Health inspection·August 12, 2024

F 0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. 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 reviews, the facility failed to provide an environment free of pests in 4 of 15 rooms on the 2 South Unit (room [ROOM NUMBER], #241, #250 and #251). Residents Affected - Few The findings included: Review of the second floor Maintenance Report Logbook, located at the nurse's station, revealed the following: - Concern regarding roaches in room [ROOM NUMBER]-A on 06/12/24, documented as 'fixed' on the same day. - Infestation of roaches in room [ROOM NUMBER] and 241 on 07/28/24 reported by staff. During a room-by-room tour on 08/12/24 at 10:05 AM, the following observations were made: In room [ROOM NUMBER], 2 (two) live juvenile roaches and multiple dead roaches were observed behind the [NAME]. There was also one dead juvenile roach observed on the resident's bed, while the resident was sleeping. In room [ROOM NUMBER], 2 (two) live and mature roaches were observed on the wall and floor behind vacant bed-A. In room [ROOM NUMBER], 2 (two) live juvenile roaches were observed on the floor in the shared bathroom, live and dead roaches in all stages of life were observed behind a nightstand to the left of the air conditioning unit, and dead roaches were observed by the window bed. In room [ROOM NUMBER], numerous live mature and juvenile roaches were observed behind a closet to the left of the air conditioning unit. Two (2) dead roaches were observed on the floor by the window bed. During a room-by-room tour, on 08/12/24 at 10:43 AM, accompanied by the Maintenance Supervisor and the Director of Nursing (DON), the concerns regarding pests were acknowledged and observed by both the Maintenance Supervisor and the DON. On 08/12/24 at 11:20 AM, the Administrator and the Social Services Manager were made aware of the concerns. Page 1 of 2 105659 105659 08/12/2024 Lake Worth Rehabilitation Center 1201 12th Avenue South Lake Worth, FL 33460

F 0925 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During an interview, on 08/12/24 at 11:23 AM, with Staff B, when asked of the presence of roaches, Staff B stated, most of the time it is in the hallway, they have been treating the rooms. During an interview, on 08/12/24 at 11:59 AM, with Staff D, when asked of the presence of pests and roaches, Staff D replied, I have not seen them, but families have reported to me. I haven't heard any since maybe about a month ago. During a review of pest control invoices, dated from 05/09/24 to 08/06/24, it was noted that all the invoices documented no pest activity on the following dates: 05/09/24, 06/12/24, 07/10/24, 07/24/24 and 08/06/24. During an interview, on 08/12/24 at 12:28 PM, with the Pest Control Technician who treats the facility, when asked regarding the presence of pests and roaches, the Pest Control Technician replied, I have seen roach droppings, but they were dry. I have seen signs, but no live activity. The Pest Control Technician acknowledged that he was aware of the current infestation identified by the Surveyor and stated, I requested for them to empty out the resident's nightstands and move the residents so that I can do some extra treatments. The plan will be twice a week. 105659 Page 2 of 2