Health inspection·April 10, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 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. Based on observation, and interview, the facility failed to provide a homelike dining experience in the day/dining rooms on both nursing units for all residents who ate their breakfast and dinner meals there. This affected 29 residents at the two observed meals with the potential to affect all residents who chose to eat their meals in the unit's day/dining rooms. Findings: The facility's main dining room was noted during the survey dates from 4/08/25 to 4/10/25 not to be open for residents to eat their breakfast or dinner meals. For breakfast and dinner, residents were able to eat in the day/dining room on either of the two nursing units, or in their bedroom. On 4/08/25 at 8:10 AM, six residents were observed as they ate breakfast in the day room on the 100's unit. The meals for each resident were served with their dishes, drinks, and flatware left on the meal trays from which they ate, which created an institutional appearance. There were also no centerpieces or linen on the tables. A few minutes later, at 8:20 AM, twelve residents were observed as they ate breakfast in the 200's unit dayroom which also had no centerpieces or table linens and residents eating from trays at the tables. On 4/10/25 at 8:54 AM, eleven residents were observed as they ate breakfast in the 200's unit day/dining room with their meal dishes on their meal trays. A table with four residents eating their meal from their trays with the lids from the main plates stacked in the center of the table, instead of a centerpiece. The residents at the table stated they usually ate breakfast and sometimes dinner in the unit day rooms. They explained the tables were crowded with their trays and the lids on it. Resident #59 stated it was better at lunch when the trays were removed and the dishes with food were placed on the table. She stated they also used to have flower centerpieces on the table which made it nicer. On 4/10/25 at 8:56 AM, the Activities Director stated she never noticed that meal items were left on the trays during breakfast meal service, but was sure dishes, drinks and flatware were removed and placed on the tables during lunch at the main dining room. She added she would make sure to discuss making the environment more homelike in the unit dayrooms/dining rooms, with the Administrator. At 9:30 AM , the Administrator and Regional [NAME] President of Operations stated they were aware the unit dining areas were not homelike and were going to be ordering linen tablecloths for them. They stated they were also going to spruce up the environment with plants, art, and other decorations so the residents felt like it was their home and not like they were trapped in an institution. They stated they want it to be decorated for the resident's enjoyment. Page 1 of 3 105888 105888 04/10/2025 Aviata at St Cloud 4641 Old Canoe Creek Road Saint Cloud, FL 34769

F 0584 Level of Harm - Minimal harm or potential for actual harm On 4/10/25 at 12:58 PM, Certified Nursing Assistant (CNA) B explained they left the dishes on the trays when the residents ate in the unit day rooms at breakfast and dinner for no specific reason, it was just how they did it. She acknowledged it was important to make the environment homelike for residents as it was their home and made them, especially the more confused residents, feel more like they were at home rather than an institutional facility. Residents Affected - Some On 4/10/25 at 1:05 PM, CNA A stated she had worked there for a long time and they had never been told to remove the dishes from the meal trays when serving meals in the unit dayrooms, only in the main dining room. She added, we always did it this way. The facility's policy entitled, Meal Distribution, dated February 2023, did not include information for providing a homelike dining experience for residents. 105888 Page 2 of 3 105888 04/10/2025 Aviata at St Cloud 4641 Old Canoe Creek Road Saint Cloud, FL 34769

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observation, and interview, the facility failed to implement hand hygiene protocol for residents to help prevent the development and transmission of communicable diseases and infections for 23 residents who ate meals in the dining room. Residents Affected - Some Findings: On 4/07/25 at 11:49 AM, in the facility main dining room, 23 residents were observed as they were assisted to their tables to dine. Several residents stated they arrived from physical therapy. None of the residents were offered a way to clean their hands before they ate. A short time later at 12:12 PM, staff sat next to and provided meal assistance to four residents without providing hand hygiene for them. On 4/10/25 at 8:58 AM, Certified Nursing Assistant (CNA) D explained that several years ago they used to hand out wipes to residents to clean their hands before they ate but over time that practice stopped. She added, it would be a good thing to do that again because cleaning hands was important to help stop the spread of germs. CNA D said the residents often touched their food while eating and they could have germs on their hands. On 4/10/25 at 9:03 AM, CNA C explained they never reminded residents to wash their hands or offered hand hygiene prior to eating meals during the two years she had worked at the facility. CNA C acknowledged that staff could offer the residents disinfectant gel or wipes to clean any germs or dirt from their hands. On 4/10/25 at 12:58 PM, CNA B stated it was important for people to wash their hands before eating because germs were everywhere. She said there was, .no saying what the residents have touched prior to their eating. CNA B added staff had never been told to clean the resident's hands before meals, and she just hadn't thought about it herself. On 4/10/25 at 1:05 PM, CNA A did not remember ever washing resident's hands prior to eating meals in the past 20 years since she had worked there. She stated it was important in order to not spread germs. On 4/10/25 at 3:12 PM, the facility's Infection Preventionist stated it was important for people to wash their hands before they ate and she was sure the facility had provided education on the importance of hand hygiene before meals last year. She added this was common knowledge we all learned as a child and as nursing staff, we know this. The Infection Preventionist said she was disappointed that nursing staff stated they were never educated or did not know to offer to clean residents' hands prior to mealtimes. She added, washcloths, hand wipes and disinfection gel were all available for use. The facility's policy entitled Handwashing/Hand Hygiene, dated 2019, stated the facility considered hand hygiene as the primary means to prevent the spread of infections and staff should make sure to clean their hands before and after assisting a resident with meals. The policy indicated residents would be encouraged to practice hand hygiene, but did not specify staff should offer hand hygiene to residents prior to meals. 105888 Page 3 of 3