Health inspection·June 19, 2023

F 0554 Allow residents to self-administer drugs if determined clinically appropriate. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure medications were administered by a licensed nurse and not stored on an over bed table for self-administration for one (#4) out of three sampled residents. Residents Affected - Few Findings Included: On 06/19/2023 at 10:00 a.m., the west unit was toured and revealed a souffle cup sitting on top of an over bed table. The cup was observed with multiple pills that ranged in different sizes and colors. Resident #4 was not in the bedroom at the time (photographic evidence obtained). At 10:11 a.m., Staff A, Assistant Director of Nursing (ADON) was in the hallway, and was asked who administered medications on the west unit. She stated, she's right there. The ADON went to the nursing station and returned shortly with Staff B, Registered Nurse. At 10:12 a.m., Staff B, along with the ADON observed the cup of medications on Resident #4's, over bed table. At that time, the ADON pushed the souffle cup next to the tissue box. Staff B stated, he can take his own medications. He went to take a shower first then to physical therapy. The ADON and RN were asked if the resident had a self-administration assessment. They left the bedroom and returned to the nursing station. The medications remained unsupervised on the over bed table. Staff B provided a copy of Resident #4 Self Administration of Medication Evaluation form with Effective Date: 01/10/2023. Review of the form Instructions: Complete this assessment prior to resident initiating self administration of medication and with any medication order changes, changes in function/condition that might affect the resident ability to safely self administer medications. A. List all medications that are being considered for resident self administration. List medication, route, dose and frequency. Number of medications considered for self administration Medication #1 order: albuterol inhaler, Medication #2 order: anoro elipata. At 10:28 a.m., the Director of Nursing (DON) was asked about their process on leaving medications at the bedside. He did not immediately respond. The DON observed the medications that remained on Resident #4's over bed table and removed the cup. The DON confirmed medications should not be left unattended. He was informed the ADON and Staff B had observed the cup of medications on the table and left the bedroom and the medications indicating it was common practice. The DON confirmed it was not a facility practice to leave medications unsupervised. Page 1 of 2 105697 105697 06/19/2023 East Bay Rehabilitation Center 4470 E Bay Dr Clearwater, FL 33764

F 0554 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Medical record of Resident #4 admission Record form revealed he had resided at the facility over two years and was geriatric in age. The diagnosis information listed constipation, benign prostatic hyperplasia, anemia, type 2 diabetes, hypoglycemia, major depression disorder, hypertension, and Parkinson's disease. Review of Physician orders showed, May self-administer inhaler medications WITH SUPERVISION, dated 07/01/2022. On 06/19/2023 at approximately 1:00 p.m., the DON provided a copy of Resident #4's Progress note dated 06/19/2023 at 11:07 a.m., all 9 am medications were appropriately administered at 10:50 a.m. On 06/19/2023 at 3:57 p.m., an interview was conducted with Resident #4. He confirmed he had a shower this morning and went to physical therapy. Resident #4 stated, I don't know how many pills in the morning I'm supposed to have. He denied knowing the names of the pills and what they were for. Resident #4 stated a lot of them leave my medications on the table. I don't know who they are, but it happens a lot. Resident #4 stated I just take them when I return to my room. Review of facility policy Preparation and General Guidelines dated August 2014. II2 Medication Administration General Guidelines Policy: Medications are administered as prescribed in accordance with good nursing principles and practices and only by persons legally authorized to do so. Personnel authorized to administer medications do so only after they have been properly oriented to the facility's medication system (procurement, storage, handing, and administration). Procedures A. preparation 4) FIVE RIGHTSRight resident, right drug, right dose, right route, and right time, are applied for each medication being administered. B. Administration 4). When medications are administered by a mobile cart taken to the resident location medications are administered the time, they are prepared. 7) The person who prepares the does for administration is the person who administers the dose. 14) Residents are allowed to self-administer medications when specifically authorized by the attending physician and in accordance with the procedures for self-administration of medications. 17) For residents not in their rooms or otherwise unavailable to receive medications on the pass, the MAR is flagged with [tags, colored plastic strips, drinking straw, or paper clips]. After completing the medication pass, the nurse returns to the missed resident to administer the medication. 18) The resident is always observed after administration to ensure that the dose was completely ingested. 105697 Page 2 of 2