Health inspection·June 8, 2023

F 0563 Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews, the facility failed to honor resident's rights for visitation for one (Resident #1) of thirteen sampled residents. Residents Affected - Few Findings included: A review of Resident #1's medical record revealed Resident #1 was admitted to the facility on [DATE] with diagnoses of traumatic subdural hemorrhage and dementia. A review of Resident #1's progress notes revealed a note, dated 4/12/2023 at 8:07 PM, resident returned to the facility from the hospital with her family member present. The family was told her visit would be supervised and visiting hours were over at 8:00 PM. A note dated 4/12/2023 at 9:55 PM revealed Resident #1's family member was informed by the nurse her visit would be supervised and she would have to leave after thirty minutes because it was already 8:00 PM. Resident #1's family member became upset and expressed to the nursing staff she was told she could visit any time she wanted. A note dated 5/3/2023 at 3:55 PM revealed Resident #1's family member was informed by nursing staff visiting hours were over. A note dated 5/11/2023 at 8:35 PM revealed Resident #1's family member left the facility after being reminded multiple times about visiting hours. A review of Resident #1's Continuity of Care Document revealed Resident #1's family member was listed as Next of kin. An interview was conducted on 6/6/2023 at 3:57 PM with the facility's Nursing Home Administrator (NHA). The NHA stated Resident #1's family member had no restrictions on visitation but the facility had some concerns with the family member interfering in Resident #1's care. The NHA stated Resident #1's representative was contacted several times to report the issues related to the family member's interference with Resident #1's care but a call was not returned regarding limiting or supervising visitation. The NHA also stated there had been no restrictions placed on Resident #1's family member's visitation because Resident #1's representative did not state to do so. The NHA stated the facility does not have visitation hours and would not expect nursing staff to implement visitation hours without the resident or the resident representatives approval. An interview was conducted on 6/7/2023 at 11:36 AM with Staff K, Licensed Practical Nurse (LPN). Staff K, LPN stated she had worked for the facility for about two weeks. Staff K, LPN also stated during orientation, she was told facility visitation hours were from 8:00 AM to 8:00 PM. Staff K, LPN stated if she saw a visitor in the facility after 8:00 PM, she would let them know it was past visiting hours and they would need to wrap it up and return the following day. Staff K, LPN also stated her (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: 106103 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 106103 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/08/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Gulfport Nursing Center 1430 Pasadena Ave S Pasadena, FL 33707 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)