Inspection·August 3, 2023

F 0583 Keep residents' personal and medical records private and confidential. Level of Harm - Minimal harm or potential for actual harm Based on observation, record review, staff interview, and facility policy and procedure review, the facility failed to ensure residents' personal privacy during medical treatment for one (Resident #1) of two residents observed during medication administration. Resident #1 was not provided privacy during medication administration via her gastrostomy tube (feeding tube). Residents Affected - Few The findings include: On 8/2/23 at 1:00 p.m., Licensed Practical Nurse B was observed preparing medications for Resident #1. A review of the resident's medication orders revealed that all her medications were administered through her gastrostomy tube (feeding tube). LPN B was observed administering two medications through the gastrostomy tube to Resident #1. LPN B did not provide privacy to the resident during the medication administration process. LPN B did not pull the privacy curtain or close the door to the room. The resident was visible from the hallway during this medication administration. LPN B then prepared an additional medication that was due but did not provide privacy to the resident during the medication administration process. LPN B did not pull the privacy curtain or close the door to the room. LPN B was asked how she provided privacy to residents during medication administration. She stated, By pulling the curtain. She was asked why she did not provide privacy for Resident #1 during her medication administration. She replied, I don't know, I guess I just thought because you were watching I didn't have to. A review of facility policies and procedures revealed: Medication Administration (revised 4/28/23) Policy Explanation and Compliance Guidelines: 7. Provide privacy Medication Administration via Enteral Tube (revised 4/28/23) 8. Procedure: d. Provide privacy by pulling the privacy curtain or closing the door to a private room. . 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: 105743 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 105743 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Fleet Landing One Fleet Landing Blvd Atlantic Beach, FL 32233 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)