Health inspection·January 27, 2022

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to provide adequate and appropriate health care to address the edema (swelling) for 1 (Resident #8) of 15 residents reviewed for treatments and care. Residents Affected - Few The findings included: The facility policy titled Nursing admission Assessments and Orders with a revised date of 9/2017 read, . This initial or temporary plan of care is to address major medical needs/ concerns and total ADL [Activities of daily living] needs . The ADL needs of the resident and current care and treatment approaches shall be identified . on the MAR [Medication Administration Record] and TX [Treatment] records. Review of the admission Minimum Data Set (MDS) assessment with a target date of 1/20/22 showed Resident #8 was admitted to the facility on [DATE]. The active diagnoses included coronary artery disease (CAD), heart failure and hypertension (HTN). The Order Summary Report listed a physician's order with a start date of 1/20/22 for offloading boots to be placed to Resident #8's bilateral lower extremities (BLE) when in recliner every day and night shift for preventative measures. On 1/24/22 at 10:15 a.m., Resident #8 was observed sitting in a wheelchair in his room. His legs were not elevated. The resident's bilateral lower extremities were noted with edema (swelling caused by excess fluid trapped in the tissues), the right leg greater than the left leg. Resident #8 was wearing yellow socks and black shoes. The socks were rolled down to the ankle. Both lower legs were discolored. The right leg had dry, cracked skin. Resident #8 said he was being treated for the swollen legs. He was not wearing the offloading boots as ordered. The Interim admission Care plan dated 1/14/22 did not list interventions to address the edema of the resident's legs. On 1/24/22 at 2:38 p.m., Resident #8 was observed sitting in a recliner wearing yellow socks and black shoes. His legs remain swollen. The legs were not elevated, and the resident was not wearing the offloading boots as ordered. On 1/25/22 at 9:29 a.m., Resident #8 was observed awake and alert sitting in a recliner. Resident #8's legs were swollen with edema with the right being worse than the left. There was dry, cracked skin on Resident #8's right lower leg. Resident #8 was wearing yellow socks rolled down to his ankles and black shoes. The feet were in the down position and resting on the floor. (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 2 Event ID: 106070 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 106070 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/27/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Desoto Health and Rehab 475 Nursing Home Dr Arcadia, FL 34266 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)