F 0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
record review and interview, the facility failed to provide follow-up care for a surgical wound in a timely
manner as evidenced by not attending to follow up surgical appointment and not informing the surgeon of
the worsening condition of the resident's wound for 1 of 3 sampled residents (Resident #1).The findings
included:Record review revealed Resident #1 was admitted to the facility on [DATE] with diagnoses
included Diabetes, Chronic Kidney Disease, and Right Below the Knee Amputation, status post left foot
toes amputation. A comprehensive assessment dated [DATE] documented the resident was cognitively
intact and required partial/moderate assistance with activities of daily living. A review of Resident #1's care
plan revealed the resident did not have a care plan for the left foot surgical wound. A review of Resident
#1's orders revealed an order dated 03/10/25 for intravenous (IV) antibiotics for 25 days (until 04/05/25) ,
and an order dated 03/12/25 to follow up with the surgeon and infectious disease.A review of Resident #1's
records did not reveal any documentation of the resident's left foot surgical wound's condition, or any
treatment provided from admission on [DATE] until 03/17/25. Further review of Resident #1's orders
revealed an order dated 03/17/25 for wound care to cleanse the foot surgical wound with Normal Saline
and apply a dry dressing one time only. An order dated 03/19/25 documented for a dressing change to left
foot to cleanse with Normal Saline, and apply a wound vacuum-assisted closure (vac) three times a week
on Monday, Wednesday, and Fridays. A review of Resident #1's Treatment Administration Record (TAR)
revealed that the dressing change and wound vac were applied on 03/21/25. However, there is no
documentation indicating that the treatment was performed on 03/24/25 and 03/26/25. Additionally, no
explanation was provided for the missed treatments on those dates.Record review revealed an order dated
03/20/25 for an appointment with the surgeon on 03/27/25 at 3:15 PM. An order dated 03/25/25
documented an appointment with infectious disease on 04/01/25 at 2:30 PM. A review of Resident #1's
progress notes revealed a note dated 03/27/25 at 8:02 PM that documented Resident #1 went to a doctor
visit for his wound today. No new orders received. Resident has a follow up appointment on 04/10/2025 at
2:30 PM. Plan of care ongoing.A review of a progress note dated 04/01/25 at 9:53 PM documented
Resident #1 returned from a doctor's appointment. Orders received to continue IV antibiotics until 04/05/25,
then remove IV line. A follow up with podiatrist (surgeon) will be necessary.Further record review did not
reveal any documentation of the resident's left foot surgical wound's condition, or any treatment provided
until 04/26/25. A progress note dated 04/26/25 at 3:32 PM documented Resident #1's left foot wound
culture was positive for Pseudomonas, antibiotics were changed and the resident was to continue to follow
up with the surgeon. Record review did not provide any evidence that Resident #1 went to his scheduled
surgeon appointment on 04/10/25. Furthermore there was no evidence Resident #1's surgeon was notified
of a change in the condition of the resident's wound.A review of Resident #1's progress notes dated
04/30/25 revealed the resident had an appointment with infectious disease, and an IV antibiotic was
initiated. Again, there was
Residents Affected - Few
(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 2
Event ID:
105795
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
105795
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
07/02/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Aviata at Coral Bay
2939 S Haverhill Rd
West Palm Beach, FL 33415
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)
F 0684
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
no evidence that Resident #1's surgeon was notified of a change in the resident's wound.A review of a
physician progress note dated 05/02/25 at 2:28 PM documented: Wound is reviewed with wound care
nurse, wound vac was on place, after removed showed infected tissue, fetid (bad smelling), with bone
exposure and discoloration and soft area of bone consistent with osteomyelitis, purulent discharge, foul
smell, Meropenen (antibiotic) on IV BID (twice daily) X 10 days, follow up with ID (infectious disease) and
foot surgeon will be arranged by nursing.Further record review revealed Resident #1 was transferred to the
hospital on [DATE] for evaluation of the left foot wound. Resident #1 returned to the facility on [DATE]. There
was no documentation of Resident #1's surgeon being notified of the change in the resident's
wound.Record review revealed an order dated 05/05/25 for an appointment with resident #1's surgeon on
05/07/25 at 2:15 PM.A review of Resident #1's progress notes dated 05/07/25 at 3:55 PM documented
Resident #1 returned back from the doctor's office with an order to send the resident to the hospital for
evaluation.An interview was conducted with the Director of Nursing (DON) on 07/02/25 at 3:00 PM. The
DON acknowledged the above.
Event ID:
Facility ID:
105795
If continuation sheet
Page 2 of 2