Inspection·November 7, 2024

F 0678 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on staff interviews and review of the Electronic Medical Record (EMR), the facility failed to properly document the residents code status preference (preference on whether life saving measures should be implemented should the person's heart or breathing stop) and advance directives for 2 of 5 residents reviewed. (Resident #48 and #327) The findings include: On 11/05/24 at approximately 10:28 AM, an initial review of the EMR and paper chart for Resident 48 and 327 was performed. A record review including the EMR and paper chart revealed that Resident #48 was admitted on [DATE], but the code status and advaned directives were not documented in the EMR or paper chart at the time of the record review. A review of the Order Summary Sheet signed by the physician on 11/1/2024 does not include code status orders for Resident #48. A record review including the EMR and paper chart revealed that Resident #237 was admitted on [DATE], but the code status and advaned directives were not documented in the EMR or paper chart at the time of the record review. A review of the Order Summary Sheet signed by the physician on 11/1/2024 does not include a code status orders for Resident #237. On 11/05/24 at approximately 3:12 PM, an interview with Staff A, a Registered Nurse (RN) supervisor, revealed that sometimes the floor nurses transcribe admission orders if they do not have a supervisor available. On 11/05/24 at approximately 03:30 PM an interview with the Social Services Director revealed she is responsible for having the discussion about advance directives and code status with all new admissions. She communicates the resident's code status preference with the nursing staff, who is responsible for putting the order in the EMR. On 11/06/24 at approximately 08:41 AM, afollow up with Staff A was performed. She was asked where the code status of the residents is found. She stated it would be in the physician's orders and on the Medication Administration Record (MAR) of the resident. Staff A was asked to show the code status order for Resident #48 and #237. Staff A reviewed the orders in the EMR and paper chart for Resident #48 and #237 and acknowledged the code status and advanced directives were missing. On 11/06/24 at approximately 09:40 AM, during an interview with Director of Nursing (DON), she explained that the expectation is that code status would be entered by the admitting nurse who is entering orders. This may be a supervisor or the nurse on the cart depending on the time/day of the admission. She stated that every new admission has a partners in care meeting in the first 72 hours (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: 105860 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 105860 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/07/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Century Center for Rehabilitation and Healing 6020 Industrial Blvd Century, FL 32535 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)