Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Stratford Court Of Boca Raton during CMS and state inspections, most recent first.
Surveyors found that the facility did not have documentation showing completion of the required annual 90‑minute test of emergency lighting. During record review and interview, the Director of Facilities confirmed that records of this annual test, required under NFPA 101 sections 19.2.9.1 and 7.9, were not available. This deficiency was cited as affecting all occupants in the event of a fire or other emergency.
Surveyors found that the facility failed to perform and/or document the required annual Duct Detector Differential testing for the fire alarm system in accordance with NFPA 101, NFPA 70, and NFPA 72. During record review and interviews with the Director of Facilities, no documentation could be produced to show that this annual testing had been completed, and the Director acknowledged the lack of records. This deficiency was cited as potentially affecting all occupants in the event of a fire or other emergency.
Surveyors found that the facility failed to perform and/or document required annual testing and exercising of main and feeder circuit breakers in accordance with NFPA 99 and manufacturer recommendations. During record review, no documentation could be produced to show that the annual breaker exercises had been completed, and the Director of Facilities acknowledged this lack of records. This deficiency relates to the essential electrical system that supports life safety and critical branches during emergencies.
Surveyors observed that an adapter was used to power a refrigerator in the kitchen and a refrigerator in the dining room manager's office was plugged into a power strip. The Director of Facilities confirmed both uses, which did not comply with NFPA 99 and NFPA 70 requirements prohibiting adapters and power strips from being used as substitutes for permanent wiring.
Surveyors found that food service operations failed to meet professional food safety standards in both the main and satellite kitchens. In the main kitchen, a cook’s facial hair was not fully covered, the handwashing sink did not initially provide warm water, wet-nested pans and dirty plate domes were stored for use, ice buckets were stained with mold-like discoloration, and the high-temp dishwasher failed to reach the required sanitizing temperature. In the satellite pantry, the dishwasher did not reach required wash temperatures, vents and cabinets above serving dishes had mold-like buildup and residue, floors were damaged and soiled, the dishwasher chemical cabinet was rusted, the AC filter was heavily soiled, the juice dispenser had debris near clean cups, and tray carts contained dirty sheet trays. During tray line observation, salad items were held above 41°F, and a pureed vegetable listed on the menu extension was not available on the line.
Two residents on physician-ordered modified diets (pureed and mechanical soft with nectar-thick liquids) were given Regular Menus listing items such as fresh fruit, salad greens, and grilled cheese that were not compatible with their diet orders. Both residents selected items from these Regular Menus, but the facility either could not provide the chosen foods due to diet restrictions or substituted different items (e.g., canned peach halves instead of fresh fruit), despite the residents’ expressed preferences. The RD and dietetic technician confirmed that Regular Menus were routinely provided to all residents, including those on mechanically altered diets, leading to menu choices that did not align with ordered diet consistencies.
Surveyors found that the facility did not follow physician-ordered therapeutic diets or provide prescribed Magic Cup nutritional supplements for several cognitively impaired residents. A resident on a pureed diet with honey-thick liquids was served a lunch without the ordered pureed vegetable, and tray line review on another day showed no pureed vegetables available despite the menu specifying them. Multiple residents with orders for Magic Cup supplements had these listed on their meal tickets but were instead served other desserts or received no supplement at all, while documentation on the MAR indicated full consumption. Dietary staff acknowledged responsibility for providing Magic Cups but could not explain why residents in the dining room did not receive them.
Surveyors determined that the facility did not comply with FAC 59A-4.126 when it failed to conduct and/or maintain documentation of the required semi-annual testing of its comprehensive emergency management plan for internal or external disasters. During record review and interviews with the Director of Facilities and the Administrator, the facility was unable to produce records showing that these emergency plan drills or tests had been performed, and leadership acknowledged the lack of documentation. This Class III deficiency was identified as potentially affecting all occupants during a fire or other emergency.
Two residents on physician-ordered modified diets (pureed and mechanical soft with nectar-thick liquids) were routinely given Regular Menus listing items such as fresh fruit, salad greens, stir-fried vegetables, and grilled cheese sandwiches that were not compatible with their diet orders. One resident with severe cognitive impairment had a pureed, honey-thick diet but received a Regular Menu with no appropriate options, while another resident with moderate cognitive impairment selected fresh fruit from a Regular Menu but was served canned peach halves instead and voiced dissatisfaction. The RD and dietary manager confirmed that Regular Menus were provided to all residents, including those on mechanically altered diets, resulting in residents being offered choices that could not be honored according to their prescribed diet consistencies.
Surveyors identified that the facility did not follow physician-ordered therapeutic diets or provide ordered nutritional supplements. A resident on a pureed, honey-thick diet with severe cognitive impairment was repeatedly served lunches without the ordered pureed vegetable, and tray line review showed no pureed vegetables available despite the menu specifying them. In addition, several residents with orders for 4 oz Magic Cup supplements at meals did not receive them as listed on their meal tickets; one was given regular desserts instead, even though the MAR documented full consumption of the supplement. The RD and dietary manager confirmed that dietary staff were responsible for Magic Cups but could not explain the failures in provision.
The facility failed to maintain professional standards for food service safety, with issues such as open garbage bins, undated and improperly stored food, and incorrect food temperatures observed in the main and satellite kitchens. These deficiencies were acknowledged by the facility's Administrator, potentially affecting 48 residents.
The facility failed to ensure a clean environment in four resident rooms, where AC filters and vents were found with a black mold-like substance. Residents in these rooms, who were on oxygen therapy, reported issues such as shortness of breath. Despite routine cleaning by maintenance staff, the mold-like substance persisted, indicating a lapse in maintaining a safe and sanitary environment.
