Inspection·January 26, 2023

N 000 INITIAL COMMENTS

N 000 An unannounced Relicensure survey and complaint investigation numbers 2022011109 and 2022011840, was conducted on Vi at Aventura. The complaint allegations were not substantiated. The facility had deficiencies at the time of the survey.

N 201 400.022(1)(f), FS Right to Adequate and SS=D

N 201 (f) The right to receive adequate and appropriate health care and protective and support services, including social services; mental health services, if available; planned recreational activities; and therapeutic and rehabilitative services consistent with the resident care plan, and established and recognized practice standards within the community, and with rules as adopted by the agency. This Statute or Rule is not met as evidenced by: Based on interview and record review, the facility failed to ensure adequate and appropriate care is being provided to 1 (Resident #9) out of 1 sampled residents receiving hospice services, as evidence by lack of coordinated care for hospice. There were 3 residents residing in the facility receiving hospice services at the time of the survey. The findings included: Review of clinical records revealed, Resident #9 was admitted to the facility on ___, and readmitted on ___. A comprehensive assessment dated ___, documented the resident had severe ___, and required total two-person assist with activities of daily living. The assessment further documented This plan of correction is submitted as required under Federal and State regulations and statues applicable to long term care providers. This plan of correction does not constitute an admission of liability on the part of the facility, and such liability is hereby specifically denied. The submission of this plan does not constitute agreement by the facility that the surveyors findings or conclusion are accurate, that the findings constitute a deficiency or that the scope or severity deficiencies cited are correctly applied. In order to ensure that the services provided at Vi at Aventura meet the professional standards of quality, the team has initiated the following plan of correction. /23 STATE FORM 6809 KX2E11 35961002 01/26/2023 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX PREFIX COMPLETE DATE

N 201 Continued From page 1 the resident received hospice services. N 201 Resident #9 was care planned for hospice services on ________. An intervention dated included: Hospice Nurse and Hospice CNA (Certified Nurse Assistant) to visit weekly/ as needed. Coordinate care and services via communication among staff. Record review revealed an order dated for Resident #9 to be admitted under Hospice. An interview was conducted with the hospice nurse on at 11:00 AM. The hospice nurse stated she comes once a week to evaluate Resident #9. The hospice nurse stated she communicates with the resident's nurse for any changes and updates. The hospice nurse provided documentation of such visits kept in a hospice binder at the facility's nursing station. The hospice nurse further stated Resident #9 received hospice CNA services 3 times a week. The hospice nurse stated the CNA does not leave any documentation at the facility, but does electronic charting through the hospice system. The hospice nurse stated the CNA used to make their own schedules, and just show up. Now the CNA has a set schedule, and was scheduled to visit Resident #9 on Monday, Tuesday, and Wednesday. The facility's Unit Manager (UM) overheard the above conversation and stated she did not see the hospice CNA yesterday (Wednesday). The UM presented a sign in sheet for hospice at the nursing station. The sign in sheet last documented a visit from hospice on ________. When asked if there was any other place someone would have to sign in, the UM stated they would sign in at the front gate/garage prior to... F684- Quality of Care-Failure to Coordinate Care with Hospice & N201 Right to Adequate an Appropriate Health Care Based on Observation, record review, interview and review of policy and procedure facility failed to coordinate care with Hospice for one resident (of three total residents) residing in the facility under hospice services at time of survey. (a) What corrective action(s) will be accomplished for those residents found to have been affected by the practice: 1. Hospice updated care plan for Resident #9 to include frequency of visitation. (b) How you will identify other residents having potential to be affected by the same practice and what corrective action will be taken: 1. DON/Designee will complete an audit of current residents receiving Hospice services to ensure frequency of visitations align with Hospice plan of care and audit findings will be reported to Hospice providers--. 2. Hospice providers will conduct an audit of current residents on Hospice services and implement appropriate interventions based on the audit results focusing on frequency of visitation being reflected on the plan of care and properly followed by hospice personnel. (c) What measures will be put into place or what systematic changes you will make STATE FORM notes KX2E11 35961002 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

N 201 Continued From page 2 entering the facility. The surveyor requested documentation for hospice visits for Resident #9.

