Health inspection·April 3, 2024

F 0569 Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death. Level of Harm - Minimal harm or potential for actual harm Based on record review and interview the facility failed to ensure that within 30 days of discharge, eviction or death, residents personal funds and a final accounting is provided to the individual or probate jurisdiction administering the estate for 1 (Resident #1) of 3 residents reviewed discharged mid month. Residents Affected - Few The findings included: On 4/1/24 at 9:53 a.m., Resident #1's son said his mother passed away on January 13, 2024. He said he had still not received a refund from the facility. Resident #1's son said he spoke with someone he believed to be corporate in New Jersey approximately 5 weeks earlier who told him the refund was approved but they were waiting for the check to be cut. Resident #'1's son said he had not yet received a check and had heard nothing since. On 4/1/24 at 1:33 p.m., the Administrator said if a Resident is discharged or passed away, the business office has to issue a refund from that date to the end of the month. He explained the request for refund is handled at the facility but the disbursement is by a third party company. On 4/1/24 at 2:17 p.m., the Administrator said he reviewed Resident #1's account. He said the account was actually closed on 2/21/24 by account rep who works for the third party company. The Administrator said in looking through the account it did look like the refund check was never mailed out. The Administrator said he cannot answer why they did not cut the check and mail it. The Administrator said they are going to go back and audit to make sure there are no other outstanding accounts like that. He said it was an oversight and does not know why it wasn't done. 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: 105702 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 105702 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/03/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Vivo Healthcare Meadows 5157 Park Club Drive Sarasota, FL 34235 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)