Inspection·April 27, 2023

F 0825 Provide or get specialized rehabilitative services as required for a resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to provide timely assessments and treatments for therapy services for 1 of 1 resident reviewed for rehabilitation and restorative services from a total sample of 20 residents, (#239). Residents Affected - Few Findings: Review of the medical record revealed resident #239 was admitted to the facility on [DATE] from a skilled nursing facility with diagnoses including dysphagia (difficulty swallowing), repeated falls, difficulty in walking, cognitive communication deficit, and Alzheimer's disease. The Minimum Data Set (MDS) admission comprehensive assessment with Assessment Reference Date 4/16/2023 identified the resident was unable to complete the Brief Interview for Mental Status and noted the resident was severely cognitively impaired. The assessment indicated the resident did not exhibit any rejection of evaluation or care necessary for health and well-being. He required extensive staff assistance to eat and complete activities of daily living and was totally dependent on staff for transfers, locomotion, toilet use, and bathing. The assessment showed there were no special treatments for Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST), or Restorative Nursing services provided during the look back period. The care plan completed 4/10/2022 included a Therapy Plan of Care for PT, OT, and ST services. Review of the Physician's Order Summary Report included physician's orders for PT, ST, and OT to evaluate and treat as needed dated 4/13/2023. Review of the therapy progress note dated 4/11/23 and 4/25/23 showed Speech Language Pathologist (SLP) A completed a note that a speech therapy screening had been completed and that a further ST evaluation was required. On 4/25/2023 at 9:06 AM, the resident was observed in the memory care unit common area sitting in a wheelchair at a table being assisted by staff to eat his breakfast. The resident was noted to be coughing while attempting to eat. On 4/27/2023 at 10:30 AM, SLP A said she completed resident #239's speech therapy screen on 4/11/2023 and determined the resident required further evaluation. She stated she completed the evaluation on 4/25/2023 when she observed the resident coughing while swallowing medications and eating. She explained she was concerned the resident had a high risk for aspiration, and she recommended a downgrade of his food texture to mechanically altered on 4/25/23. She explained an unidentified decline in residents' swallowing abilities could cause aspiration pneumonia. She explained she typically completed resident evaluations within 2 days after screening, and she did not explain why resident #239's evaluation was delayed for 14 days. She conveyed it was best clinical practice to complete them, right away. A review of the therapy progress notes showed resident #239 was screened for Physical Therapy on 4/25/23, twelve days after the physician's order. The screening noted a further evaluation was required. The record did not show an Occupational Therapy screening assessment was completed. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106130 If continuation sheet Page 2 of 3 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 106130 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Orlando Health Center for Rehabilitation 1300 Hempel Avenue Ocoee, FL 34761 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 0825 Level of Harm - Minimal harm or potential for actual harm On 4/26/2023 at 10:06 AM, the Director of Rehabilitation stated all physician orders for admission screening assessments for PT, OT, and ST were expected to be completed within 48 hours. She explained any screening that indicated further evaluation was required should have been completed within 1 day. She acknowledged resident #239's therapy care services were completed late. She said residents were at risk for decline when care and services were delayed. Residents Affected - Few Review of the facility's policies and procedures titled, Functional Impairment - Clinical Protocol, dated revised September 2012, read, 1. Upon admission to the facility . staff will assess the resident's physical condition and functional status. Review of, Resident Screening (5006) document #88 read, 1. The screening procedure will be performed and documented within 2 working days of admission. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106130 If continuation sheet Page 3 of 3