N 201 to ensure that the practice does not recur: 1. HIPAA (Health Insurance Portability and Accountability) compliant identifier for Hospice residents will be placed on resident's door. An interview was conducted with Staff E, a CNA, on at 11:30 AM. Staff E stated she did not know if Resident #9 was on hospice services. Staff E, CNA stated they alternate assignments, and she was a float (works where she is needed). 2. The Hospice Plan of Care to specify the frequency of staff visitation will be readily available at the nursing station. An interview was conducted with Staff F, a CNA, on at 11:35 AM. Staff F stated she works with Resident #9 frequently. The resident requires 2 persons assist. Staff F stated she usually gets assistance from restorative for care. Staff F stated she knows the resident receives hospice services, but the new CNA has not had any communication. Staff F stated they do not wait for the hospice CNA, because they don't know when they are coming. Staff F reported that hospice drops off supplies for Resident #9 on Fridays. 3. Hospice personnel will visit resident as indicated on the resident's Hospice Plan of Care 4. Hospice personnel will sign-in the Hospice Attendance record available at the nursing station to validate visits. An interview was conducted with the hospice CNA via telephone on at 11:40 AM. The hospice CNA reported that she saw Resident #9 on a regular basis, and asks the CNA if they need any help. She last saw the resident on Monday and Tuesday ( and ). The hospice CNA stated she was not aware of a sign in sheet at the facility, as she just started working with the resident a little over a month ago. The CNA stated she spoke to the CNA on Monday, but does not remember the CNA's name. The hospice CNA stated she did not speak with anyone on Tuesday. The hospice CNA stated she did not come to the facility on Wednesday ( ). She usually drops off supplies on Friday. (d) How the corrective action(s) will be monitored to ensure the practice will not recur, i.e., what quality assurance program will be put into place: 1. The DNS/Designee will conduct a weekly audit for 4 weeks than 2 times a month for 2 more months on the above listed components, and/or until substantial compliance has been determined by the QAPI (Quality Assurance and Performance Improvement) committee. 2. Findings will be reported at the monthly QAPI/Risk Management meeting until substantial compliance has been achieved. A copy of the hospice CNA's notes was provided STATE FORM 35961002 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

N 201 Continued From page 3

N 201 by the hospice nurse. The hospice CNA has notes dated , and that documented care provided by the hospice nurse for Resident #9. A review of the sign in document from the front gate/garage prior to entering the facility revealed the hospice nurse signed into the facility grounds on and and . Class III

N 428 400.141(1)(m), FS AHCA Information Poster SS=D Required

N 428 Every licensed facility shall comply with all applicable standards and rules of the agency and shall: (m) Publicly display a poster provided by the agency containing the names, addresses, and telephone numbers for the state's hotline, the State Long-Term Care Ombudsman, the hotline, the Advocacy Center for Persons with , the Florida Statewide Advocacy Council, and the Medicaid Fraud Control Unit, with a clear description of the assistance to be expected from each. This Statute or Rule is not met as evidenced by: Based on observation, interview and record review, the facility failed to have the current version of the AHCA Poster posted. The findings included: During a tour of the unit corridor by the dining This plan of correction is submitted as required under Federal and State regulations and statues applicable to long term care providers. This plan of correction does not constitute an admission of liability on the part of the facility, and such liability is hereby STATE FORM notes KX2E11 COMPLETED 01/26/2023 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX PREFIX COMPLETE DATE

N 428 Continued From page 4 room, on . . . . . at 8:44 AM, accompanied by the Administrator it was noted that The AHCA poster that was posted on the wall in the corridor was an old version that did not include the most current contact information for the agencies listed, including websites and addresses. At the conclusion of the tour, the Administrator was referred to the Agency website in order to obtain the current poster.