A resident with severe cognitive impairment experienced significant weight loss due to inadequate nutritional monitoring and intervention. The facility failed to provide timely and consistent administration of prescribed nutritional supplements, and the Certified Dietary Manager discontinued a high-calorie supplement without an alternative plan. Staff interviews revealed a lack of coordination and awareness regarding the resident's nutritional needs.
A resident with end-stage renal disease missed dialysis treatments due to transportation issues and lack of coordination between the LTC facility and the dialysis center. The resident required a stretcher for transport due to a recent hip fracture, but transportation arrived with inappropriate equipment. Additionally, a positive Covid-19 test further complicated the situation, leading to hospitalization.
The facility failed to properly manage controlled substances for two residents, leading to discrepancies in medication reconciliation. A Buprenorphine patch was not discarded as required, and a tablet of Oxycodone-Acetaminophen was removed without a physician order or documentation. These actions highlight failures in medication management processes.
The facility failed to maintain a medication error rate below 5%, resulting in a 10.34% error rate affecting two residents. Errors included omitted medications and incorrect administration, with discrepancies in documentation and availability of prescribed medications.
The facility failed to provide the correct diet consistency for two residents on a Pureed diet. Both residents, with severe cognitive impairments, were served Cream of Mushroom soup that was lumpy and thick, contrary to the required smooth texture. The Executive Chef admitted to estimating the amount of thickener, leading to improper food consistency. The Speech Pathologist confirmed the deficiency upon reviewing photographic evidence.
A facility failed to implement proper infection control measures for a resident with a bacterial UTI, as staff did not use PPE or place the resident on contact precautions upon admission. Additionally, during wound care for another resident, a nurse neglected to perform hand hygiene between glove changes, violating the facility's infection control policy.
Failure to Document Required Annual 90‑Minute Emergency Lighting Test
Penalty
Summary
Surveyors identified a deficiency related to emergency lighting when, during record review and staff interview between 11:30 AM and 3:00 PM with the Director of Facilities, the facility was unable to provide documentation that the required annual 90‑minute testing of emergency lighting had been performed. The Director of Facilities acknowledged that there was no documentation available to show completion of this annual 90‑minute emergency lighting test, as required by NFPA 101 (2012 and 2021 editions), sections 19.2.9.1 and 7.9. This failure to document the annual emergency lighting test was cited as a noncompliance that could affect all occupants of the facility in the event of a fire or other emergency. No specific residents, medical histories, or clinical conditions were mentioned in the report; the deficiency pertains to facility-wide life safety systems and their required testing and documentation.
Plan Of Correction
Emergency Lighting CFR(s): NFPA 101 Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required Emergency Lighting K0291 The facility immediately conducted a comprehensive inspection of all emergency lighting systems. On The Director of Facilities performed the required 90-minute annual testing of all emergency lighting units. Documentation of testing has been completed and is maintained on-site. 2. All areas of the facility were considered at risk due to lack of documented annual testing. A full facility-wide audit of all emergency lighting units was completed on by the Director of Facilities to ensure compliance. 3. The facility implemented a preventative maintenance schedule to ensure annual 90-minute emergency lighting testing is completed in accordance with NFPA 101 (2012), Section 7.9. A log tracking system has been developed to document all required testing. The Director of Facilities/designee will receive re-education on Life Safety Code requirements and documentation standards. 4. The Director of Facilities will review fire alarm testing records quarterly for 12 months, will present the findings for 12 months at Quality Assurance Performance Improvement (QAPI) meetings to confirm inspections have taken place. During and at the conclusion of the twelve months, the QAPI committee will re-evaluate and initiate necessary action or extend the review period. The Administrator is responsible for confirming implementation and ongoing compliance with the components of the Plan of Correction, and resolving variances that may occur. The Administrator is responsible for confirming the status of this Plan of Correction is reviewed and discussed at QAPI meetings and action initiated if required. Emergency Lighting CFR(s): NFPA 101 Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required Emergency Lighting K0291 The facility immediately conducted a comprehensive inspection of all emergency lighting systems. On The Director of Facilities performed the required 90-minute annual testing of all emergency lighting units. Documentation of testing has been completed and is maintained on-site. 2. All areas of the facility were considered at risk due to lack of documented annual testing. A full facility-wide audit of all emergency lighting units was completed on by the Director of Facilities to ensure compliance. 3. The facility implemented a preventative maintenance schedule to ensure annual 90-minute emergency lighting testing is completed in accordance with NFPA 101 (2012), Section 7.9. A log tracking system has been developed to document all required testing. The Director of Facilities/designee will receive re-education on Life Safety Code requirements and documentation standards. 4. The Director of Facilities will review fire alarm testing records quarterly for 12 months, will present the findings for 12 months at Quality Assurance Performance Improvement (QAPI) meetings to confirm inspections have taken place. During and at the conclusion of the twelve months, the QAPI committee will re-evaluate and initiate necessary action or extend the review period. The Administrator is responsible for confirming implementation and ongoing compliance with the components of the Plan of Correction, and resolving variances that may occur. The Administrator is responsible for confirming the status of this Plan of Correction is reviewed and discussed at QAPI meetings and action initiated if required.
Failure to Perform and Document Annual Duct Detector Differential Testing
Penalty
Summary
Surveyors identified a deficiency related to the facility’s fire alarm system testing and maintenance, specifically the required annual Duct Detector Differential testing. During record review conducted between 11:30 AM and 3:00 PM, surveyors requested documentation demonstrating that this annual testing had been completed in accordance with NFPA 101 (2012 and 2021 editions), NFPA 70, and NFPA 72. The facility was unable to produce records showing that the Duct Detector Differential testing had been performed as required. In an interview conducted during the same time frame, the Director of Facilities acknowledged that the facility failed to provide documentation of the annual Duct Detector Differential testing. The deficiency was cited under NFPA 101 2012 (19.2.9.1, 7.9) and NFPA 101 2021 (19.2.9.1, 7.9), indicating noncompliance with the standards that require fire alarm detection systems, including duct detectors, to be tested and maintained annually. The report notes that this deficiency could affect all occupants of the facility in the event of a fire or other emergency.
