Health inspection·February 7, 2024

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure that drugs and biologicals used in the facility were stored and labeled in accordance with currently accepted professional principles in 3 of 4 medication carts. Findings include: During an observation of 400 Hall Medication Cart on [DATE] at 9:18 AM with Staff B, Licensed Practical Nurse (LPN), there were one opened bottle of Timolol Maleate Ophthalmic Solution 0.5% eye drops for Resident #77 with no opened or expiration dates and one opened bottle of Latanoprost 0.005% eye drops for Resident #47 with no opened or expiration dates. During an interview on [DATE] at 9:23 AM, Staff B, LPN, stated, There is no open date or expiration date written on the eye drops. When the eye drops are opened, the date opened and the expiration date are written on the bottle. The eye drops expire in 28 days. During an observation of 300 Hall Medication Cart on [DATE] at 9:29 AM with Staff C, LPN, there was one opened Insulin Lispro 100 unit/ml (milliliter) Pen for Resident #65 with an expiration date of [DATE]. During an interview on [DATE] at 9:30 AM, Staff C, LPN, stated, The insulin is expired and should have been thrown away and replaced. During an observation of 100 Hall Medication Cart on [DATE] at 9:41 AM with Staff D, LPN, there were one bottle of Latanoprost 0.005% eye drops for Resident#16 opened on [DATE] and expired on [DATE], one bottle of Latanoprost 0.005% eye drops for Resident #14 with opened date of [DATE] and expiration date of [DATE], and one Novolog 100 unit/ml Flex pen for Resident #68 opened on [DATE] and expired on [DATE]. During an interview on [DATE] at 9:44 AM, Staff D, LPN, confirmed that the eye drops for Resident #16 and Resident #14 and insulin pen for Resident #68 were expired. During an interview on [DATE] at 9:58 AM, Staff E, LPN, Unit Manager, stated, Eye drops expire 30 days after they are opened, and insulin expires 28 days after it is removed from the refrigerator and opened. The Medications are to be removed from the cart returned to the pharmacy for destruction when they are expired. (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 3 Event ID: 105703 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 105703 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/07/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Arbor Trail Rehab and Skilled Nursing Center 611 Turner Camp Rd Inverness, FL 34453 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)