Inspection·June 16, 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 interview and record review the facility failed to provide care in accordance with professional standards of practice for 2 of 6 residents, Residents #14 and #114, reviewed for unnecessary medications. Residents Affected - Few Findings: Review of the medical record for Resident #14 documented the resident was admitted to the facility on [DATE] with the following diagnoses: spondylosis, history of falling, atherosclerotic heart disease of native coronary artery without angina pectoris (chest pain), chronic obstructive pulmonary disease, benign prostatic hyperplasia without lower urinary tract symptoms, type 2 diabetes mellitus without complications. Review of the medical record documented vital signs dated 4/21/2022 at 10:53 PM oxygen saturation of 94% on room air. Review of the nursing progress note dated 4/22/22 at 12:20 AM authored by the Director of Nursing (DON) reads: O2 [oxygen] at 2 liters applied secondary to patient requested CPAP [continuous positive airway pressure] to be turned off. Review of the medical record vital signs dated 4/22/2022 at 12:02 AM documented an oxygen saturation of 87% on room air. Review of the physician orders document no orders for oxygen administration. During an interview conducted on 6/15/2022 at 12:00 PM the DON stated, I was the nurse that worked the 11-7 shift the night that [Resident #14's name] refused to wear his CPAP and I started him on oxygen. I was not informed immediately that his oxygen saturation was low, and he was refusing his CPAP. I did administer the oxygen at two liters and attempted to get him to wear his oxygen and CPAP. There is no assessment of his lung sounds when I put him on the oxygen and his saturation dropped to 87%, there should have been. There are no other vital signs or oxygen saturation and there should have been. I should have called the doctor and gotten an order for the oxygen after I started it. We do need a doctor's order for oxygen, but we can start it if we feel we need to and call the doctor after that. I should have called the doctor. During an interview conducted on 06/16/22 at 3:38 PM Medical Doctor (MD) stated, I want to be notified if any patient has an oxygen saturation less than 90% so that I can determine if I need to add any further treatments. I would expect that the nurses would call with any other assessment such as lung sounds. I want to be notified immediately to determine the need to possibly return the patient to the hospital. Review of the policy and procedure titled Oxygen Administration approval date of 7/8/2021 reads, Purpose: The purpose of this procedure is to provide guidelines for safe oxygen administration. Preparation: 1. Verify that there is a physician's order or facility protocol for oxygen administration. Assessment. Before administering oxygen, and while the resident is receiving oxygen therapy, assess for the following: 1. Signs and symptoms of cyanosis (i.e., blue tone to the skin and mucous membranes). 2. Signs and symptoms of hypoxia (i.e., rapid breathing, rapid pulse rate, restlessness, confusion). 4. Vital signs. 5. Lung sounds. 6. Arterial blood gas and oxygen saturation, if applicable. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106105 If continuation sheet Page 2 of 10 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 106105 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Skytop View Rehabilitation Center 2145 North Don Wickham Drive Clermont, FL 34711 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 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Documentation: After completing the oxygen setup or adjustment, the following information should be recorded in the resident's medical record: 6. All assessment data obtained before, during, and after the procedure. 2. Review of the medical record for Resident #114 documented the resident was admitted to the facility on [DATE] with the following diagnoses: aftercare following joint replacement, presence of artificial shoulder joint, essential (primary) hypertension, hyperlipidemia, heart failure, unspecified. Review of the physician orders dated 6/10/2022 reads, Lovenox Solution Prefilled syringe (Enoxaparin Sodium) inject 0.9 ml [milliliters]/hr [hour] subcutaneously two times a day for DVT [a blood clot]. Review of the physician order dated 6/10/2022 reads, Lovenox solution prefilled syringe 80 mg (milligrams)/0.8 ml [Enoxaparin Sodium] inject 0.8 ml subcutaneously two times a day for PE [pulmonary emboli] d/c [discontinue] once INR [international ratio] is therapeutic above 2.0. Review of the Medication Administration Record documented Lovenox was not administered on 6/10/2022 at 9:00 PM, 6/11/2022 at 9:00 AM and 6/11/2022 at 9:00 PM as prescribed by the physician. Review of the administration note dated 6/11/2022 at 8:24 AM authored by Staff A, Licensed Practical Nurse (LPN) reads, pending pharmacy delivery. Review of the administration note dated 6/11/2022 at 8:28 PM authored by Staff C, LPN reads awaiting delivery. During an interview conducted on 6/15/2022 at 1:50 PM Staff A, LPN stated, If there is an order for Lovenox and we are unable to administer it, we should call the doctor to see if they want any other orders. I did not call the doctor about the Lovenox and that I could not administer it. I should have called with the missed dose. During an interview conducted on 6/15/2022 at 4:10 PM Staff C, LPN stated, I was not able to