Plan Of Correction
Fire Alarm System - Testing and Maintenance CFR(s): NFPA 101 Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required Fire Alarm System - Testing and Maintenance K0345 1. On The facility a certified fire alarm vendor to perform annual duct detector differential testing. All required testing has now been completed and documented. 2. All residents and staff were considered at risk due to lack of documented testing. A facility-wide review of all fire alarm components was conducted on 3. The facility established a service agreement to ensure all fire alarm testing (including duct detectors) is completed annually per NFPA 72 and NFPA 101 requirements. A compliance calendar has been implemented with alerts for required inspections and testing. The Director of Facilities/designee has been re-educated on required testing intervals and documentation. 4. The Director of Facilities or designee will audit for 3 months all documentation for the annual testing and inspection of the duct detector pressure differential test. The Director of Facilities will present the findings of site inspections for 3 months at Quality Assurance Performance Improvement (QAPI) meetings to confirm inspections have taken place. During and at the conclusion of the three months, the QAPI committee will re-evaluate and initiate necessary action or extend the review period. The Administrator is responsible for confirming implementation and ongoing compliance with the components of the Plan of Correction, and resolving variances that may occur. The Administrator is responsible for confirming the status of this Plan of Correction is reviewed and discussed at QAPI meetings and action initiated if required Fire Alarm System - Testing and Maintenance CFR(s): NFPA 101 Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required Fire Alarm System - Testing and Maintenance K0345 1. On The facility a certified fire alarm vendor to perform annual duct detector differential testing. All required testing has now been completed and documented. 2. All residents and staff were considered at risk due to lack of documented testing. A facility-wide review of all fire alarm components was conducted on. 3. The facility established a service agreement to ensure all fire alarm testing (including duct detectors) is completed annually per NFPA 72 and NFPA 101 requirements. A compliance calendar has been implemented with alerts for required inspections and testing. The Director of Facilities/designee has been re-educated on required testing intervals and documentation. 4. The Director of Facilities or designee will audit for 3 months all documentation for the annual testing and inspection of the duct detector pressure differential test. The Director of Facilities will present the findings of site inspections for 3 months at Quality Assurance Performance Improvement (QAPI) meetings to confirm inspections have taken place. During and at the conclusion of the three months, the QAPI committee will re-evaluate and initiate necessary action or extend the review period. The Administrator is responsible for confirming implementation and ongoing compliance with the components of the Plan of Correction. The Administrator is responsible for confirming the status of this Plan of Correction is reviewed and discussed at QAPI meetings and action initiated if required
Failure to Perform and Document Annual Main and Feeder Breaker Testing
Penalty
Summary
The deficiency involves the facility’s failure to perform and document required annual maintenance and testing of the main and feeder circuit breakers in accordance with NFPA 99 and manufacturer recommendations. During a record review conducted between 11:30 AM and 3:00 PM, surveyors requested documentation of the annual main and feeder breaker exercise. The facility was unable to provide records demonstrating that this testing and exercising had been completed as required. In interviews conducted during the same time frame, the Director of Facilities acknowledged that the facility did not have documentation showing that the annual main and feeder breaker exercise was performed according to manufacturer recommendations. The report notes that this failure to comply with NFPA 99 (2012 and 2021 editions, Sections 6.4.4 and 6.5.4) could affect all occupants of the facility in the event of a fire or other emergency, and that written records of maintenance and testing are required to be maintained and readily available.
Plan Of Correction
Electrical Systems - Essential Electric System CFR(s): NFPA 101 Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required Electrical Systems - Essential Electric System Maintenance and Testing K0918 1. On A licensed electrical contractor performed the annual main and feeder breaker testing/exercising in accordance with manufacturer recommendations. Documentation has been completed and is maintained on-site. 2. All residents were considered at risk due to lack of documented testing. A full review of the essential electrical system was conducted on 3. A preventative maintenance program has been implemented to ensure that annual breaker testing is completed per NFPA 99 (2012). The facility has incorporated electrical system testing into its environmental compliance tracking system. The Director of Facilities/designee received re-education on NFPA requirements. 4. The Director of Facilities will audit electrical system maintenance logs quarterly for 12 months. Inspections have taken place. During and at the conclusion of the three months, the QAPI committee will re-evaluate and initiate necessary action or extend the review period. The Administrator is responsible for confirming implementation and ongoing compliance with the components of the Plan of Correction, and resolving variances that may occur. The Administrator is responsible for confirming the status of this Plan of Correction is reviewed and discussed at QAPI meetings and action initiated if required. Electrical Systems - Essential Electric System CFR(s): NFPA 101 Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required Electrical Systems - Essential Electric System Maintenance and Testing K0918 1. On A licensed electrical contractor performed the annual main and feeder breaker testing/exercising in accordance with manufacturer recommendations. Documentation has been completed and is maintained on-site. 2. All residents were considered at risk due to lack of documented testing. A full review of the essential electrical system was conducted on . 3. A preventative maintenance program has been implemented to ensure that annual breaker testing is completed per NFPA 99 (2012). The facility has incorporated electrical system testing into its environmental compliance tracking system. The Director of Facilities/designee received re-education on NFPA requirements. 4. The Director of Facilities will audit electrical system maintenance logs quarterly for 12 months. Inspections have taken place. During and at the conclusion of the three months, the QAPI committee will re-evaluate and initiate necessary action or extend the review period. The Administrator is responsible for confirming implementation and ongoing compliance with the components of the Plan of Correction, , and resolving variances that may occur. The Administrator is responsible for confirming the status of this Plan of Correction is reviewed and discussed at QAPI meetings and action initiated if required.
