Health inspection·October 4, 2023

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, resident interviews, and staff interview, the facility failed to provide housekeeping and maintenance services to maintain a clean and orderly environment and ensure sufficient hot water in 6 of 16 sampled resident rooms. (Rooms 110, 206, 207, 212, 214, and 216) The findings include: An observation of room [ROOM NUMBER] was conducted on 10/2/23 at 2:43 PM. The overbed table was missing the plastic border and had exposed rough edges. In addition, the bathroom had a rusted toilet riser and peeling paint on the wall. (Photographic evidence obtained.) It was further discovered that after the hot water ran in the bathroom sink for approximately 3 minutes, the water did not get warm. An interview was conducted with Resident #51 at this time, and she stated they have not had any hot water in the bathroom since Hurricane Idalia about a month ago. An observation of room [ROOM NUMBER] was conducted with the Administrator on 10/4/23 at 2:32 PM. She observed and confirmed the peeling paint in the bathroom, the rusted toilet riser, and the damaged overbed table. She checked the hot water in the bathroom after allowing the hot water to run for about 3 minutes and it read 76 degrees on her thermometer. The Administrator stated the facility had obtained a quote on 10/3/23 for a circulating pump and the hot water had been out on that side of the building since right after the hurricane on 9/15/23. She stated it affected the entire hall. An observation of room [ROOM NUMBER] was conducted on 10/2/23 at 1:28 PM. After allowing the hot water to run in the bathroom sink for about 3 minutes, the water did not get warm. At this time, Resident #72 stated they had not had hot water in the bathroom since Hurricane Idalia. An observation of room [ROOM NUMBER] was conducted with the Administrator on 10/4/23 at 2:34 PM. The Administrator tested the hot water from the bathroom sink after allowing it to run for about 3 minutes and the temperature read 75.9 degrees. The wall around the sink was damaged with peeling paint and there was peeling paint on the wall under the television. The Administrator stated they were aware of damaged walls and had started some repairs. An observation of room [ROOM NUMBER] was conducted on 10/2/23 at 3:43 PM. Several blankets were on the floor under the packaged terminal air conditioner (PTAC) unit and the overbed table was missing the outer border and had exposed particle board. (Photographic evidence obtained) An observation of room [ROOM NUMBER] was conducted with the Administrator on 10/4/23 at 2:40 PM. Several blankets remained in the floor under the PTAC unit and the overbed table remained damaged. The Page 1 of 2 105631 105631 10/04/2023 Aviata at Big Bend 207 Marshall Dr Perry, FL 32347

F 0584 Administrator stated the PTAC was leaking, and it had been discussed in the morning meeting. Level of Harm - Minimal harm or potential for actual harm An observation of room [ROOM NUMBER] was conducted on 10/2/23 at 2:18 PM. The privacy curtain between the 2 beds was observed to be stained. Residents Affected - Few Another observation of room [ROOM NUMBER] was conducted with the Administrator on 10/4/23 at 2:36 PM. She observed and confirmed the stains on the privacy curtain. An observation of room [ROOM NUMBER] was conducted on 10/2/23 at 1:11 PM. After allowing the hot water to run in the bathroom sink for about 5 minutes, it did not get warm. At this time Resident #53 stated there was no hot water in the bathrooms and they must wash themselves with cold water. On 9/2/23 at approximately 11:54 AM, a tour was done of room [ROOM NUMBER]. The bathroom was dirty. The floor was dirty and the toilet riser was rusty and dirty. There was a dark gray thick build up, especially on the corners of the walls. There was also some sticky like substance on the toilet riser bars. (Photographic evidence obtained) Resident #69, the current occupant of room [ROOM NUMBER], was interviewed. She stated she was very aware of the condition of the bathroom. She stated she hated how dirty the riser was. When asked if she had let staff know, she said she had but nothing happened. She said she hated sitting on the toilet but there was nothing the staff had done about it. A second visit was performed on 9/2/23 after housekeeping had been down that hall and finished cleaning. The issues seen in the bathroom previously had not been addressed. 105631 Page 2 of 2