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F0559
E

Failure to Document Resident Room Change Notifications

Saint Petersburg, Florida Survey Completed on 10-15-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to document notifications of room changes for three residents, as required by resident rights regulations. Record reviews showed that one resident changed rooms multiple times, but notifications of these changes were not documented in the progress notes for several of the moves. Similarly, two other residents experienced room changes, and there was no documentation in their progress notes indicating that they or their representatives were notified of the changes or the reasons for them. The Director of Nursing (DON) confirmed during interviews that the Social Services Director (SSD) is responsible for notifying families and that nursing staff complete the transfers, but acknowledged that documentation of these notifications was missing for the affected residents. The facility's policy on resident rights, which includes the right to be informed about room changes, was not followed in these instances. The DON reviewed the records and confirmed the lack of documentation for the required notifications and reasons for the room changes. The absence of these records indicates that the facility did not consistently honor the residents' rights to receive written notice before a room change was made.

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