Improper Use of Adapters and Power Strips for Refrigerators
Penalty
Summary
The deficiency involves improper use of electrical adapters and power strips as substitutes for permanent wiring, in violation of NFPA 99 and NFPA 70 requirements. During an observation with the Director of Facilities, surveyors found that an adapter was being used to power a refrigerator in the kitchen. The Director of Facilities acknowledged that an adapter was in use for this refrigerator, contrary to the standards that prohibit adapters from being used in place of fixed wiring. In a separate observation with the Director of Facilities, surveyors identified that a refrigerator in the dining room manager's office was plugged into a power strip. The Director of Facilities acknowledged that a power strip was being used for this refrigerator. These findings showed that the facility was not complying with NFPA 99 provisions that require power strips and adapters not be used as substitutes for permanent wiring for such equipment.
Plan Of Correction
Formatted text (without <text> tags or quotes): Electrical Equipment - Power and Extension Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required Electrical Equipment - Power and Extension K0920 1. On The adapter in the kitchen refrigerator and the power strip in the dining room manager's office were immediately removed. All equipment was plugged directly into approved wall outlets. 2. On A facility-wide inspection was conducted by The Director of Facilities to identify improper use of power strips and adapters. Any non-compliant items were removed immediately. 3. On Staff were educated on proper electrical safety practices, including prohibited use of extension and adapters. Routine environmental rounds now include electrical safety checks. 4. The Director of Facilities/designee will conduct monthly environmental rounds for 3 months, then quarterly thereafter. Quality Assurance Performance Improvement (QAPI) meetings to confirm inspections have taken place. During and at the conclusion of the three months, the QAPI committee will re-evaluate and initiate necessary action or extend the review period. The Administrator is responsible for confirming implementation and ongoing compliance with the components of the Plan of Correction, and resolving variances that Continued from page occur. The Administrator is responsible for confirming the status of this Plan of Correction is reviewed and discussed at QAPI meetings and action initiated if required. Electrical Equipment - Power and Extension CFR(s): NFPA 101 Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required Electrical Equipment - Power and Extension K0920 1. On The adapter in the kitchen refrigerator and the power strip in the dining room manager's office were immediately removed. All equipment was plugged directly into approved wall outlets. 2. On A facility-wide inspection was conducted by The Director of Facilities to identify improper use of power strips and adapters. Any non-compliant items were removed immediately. 3. On Staff were educated on proper electrical safety practices, including prohibited use of extension and adapters. Routine environmental rounds now include electrical safety checks. 4. The Director of Facilities/designee will conduct monthly environmental rounds for 3 months, then quarterly thereafter. Quality Assurance Performance Improvement (QAPI) meetings to confirm inspections have taken place. During and at the conclusion of the three months, the QAPI committee will re-evaluate and initiate necessary action or extend the review period. The Administrator is responsible for confirming implementation and ongoing compliance with the components of the Plan of Correction, and resolving variances that may occur. The Administrator is responsible for confirming the status of this Plan of Correction is reviewed and discussed at QAPI meetings and action initiated if required.
Food Safety and Sanitation Deficiencies in Main and Satellite Kitchens
Penalty
Summary
Surveyors identified multiple failures to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in both the main kitchen and a satellite pantry kitchen. In the main kitchen, a cook’s beard cover did not fully cover all facial hair, and the handwashing sink initially did not provide warm water until the Executive Director manually adjusted a valve under the sink. In the pot washing area, full-sized steam table pans were stacked while still wet, and more than five plate domes with stuck-on food particles were found piled in the tray line area ready for use, indicating they had not been properly washed. Two large ice buckets were stained with black and grey mold-like discoloration and white wear marks. The high-temperature dishwashing machine in the main kitchen was run three times but failed to reach the required 180°F rinse temperature, only reaching 172°F, meaning dishes were not properly sanitized. In the second-floor satellite pantry kitchen, the high-temperature dishwashing machine was also run three times and failed to meet required wash temperatures, reaching only 139°F instead of the required 150–165°F, so dishes were not properly cleaned and sanitized. Additional sanitation and maintenance issues were observed, including a vent above serving dishes with a mold-like accumulation, broken and soiled cabinets above serving dishes with residue on the handles, and pantry floors with cracked, broken, and missing tiles with debris or residue buildup. The dishwasher chemical cabinet lock was rust-laden, the AC filter was covered with dark grey soot and dust, the juice dispenser with clean cups nearby had debris on top, and tray delivery carts contained large sheet trays with residue and stuck-on food debris. During a tray line observation, chopped tomatoes and sliced avocados on the salad line were held at 44°F and 45°F respectively, above the required 41°F or less, and the menu extension listed pureed peas for a pureed diet, but no pureed vegetable was present on the line.
Plan Of Correction
Food Procurement, Store/Prepare/Serve-Sanitary CFR(s): 483.60(i)(1)(2) §483.60(i) Food safety requirements. Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required F0812 1. All identified sanitation issues were corrected on Hot water valve was fixed immediately by maintenance team Steam table pan wet nesting was corrected The 5 plate domes that were dirty were taken to the dishwasher to be washed Stained ice buckets were replaced with new ones Dishwashing machine not reaching temperature for rinse cycle was fixed by Eco lab the same day Team member was provided education and in-service on proper use of beard guard. Corrected on [R] 2.Identified issues from satellite Kitchen were corrected on [R] Dishwashing machine not reaching temperature for rinse cycle was fixed by Eco lab the same day The vent located above the serving dishes was cleaned by maintenance team The cabinets were cleaned immediately The floors of the pantry area were observed with broken, cracked, missing tiles, with buildup residue and debris. Maintenance director made aware in the process of getting replaced. The locking mechanism of the dishwasher chemical cabinet is rust laden. Laden removed and in the process of being replaced. The AC filter was cleaned by maintenance team Th juice dispenser was cleaned by dietary aide The large delivery trays with residue and food debris were discarded 3. Issues identified during Tray line observation were corrected: The chopped tomatoes and sliced avocados were discarded Pureed vegetable was added to the line. Inservice on serving all food groups, starches, protein and vegetables to residents on texture modified diet order. Inservice provided to all dietary aides Inservice on maintaining and holding temperatures for ready to eat foods. Inservice provided to all cooks and dietary aides Daily sanitation rounds will be conducted by the Certified Dietary manager /designee for one week. Weekly for 2 months. 4. The Certified Dietary Manager/Executive Chef/designee will report the findings of the above observations and audits to the monthly QAPI Committee. The Administrator is responsible for confirming implementation and compliance of this POC and and resolving any variances that may occur.
