with the intervention to provide assistance / supervision as needed. A care plan dated 07/09/2021 documented Resident #94 wishes to remain Long Term Care in the center with the intervention provide services according to care plan in effort to enhance well-being. On 08/30/22 at 8:38 AM, Resident #94 said he has had a shower once in the last month. He stated he is supposed to have a shower every Thursday and Sunday. He said he keeps asking the staff for a shower, but they just give him a bed bath. He stated he did not understand and has almost given up. The facility Intervention / Task form For Resident #94 documented ADL- Bathing Type is Shower Sunday and Thursdays. If patient refuses or is not available, you must notify the Director of Clinical Services. Review of the Intervention / Task form documented one shower given between the dates of 07/30/22 through 08/30/22. On 08/31/22 at 9:46 AM, Staff A, Certified Nursing Assistant / CNA, stated the unit has a shower book; and every morning she checks it to know her residents' shower schedule for the day. She said if the resident does not want a shower, there is a refusal form that must be filled out. She said the unit manager also signs the shower refusal form acknowledging the resident did not shower and it gets charted on the resident's chart. On 09/01/22 at 12:35 PM, the Unit Manager of Independence Wing stated there were no shower refusal forms for Resident #94. 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: 105592 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 105592 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/01/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Palm Garden of Vero Beach 1755 37th Street Vero Beach, FL 32960 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)