Inspection·March 6, 2025

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews and clinical record review, the facility failed to ensure that residents who are unable to carry out their activities of daily living to maintain personal hygiene, grooming, mobility are provided the necessary care and services in a timely manner. The facility also failed to maintain accurate documentation of the care and services that are provided. This failure affected 3 of 6 sampled residents (Resident #1, #5 and a confidential random resident). Residents Affected - Few The findings included: 1) Review of the clinical record for Resident #5 revealed that the resident was admitted to the facility on [DATE] with diagnoses which included, Dysphasia following Cerebral Infarction, Pneumonitis following ingestion of other solids and liquids, Acute Respiratory Failure, Sepsis, Cardiac Arrest due to other underlying conditions, Gastrostomy, Hemiplegia and Hemiparesis following cerebral infarction affecting right dominant side and Metabolic Encephalopathy. Review of the 03/04/25 plan of care revealed that the resident takes nothing by mouth and receives enteral feeding. It is noted that the resident is dependent for the performance of his activities of daily living including bathing, bed mobility, transfers and is incontinent of bowel and bladder. An observation of Resident # 5, conducted on 03/06/25 at approximately 2:15 PM revealed that the resident was lying in bed with the top sheet removed, exposing his adult incontinent brief, which was obviously wet. The surveyor summoned the aide, Staff E, at this time. An interview was conducted with Staff E, who admitted that the last time she provided care for Resident #5 was about 10:30 AM this morning, approximately 4 hours ago. 2) A review of the Paramedic Trip records dated 02/25/25 at 10:59 AM for Resident #1, documented, upon arrival the crew found the patient (pt), unresponsive and lying in bed. The pt had a CPAP (Continuous Positive Airway Pressure) machine on his face with normal respirations, a strong radial pulse with cool extremities. The pt has old urine soiling his clothing and his bed sheets. The PA (Physician Assistant) on scene advised that the pt is being treated for the flu and a UTI (Urinary Tract Infection), he is on multiple antibiotics and steroids. They advised that the pt is normally alert and talking with no deficits. The facility is unable to tell the crew how long the pt has been unresponsive. The clinical record for Resident #1 revealed that the resident was admitted to the facility on [DATE] with diagnoses which included, Obstructive Sleep Apnea, Shortness of Breath, Chronic Kidney Disease, Stage 4, Diabetes Mellitus Type 2 with circulatory complications, and Influenza. (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: 106148 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/06/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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)