Failure to Honor Diet-Appropriate Menu Choices for Residents on Modified Diets
Penalty
Summary
The facility failed to provide residents with menu choices that matched their physician-ordered diet textures and liquid consistencies. One resident with severe cognitive impairment had a physician order for a controlled diet with pureed texture and honey-thick liquids. During a noon meal observation, this resident’s meal ticket was stapled to a Regular Menu listing items such as lettuce and tomato salad, stir-fried vegetables, and a grilled cheese sandwich, none of which were appropriate for the resident’s ordered diet. The Registered Dietitian and the Dietetic Technician confirmed that Daily Menu printouts with Regular Menu options were provided to all residents, including those on mechanically altered diets, resulting in residents being offered choices that could not be honored due to diet restrictions. Another resident with moderate cognitive impairment had a physician order for a mechanical soft diet with nectar-thick liquids. This resident’s lunch tray ticket was also stapled to a Regular Menu that included salad greens, which are not allowed on a mechanical soft diet. On a separate breakfast observation, the same resident’s Regular Menu included fresh fruit as a choice, which the resident circled, but the tray contained canned peach halves instead. The resident stated she wanted her chosen fresh fruit rather than the peaches and reiterated her food preferences during the interview. Photographic evidence was obtained to document these discrepancies between ordered diets, menu offerings, and the food actually provided.
Plan Of Correction
Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is requiredF05501. Resident #54 and Resident #56 were immediately assessed by the Registered Dietitian (RD) & CDM (Certified Dietary Manager) for food preferences on Residents #54 and #56 were offered meal choices consistent with the prescribed diet. No adverse outcomes were identified. 2. 100% audit of all residents with therapeutic diets was completed on [R] by CDM to ensure menus and meal selections consistent with physician-ordered diets.On [R] , CDM provided in-service provided to dietary aides, certified nursing assistants, nurses, managers on new selective menu processes. 3. The facility implemented a diet-specific menu system and pre-meal diet verification process by reviewing the diet in tray ticket program IMPAC and PCC. Copies of the menus to be provided as part of the audits.Diet Menu was revised to include a mechanically altered diet to be consistent with physician orders. Therapeutic diets menus are available and offered to each resident according to physician orders. The Dietary Manager or designee will conduct weekly audits of 4 residents on therapeutic diets x 4 weeks then monthly x 2months, to verify the correct menu is offered and served. 4. The Dietary Manager or designee will report findings at the monthly QAPI meeting. The Administrator is responsible for confirming implementation and compliance with this POC and [R] , and resolving any variances that occur.
Failure to Follow Therapeutic Diet Orders and Provide Prescribed Nutritional Supplements
Penalty
Summary
The deficiency involves the facility’s failure to follow physician-ordered therapeutic diets and prescribed nutritional supplements for multiple residents. One resident with severe cognitive impairment and a physician’s order for a controlled diet with pureed texture and honey-thick liquids was observed at lunch without the ordered pureed vegetable; her plate contained only pureed chicken, a pureed starch, and possibly a pureed bread, all covered in gravy. The pureed menu for that meal listed broccoli as the vegetable, and a subsequent tray line observation on another day showed no pureed vegetables available, despite the pureed menu specifying pureed peas. The dietary manager and registered dietitian were informed of the missing pureed vegetables, and photographic evidence was obtained. The facility also failed to provide ordered Magic Cup nutritional supplements as prescribed. One resident with severe cognitive impairment and a care plan addressing risk for compromised nutritional status had a physician’s order for a 4 oz Magic Cup on day and evening shifts with lunch and dinner; during a breakfast observation, the meal ticket listed Magic Cup, but none was provided. Another resident with moderate cognitive impairment had a physician’s order for a 4 oz Magic Cup with lunch; during lunch observation, the meal ticket indicated Magic Cup, but the resident was served chocolate ice cream and ate coconut cream pie for dessert instead. The MAR documented 100% consumption of a Magic Cup on two consecutive days, despite the observed failure to provide it. During interviews, the RD and dietary manager explained that Magic Cups were to be provided by dietary staff either on trays or via the dessert/ice cream cart, but they could not explain why residents in the dining room did not receive the ordered supplements. Photographic evidence was obtained of these occurrences.
Plan Of Correction
Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required F0803 1. Upon identification, resident #54 was given pureed vegetables. Residents #23, #39, and #54 were given Magic Cup supplements as ordered. On [R] CDM re-educated team members on supplement delivery including proper documentation and confirming that pureed diet being served matches what is listed on spread sheet. Dietary aides' morning and evening shifts are accountable for serving all food groups including vegetables when serving puree meals to residents. 2. A 100% audit of all residents with therapeutic diets and/or supplements was completed on [R] by Certified Dietary Manager. 3. A tray line checklist and diet/supplement reconciliation process between dietary and nursing were implemented by [R]. RD oversight of menu compliance was initiated. The Certified Dietary Manager or designee will audit food tray weekly x 4 weeks then weekly x 2 months. 4. The Certified Dietary Manager/Designee will report on the findings at the monthly QAPI meeting. The Administrator is responsible for confirming implementation and compliance with this POC and [R], and resolving any variances that may occur.