N 428 specifically denied. The submission of this plan does not constitute agreement by the facility that the surveyors findings or conclusion are accurate, that the findings constitute a deficiency or that the scope or severity regarding any of these deficiencies cited are correctly applied. In order to ensure that the services provided at VI at Aventura meet the professional standards of quality, the team has initiated the following plan or correction. A. The AHCA poster was immediately posted. B. The Social Worker will monitor AHCA website quarterly for updated posting requirements. C. The Administrator will monitor AHCA website quarterly for updates to ensure compliance.

N 433 400.1915(a)2, FS Nursing Home Guide Posted SS=D (5) Every nursing home facility licensee shall: (a) Post, in a sufficient number of prominent positions in the nursing home so as to be accessible to all residents and to the general public: 2. A copy of all of the pages that list the facility in the most recent version of the Nursing Home Guide. This Statute or Rule is not met as evidenced by: Based on observation, interview and record review, the facility failed to have the current version of the Nursing Home Guide available to the residents and the general public.

N 433 This plan of correction is submitted as required under Federal and State regulations and statutes applicable to long term care providers. This plan of STATE FORM notes KX2E11 35961002 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

N 433 Continued From page 5

N 433 The findings included: During a tour of the unit corridor by the dining room, on ______ at 8:44 AM, accompanied by the Administrator, the Administrator directed this surveyor to a binder that was mounted to the wall of the corridor that contained the Nursing Home Guide. The Nursing Home Guide that was in the binder, available to the residents and the general public to review, was date ________. The current most current version of the Nursing Home Guide, on the Agency website was most recently updated At the conclusion of the tour, the Administrator was referred to the Agency website in order to obtain the current version of the Nursing Home Guide. correction does not constitute an admission of liability on the part of the facility, and such liability is hereby specifically denied. The submission of this plan does not constitute agreement by the facility that the surveyors findings or conclusion are accurate, that the finds constitute a deficiency or that the scope or severity regarding any of these deficiencies cited are correctly applied. In order to ensure that the services provided at Vi at Aventura meet the professional standards of quality, the team has initiated the following plan or correction. A. The Nursing Home Guide was immediately posted. B. The Social Worker will monitor AHCA website quarterly for the most current guide and will then post. C. The Administrator will also monitor the AHCA website quarterly for the guide updates to ensure compliance. STATE FORM notes KX2E11 106076 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG

F 000 INITIAL COMMENTS An unannounced Recertification survey in conjunction with complaint investigation numbers 2022011109 and 2022011840, was conducted on to at Vi at Aventura. The complaint allegations were not substantiated. The facility is not in compliance with 42 CFR Part 483, Requirements for Long Term Care Facilities.

F 684 SS=D Quality of Care CFR(s): 483.25 § 483.25 Quality of care Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices. This REQUIREMENT is not met as evidenced by: Based on interview and record review, the facility failed to coordinate care with Hospice for 1 of 1 sampled resident for hospice care (Resident #9). There were 3 residents residing in the facility receiving hospice services at the time of the survey. The findings included: Review of clinical records revealed, Resident #9 was admitted to the facility on , and readmitted on . A comprehensive assessment dated , documented the resident had severe , , and required total two-person assist with activities of daily living. The assessment further documented ID PREFIX TAG

F 000 DEFICIENCY) COMPLETION DATE This plan of correction is submitted as required under Federal and State regulations and statutes applicable to long term care providers. This plan of correction does not constitute an admission of liability on the part of the facility, and such liability is hereby specifically denied. The submission of this plan does not constitute agreement by the facility that the surveyors findings or conclusion are accurate, that the finds constitute a deficiency or that the scope or severity regarding any of these deficiencies cited are correctly applied. In order to ensure that the services provided at Vi at Aventura meet the

F 684 /2023 SURVEY OF DEFICIENCIES COMPLETED 01/26/2023 VIA AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

