Encore at Boca Raton Rehabilitation and Nursing Ce

Inspectors wroteBased on observation, interview, and record review the facility failed to maintain a Resident's privacy for 1 of 1 sampled resident (Resident #190), reviewed for privacy.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide breakfast meals for 1 of 25 sampled residents on the Windsor Unit (Resident #87).

Inspectors wroteBased on observation and interview, it was determined that the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety. This was observed during 3 of 4 visits conducted in the Main Kitchen and Pantries.

Inspectors wroteBased on observation, interview, and record review, the facility failed to follow their facility assessment regarding their staffing plan for Certified Nursing Assistants (CNAs).

Inspectors wroteBased on interview, and record review, the facility failed to follow their own policy for water system management by failing to monitor and control contaminants in a resident room's water source after a Legionella pneumophilia result was found above the acceptable standard measures.

Inspectors wroteBased on record reviews and interviews, the facility failed to provide blood pressure monitoring to meet the needs of a resident, and failed to assess the accuracy of medication administration, for 1 of 3 sampled residents (Resident #1).

Inspectors wroteBased on record reviews and interview, the facility failed to ensure adequate hydration and nutrition for 1 of 3 sampled residents (Resident #1)

Inspectors wroteBased on observations and interviews, the facility failed to prepare foods in a manner consistent with standards for food safety.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to follow the Menu Planning, in accordance with established national standards, for one week out of three menu cycles. This had the potential to affect all residents that consume their meals prepared by the facility.

Inspectors wroteBased on observations, interviews and record review the facility failed to 1) ensure access to call device for 2 of 32 sampled residents (Residents #46 and #94); 2) ensure function of air mattress for 2 of 31 sampled residents provided with air mattress (Residents #80 and #90); 3) provide access to wall light for 7 out of 26 sampled residents on 1 of 2 hallways on the [NAME] unit (Residents #94, #6, #68, #72, #80, #90, #53); 4) provide unobstructed access to bathroom and provide paper towels to 1 of 34 sampled residents (Resident #27); 5) provide clean linen in timely manner for 1 of 34 sampled residents (Resident #86).

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to develop a comprehensive care plan for Post-Traumatic Stress Disorder (PTSD), for 2 of 2 sampled residents reviewed for behavior, (Residents #72 and Resident #28); failed to implement care plan interventions for 2 of 5 sampled residents reviewed for unnecessary medications, (Resident #88 and Resident #111); and failed to implement interventions regarding psychotropic medications' side effects for 2 of 2 sampled residents (Resident #111 and Resident #88) reviewed for Psychotropic Medications.

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure the resident environment remains free of accident hazards including 1 out of 4 emergency carts containing sharps left unlocked and unattended, 1 out of 7 med carts with a broken sharp disposal container, and 2 out of 32 sampled residents with sharps at the bedside (Resident #88 and #108).

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure the drainage bag for a resident with an indwelling urinary catheter is maintained in a manner to prevent infection and maintain dignity for 1 of 1sampled resident reviewed for a urinary catheter (Resident #46).

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to monitor intake of nutritional supplements for 2 of 3 sampled residents reviewed for Nutrition (Residents #98 and Resident #53).

Inspectors wroteBased on observations, and record review, the facility failed to ensure a resident receiving oxygen has a physician's order for 1 of 4 sampled residents reviewed for respiratory affecting Resident #111 and failed to ensure respiratory supplies are cared for in a manner to prevent infection for 4 of 4 sampled residents for respiratory affecting Residents #17, # 111, #6 and #8.

Inspectors wroteBased on observations, interviews and record reviews the facility failed to identify triggers for residents diagnosed with Post-Traumatic Stress Disorder (PTSD), for 2 of 2 residents sampled for mood and behavior, (Resident #72 and Resident #28).

Inspectors wroteBased on observations, interviews, and review, the facility failed to ensure the controlled substance medication reconciliations were accurate for 6 of 12 sampled residents reviewed during the controlled substance record review (Residents #10, #51, #73, #88, #345, and #346).

Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure medication error rate was below 5 percent; a total of 32 opportunities were observed with 4 medication errors identified which yield a medication error rate of 12.50 percent, affecting 2 of 5 sampled residents reviewed for medication administration, Resident #63 and Resident #32.

Inspectors wroteBased on observations, interviews and record review, the facility failed to secure medications at bedside for 3 out of 34 sampled residents; (Residents #49, # 72, 115 ) and failed to secure 1 of 7 med carts; failed to secure medication left on top of 1 of 7 med carts; and failed to properly dispose of medication(s) during 2 out of 5 medication observations.

Inspectors wroteBased on observations, interviews and record reviews, the facility failed to provide food that meets residents' preferences, allergies and intolerances for 6 of 6 sampled residents observed during dining observation (Resident's #122, #54, #39, #69, #44, and #46).

Inspectors wroteBased on observations, interviews and record review, the facility failed to provide special eating equipment (adaptive devices) who need them when consuming meals and snacks for 1 of 1 sampled resident reviewed for adaptive equipment, affecting Resident #46.

Inspectors wroteBased on observations, interview and record review, the facility's Quality Assurance and Performance Improvement Activities (QAPI/QAA) failed to demonstrate effective plan of actions were implemented to correct identified quality deficiencies in the problem area as evidenced by repeated deficient practices for F755, Pharmacy services, procedures, pharmacist, records; and F810, assistive devices, eating equipment, utensils. These repeated deficient practices have the potential to affect all 146 residents residing in the facility at the time of this survey.

Inspectors wroteBased on observations, record reviews and interviews, the facility failed to follow Standard Infection Control procedures while performing perineal care for 1 of 1 sampled resident (Resident # 28); failed to safely dispose of contaminated lancets used for glucose monitoring; and failed to maintain personal drink on a medication cart, in a manner to prevent contamination.

Inspectors wroteBased on record review, observations and interviews, the facility failed to provide a safe environment to the residents as evidenced by allowing a visitor to enter the facility at 6:14 AM, without properly identifying the visitor.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure that a resident received wound care consistent with professional standards of practice for 1 of 1 sampled resident for wound care (Resident #3).

Inspectors wroteBased on observations, interviews and record review, the facility failed to provide toileting/incontinence care to 3 of 3 sampled residents (Residents #1, #2 and #3), reviewed for toileting / incontinent care and failed to follow the physician orders regarding blood glucose results for 2 of 3 sampled residents (Resident #1 and #2).

Inspectors wroteBased on observations and interviews, the facility failed to provide a safe and clean environment in resident rooms and common areas, as well as failed to maintain laundry equipment in a repair.

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety for potentially 141 of the 145 facility residents that included; elimination of potential use of dented cans of food, maintenance of refrigeration units, maintenance of exhaust hoods, proper cleaning and maintenance of food preparation equipment, proper labeling and dating of opened food packages, and maintaining regulatory chemical levels in the 3-compartment sink.

Inspectors wroteBased on observations and interviews the facility failed to assure that staff handle, store, process, and transport laundry to prevent the spread of infection and failed to implement a surveillance plan to accurately identify, track, and report a Covid outbreak infection.

Inspectors wroteBased on observation, interview, record and policy review; the facility failed to administer a psychotropic medication ordered upon admission for 1of 2 sampled residents reviewed for admission orders (Resident #299).

Inspectors wroteBased on observation, records review, and interviews, the facility failed to follow the order and facility protocol for enteral feeding for 1 of 1 sampled residents reviewed for tube feeding (Resident #50).

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide medications to meet the needs for 1 of 13 sampled residents reviewed during medication reconciliation of controlled substances (Resident #349); and failed to provide medications to meet the needs for 1 of 7 sampled residents observed for medication administration (Resident #297).

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to provide special drinking equipment while consuming meals for 3 (Resident #30, #92, and #94) of 3 sampled residents.

Inspectors wroteBased on observations, interviews and record review, the facility failed to provide ceiling suspended curtains, to provide total visual privacy for 2 of 145 residents.