Inspection·June 28, 2024

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 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 ensure medications were kept secured in the facility in 2 of 4 residents rooms observed, Resident #2 and Resident #4 (Photographic evidence obtained). Findings include: During an observation on 6/28/2024 at 9:30 AM, there were Systane eyedrops on Resident #2's bedside table within resident's reach, and Equate Baby Powder and Equate Arthricream Rub on the shelf inside the resident's room. During an interview on 6/28/2024 at 9:30 AM, Resident #2 stated, I use the eyedrops at least twice a day sometimes 4 times a day. I only use the baby powder and the cream if I need it. Review of Resident #2's physician orders revealed no orders for self-administration of medications. During an observation on 6/28/2024 at 9:55 AM, there was a bottle of Systane eyedrops on the bedside table by the bed within reach in Resident #4's room. During an interview on 6/28/2024 at 9:55 AM, Resident #4 stated, I use the eye drops whenever my eyes get blurry and I used them yesterday. Review of Resident #4's physician orders revealed no orders for self-administration of medications. During an interview on 6/28/2024 at 9:55 AM, Staff A, Licensed Practical Nurse (LPN), verified that Systane eyedrops, baby powder and Arthricream cream were at the bedside and stated, No medications are supposed to be left at the bedside unless they have been approved by the physician and a self-administration form has been completed. [Resident #2's name] does not have any orders for eye drops and cannot self-administer medication. During an interview on 6/28/2024 at 10:57 PM, the Assistant Director of Nursing stated, Residents are not allowed to keep medications at bedside or self-administer medications unless the doctor has written an order for self-administration of medications and a self-administration evaluation has been completed. The Assistant Director of Nursing confirmed that Resident #2 and Resident #4 could not self-administer medications and had no orders or evaluation for self-administration of medications. (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: 106145 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 106145 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/28/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Oak Hill Health & Rehabilitation 7371 Cortez Oaks Blvd Brooksville, FL 34613 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)