F 684 Continued From page 1 the resident received hospice services. Resident #9 was care planned for hospice services on ______. An intervention dated included: Hospice Nurse and Hospice CNA (Certified Nurse Assistant) to visit weekly/ as needed. Coordinate care and services via communication among staff. Record review revealed an order dated for Resident #9 to be admitted under Hospice. An interview was conducted with the hospice nurse on at 11:00 AM. The hospice nurse stated she comes once a week to evaluate Resident #9. The hospice nurse stated she communicates with the resident's nurse for any changes and updates. The hospice nurse provided documentation of such visits kept in a hospice binder at the facility's nursing station. The hospice nurse further stated Resident #9 received hospice CNA services 3 times a week. The hospice nurse stated the CNA does not leave any documentation at the facility, but does electronic charting through the hospice system. The hospice nurse stated the CNA used to make their own schedules, and just show up. Now the CNA has a set schedule, and was scheduled to visit Resident #9 on Monday, Tuesday, and Wednesday. The facility's Unit Manager (UM) overheard the above conversation and stated she did not see the hospice CNA yesterday (Wednesday). The UM presented an in sheet for hospice at the nursing station. The sign in sheet last documented a visit from hospice on When asked if there was any other place someone would have to sign in, the UM stated ...

F 684 professional standards of quality, the team has initiated the following plan or correction.

F684- Quality of Care-Failure to Coordinate Care with Hospice & N201 Right to Adequate an Appropriate Health Care Based on Observation, record review, interview and review of policy and procedure facility failed to coordinate care with Hospice for one resident (of three total residents) residing in the facility under hospice services at time of survey. (a) What corrective action(s) will be accomplished for those residents found to have been affected by the practice: 1. Hospice updated care plan for Resident #9 to include frequency of visitation. (b) How you will identify other residents having potential to be affected by the same practice and what corrective action will be taken: 1. DON/Designee will complete an audit of current residents receiving Hospice services to ensure frequency of visitations align with Hospice plan of care and audit findings will be reported to Hospice providers-- 2. Hospice providers will conduct an audit of current residents on Hospice services and implement appropriate interventions based on the audit results focusing on frequency of visitation being reflected on the plan of care and properly ... COMPLETED 01/26/2023 VIA AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

F 684 Continued From page 2 they would sign in at the front gate/garage prior to entering the facility. The surveyor requested documentation for hospice visits for Resident #9. An interview was conducted with Staff E, a CNA, on at 11:30 AM. Staff E stated she did not know if Resident #9 was on hospice services. Staff E, CNA stated they alternate assignments, and she was a float (works where she is needed). An interview was conducted with Staff F, a CNA, on at 11:35 AM. Staff F stated she works with Resident #9 frequently. The resident requires 2 persons assist. Staff F stated she usually gets assistance from restorative for care. Staff F stated she knows the resident receives hospice services, but the new CNA has not had any communication. Staff F stated they do not wait for the hospice CNA, because they don't know when they are coming. Staff F reported that hospice drops off supplies for Resident #9 on Fridays. An interview was conducted with the hospice CNA via telephone on at 11:40 AM. The hospice CNA reported that she saw Resident #9 on a regular basis, and asks the CNA if they need any help. She last saw the resident on Monday and Tuesday ( and ). The hospice CNA stated she was not aware of a sign in sheet at the facility, as she just started working with the resident a little over a month ago. The CNA stated she spoke with Monday, but does not remember the CNA's name. The hospice CNA stated she did not speak with anyone on Tuesday. The hospice CNA stated she did not come to the facility on Wednesday ( ). She usually drops off supplies on Friday.

