Inspection·September 21, 2023

F 0585 Level of Harm - Minimal harm or potential for actual harm Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Based on policy review, interview, and record review, the facility failed to act upon a grievance voiced by a resident regarding care for 1 of 2 sampled residents (Resident #266). Residents Affected - Few The findings included: Policy titled complaints/grievances of resident/family member. Revised date January 2018. Department approval: Director of social services. The objective included: to ensure that all residents have complaints addressed to their satisfaction; to provide a mechanism for residents to access a grievance process. The procedure included: Complaints received by social services or staff member: 1.the staff member brings the complaint to their department manager immediately. 2.the social service director or department manager arranges a meeting with the involved discipline and the resident and/or family member where attempts shall be made to resolve the issues. 3.a resident/family complaint/grievance resolution form is completed and forwarded to the director of social services who will present the data at the quality assurance/performance improvement committee meeting. Record review revealed Resident #266 was admitted to the facility on date 09/07/23. The admission Minimum Data Set (MDS) assessment, reference date 09/18/23 documented a brief interview for mental status score (BIMS) of 15, indicating Resident #266 was cognitively intact. This MDS documented no mood and behavior issue. The MDS revealed Resident # 266 required total assistance from the staff with activities of daily living (ADLs), including: bed mobility, locomotion on and off unit, toilet use and personal hygiene. Review of the comprehensive care plan dated 09/14/23 revealed Resident #266 needed total assistance in almost all aspects of care. Interventions included: to anticipate and meet her needs, explain plan of care, and Promote dignity by ensuring privacy. Review of the grievance log dated for September 2023 revealed no documented evidence of grievance for Resident #266. Review of progress note dated 09/18/23 (a late entry note) written by the social worker, the note indicated, on Friday 09/15/23 I (social worker) received a message from Resident (#266's) daughter that Resident (#266) was complaining that she needed to be changed. Upon speaking to nursing staff, the attending nurse advised that (Staff A) was Resident (#266's) certified nursing assistance (CNA). The attending Nurse stated that Staff A was with another resident giving care and had already spoken with Resident (#266) and told her that she would change her when she's done giving care to the other resident. It was explained to Resident (#266) that CNA had other residents and would provide care to her when finished. Resident (#266) verbalized understanding. (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 3 Event ID: 106018 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 106018 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Glades Health Care Center 230 South Barfield Highway Pahokee, FL 33476 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)