Aviata At North Florida

F 0580 Level of Harm - Minimal harm or potential for actual harm

nurse is to notify the attending physician and resident representative when there is a (n): significant change

in the patient/resident physical, mental, or psychosocial status, need to alter treatment significantly, new treatment. The nurse is to complete an evaluation of the patient/resident. Document the evaluation in the medical record. Notify the patient/resident and the resident representative of the change in condition.

Document the notification in the medical record.

Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/10/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Aviata at North Florida

6700 NW 10th Place Gainesville, FL 32605

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

9/10/2025. I was not able to administer the IV vancomycin because the IV pump was malfunctioning. I called the pharmacy and was told that the pharmacy had to receive the malfunctioning pump back before

they would send a replacement IV pump. I spoke with the in-house nurse practitioner, [Name of APRN #1], who was in the building at that time. The nurse practitioner gave an order to hold the vanco, but I don't remember if the NP [nurse practitioner] said to hold the vanco for one dose or for one day. On 9/11[2025] there was a stat lab to check his vancomycin level. I had a conversation with a provider regarding the results of the vanco level and it would have been [APRN #1's name] I would have called. I can't remember if I told [APRN #1's name] that the pump was still not there. I called the pharmacy again regarding the IV pump and was told the pump would be delivered that day. The pump arrived before the end of my shift on

the day before he went to the hospital. During an interview on 10/09/2025 at 10:37 AM the Administrator stated, Nurses are educated in orientation regarding medication administration and the associated processes, including ordering medications and equipment from the pharmacy. The expectation was that when a resident was admitted their medication orders were sent to the pharmacy. The facility had previously had issues regarding medication availability and administration, and it was a topic they all focused on. The process with the pharmacy was to deliver the medications and any equipment on their next run. If medication was not available from the pharmacy, the nurses had access to the [name of automated medication dispensing machine] and the pharmacy was able to get medications from a sister pharmacy if necessary. During an interview on 10/10/2025 at 2:06 PM with the DON when asked regarding the significant medication errors related to the administration of vancomycin and cefepime for Resident #1 the DON stated, I am new to the facility. I wasn't here when this hap

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/10/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Aviata at North Florida

6700 NW 10th Place Gainesville, FL 32605

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0694 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

dressing. If gauze dressing is used, cover the gauze with a TSM and change the dressing every 48 hours.Review of the policy and procedure titled Flushing Central Venous and Midline Catheters with an effective date of 1/17/2019 and the last approval date of 2/7/2025 read, Policy: Midline and central line access devices (CVADs) [Sic.] will be flushed to maintain patency, prevent mixing of incompatible medications and solutions; and to ensure entire dose of solution or medication is administered into the venous system. General Guidelines: Flushing Technique: 2. Use a push-pause or pulsing motion for flushing technique. 3. Aspirate the CVAD catheter for blood to confirm patency prior to administration of medications and solutions. Procedure: Flushing when giving medications: 6. Aspirate slowly for blood return to ensure patency of catheter. 7. Flush with normal saline (amount established by pharmacy of facility protocol) using push-pause method.Review of the policy and procedure titled Catheter Insertion and Care: Central Venous Catheter Dressing Changes with an effective date of 1/17/2019 and the last approval date of 2/7/2025 read, Policy: Central venous catheter dressings will be changed at specific intervals, or when needed, to prevent catheter-related infections associated with contaminated, loosened or soiled catheter-site dressings.

General Guidelines: 2. Change transparent semi-permeable membrane (TSM) dressings at least every 5-7 days and PRN (when wet, soiled, or not intact).

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/10/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Aviata at North Florida

6700 NW 10th Place Gainesville, FL 32605

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0726 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

[APRN #1's name] that the pump was still not there. I called the pharmacy again regarding the IV pump and was told the pump would be delivered that day. The pump arrived before the end of my shift on the day

before he went to the hospital. During an interview on 10/10/2025 at 2:06 PM with the DON when asked regarding the significant medication errors related to the administration of vancomycin and cefepime for Resident #1 the DON stated, I am new to the facility. I wasn't here when this happened.2) Review of Resident #3's admission record documented the resident was admitted on [DATE REDACTED] with diagnoses to include acute osteomyelitis, left ankle and foot, orthopedic aftercare following surgical amputation, type 2 diabetes, acquired absence of left leg below knee, acquired absence of other left toes, and unspecified sequelae of cerebral infraction.Review of Resident #3 physician order dated 10/3/2025 read, IVs: Flush Midline with 10cc of normal saline every shift and as needed. Review of Resident #3 MAR for the month of October 2025 for IV Flush 10cc documented on 10/4/2025 and 10/5/2025 at 12 :00 (midnight) administered by Staff H, LPN.Review of Resident #3's physician order dated 10/4/2025 read, Linezolid [antibiotic used to treat serious bacterial infections] intravenous solution 600 mg/300 ml (Linezolid) Use 300 ml intravenously every 12 hours for skin/skin infection for 5 days 150 ml/hr [milliliter per hour].Review of Resident #3's MAR for the month of October 2025 for Linezolid Intravenous Solution 300 ml documented on 10/04/2025 at 2100 [9:00 PM] administer by Staff H, LPN, and on 10/5/2025 at 2100 administered by Staff H, LPN.Review of Resident #3's physician orders dated 10/2/2025 read, Zosyn [intravenous antibiotic combination piperacillin and tazobactam; a broad-spectrum antibiotic used to treat moderate-to-severe bacterial infections] intravenous solution 3-0.375 gm/50 ml (3 grams of piperacillin and 0.375 grams of the beta-lactamase inhibitor tazobactam in De

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/10/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Aviata at North Florida

6700 NW 10th Place Gainesville, FL 32605

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0757

administered in accordance with prescriber orders, including any required time frame.

Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/10/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Aviata at North Florida

6700 NW 10th Place Gainesville, FL 32605

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0760 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

convenience. Factors that are considered include: a. Enhancing optimal therapeutic effect of the medication.

1. 6. Medication errors are documented, reported, and reviewed by the QAPI committee to inform process

changes and or the need for additional staff training.Review of the policy and procedure titled, 1.0 Providing Pharmacy Services, with the last review date of 02/07/2025 read, Policy: [Name of Pharmacy Provider] will: Provide a continuum of pharmaceutical services to the facility and essential medication and services for the customers. Ensure that the facility staff has access to medications, emergency service for medications, and drug information on a twenty-four (24) hour basis. Procedure: A. [Name of Pharmacy Provider] provides the facility with details how the customer can contact [Name of Pharmacy Provider] twenty-four (24) hours a day, seven (7) days a week. D. If orders for medication are received from the physician the facility may: 1. A delay in medication therapy can be prevented by using a drug that is included in the facility's Back-up Box/stat/emergency kit drug supply [located in the [name of the automated medication dispensing machine]. 3. If a drug is considered essential and cannot be substituted or delayed, please contact the [Name of Pharmacy Provider] Emergency Number.

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/10/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Aviata at North Florida

6700 NW 10th Place Gainesville, FL 32605

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

Federal health inspectors cited AVIATA AT NORTH FLORIDA in GAINESVILLE, FL for a deficiency under regulatory tag F-F0842 during a complaint investigation conducted on 2025-10-10.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 7 deficiencies cited during this inspection of AVIATA AT NORTH FLORIDA.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-11-20.