Inspection·January 13, 2025

F 0919 Make sure that a working call system is available in each resident's bathroom and bathing area. Level of Harm - Minimal harm or potential for actual harm Based on staff interview, resident interview, observations and resident medical record review, it was determined that the facility failed to ensure the residents' right to call light access for two residents (Resident #3 and Resident #4) out of eight residents observed during the survey. Residents Affected - Few The findings included: During an initial tour of the facility which commenced on 1/13/25 at 10:00 a.m., Resident #3 was observed sitting up in her wheelchair on the window side (left side) of her bed. There was no call light observed within her reach. In an interview with Resident #3 conducted on 1/13/25 at 10:05 a.m., she was asked how she would get the staff's attention if she needed anything. She stated I guess I'd push the button. Oh, wait this is the TV remote. I don't know where the button is. The call light was observed to be on the floor, on the opposite (right) side of her bed from where she was sitting, out of her reach. She was asked if she could reach her call light where it was. She smiled and said, No, how could I get there? She was asked if her call light was usually within her reach. She stated, Not always. I can't reach it now. Photographic evidence obtained. Employee A, a certified nurses' aide (CNA) entered the room at 10:17 a.m. He was asked if he was caring for Resident #3 today. He stated yes. He was asked if she had access to a call light. He looked around and stated, Oh, it's on the floor. He was asked to confirm the call light was out of the resident's reach. He stated, When I made her bed earlier, I forgot it. I usually only work the weekends, so she is usually in bed when I am working, and I usually attach her to her blankets. She got up today and I must have forgot it because I'm not used to her being up. A medical record review conducted for Resident #3 revealed: An MDS (Minimum Data Set) admission assessment conducted on 12/27/24 revealed a Brief Interview for Mental Status (BIMS) score of 10. A score of 8-10 suggests moderate cognitive impairment. Further record review for Resident #3 revealed a care plan which showed: Focus: (12/28/24): I have impaired balance and weakness. I have impaired cognition. Goal: I will have no falls with current interventions through the next review date. (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: 106090 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 106090 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Benderson Family Skilled Nursing and Rehab Center 1959 N Honore Ave Sarasota, FL 34235 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)