F 684 followed by hospice personnel. (c) What measures will be put into place or what systematic changes you will make to ensure that the practice does not recur: 1. HIPAA (Health Insurance Portability and Accountability) compliant identifier for Hospice residents will be placed on resident's door. 2. The Hospice Plan of Care to specify the frequency of staff visitation will be readily available at the nursing station. 3. Hospice personnel will visit resident as indicated on the resident's Hospice Plan of Care 4. Hospice personnel will sign-in at the Hospice Attendance record available at the nursing station to validate visits. (d) How the corrective action(s) will be monitored to ensure the practice will not recur, i.e., what quality assurance program will be put into place: 1. The DNS/Designee will conduct a weekly audit for 2 weeks than 2 times a month for 2 more months on the above listed components, and/or until substantial compliance has been determined by the QAPI (Quality Assurance and Performance Improvement) committee. 2. Findings will be reported to the monthly QAPI/Risk Management meeting until substantial compliance has been achieved. 106076 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

F 684 Continued From page 3

F 684 A copy of the hospice CNA's notes was provided by the hospice nurse. The hospice CNA has notes dated , , and that documented care provided by the hospice nurse for Resident #9. A review of the sign in document from the front gate/garage prior to entering the facility revealed the hospice nurse signed into the facility grounds on . . . and . . . COMPLETED 01/26/2023 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX ID PREFIX DEFICIENCY) COMPLETE DATE

N 000 INITIAL COMMENTS

N 000 An unannounced Relicensure survey and complaint investigation numbers 2022011109 and 2022011840, was conducted on Vi at Aventura. The complaint allegations were not substantiated. The facility had deficiencies at the time of the survey.

N 201 400.022(1)(f), FS Right to Adequate and SS=D Appropriate Health Care

N 201 (f) The right to receive adequate and appropriate health care and protective and support services, including social services; mental health services, if available; planned recreational activities; and therapeutic and rehabilitative services consistent with the resident care plan, and established and recognized practice standards within the community, and with rules as adopted by the agency. This Statute or Rule is not met as evidenced by: Based on interview and record review, the facility failed to ensure adequate and appropriate care was being provided for 1 (Resident #9) out of 1 sampled residents receiving hospice services, as evidence by lack of coordinated care with hospice. There were 3 residents residing in the facility receiving hospice services at the time of the survey. The findings included: Review of clinical records revealed, Resident #9 was admitted to the facility on ____ , and readmitted on ____ . A comprehensive assessment dated ____ documented the resident had severe ____ , and required total two-person assist with activities of daily living. The assessment further documented 35961002 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

N 201 Continued From page 1 the resident received hospice services. Resident #9 was care planned for hospice services on . An intervention dated included: Hospice Nurse and Hospice CNA (Certified Nurse Assistant) to visit weekly/ as needed. Coordinate care and services via communication among staff. Record review revealed an order dated for Resident #9 to be admitted under Hospice. An interview was conducted with the hospice nurse on at 11:00 AM. The hospice nurse stated she comes once a week to evaluate Resident #9. The hospice nurse stated she communicates with the resident's nurse for any changes and updates. The hospice nurse provided documentation of such visits kept in a hospice binder at the facility's nursing station. The hospice nurse further stated Resident #9 received hospice CNA services 3 times a week. The hospice nurse stated the CNA does not leave any documentation at the facility, but does electronic charting through the hospice system. The hospice nurse stated the CNA used to make their own schedules, and just show up. Now the CNA has a set schedule, and was scheduled to visit Resident #9 on Monday, Tuesday, and Wednesday. The facility's Unit Manager (UM) overheard the above conversation and stated she did not see the hospice CNA yesterday (Wednesday). The UM presented a sign in sheet for hospice at the nursing station. The sign in sheet last documented a visit from hospice on . . . When asked if there was any other place someone would have to sign in, the UM stated they would sign in at the front gate/garage prior to

N 201 STATE FORM notes KX2E11 35961002 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