administer Lovenox when the doctor ordered it. I should have notified him that it couldn't be given because we didn't have it. It is a routine practice to notify a doctor when we can't give a medication like a blood thinner. During an interview conducted on 6/16/2022 at 10:45 AM the Director of Nursing (DON) stated, I was not aware that the staff did not administer the Lovenox when it was ordered. We should have notified the doctor when they were not able to administer the Lovenox. During an interview conducted on 6/16/22 3:35 PM the Medical Doctor (MD) stated, When I am bridging anticoagulant therapy of coumadin with Lovenox it is because the INR is subtherapeutic and the patient has a need for the additional therapy and I absolutely want to be notified that they cannot get the additional coverage needed. Review of the Policy and procedure titled, Adverse Consequences and Medication Errors with an approval date of 7/5/2021 reads, Policy interpretation and Implementation 5. A medication error is defined as the preparation or administration of drugs or biologicals which is not in accordance with physician's orders, manufacturers specifications, or accepted professional standards and principles of the professional(s) providing services. 6. Examples of medication errors include: a. Omission-a drug (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106105 If continuation sheet Page 3 of 10 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 106105 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Skytop View Rehabilitation Center 2145 North Don Wickham Drive Clermont, FL 34711 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 0684 is ordered but not administered. B. Unauthorized drug-a drug is administered without a physician's order. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106105 If continuation sheet Page 4 of 10 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 106105 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Skytop View Rehabilitation Center 2145 North Don Wickham Drive Clermont, FL 34711 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 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 3. Review of the admission Record documented Resident #12 was admitted to the facility on [DATE] with diagnoses that included fracture of upper end of right humerus, atrial fibrillation, unsteadiness on feet, muscle weakness and history of falling. Residents Affected - Some On 06/14/22 at 12:45 PM, Resident #12 was observed sitting at the bedside wearing a nasal cannula. The oxygen tubing was observed along the floor from the resident to the bathroom. The oxygen concentrator was located inside the bathroom door. The oxygen concentrator was off. During an interview on 06/14/22 at 12:45 PM, Resident #12 stated therapy was trying to wean her off oxygen, but she was usually on 1-2 liters. On 06/15/22 at 04:09 PM, Resident #12 was observed with oxygen being administered at 4 L (liters) via an oxygen concentrator. During an interview on 6/14/22 at 4:10 PM Staff A, Licensed Practical Nurse (LPN) confirmed the oxygen was being administered at 4 L and stated, She is not supposed to be on 4 liters, I think it's supposed to be at 2 liters. You know she is a retired nurse and I think she adjusts it herself. During an interview on 06/16/22 at 10:49 AM, Resident #12 when asked if she ever changes her oxygen for her own comfort she stated, There is no way I can do that. I can't bend over, plus just trying to get to it [the concentrator inside the bathroom]. Besides I want to get off oxygen. I was not on it prior to being here at the facility. Review of the physician orders dated 6/1/22 documented, Oxygen @ [at] 2 L [liters] via NC [nasal cannula] every shift. 4. Review of the admission Record documented Resident #68 was admitted to the facility on [DATE] with diagnoses that included obstructive sleep apnea, sepsis, and type 2 diabetes mellitus. On 6/15/22 at 12:05 PM Resident #68 was observed sitting at bedside in a chair eating lunch. On the resident's nightstand was a CPAP (continuous positive airway pressure) machine. During an interview on 6/15/22 at 12:05 PM Resident #68 stated that he uses the CPAP at night. Review of the physician orders for Resident #68 dated 06/08/22 read, Oxygen @ 2 L via nasal cannula at HS [hour of sleep] (CPAP machine not available) as needed for OSA [obstructive sleep apnea]. During an interview on 06/15/22 at 2:45 PM Staff B, RN stated that it was a standard of practice to obtain physician orders for CPAP therapy. She confirmed Resident #68 has a CPAP and there was no physician's order. During an interview on 06/15/22 at 2:52 PM the Direction of Nursing (DON) confirmed Resident #68 does not have an order for CPAP therapy. She confirmed that it was a standard of practice to obtain a physician's order for CPAP therapy. Review of the policy titled CPAP/BiPAP [bilevel positive airway pressure] Support revised October (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106105 If continuation sheet Page 5 of 10 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 106105 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Skytop View Rehabilitation Center 2145 North Don Wickham Drive Clermont, FL 34711 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 0695 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 2010, last reviewed on July 7, 2021, reads: Purpose. 1. To provide the spontaneously breathing resident with continuous positive airway pressure with or without supplemental oxygen. Preparation. 