Failure to Conduct and Document Semi-Annual Emergency Management Plan Testing
Penalty
Summary
The facility failed to comply with Florida Administrative Code 59A-4.126 by not conducting and/or documenting the required semi-annual testing of its written, comprehensive emergency management plan for internal or external disasters or emergencies. During record review and staff interviews conducted between 11:30 AM and 3:00 PM with the Director of Facilities and the Administrator, surveyors requested documentation showing that semi-annual testing of the emergency management plan had been performed. The facility was unable to provide any such documentation, and both the Director of Facilities and the Administrator acknowledged that they failed to provide documentation showing that the semi-annual testing of the emergency management plan was performed. The deficiency was cited as a Class III violation and was noted as having the potential to affect all occupants of the facility in case of a fire or other emergency. No specific residents, medical histories, or clinical conditions were mentioned in the report, and the deficiency pertained to facility-wide emergency preparedness processes rather than individual patient care events.
Plan Of Correction
Emergency Management Plan CFR(s): FAC 59A-4.126 Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required. Emergency Management Plan K10531. On The Director of Facilities conducted a comprehensive emergency management drill to meet semi-annual testing requirements. Documentation of the drill and evaluation has been completed. 2. On Emergency preparedness documentation was reviewed by The Director of Facilities to ensure all required drills and evaluations are up to date. 3. A structured emergency preparedness calendar has been implemented to ensure semi-annual drills are conducted and documented in compliance with FAC 59A-4.126. 4. The Director of Facilities will present emergency preparedness documentation quarterly for compliance at Quality Assurance Performance Improvement (QAPI) meetings. During and at the conclusion of the three months, the QAPI committee will re-evaluate and initiate necessary action or extend the review period. The Administrator is responsible for confirming implementation and ongoing compliance with the components of the Plan of Correction, [R] and resolving variances that may occur. The Administrator is responsible for confirming the status of this Plan of Correction is reviewed and discussed at QAPI meetings and action initiated if required.
Failure to Honor Diet-Appropriate Menu Choices for Residents on Modified Diets
Penalty
Summary
The deficiency involves the facility’s failure to provide residents with appropriate menu choices that matched their physician-ordered diets, thereby not assuring residents’ rights to knowledge of available choices and independent personal decisions. One resident with severe cognitive impairment was admitted with multiple medical diagnoses and had a physician’s order for a controlled diet with pureed texture and honey-thick liquids. During a lunch observation, this resident’s meal ticket was found stapled to a Regular Menu listing items such as lettuce and tomato salad, stir-fried vegetables, and a grilled cheese sandwich, none of which were compatible with the resident’s ordered pureed diet. The Registered Dietitian and the Dietary Manager confirmed that Daily Menu printouts for the Regular Menu were provided to all residents, including those on mechanically altered diets, and acknowledged that residents on such diets would be offered items like fresh fruit that could not actually be provided according to their prescribed diet consistency. Another resident with moderate cognitive impairment and multiple medical diagnoses, including failure-related conditions, had a physician’s order for a mechanical soft diet with nectar-thick liquids. This resident’s lunch tray was observed with a meal ticket stapled to a Regular Menu that included salad greens, which are not allowed on a mechanical soft diet. On a separate breakfast observation, the same resident’s meal ticket was again stapled to a Regular Menu that listed fresh fruit as a choice. The resident had circled fresh fruit as her preference but instead received canned peach halves on her tray and verbally expressed that she wanted her chosen item rather than the peaches, reiterating her food preferences before the surveyor left the room. These observations, along with staff interviews, showed that residents on modified diets were routinely given Regular Menus with options that could not be honored due to their diet orders.
Plan Of Correction
Resident Rights/Exercise of Rights Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required N0181 1. Resident #54 and Resident #56 were immediately assessed by the Registered Dietitian (RD) & CDM (Certified Dietary Manager) for food preferences on [R] . Residents #54 and #56 were offered meal choices consistent with the prescribed diet. No adverse outcomes were identified. 2. 100% audit of all residents with therapeutic diets was completed on [R] by CDM to ensure menus and meal selections consistent with physician-ordered diets. On [R] , CDM provided in-service provided to dietary aides, certified nursing assistants, nurses, managers on new selective menu processes. 3. The facility implemented a diet-specific menu system and pre-meal diet verification process by reviewing the diet in tray ticket program IMPAC and PCC. Copies of the menus to be provided as part of the audits. Diet Menu was revised to include a mechanically altered diet to be consistent with physician orders. Therapeutic diets menus are available and offered to each resident according to physician orders. The Dietary Manager or designee will conduct weekly audits of 4 residents on therapeutic diets x 4 weeks then monthly x 2months, to verify the correct menu is offered and served. 4. The Dietary Manager or designee will report findings at the monthly QAPI meeting. The Administrator is responsible for confirming implementation and compliance with this POC and [R] and resolving any variances that may occur.
