Health inspection·January 26, 2023

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 interview and record review, the facility failed to coordinate care with Hospice for 1 of 1 sampled resident for hospice care (Resident #9). There were 3 residents residing in the facility receiving hospice services at the time of the survey. Residents Affected - Few The findings included: Review of clinical records revealed, Resident #9 was admitted to the facility on [DATE], and readmitted on [DATE]. A comprehensive assessment dated [DATE] documented the resident had severe cognitive impairment, and required total two-person assist with activities of daily living. The assessment further documented the resident received hospice services. Resident #9 was care planned for hospice services on 03/28/22. An intervention dated 01/20/23 included: Hospice Nurse and Hospice CNA (Certified Nurse Assistant) to visit weekly/ as needed. Coordinate care and services via communication among staff. Record review revealed an order dated 03/26/22 for Resident #9 to be admitted under Hospice. An interview was conducted with the hospice nurse on 01/26/23 at 11:00 AM. The hospice nurse stated she comes once a week to evaluate Resident #9. The hospice nurse stated she communicates with the resident's nurse for any changes and updates. The hospice nurse provided documentation of such visits kept in a hospice binder at the facility's nursing station. The hospice nurse further stated Resident #9 received hospice CNA services 3 times a week. The hospice nurse stated the CNA does not leave any documentation at the facility, but does electronic charting through the hospice system. The hospice nurse stated the CNA used to make their own schedules, and just show up. Now the CNA has a set schedule, and was scheduled to visit Resident #9 on Monday, Tuesday, and Wednesday. The facility's Unit Manager (UM) overheard the above conversation and stated she did not see the hospice CNA yesterday (Wednesday). The UM presented a sign in sheet for hospice at the nursing station The sign in sheet last documented a visit from hospice on 01/07/23. When asked if there was any other place someone would have to sign in, the UM stated they would sign in at the front gate/garage prior to entering the facility. The surveyor requested documentation for hospice visits for Resident #9. An interview was conducted with Staff E, a CNA, on 01/26/23 at 11:30 AM. Staff E stated she did not know if Resident #9 was on hospice services. Staff E, CNA stated they alternate assignments, and she was a float (works where she is needed). Page 1 of 2 106076 106076 01/26/2023 VI at Aventura 19333 West Country Club Drive Aventura, FL 33180

F 0684 Level of Harm - Minimal harm or potential for actual harm An interview was conducted with Staff F, a CNA, on 01/26/23 at 11:35 AM. Staff F stated she works with Resident #9 frequently. The resident requires 2 persons assist. Staff F stated she usually gets assistance from restorative for care. Staff F stated she knows the resident receives hospice services, but the new CNA has not had any communication. Staff F stated they do not wait for the hospice CNA, because they don't know when they are coming. Staff F reported that hospice drops off supplies for Resident #9 on Fridays. Residents Affected - Few An interview was conducted with the hospice CNA via telephone on 01/26/23 at 11:40 AM. The hospice CNA reported that she saw Resident #9 on a regular basis, and asks the CNA if they need any help. She last saw the resident on Monday and Tuesday (01/23/23 and 01/24/23). The hospice CNA stated she was not aware of a sign in sheet at the facility, as she just started working with the resident a little over a month ago. The CNA stated she spoke to the CNA on Monday, but does not remember the CNA's name. The hospice CNA stated she did not speak with anyone on Tuesday. The hospice CNA stated she did not come to the facility on Wednesday (01/25/23). She usually drops off supplies on Friday. A copy of the hospice CNA's notes was provided by the hospice nurse. The hospice CNA has notes dated 01/23/23, 01/24/23, and 01/25/23 that documented care provided by the hospice nurse for Resident #9. A review of the sign in document from the front gate/garage prior to entering the facility revealed the hospice nurse signed into the facility grounds on 01/23/23 and 01/24/23. 106076 Page 2 of 2