Health inspection·February 29, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and interviews, the facility failed to provide a clean, safe and home-like environment for 11 of 94 occupied areas. The findings include: On 2/28/24 at 10:34, during the initial tour of the facility, the following environmental concerns were observed: Occupied room [ROOM NUMBER]-B had a fall mat with brown-colored stains. Occupied room [ROOM NUMBER]-B had an overhead table with exposed edges. Occupied room [ROOM NUMBER]-B had a fall mat with brown-colored stains. Occupied room [ROOM NUMBER]-A had a fall mat with sticky tape covered with a dark brown substance. Occupied room [ROOM NUMBER]-B had a fall mat with sticky tape covered with a dark brown substance. Occupied room [ROOM NUMBER]-A had wall paper peeling off the wall and a patched up white substance on the wall. Occupied room [ROOM NUMBER] had overhead tables with the plastic rim detached, exposing particle wood. Occupied room [ROOM NUMBER]-A had an overhead table with edges that are chipped. Additionally, the bed's frame is rusted. Occupied room [ROOM NUMBER]-A had an overhead table with the plastic rim detached, exposing particle wood. Occupied room [ROOM NUMBER]-B had an overhead table with the plastic rim detached exposing particle wood, and dresser also had particle wood exposed on the edges. In the public 200 Hallway, there was an approximately 6 foot long baseboard that was detached from the wall. Page 1 of 3 105764 105764 02/29/2024 Aviata at the Gardens - Tallahassee 1650 Phillips Rd Tallahassee, FL 32308

F 0584 (Photographic evidence was obtained) Level of Harm - Minimal harm or potential for actual harm On 2/29/24 at 12:50, a follow-up tour was conducted with the Administrator, DON and Regional Consultant. The Administrator stated all the overhead tables and the fall mat would be replaced for new ones. The DON stated the wall paper in room [ROOM NUMBER] would be replaced immediately. The Administrator further stated the bed in room [ROOM NUMBER]-A would be fixed by a new one once the impending shipment arrived. Invoices showing this bed was ordered was requested but were not provided. Residents Affected - Few 105764 Page 2 of 3 105764 02/29/2024 Aviata at the Gardens - Tallahassee 1650 Phillips Rd Tallahassee, FL 32308

F 0755 Level of Harm - Minimal harm or potential for actual harm Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Based on record review and staff interview, the facility failed to administer a medication as ordered by a physician for 1 of 3 resident sampled for medication administration. (Resident #2) Residents Affected - Few The findings include: On 2/29/24, a review of Resident #2's medical record was conducted. A physician order stated to inject dexamethasone sodium phosphate (a medication used to treat many inflammatory and autoimmune disorders) 8 mg intramuscularly one time only for pain related to gout. This order was dated 12/29/24 with an end date of 12/30/24. The physician order summary was reviewed and stated it was completed. The Resident's Medication Administration Record (MAR) revealed medication was not documented as given on 12/29/23 and on 12/30/23 documentation was signed with nurse initials BT31 with a code number 9 that indicated see progress notes. A review of progress notes dated 12/30/23 at 00:40 AM and signed by Staff A, a Licensed Practical Nurse (LPN) stated dexamethasone sodium phosphate injection solution medication unavailable to administer. On 2/29/24 at 11:22 AM, an interview was conducted with Director of Nursing (DON). She reviewed Resident #2's medical record and stated the facility kept the medication onsite. She further stated Staff A, LPN, should have notified and follow up with the doctor. The DON added that this omission should not have happened. 105764 Page 3 of 3