3. Review the physician's order to determine the oxygen concentration and flow, and the PEEP (Positive end-expiratory pressure) pressure (CPAP, IPAP [inspiration] and EPAP [expiration]) for the machines. Based on observation, interview, and record review the facility failed to provide respiratory care services in accordance with professional standards of practice for 4 of 7 residents, Residents #12, #68, #118, and #119, reviewed for oxygen administration and respiratory equipment. Findings: 1. During an observation on 6/14/2022 at 9:44 AM Resident #119 was observed sitting at the bedside with oxygen being administered at 2 liters per minute by nasal cannula. Review of the medical record for Resident #119 documented the resident was admitted to the facility on [DATE] with the following diagnoses: type 2 diabetes mellitus without complications, chronic obstructive pulmonary disease, chronic kidney disease stage 4, hypertensive chronic kidney disease, hyperlipidemia (high cholesterol}, history of falling, fracture of third thoracic vertebra, pulmonary embolism (a blood clot) without acute cor pulmonale (a form of sudden right sided heart failure), traumatic subarachnoid hemorrhage (bleeding in the brain). Review of the physician's orders dated 6/3/2022 reads Oxygen at 3 L [liters] via NC [nasal cannula]. During an observation on 6/15/2022 at 8:32 AM Resident #119 was sitting in a wheelchair at the bedside with no oxygen being administered. During an observation on 6/15/2022 at 11:37 AM Resident #119 was observed sitting at the bedside in a wheelchair with no oxygen being administered. During an interview on 6/15/2022 at 11:37 AM Staff B, Registered Nurse (RN) verified Resident #119 was not being administered oxygen and the physician's order was for continuous oxygen administration. Staff B, RN stated, I thought that her order was PRN [as needed]. I should get an order to have the oxygen prn. It should be administered as a doctor ordered it to be administered or we should get the order changed. 2. On 6/14/2022 at 9:39 AM Resident #118 was observed with oxygen being administered at 4 liters per minute by nasal cannula. Review of the medical record for Resident #118 documented the resident was admitted to the facility on [DATE] with the following diagnoses: chronic obstructive pulmonary disease, atherosclerotic heart disease of native coronary artery (heart disease) without angina pectoris (chest pain), unspecified dementia without behavioral disturbances, hyperlipidemia, major depressive disorder, anxiety disorder, malignant neoplasm (cancer) of colon, encounter for surgical aftercare, and unspecified severe protein calorie malnutrition. Review of the physician's order dated 6/3/2022 reads Oxygen 2 L/M [liters per minute] via n/c [nasal cannula] every shift for shortness of breath. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106105 If continuation sheet Page 6 of 10 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 106105 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Skytop View Rehabilitation Center 2145 North Don Wickham Drive Clermont, FL 34711 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 0695 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an observation on 6/15/2022 at 9:09 AM Resident #118 was resting in bed, with no oxygen being administered and signs of mild shortness of breath; the Resident was unable to say more than two to three words before needing to take a breath. During an interview conducted on 6/15/2022 at 9:09 AM Resident #118 stated, I feel a little short of breath, but I'm always a little short of breath. During an observation on 6/15/2022 at 11:42 AM Resident #118 was observed sitting at the bedside in a wheelchair with no oxygen being administered. The Resident continued to say two to three words before needing a deep breath. On 6/15/2022 at 11:42 AM Staff B, Registered Nurse (RN) verified Resident #118 was not being administered oxygen and the physician order was for continuous oxygen administration. Staff B, RN stated, No oxygen was running per orders and there should be oxygen running if there is an order otherwise, they need a physician order for PRN oxygen use. Review of the policy and procedure titled, Oxygen Administration with an approval date of 07/07/21 reads, Purpose: The purpose of this procedure is to provide guidelines for safe oxygen administration. Preparation: 1. Verify that there is a physician's order or facility protocol for oxygen administration. Assessment: Before administering oxygen, and while the resident is receiving oxygen therapy, assess for the following: 1. Signs and symptoms of cyanosis (i.e., blue tone to the skin and mucous membranes). 2. Signs and symptoms of hypoxia (i.e., rapid breathing, rapid pulse rate, restlessness, confusion. 4. Vital signs. 5. Lung sounds. 6. Arterial blood gas and oxygen saturation, if applicable. Documentation: After completing the oxygen setup or adjustment, the following information should be recorded in the resident's medical record: 6. All assessment data obtained before, during, and after the procedure. