Inspection·August 15, 2024

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure 1 of 2 residents reviewed for Care Planning were offered participation in plans or revisions to their care, of a total sample of 40 residents, (#65). Findings: Review of the medical record revealed resident #65, a [AGE] year old female was admitted to the facility on [DATE], and readmitted from an acute care hospital on 5/26/24 with diagnoses of malnutrition, type 2 diabetes mellitus, adjustment disorder with anxiety and depressed mood, gastrostomy (feeding tube) status, and acute duodenal (intestine) ulcer with perforation. The most recent Minimum Data Set (MDS) admission 5-day Assessment with an Assessment Reference Date (ARD) of 6/02/24 noted during the look back periods, the resident scored 12 out of 15 on the Brief Interview for Mental Status (BIMS) that indicated her cognition was moderately impaired. There were no signs and symptoms of delirium or rejection of care necessary to achieve health and well-being goals. The resident scored 13 out of 27 on the PHQ-2 to 9© (Resident Mood Interview) that indicated moderate depression, and she felt down, depressed, or hopeless nearly every day. The assessment showed the resident's customary routines and activities preferences were very important to her, and she required a feeding tube to sustain nutrition and hydration. The Order Summary Report included active physician's orders for nothing by mouth (NPO) diet, regular diet, regular texture, thin consistency, meat cut into bite size, sandwiches with lunch/dinner, no straw, and J (small intestine) tube/surgical site care. On 8/12/24 at 10:53 AM, resident #65 was observed sitting in a wheelchair in her room while her family representative visited. The resident was visibly upset when she said although she had asked staff on multiple occasions, they hadn't kept her updated about having her feeding tube removed. She stated, Maybe it's going to happen on Wednesday. Review of the Comprehensive Care Plan included focuses, goals, and interventions that included nutrition and hydration with a mechanically altered diet and tube feeding. The care plan showed resident #65 was at the facility for short term placement, and the resident/representative clearly expressed a desire to discharge from the facility. It was noted the resident had an alteration in mood as evidenced by adjustment disorder with mixed anxiety and read, endorses depressed mood. During an interview on 8/12/24 at 10:54 AM, the resident's representative conveyed the resident had (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: 105885 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 105885 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Viera Healthcare and Rehabilitation Center 8050 Spyglass Hill Rd Viera, FL 32940 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)