Failure to Follow Therapeutic Diet Orders and Provide Ordered Nutritional Supplements
Penalty
Summary
Surveyors found that the facility failed to follow physician-ordered therapeutic diets and provide ordered supplements. One resident on a controlled pureed diet with honey-thick liquids, who had severe cognitive impairment and was care planned for risk of compromised nutritional status, was not served a vegetable at lunch; her tray contained only pureed chicken, a pureed starch, and possibly a pureed bread covered in gravy, despite the menu listing a pureed vegetable (broccoli on one day and peas on another). During tray line observation, no pureed vegetables were present on the line even though the pureed menu specified a pureed vegetable. The Dietary Manager and Registered Dietitian were informed of the missing pureed vegetable and acknowledged the absence. The facility also failed to provide physician-ordered Magic Cup nutritional supplements as specified. One resident with varying dietary intake and a care plan for compromised nutritional status had an order for a 4 oz Magic Cup on day and evening shifts with lunch and dinner, but during a breakfast observation the Magic Cup was listed on the meal ticket and not provided. Another resident observed at the same breakfast also had a Magic Cup ordered but did not receive it. A third resident with moderate cognitive impairment had an order for a 4 oz Magic Cup with lunch; during lunch observations, this resident’s ticket read Magic Cup, but she was given a chocolate ice cream cup and ate coconut cream pie for dessert instead of the ordered supplement, while the MAR documented 100% consumption of a Magic Cup on consecutive days. The RD and Dietary Manager stated that dietary staff were responsible for providing Magic Cups but could not explain why residents in the dining room did not receive them.
Plan Of Correction
Dietary Services CFR(s): 400.141(1)(i), FS Preparation and/or execution of this plan does not constitute admission or agreement by the provider that a deficiency exists. This response is also not to be construed as an admission of fault by the facility, its employees, agents or other individuals who draft or may be discussed in this response and plan of correction. This plan of correction is submitted as the facility's credible allegation of compliance and Soley because it is required N0407 1. Upon identification, resident #54 was given pureed vegetables. Residents #23, #39, and #54 were given Magic Cup supplements as ordered. On CDM re-educated team members on supplement delivery including proper documentation and confirming that pureed diet being served matches what is listed on spread sheet. Dietary aides' morning and evening shifts are accountable for serving all food groups including vegetables when serving puree meals to residents. 2. A 100% audit of all residents with therapeutic diets and/or supplements was completed on by Certified Dietary Manager. 3. A tray line checklist and diet/supplement reconciliation process between dietary and nursing were implemented by [R] . RD oversight of menu compliance was initiated. The Certified Dietary Manager or designee will audit food tray weekly x 4 weeks then weekly x 2 months. 4. The Certified Dietary Manager/Designee will report on the findings at the monthly QAPI meeting. The Administrator is responsible for confirming implementation and compliance with this POC and [R] and resolving any variances that may occur.
Food Safety Deficiencies in Kitchen and Satellite Kitchen
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, as observed during a tour of the main kitchen and satellite kitchen. In the main kitchen, several issues were noted, including open garbage bins without lids, a Styrofoam cup with an employee's name in the food production area, and dirty Traulsen reach-in refrigerators. The commercial charcoal grills were found with an old sticky black substance, and a rectangular silver tray had debris and dirt. The walk-in refrigerator contained undated boxes of chicken breast filets sitting in a pool of red fluid, and the chicken was not sealed properly. Additionally, a container of clam base was found to be ten days old, exceeding the recommended usage period of three days. The walk-in refrigerator also had undated boxes of oven-roasted chicken halves and raw fish, and the floor in the dry storage area was dirty with a live insect observed on the wall. In the 2nd floor satellite kitchen, an open garbage container without a lid was observed. Further observations revealed that the internal temperatures of blue cheese and ham and cheese sandwiches were above the recommended 40 degrees Fahrenheit, measuring 44.2 and 45.8 degrees Fahrenheit, respectively. These findings were acknowledged by the facility's Administrator during an interview, indicating a failure to maintain proper food storage, preparation, and distribution standards, potentially affecting 48 residents in the facility.
Failure to Maintain Clean AC Units in Resident Rooms
Penalty
Summary
The facility failed to maintain a sanitary and clean environment in four residents' rooms, specifically regarding the air conditioning (AC) filters and vents, which were observed to have a black mold-like substance. During an initial tour on September 23, 2024, the surveyors noted the presence of this substance in rooms 238-B, 235-D, 226-W, and 232-B. Photographic evidence was obtained to document these findings. Interviews with residents in these rooms revealed that they were on oxygen therapy, with one resident expressing feelings of shortness of breath. Staff E, a Maintenance Assistant, acknowledged the presence of the mold-like substance during an environmental tour on September 26, 2024, and stated that he usually cleans the AC filters once a week. Despite this routine maintenance, the black mold-like substance was still present, indicating a failure in maintaining a clean and safe environment for the residents. The census at the time of the survey was 48, highlighting the potential impact of this deficiency on multiple residents within the facility.
Failure to Monitor and Address Nutritional Needs
Penalty
Summary
The facility failed to adequately monitor and address the nutritional needs of a resident, leading to a significant weight loss over several months. The resident, who was readmitted with severe cognitive impairment and required substantial assistance with eating, experienced a weight decline from 128 pounds to 118 pounds over a period of approximately five months. Despite this weight loss trend, the facility did not implement timely or effective nutritional interventions. The Certified Dietary Manager discontinued a high-calorie nutritional supplement without providing an alternative plan, even though the resident's oral intake was inconsistent and ranged from 50% to 75% of meals. Additionally, there were inconsistencies in the administration of prescribed nutritional supplements, with several instances of delayed administration recorded. The resident was supposed to receive Ensure three times a day, but it was often given late or not at all, as noted in the Medication Administration Audit Report. Interviews with staff revealed a lack of awareness and coordination regarding the resident's nutritional needs and supplement schedule. The Clinical Dietitian and Certified Dietary Manager did not adequately monitor or respond to the resident's weight loss, failing to make necessary adjustments to the care plan.