N 201 Continued From page 2

N 201 entering the facility. The surveyor requested documentation for hospice visits for Resident #9. An interview was conducted with Staff E, a CNA, on . at 11:30 AM. Staff E stated she did not know if Resident #9 was on hospice services. Staff E, CNA stated they alternate assignments, and she was a float (works where she is needed). An interview was conducted with Staff F, a CNA, on . at 11:35 AM. Staff F stated she works with Resident #9 frequently. The resident requires 2 persons assist. Staff F stated she usually gets assistance from restorative for care. Staff F stated she knows the resident receives hospice services, but the new CNA has not had any communication. Staff F stated they do not wait for the hospice CNA, because they don't know when they are coming. Staff F reported that hospice drops off supplies for Resident #9 on Fridays. An interview was conducted with the hospice CNA via telephone on . at 11:40 AM. The hospice CNA reported that she saw Resident #9 on a regular basis, and asks the CNA if they need any help. She last saw the resident on Monday and Tuesday ( and ). The hospice CNA stated she was not aware of a sign in sheet at the facility, as she just started working with the resident a little over a month ago. The CNA stated she spoke to the CNA on Monday, but does not remember the CNA's name. The hospice CNA stated she did not speak with anyone on Tuesday. The hospice CNA stated she did not come to the facility on Wednesday ( . ). She usually drops off supplies on Friday. A copy of the hospice CNA's notes was provided STATE FORM notes KX2E11 35961002 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

N 201 Continued From page 3 by the hospice nurse. The hospice CNA has notes dated , , and that documented care provided by the hospice nurse for Resident #9. A review of the sign in document from the front gate/garage prior to entering the facility revealed the hospice nurse signed into the facility grounds on , , and . Class III

N 201

N 428 SS=D 400.141(1)(m), FS AHCA Information Poster Required

N 428 Every licensed facility shall comply with all applicable standards and rules of the agency and shall: (m) Publicly display a poster provided by the agency containing the names, addresses, and telephone numbers for the state's hotline, the State Long-Term Care Ombudsman, the hotline, the Advocacy Center for Persons with , the Florida Statewide Advocacy Council, and the Medicaid Fraud Control Unit, with a clear description of the assistance to be expected from each. This Statute or Rule is not met as evidenced by: Based on observation, interview and record review, the facility failed to have the current version of the AHCA Poster posted. The findings included: During a tour of the unit corridor by the dining STATE FORM 35961002 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

N 428 Continued From page 4

N 428 room, on . . . . . at 8:44 AM, accompanied by the Administrator it was noted that The AHCA poster was posted on the wall in the corridor was an old version that did not include the most current contact information for the agencies listed, including websites and addresses. At the conclusion of the tour, the Administrator was referred to the Agency website in order to obtain the current poster.

N 433 400.191(5)(a)2, FS Nursing Home Guide Posted SS=D

N 433 (5) Every nursing home facility licensee shall: (a) Post, in a sufficient number of prominent positions in the nursing home so as to be accessible to all residents and to the general public: 2. A copy of all of the pages that list the facility in the most recent version of the Nursing Home Guide. This Statute or Rule is not met as evidenced by: Based on observation, interview and record review, the facility failed to have the current version of the Nursing Home Guide available to the residents and the general public. The findings included: During a tour of the unit corridor by the dining room, on . . . . . at 8:44 AM, accompanied by the Administrator, the Administrator directed this surveyor to a binder that was mounted to the wall of the corridor that contained the Nursing Home Guide. The Nursing Home Guide that was in the binder, available to the residents and the general public to review, was date . . . . . . . The current STATE FORM notes KX2E11 35961002 01/26/2023 VI AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETE DATE

N 433 Continued From page 5

N 433 most current version of the Nursing Home Guide, on the Agency website was most recently updated. At the conclusion of the tour, the Administrator was referred to the Agency website in order to obtain the current version of the Nursing Home Guide. STATE FORM notes KX2E11 106076 VIA AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 01/26/2023 PREFIX TAG COMPLETION DATE DEFICIENCY) ID PREFIX TAG

F 000

F 000 INITIAL COMMENTS An unannounced Recertification survey in conjunction with complaint investigation numbers 2022011109 and 2022011840, was conducted on to at Vi at Aventura. The complaint allegations were not substantiated. The facility is not in compliance with 42 CFR Part 483, Requirements for Long Term Care Facilities.

