Health inspection·June 8, 2023

F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure showers as per resident's choice for 1 of 6 sampled residents, and failed to ensure a right to choose the location to obtain care and services of a suprapubic catheter (urinary drainage device) for 1 of 1 sampled residents (Resident #56). The findings included: 1) During an interview on 06/05/23 at 2:59 PM, Resident #56 stated they used to get showers three times a week, but the schedule was changed to twice weekly. When asked how many showers she would like each week, Resident #56 stated she would like three. When asked if she had requested showers three times weekly, Resident #56 stated she had, and that staff had told her they schedule everyone to have showers twice weekly. Resident #56 stated she had asked why two showers a week and not three, and was not provided with an answer. Review of the record revealed Resident #56 was admitted to the facility on [DATE] and moved into her current room on 10/05/21. Review of the current Minimum Data Set (MDS) assessment dated [DATE] documented Resident #56 had a Brief Interview for Mental Status (BIMS) score of 15, on a 0 to 15 scale, indicating the resident was cognitively intact. The annual MDS completed on 02/04/23 documented it was very important for the resident to choose between a bath and a shower. Review of the current care plan initiated on 06/19/20 regarding the need for Resident #56 to have assistance with her Activities of Daily Living (ADLs), documented as of 11/10/22 that the resident preferred showers three times per week. Review of the task documentation for showers, completed by the Certified Nursing Assistants (CNAs), from November 2022 to June 2023, revealed the task was set up for Resident #56 to receive a shower every Monday, Wednesday, and Saturday, but documentation confirmed she only received showers twice weekly on Wednesdays and Saturdays. On Mondays the CNAs documented either N/A for not applicable, or BB for bed bath. During an interview on 06/08/23 at 10:05 AM, Staff F, Certified Nursing Assistant (CNA), was asked the resident shower process at the facility. Staff F stated that each resident was scheduled a shower twice weekly, but some residents want them three times a week. When asked how she knows the schedule or preferences, Staff F stated there was a shower book, and provided it from the nurses' station. Review of this shower book revealed a schedule that documented Resident #56 was scheduled for a shower on the 7 AM to 3 PM shift each Wednesday and Saturday. The CNA pointed out the addition of two residents who were scheduled three times weekly, neither of whom were Resident #56. When asked (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 9 Event ID: 106012 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 106012 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/08/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Life Care Center of Port Saint Lucie 3720 SE Jennings Rd Port Saint Lucie, FL 34952 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)