Scott Lake Health And Rehabilitation Center

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

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

were sent to the physician; the physician reviewed and verified the orders and sent clarification and/or new orders. The Medical Director said the provider is expected to review orders between visits to ensure accuracy. He said he expected the nurses to have completed audits to ensure accuracy. He confirmed he would have expected the nurse to have documented that medications were reconciled with the provider.

The Medical Director said no doubt a provider should have been notified if a resident's vital signs and lab results were out of normal parameters. He said as the Medical Director of the facility, if the facility had difficulty with a provider not responding to a condition or if education to another provider was necessary, he should have been notified because it was his job to have discussions regarding protocols and standards of practice. Review of Resident #1's hospital records dated 8/30/25 showed:Presenting Problem: hyperglycemia, given 15 units of insulin at facility.History of Present Illness: [AGE] year-old female with a past medical history of diabetes, hyperlipidemia,hypertension, and prior breast cancer (status post left mastectomy and lymph node removal, in remission), [NAME] [inferior mesenteric artery] occlusion and SMA [superior mesenteric artery] stenosis presents with a 3-day history of abdominal pain and hyperglycemia. Glucose greater than 600 at facility given insulin prior to transport. Patient notes her pain is diffuse 8 out of 10 intensity nonradiating with no alleviating factors. Lab results in the emergency department showed:8/30/2025 5:58 p.m.WBC (white blood cell count) 16.42 x10^3/ microliter (uL) HIGHPlatelet 600 x10^3/uL HIGHNeutrophil Auto 72.5 % HIGHLymphocyte Auto 13.3 % LOWMonocyte Auto 12.4 % HIGHEosinophil Auto 0.3 % LOWAbsolute Neutrophil 11.91 x10^3/uL HIGHAbsolute Monocyte 2.03 x10^3/uL HIGHBUN 44 mg/dL HIGHCreatinine 1.47 mg/dL HIGHEstimated glomerular filtration rate (eGFR) Chronic kidney disease-equation for prediction and interpretation (CKD-EPI) 36 mL/min/1.73m^2 LOWCalcium Level 11.3 mg/dL HIGHAlkaline Phosphatase 182 U/L HIGHLipase Level 127 U/L HIGHPro b-type natriuretic peptide (PBNP) 1,010 pg/mL HIGHHS Troponin-T 60 ng/L CRITICALLY HIGHCarbamaz Level <2.0 ug/mL LOWT4 Free 1.86 ng/dL HIGHUrinalysis (UA) Appear ClearUA Color Pale yellowUA Glucose 4+UA Ketones 1+UA Protein 3+UA Bacteria Auto FewUA Epithelial Cells Auto None SeenUA Hyaline Cast Auto Few8/30/25 6:22 p.m.POC [point of care] Potassium 3.4 mmol/L LOWPOC Sodium 129 mmol/L LOWPOC [NAME] [lactate] 3.30 mmol/L HIGH Vital signs8/30/25 6:00 p.m.Blood pressure 158/93Heart rate 101Respiratory rate 18 breathes/minute Discussion of Management with Hospitalist revealed: [AGE] year-old female presents to the emergency department with diffuse abdominal pain in the setting of known severe atherosclerosis of the aorta [NAME] SMA. CT [comp[TRUNCATE

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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

10/01/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Scott Lake Health and Rehabilitation Center

800 E County Rd 540a Lakeland, FL 33813

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

orders and sent clarification and/or new orders. The Medical Director said the provider is expected to review orders between visits to ensure accuracy. He said he expected the nurses to have completed audits to ensure accura[TRUNCATED]

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

10/01/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Scott Lake Health and Rehabilitation Center

800 E County Rd 540a Lakeland, FL 33813

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

ug/mL LOWT4 Free 1.86 ng/dL HIGHUrinalysis (UA) Appear ClearUA Color Pale yellowUA Glucose 4+UA Ketones 1+UA Protein 3+UA Bacteria Auto FewUA Epithelial Cells Auto None SeenUA Hyaline Cast Auto Few8/30/25 6:22 p.m.POC [point of care] Potassium 3.4 mmol/L LOWPOC Sodium 129 mmol/L LOWPOC [NAME] [lactate] 3.30 mmol/L HIGH Vital signs8/30/25 6:00 p.m.Blood pressure 158/93Heart rate 101Respiratory rate 18 breathes/minute Discussion of Management with Hospitalist revealed: [AGE] year-old female presents to the emergency department with diffuse abdominal pain in the setting of known severe atherosclerosis of the aorta [NAME] SMA. CT [computed tomography] angiogram above no evidence of ischemic colitis unclear etiology of the patient's pain white count is 17 she was given vancomycin and Zosyn. Glucose greater than 600 now in the 400s after insulin. Given further fluids and insulin in the emergency department. She will be admitted for further management of her hyperglycemia possible underlying sepsis blood cultures were sent. Lactate was 3.3. [normal is <2] Of note patient also with new ischemic appearing EKG [electrocardiogram] with lateral ST depressions elevated troponins of 60 and 54. She is not complaining of chest pain however concern for potential NSTEMI [Non-ST-Segment Elevation Myocardial Infarction] given elevated troponins and ischemic EKG. She will be admitted to the cardiac floor for further management of numerous above conditions.Diagnoses listed were hyperglycemia due to type 2 diabetes mellitus, abnormal EKG, elevated troponin, lactic acidemia, hypertension, and abdominal pain. A Cleveland Clinic article titled Troponin Test, reviewed on 3/17/22, explained: A troponin test looks for the protein troponin (there are two forms related to your heart, troponin I and troponin T) in your blood. Normally, troponin stays inside your heart muscle's cells, but damage to those cells - like the kind of damage from a heart attack - causes troponin to leak into your blood. Higher levels of troponin in[TRUNCATE

Event ID:

Facility ID:

If continuation sheet