F 684

F 684 Quality of Care SS=D CFR(s): 483.25 $ 483.25 Quality of care Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices. This REQUIREMENT is not met as evidenced by: Based on interview and record review, the facility failed to coordinate care with Hospice for 1 of 1 sampled resident for hospice care (Resident #9). There were 3 residents residing in the facility receiving hospice services at the time of the survey. The findings included: Review of clinical records revealed, Resident #9 was admitted to the facility on ______, and readmitted on ______. A comprehensive assessment dated ______ documented the resident had severe ______, and required total two-person assist with activities of daily living. The assessor further documented /2023 | VI AT AVENTURA | | 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 | | | F 684 | Continued From page 1 the resident received hospice services. Resident #9 was care planned for hospice services on . An intervention dated . . . . . . include: Hospice Nurse and Hospice CNA (Certified Nurse Assistant) to visit weekly/ as needed. Coordinate care and services via communication among staff. Record review revealed an order dated for Resident #9 to be admitted under Hospice. An interview was conducted with the hospice nurse on at 11:00 AM. The hospice nurse stated she comes once a week to evaluate Resident #9. The hospice nurse stated she communicates with the resident's nurse for any changes and updates. The hospice nurse provided documentation of such visits kept in a hospice binder at the facility's nursing station. The hospice nurse further stated Resident #9 received hospice CNA services 3 times a week. The hospice nurse stated the CNA does not leave any documentation at the facility, but does electronic charting through the hospice system. The hospice nurse stated the CNA used to make their own schedules, and just show up. Now the CNA has a set schedule, and was scheduled to visit Resident #9 on Monday, Tuesday, and Wednesday. The facility's Unit Manager (UM) overheard the above conversation and stated she did not see the hospice CNA yesterday (Wednesday). The UM presented a sign in sheet for hospice at the nursing station.. The sign in sheet last documented a visit from hospice on . . . . . When asked if there was any other place someone would have to sign in, the UM stated | F 684 | | | PLAN OF CORRECTION COMPLETED 01/26/2023 VIA AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

F 684 Continued From page 2 they would sign in at the front gate/garage prior to entering the facility. The surveyor requested documentation for hospice visits for Resident #9. An interview was conducted with Staff E, a CNA, on at 11:30 AM. Staff E stated she did not know if Resident #9 was on hospice services. Staff E, CNA stated they alternate assignments, and she was a float (works where she is needed). An interview was conducted with Staff F, a CNA, on at 11:35 AM. Staff F stated she works with Resident #9 frequently. The resident requires 2 persons assist. Staff F stated she usually gets assistance from restorative for care. Staff F stated she knows the resident receives hospice services, but the new CNA has not had any communication. Staff F stated they do not wait for the hospice CNA, because they don't know when they are coming. Staff F reported that hospice drops off supplies for Resident #9 on Fridays. An interview was conducted with the hospice CNA via telephone on ____ at 11:40 AM. The hospice CNA reported that she saw Resident #9 on a regular basis, and asks the CNA if they need any help. She last saw the resident on Monday and Tuesday (____ and ____). The hospice CNA stated she was not aware of a sign in sheet at the facility, as she just started working with the resident a little over a month ago. The CNA stated she spoke to the CNA's name. The hospice CNA stated she did not speak with anyone on Tuesday. The hospice CNA stated she did not come to the facility on Wednesday (____). She usually drops off supplies on Friday.

F 684 106076 01/26/2023 VIA AT AVENTURA 19333 WEST COUNTRY CLUB DRIVE AVENTURA, FL 33180 PREFIX TAG ID PREFIX TAG DEFICIENCY) COMPLETION DATE

F 684 Continued From page 3

F 684 A copy of the hospice CNA's notes was provided by the hospice nurse. The hospice CNA has notes dated , and that documented care provided by the hospice nurse for Resident #9. A review of the sign in document from the front gate/garage prior to entering the facility revealed the hospice nurse signed into the facility grounds on . . . . . . and . . . . . .