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106105 If continuation sheet Page 7 of 10 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 106105 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Skytop View Rehabilitation Center 2145 North Don Wickham Drive Clermont, FL 34711 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, interview and record review the facility failed to label and store all medications available for use in accordance with professional standards in 2 out of 2 medications carts reviewed. Findings: During an observation conducted on 6/14/22 at 8:22 AM with Staff A, Licensed Practical Nurse (LPN) medication cart #1 contained one opened Aspart insulin pen with no date opened or expiration date, and two Aspart insulin pens unopened with a label from the pharmacy to refrigerate until opened. During an interview conducted on 6/14/2022 at 8:28 AM Staff A, LPN stated, I haven't gotten to check these yet and all insulin if it is on the cart should have the date opened on them or be kept in the refrigerator until they are opened During an observation conducted on 6/14/22 at 8:36 AM with Staff B, Registered Nurse (RN) medication cart #2 contained one opened Toujeo insulin pen with no date opened or expiration date, and two unopened Aspart insulin pens with a label from the pharmacy to refrigerate until opened During an interview conducted on 6/14/2022 at 8:40 AM Staff B, Registered Nurse stated, These should not be on the cart if they haven't been opened yet and once they are opened we need the dates on them. During an interview conducted on 6/15/22 at 2:34 PM, The Director of Nursing (DON) stated, All insulin should be labeled when they are taken from the refrigerator otherwise, they should stay in the refrigerator until we need them. Review of the policy and procedure titled, Storage and Expiration of Medications, Biologicals, syringes and needles with an approval date of 7/5/2021 reads, Procedure: 4. Facility should ensure that medications and biologicals: 4.1 Have an expiration date on the label. 5. Once any medication or biological package is opened, Facility should follow manufacturer/supplier guidelines with respect to expiration dates for opened medications. Facility should record the date opened on the medication container when the medication has a shortened expiration date once opened. 11. Facility should ensure that all medications and biologicals for each resident are stored at their appropriate temperatures according to the United States Pharmacopeia guidelines for temperature ranges. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106105 If continuation sheet Page 8 of 10 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 106105 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Skytop View Rehabilitation Center 2145 North Don Wickham Drive Clermont, FL 34711 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 0801 Level of Harm - Minimal harm or potential for actual harm Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Based on interview and record review the facility failed to ensure a qualified director of food and nutritional services was provided for oversight of the daily operations of the facility dietary services. Residents Affected - Few Findings: During an interview on 06/15/22 at 10:00 AM the Dietary Manager stated he is not certified or licensed as a Dietary Manager. During an interview on 06/15/22 at 10:00 AM the dietitian stated she works for the hospital and does not work at the facility full time as a dietitian; she stated she works part time. During an interview on 06/15/22 at 02:12 PM the Administrator stated that the Dietary Manager does not have his Certified Dietary Manager certification. He does not have an associate degree in food service management or hospitality. The dietitian works at the hospital full time and comes to the Skilled Nursing Unit part time. Review of the Dietary Manager's application documented a high school diploma; there was no associates degree contained in the file. Review of the Learner Records for [Dietary Manager's name] did not document training in Certified Dietary Manager certification courses. Review of the Completed Training for [Dietary Manager's name] did not document training in Certified Dietary Manager certificate courses. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106105 If continuation sheet Page 9 of 10 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 106105 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Skytop View Rehabilitation Center 2145 North Don Wickham Drive Clermont, FL 34711 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 0882 Level of Harm - Minimal harm or potential for actual harm Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. Based on interview and record review the facility failed to have a designated Infection Preventionist who completed specialized training in infection prevention and control. Residents Affected - Few Findings: During an interview conducted on 6/16/2022 at 11:30 AM the Director of Nursing stated, I am the designated infection control nurse I complete all the tracking and trending of infections throughout the facility. I have not taken any special course on infection control. I am not certified in Infection control, and I did not know that I needed anything special to be the infection control nurse. During a review of the education and training for the Director of Nursing there was no specialized certifications for infection control. During an interview conducted on 6/16/2022 at 12:00 PM the Facility Administrator stated, I should have known that she needed to have the Infection control training, she is new, and our previous Director of Nursing had the training. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106105 If continuation sheet Page 10 of 10