Health inspection·February 4, 2021

F 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Resident #60 felt uncomfortable with this CNA. The POA said she had taken the concern to the Administrator numerous times, most recently the prior week. The Administrator said CNA Staff K would no longer be assigned to care for Resident #60. On 2/2/21 at 4:09 p.m., during an interview Social Services Director Staff V said he was working part-time in facility and the Administrator had been handling grievances. SSD Staff V said the normal process dealing with complaints and grievances was anyone can write a grievance. When he hears of a grievance in morning meeting, he talks to the resident, identifies the matter, and hands it to appropriate authority to address. Once the investigation is completed, he reviews it and then it would go to the Administrator. On 2/2/21 at 4:50 p.m., during an interview the Administrator said he was not aware of any grievances regarding staff members. He acknowledged he spoke with Resident #60's POA the prior week regarding a concern involving a CNA but did not have a name and felt this was not a grievance. On 2/2/21 at 5:33 p.m., during an interview the Administrator said he had just gone to speak with Resident #60 who confirmed concerns regarding Staff K. He said if he had been told this last week, he did not take notes of conversation, and did not feel it was a grievance. He says he did not write it down, but possibly made staffing aware to remove her from schedule. On 2/3/21 at 9:53 a.m., during an interview CNA Staff K said she has gone to Director of Nursing (DON) numerous times regarding allegations made against her by Resident #60. CNA Staff K said the Unit Managers and the scheduler were also aware of allegations made by Resident #60 against her. CNA Staff K said the DON had told her that Resident #60 was on a lot of psych meds and to take a witness in when dealing with her. On 2/3/21 at 11:05 a.m., during an interview the Clinical Resources Coordinator Staff L said she was responsible for making the schedule and she was not aware any resident in the facility had requested not to have a certain CNA assigned to them. On 2/3/21 at 11:15 a.m., SSD Staff V said he was made aware of a grievance regarding Resident #60 and CNA Staff K last evening, at which time he went to speak with her. On 2/3/21 at 11:27 a.m., during an interview Registered Nurse Unit Manager Staff S said it was very well known Resident #60 had requested CNA Staff K not be assigned to her. On 2/3/21 at 11:44 a.m., during an interview Licensed Practical Nurse Staff M said she was aware Resident #60 on numerous occasions had requested CNA Staff K to not be assigned to her, and this had been discussed many times with the DON over the past months. On 2/3/21 at 1:27 p.m., during an interview the DON said she was made aware of an issue with Resident #60 and CNA Staff K last Thursday or Friday, and it was addressed at that time. The DON said Resident #60 never told her she did not want CNA Staff K to care for her, Resident #60 told the Administrator. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106102 If continuation sheet Page 2 of 4 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 106102 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/04/2021 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sarasota Point Rehabilitation Center 2600 Courtland Street Sarasota, FL 34237 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)

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Based on observation and staff interview, the facility failed to secure medications in 2 of 3 (Lido and Siesta halls)) medication carts reviewed. The facility also failed to have a system of record keeping ensuring an accurate inventory and reconciliation of controlled substances stored for destruction. The findings included: 1. On 2/1/21 at 11:00 a.m., observation of the Lido 2 medication cart with Licensed Practical Nurse (LPN) Staff U revealed five whole unidentified pills and four half tablets of unidentified pills in drawer of the medication cart. LPN Staff U confirmed the observation of loose, unidentified pills in the drawers. Photographic evidence obtained. 2. On 2/1/21 at 11:42 a.m., the medication cart on the Siesta hall was observed unlocked and unattended. Several staff and 2 residents were observed passing by the unlocked cart. The cart contained medications used for residents on the Siesta hall. On 2/2/21 at 11:47 a.m., the Director of Nursing confirmed the medication cart was unlocked and unattended. She proceeded to lock the cart. Photographic evidence obtained. 3. On 2/2/21 at 4:00 p.m., LPN Staff R was observed going into Resident #70's room to administer medications. LPN Staff R left a medication card of Tizanidine (used to treat muscle spasms) 2 milligrams unlocked, unattended and out of her line of vision on top of the Lido 2 cart. The medication was easily accessible to several residents observed, walking or wheeling themselves past the unsecured medication. 4. On 2/3/21 at 11:30 a.m., the process for reconciliation and disposition of controlled substances was reviewed with the Director of Nursing (DON). The DON said she counted and reconciled each medication with the count sheet with the nurse then locked all controlled substances in a file cabinet in her office. The DON said she was the only one with access to the file cabinet. The pharmacist came in monthly to count and destroy the controlled substances with her. The DON said she did not have a way to reconcile the medications or quantity of controlled substances in the locked cabinet. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106102 If continuation sheet Page 3 of 4 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 106102 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/04/2021 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sarasota Point Rehabilitation Center 2600 Courtland Street Sarasota, FL 34237 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)

F 0759 Ensure medication error rates are not 5 percent or greater. Level of Harm - Minimal harm or potential for actual harm Based on observation, clinical record review, and staff interviews, the facility failed to ensure its medication error rate remained below 5%. Three errors occurred while observing five licensed nurses on two different shifts with 27 medication administration opportunities. Three medication errors were identified resulting in an 11.11% error rate. The failure to administer medications as per the pharmacy labeling and manufacture guidelines placed the residents at risk for harmful errors, sub-optimal therapy, or pharmacological effects. Residents Affected - Some The findings included: Facility policy SHCRC30004.01 Medication Pass Guidelines (revised 4/25/2017) specified The nurse is responsible to read and follow precautionary or instructions on prescription labels and Check the Do Not Crush list before crushing medications. 1. On 2/1/21 at 10:15 a.m., the Director of Nursing (DON) was observed administering nine different medications to Resident #486 including Ventolin 90 micrograms inhaler (used to prevent and treat shortness of breath), and Trelegy EL (100-62.5-25) inhaler (used for chronic lung conditions). The DON handed the Ventolin to Resident #486 who inhaled two puffs without pausing between puffs. The DON immediately handed the Trelegy to Resident #486 who inhaled one puff of the medication. Review of the pharmacy label for the Ventolin inhaler revealed instructions to wait 1 minute between puffs. **Photographic evidence obtained** Review of the pharmacy label for the Trelegy inhaler revealed to rinse the mouth after using the Trelegy. Rinsing the mouth and spitting out the water prevents oral thrush, a fungal infection of the mouth. **Photographic evidence obtained** On 2/3/21 at 11:30 a.m., in an interview the DON confirmed she did not instruct Resident #486 to wait one minute between puffs of the Ventolin inhaler and did not instruct the resident to wait one minute between use of the two inhalers. The DON confirmed she did not instruct Resident # 486 to rinse his mouth after using the Trelegy inhaler as directed on the medication label. 2. On 2/3/21 at 9:15 a.m., Licensed Practical Nurse Staff U was observed administering eight medications to Resident #27 including Aspirin Enteric Coated (coating to prevent stomach ulcers and bleeding and is not to be crushed) 325 milligrams tablet. Staff U placed the enteric coated aspirin into a plastic pouch with other pills to be administered and crushed them together. Staff U verified she crushed the enteric coated aspirin. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106102 If continuation sheet Page 4 of 4