Health inspection·August 31, 2023

F 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some called and left her a message. She stated she has been out of the facility since Tuesday (8/29/23) and had not yet addressed the medications that were not administered on 8/26/23. A telephone interview was conducted with Employee A (LPN) on 8/31/23 at 3:16 PM. The nurse stated she was the only nurse on the south unit for the 11:00 PM-7:00 AM shift beginning on 8/25/23 and ending on 8/26/23 and was responsible for 58-60 residents. The Director of Nursing (DON) reported that another nurse was coming in but was running late. The DON had worked the 3:00 PM- 11:00 PM shift on the south unit and asked her to take both medication carts 1 and 2 on the south unit. Employee A stated she attempted to inform the DON of the situation by texting the DON around 1:30 AM on 8/26/23, and then attempted to call around 2:00 AM on 8/26/23, but the call went to voicemail. She notified the nurse on the north unit, and they attempted to call the DON again, but the call still went to voicemail. The DON called back around 3:30 AM on 8/26/23 and stated she was under the assumption that a nurse was supposed to come in. Employee A stated none of the residents on south medication cart 2 had received morning medications, blood sugar checks, or insulin as ordered by the physician on the morning of 8/26/23. She could not administer medications to 60 residents, but she did check on the residents to ensure they were stable. No one came in to assist her on the shift and she did not know if the DON attempted to call anyone in. She reported to the 7:00 AM- 3:00 PM nurse that came in on 8/26/23 that the residents on south medication cart 2 had not received their morning medications. An interview was conducted with Resident #3 on 8/31/23 at 2:12 PM. She stated she had missed a few of the morning doses of her physician ordered insulin. A review of Resident #1's August 2023 medication administration record (MAR) revealed the resident had physician orders receive insulin glargine 32 units subcutaneous daily at 6 AM, hydralazine 25 mg one by mouth every 8 hours at 6 AM, 2 PM, and 10 PM, and blood glucose checks every morning at 6:30 AM. The MAR was blank for the 6 AM medications and the 6:30 AM blood glucose check on 8/26/23. A review of Resident #2's August 2023 MAR revealed the resident had physician orders to receive levothyroxine 175 mg by mouth daily at 6 AM. The MAR was blank for the 6 AM dose on 8/26/23. A review of Resident #3's August 2023 MAR revealed that the resident had physician orders to receive Novolog insulin 10 units subcutaneous before meals with a dose at 6:30 AM and a blood glucose check at 6:30 AM daily. The MAR was blank for the administration of the insulin and blood glucose check at 6:30 AM on 8/26/23. A review of Resident #4's August 2023 MAR revealed the resident had physician orders for insulin glargine 30 units subcutaneous daily at 6 AM, omeprazole 40 mg by mouth every morning at 6 AM, and a blood glucose check at 6:30 AM daily. The MAR was blank for the administration of the insulin, omeprazole, and blood glucose check at 6:30 AM on 8/26/23. A review of Resident #5's August 2023 MAR revealed the resident had physician orders for Zoloft 100 mg by mouth daily at 6 AM, pantoprazole sodium 40 mg by mouth twice daily with a dose scheduled for 6 AM, sucralfate 1 gram by mouth before meals and at bedtime with a dose scheduled for 6:30 AM, and a blood glucose check before meals and at bedtime with one scheduled for 6:30 AM daily. The MAR was blank for the 6 AM and 6:30 AM doses of medications and the 6:30 AM blood glucose check. Review of the facility assessment (updated 7/19/23) revealed on page 8 that the facility's overall staffing plan is based on an hours per patient day basis and utilizes both historical and current labor data, census, census mix, resident acuity, all resident care and support needs, and an analysis (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105975 If continuation sheet Page 2 of 3 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 105975 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/31/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Community Health and Rehabilitation Center 3611 Transmitter Road Panama City, FL 32404 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 0725 Level of Harm - Minimal harm or potential for actual harm of how well the facility met/is meeting all of the needs of the resident population. The facility is to meet this overall staffing plan on a constant basis and adjust as needed for changes in census, acuity, and resident care and support needs. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105975 If continuation sheet Page 3 of 3