Inspection·July 15, 2025

F 0553 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Allow resident to participate in the development and implementation of his or her person-centered plan of care. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews, record review and facility policy review, the facility failed to invite resident to care plan meetings for 1 of 3 residents sampled. (Resident #2)The findings include:On 7/14/25 at 5:02 PM, an interview was conducted with Resident #2. She stated she had not participated in any care plan meeting since she arrived at the facility. She further stated she had not been invited to any care plan meeting. A review of Resident #2's medical record was conducted with Staff A, the MDS coordinator. Resident #2 was admitted on [DATE]. A record of the most recent care plan meetings indicated they were conducted on 5/2/25, 2/27/25 and 11/29/24. Care plan meeting forms were signed and dated by Staff A and the Social Services Director. There was no indication that Resident #2 was in attendance. On 7/15/25 at 9:27 AM, an interview was conducted with Staff A. She stated that Resident #2 did not participate in the care plan meetings. She was unsure of the reason Resident #2 did not attend. A review of the facility's policy and procedure was conducted. The facility policy titled, Care Plan Invitation, dated 11/30/2014, revised 9/25/2017, stated The resident and/or the resident representative shall be invited to attend each of the interdisciplinary Care Planning Conferences for the specific resident. Deliver a Care Planning invitation to the resident 7-14 days prior to the date of the conference Place a copy of the invitation in the medical record. Request that the resident and/or resident representative contact the facility designee to confirm or reschedule the date/time for the resident's conference. Have all attended to the Care Planning Conference, including resident and resident representative sign the Care Plan Conference Record to verify their attendance. 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: 105764 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 105764 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Aviata at the Gardens - Tallahassee 1650 Phillips Rd Tallahassee, FL 32308 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)