Failure to Provide Appropriate Dialysis Care Due to Transportation Issues
Penalty
Summary
The facility failed to provide appropriate dialysis care for a resident, resulting in missed dialysis treatments. The resident, who was cognitively intact and had a history of end-stage renal disease, heart failure, and a recent hip fracture, required dialysis three times a week. However, due to transportation issues, the resident missed scheduled dialysis sessions. The facility's Dialysis Policy Statement required ongoing communication and coordination with the dialysis center, but this was not effectively implemented. The resident missed dialysis on two occasions due to transportation arriving with inappropriate equipment, such as a chair instead of a stretcher, which was necessary due to the resident's hip surgery. The facility's Staff Director of Sales attempted to rectify the situation by arranging alternative transportation, but the resident still missed a dialysis session. The lack of proper communication and coordination between the facility, the transportation company, and the dialysis center contributed to these missed treatments. Additionally, the resident tested positive for Covid-19, which further complicated the situation and led to the resident being sent to the hospital. The facility's failure to ensure timely and appropriate transportation and communication with the dialysis center resulted in the resident missing critical dialysis treatments, highlighting a deficiency in the facility's adherence to professional standards of practice for dialysis care.
Controlled Substance Management Deficiencies
Penalty
Summary
The facility failed to properly manage and destroy controlled substances for two residents, leading to discrepancies in medication reconciliation. For one resident, a Buprenorphine Transdermal Patch was not discarded as required. The patch, dated 09/10/24, was found in the medication cart instead of being destroyed and documented by two nurses. The responsible nurse admitted to forgetting to complete the destruction process and did not date the controlled substance inventory sheet. Additionally, the resident's patch was administered without proper documentation of the previous patch's destruction. For another resident, a tablet of Oxycodone-Acetaminophen was removed from the controlled substance box without a corresponding physician order or documentation on the Medication Administration Record (MAR). The medication had been discontinued earlier, yet a tablet was still removed and not accounted for in the records. The Director of Nursing confirmed the discrepancy, highlighting a failure in the facility's medication management and reconciliation processes.
Medication Administration Errors Exceed Acceptable Rate
Penalty
Summary
The facility failed to maintain a medication error rate below 5 percent, resulting in a rate of 10.34 percent. This deficiency affected two residents, who were part of a sample reviewed for medication administration. The facility's policy requires medications to be administered as prescribed and documented immediately after administration. However, discrepancies were observed in the medication administration process for two residents, leading to errors. For one resident, the medication administration observation revealed that two medications, Ferrous Sulfate and Trelegy Ellipta, were omitted during the observed administration. The nurse involved claimed to have administered the Trelegy Ellipta prior to the observation, but documentation showed otherwise. Additionally, the Ferrous Sulfate was not administered as it was not available in the medication cart, despite being signed off as given. The resident's physician was later contacted, and a one-time dose of a similar medication was administered. Another resident was supposed to receive a Multivitamin with minerals, as per the physician's order. However, during the medication administration, only a Multivitamin without minerals was available and administered. The nurse confirmed that she had not seen or administered the correct Multivitamin with minerals. A review of the facility's supply confirmed that the Multivitamin without minerals was the only type available, indicating a failure to provide the correct medication as prescribed.
Improper Diet Consistency for Pureed Diets
Penalty
Summary
The facility failed to provide the correct diet consistency for residents on a Pureed diet during dining observations. Specifically, Resident #20 and Resident #6, both with severe cognitive impairments and specific dietary orders, were served Cream of Mushroom soup that did not meet the required pureed consistency. The soup was observed to be lumpy and thick, resembling an oatmeal-like consistency, which is not compliant with the pureed diet requirements that stipulate a smooth texture with no lumps. During the observation, Resident #6 was noted to cough while attempting to consume the soup, indicating potential difficulty in swallowing due to the improper consistency. The Executive Chef admitted to not measuring the thickener accurately, instead relying on estimation, which contributed to the inconsistency in the food texture. The facility's Speech Pathologist confirmed that the soup did not meet the pureed consistency standards when shown photographic evidence, further highlighting the deficiency in food preparation for residents requiring modified diets.
Infection Control Lapses in Resident Care
Penalty
Summary
The facility failed to implement an effective infection control program, as evidenced by the mishandling of a resident with a bacterial urinary tract infection (UTI). Resident #249, who was admitted with a diagnosis of sepsis and an extended spectrum beta-lactamase (ESBL) resistant E. coli UTI, was not placed on contact precautions upon admission. Despite having an active physician order for intravenous antibiotics, the resident's room lacked signage and personal protective equipment (PPE) supplies, and staff were observed not wearing PPE when interacting with the resident. The Assistant Director of Nursing (ADON) admitted to the oversight, confirming that contact precautions were only initiated several days after the resident's admission. Additionally, the facility's infection control practices were further compromised during a wound care observation for Resident #34, who had severe cognitive impairment and was dependent on staff for daily living activities. During the procedure, a registered nurse (RN) failed to perform hand hygiene between glove changes multiple times while treating the resident's pressure ulcer. The RN was observed retrieving supplies and handling the treatment cart without washing hands, despite the facility's policy requiring hand hygiene after glove removal. Both the RN and an assisting staff member acknowledged the lapse in protocol. These deficiencies highlight significant lapses in the facility's infection prevention and control measures, particularly in the areas of transmission-based precautions and hand hygiene during wound care. The failure to adhere to established protocols for infection control put residents at risk of infection transmission and compromised the quality of care provided.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Boca Raton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Willowbrooke Court Skilled Care Center - Edgewater | 0.6 mi | ★★★★★ | 0 | 0 |
| Boca Circle Rehabilitation Center | 1.5 mi | ★★★★★ | 0 | 0 |
| Encore At Boca Raton Rehabilitation And Nursing Ce | 1.8 mi | ★★★★★ | 0 | 0 |
| Legacy At Boca Raton Rehabilitation And Nursing Ce | 2.1 mi | ★★★★★ | 0 | 0 |
| Willowbrooke Court At St Andrews Estates | 2.4 mi | ★★★★★ | 0 | 0 |
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