Inspection·October 18, 2023

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 observations, interviews and record review, the facility failed to provide care and services as per physician orders for 1 of 3 sampled residents, Resident #3. Residents Affected - Few The findings included: Review of Resident #3's clinical record documented an admission on [DATE] and a readmission on [DATE]. The resident's diagnoses included Fracture of Lateral Malleolus of Left Fibula, closed fracture, Diabetes Mellitus Type 2 with Neuropathy, Legal Blindness, Acute Kidney Failure, and Dependence on Renal Dialysis. Review of Resident #3's Minimum Data Set (MDS) quarterly assessment dated [DATE] documented a Brief Interview of the Mental Status (BIMS) score of 15 indicating that the resident had no cognition impairment. The assessment documented under Functional Status that the resident needed supervision from the staff to complete the activities of daily living. Review of Resident #3's physician orders dated 06/14/23 documented Efinaconazole External solution 10%, apply to left big toe topically one time a day for fungus for 48 weeks. On 10/11/23 at 9:40 AM, during a tour to the facility's long term unit, an interview was conducted with Resident #3 who stated she had been in the facility too long. The resident stated she was concerned that she was not getting an antifungal medicine to her big toe. The resident added that there was one nurse who would give it to her and when the nurse was not working, she did not get it. The resident stated she did not get it for few days. On 10/11/23 at 3:01 PM, a side by side review of Resident #3's September 2023 Treatment Administration Record (TAR) was conducted with the Director for Nursing (DON) and the Administrator. The review revealed the resident did not receive Efinaconazole External solution 10%, apply to left big toe topically on 09/05/23, 09/06/23, 09/13/23, 09/14/23, 09/25/23 and 09/29/23. Continued side by side review of Resident #3's October 2023 Treatment Administration Record (TAR) with the DON revealed the resident did not receive Efinaconazole External solution 10%, apply to left big toe topically on 10/04/23. The DON confirmed the lack of Resident #3's medication administration documentation as noted above. The DON and the administrator were asked if there was a computer problem and stated they did not think so. On 10/11/23 at 3:31 PM, a joint interview via a telephone call with the DON, the Administrator and Staff A, Licensed Practical Nurse (LPN) was conducted. Staff A stated she started working at the facility on 08/02/23. Staff A stated that she did not administer Resident #3's Efinaconazole External (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: 105609 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 105609 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/18/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Nspire Healthcare Tamarac 5901 NW 79th Avenue Tamarac, FL 33321 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)