Miami Springs Nursing and Rehabilitation Center

Inspectors wroteBased on observation, record reviews and interviews, the facility failed to ensure all residents on the facility's Two South unit were always accommodated with working telephones, as evidenced by two observations of several telephones on the Two South Unit not having any dial tones. There were 185 residents residing at the facility at the time of the survey.

Inspectors wroteBased on observation, interview and record review, the facility failed to 1) store food under sanitary condition as evidence by failure in ensuring the 1 North Station Pantry snack/nourishment freezer on the resident unit contained a thermometer on the inside and 2) failed to ensure the correct wash temperature for washing of the dishes and utensils by not having the correct wash temperature for the operable wash tank temperature gauge on the high temperature dish machine. The missing thermometer has the potential to affect 176 out of 185 residents who eat orally residing in the facility at the time of the survey and potential to affect 42 out of 44 residents who eat orally residing on the 1 North Wing. [...]

Inspectors wroteBased on observations, records reviewed and interviews, the facility failed to demonstrate effective plans of actions implemented to correct identified quality deficiencies in problem areas, as evidenced by repeated deficient practices for F 641- Accuracy of Assessments, F812 Food Procurement Store/Prepare/Serve/Sanitary and F867- Quality Assurance and Performance Improvement (QAPI)/ Quality Assessment and Assurance (QAA). These repeated deficient practices have the potential to affect all residents residing in the facility.

Inspectors wroteBased on observations, interviews and record review the facility failed to ensure the high temperature dish machine wash cycle was working properly. This has the potential to affect 176 out of 185 residents who eat orally residing in the facility at the time of the survey.

Inspectors wroteBased on observations, records reviewed and interviews, the facility failed to ensure privacy of confidential information on one (2 North) out of two Nursing Stations on the facility's 2nd floor, as evidenced by observation of an unattended unlocked computer screen with residents' information visible. 2) Failed to provide privacy during medication administration for one (Resident # 152) out of five residents observed during medication administration. There were 185 residents residing in the facility at the time of the survey.

Inspectors wroteBased on observation, record review and interview, the facility failed to accurately code the Minimum Data Set (MDS) for one (Resident # 184) out of three sampled residents; as evidenced by the resident was discharged to an Assisted Living Facility, and the MDS was coded to indicate that the resident was discharged to a Short-Term General Hospital.

Inspectors wroteBased on observation, record review, and interviews, the facility failed to implement fall risk and seizure care plans for three residents (Resident #106, Resident # 88 and Resident #56) out of three sampled residents; as evidenced by observations of missing padding on one side rail for Resident #106, Resident #88, and Resident # 56. There were 36 residents with orders for padded side rails at the time of this survey.

Inspectors wroteBased on observations, interviews and record review, the facility failed to 1) store food under sanitary condition by ensuring the proper temperatures in the reach-in cooler and 2) ensure the reach-in cooler was working properly. This has the potential to affect 169 out of 182 residents who eat orally residing in the facility at the time of the survey.

Inspectors wroteBased on observation, record review, and interviews, the facility failed to ensure dignity during dining for one (resident #173) out of 45 sampled residents as evidenced by one facility staff was standing while feeding resident #173.

Inspectors wroteBased on interview and record review, the facility failed to accurately code the Minimum Data Set (MDS) for one resident (R # 43) out of one sampled residents reviewed for death. Resident #43 expired in the facility and the MDS Section A for Identification Information, Discharge Status did document the resident was deceased .

Inspectors wroteBased on record reviews, observations and interviews, the facility failed to provide appropriate Services and care related to foley catheter positioning as per facility policy to prevent a potential Urinary Tract Infection (UTI) for one out (Resident #153) out of 11 residents residing in the facility who had indwelling urinary catheters.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to follow the physician's orders for changing midline (intravenous catheter or IV line) dressing for one (Resident #485) out of 45 sampled residents as evidenced by a midline dressing dated over five days old.

Inspectors wroteBased on record reviews, observations and interviews, the facility failed to ensure proper labeling and disposal of medications as evidenced by one eye drop and one insulin pen past expiration dates on one the East medication cart out of five carts reviewed and two bottles of liquid medication past the expiration date printed on the bottle, in the [NAME] Medication room out of four medication rooms reviewed in facility. This affected 4 out of 45 sampled residents (Resident #8, #11, #21, and #146).

Inspectors wroteBased on observations, record review and interview, the facility failed to employ a Director of Food and Nutrition Services with required qualifications that includes two or more years of experience in the position of director of food and nutrition services in a nursing facility setting and has completed a course of study in food safety and management, by no later than October 1, 2023.

Inspectors wroteBased on observations, interview and record review, the facility failed to demonstrate effective plan of actions were implemented to correct identified quality deficiencies in the problem area related to repeated deficient practices for F550 Resident Rights/Exercise of Rights related to the facility failed to ensure that residents had a dignified existence for Resident # 173 of three residents reviewed for dignity and failed to maintain dignity during dining and F812 Food Procurement Store/Prepare/Serve/Sanitary as evidenced by facility failed to 1) store food under sanitary condition by ensuring the proper temperatures in the reach-in cooler and 2) ensure the reach-in cooler was working properly. This deficiency had the potential to affect 182 residents residing in the facility at the time of survey.

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure the reach-in cooler was working properly. This has the potential to affect 169 out of 182 residents who eat orally residing in the facility at the time of the survey.

Inspectors wroteBased on observation and interview it was determined that the facility failed to store, prepare, serve food in accordance with professional standards for food service safety. The issues included: failure to protect food from contamination, failure to maintain sanitizing chemical solutions, failure to maintain refrigeration and ice machines, and proper cleaning and maintenance of food preparation equipment.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that residents had a dignified existence for 2 (Resident # 124 and Resident # 21) of 4 residents reviewed for dignity and failed to maintain dignity during dining for 1 (Resident #15) of 4 residents reviewed for dignity.

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain privacy for one (Resident # 137) out of one resident reviewed for privacy as evidenced by, posting a visible sign on the wall in Resident # 137's room with Personal Health Information (PHI) that included Resident #137's name and hearing aids. There were one hundred-fifty-seven residents residing in the facility at the time of this survey.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide meaningful activities for 1(Resident #21) out of 2 residents reviewed for activities.

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility flailed to provide adequate supervision to prevent potential aspiration for 1 (Resident #6) of 5 residents sampled for nutrition review. The facility had 157 residents residing in the facility at the time of the survey.

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to provide physician ordered thickened liquids to meet the needs of 1 (Resident #6) of 5 residents sampled for nutrition review.

Inspectors wroteBased on observation, interview, and record review, it was determined that the facility failed to follow a physician ordered therapeutic diet (fluid restriction) for 1 (Resident #94) out of 5 residents sampled for nutrition review.

Inspectors wroteBased on observations, interview and record review, the facility failed to demonstrate effective plan of actions were implemented to correct identified quality deficiencies in problem prone area related to repeated deficient practices for Activities Meet Interest/Needs Each Resident (F 679). As evidenced by the facility failed to provide meaningful activities for Resident #21. F 812 Food Procurement Store/Prepare/Serve/Sanitary (F 812), the facility failed to follow sanitation procedures in the kitchen and failed to ensure food was kept at the proper temperature for a resident going to dialysis treatment (Resident # 142). This deficient practice has the potential to affect 147 residents residing in the facility at the time of survey.