Health inspection·March 30, 2023

F 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure respiratory care services were provided consistent with professional standards of practice for oxygen administration for 1 of 3 residents reviewed, Resident #25. Residents Affected - Few Findings include: During an observation on 3/26/2023 at 10:00 AM, Resident #25 was lying in bed, with oxygen being administered via a nasal canula. The oxygen concentrator was set at 3 liters per minute (L/min). During an observation on 3/27/2023 at 9:01 AM, Resident #25 was lying in bed, with oxygen being administered at 3 L/min. During an observation on 3/28/2023 at 8:34 AM, Resident #25 was being administered oxygen at 3 L/min. Review of the physician order dated 8/17/2022 for Resident #25 reads, Oxygen at 2 liters/ minute continuously per nasal cannula. Document O2 Sats [oxygen saturation] q [every] shift. During an interview on 3/28/2023 at 11:30 AM, Staff A, Licensed Practical Nurse (LPN), confirmed the oxygen concentrator was set at 3 L/min. Staff A verified that the physician's order was for 2 liters/minute continuously per nasal cannula. During an interview on 3/28/2023 at 11:45 AM, the Assistant Director of Nursing stated, It is my expectation that the nurses check to make sure the oxygen levels are correct daily on their shift. Review of the facility policy and procedure titled Oxygen Administration/ Safety/ Storage/ Maintenance issued 12/3/2022 read, Policy: Oxygen will be administered in accordance with physician orders and current standards of practice. 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: 105999 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 105999 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/30/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Life Care Center of Ocala 2800 SW 41st St Ocala, FL 34474 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)