Grand Boulevard Health And Rehabilitation Center
GRAND BOULEVARD HEALTH AND REHABILITATION CENTER in MIRAMAR BEACH, FL — inspection on May 28, 2026.
Found 3 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
bathroom floor, rusted pipes behind the toilet, and stained flooring,
rusted fixtures on the shower wall.
room [ROOM NUMBER] had broken furniture, in the bathroom the tub was visibly dirty with used wash cloths lying in the tub, water damage on the wall next to the air conditioner unit, with a black colored substance underneath the air conditioner unit. room [ROOM NUMBER] had hanging lights around the ceiling. room [ROOM NUMBER] was noted to have a brownish discoloration surrounding the base of the toilet and bathroom floors were stained. room [ROOM NUMBER] had broken furniture and clutter with debris on the floor by the resident's bed.
The bathroom had cracked ceiling tiles around the sprinkler head, rusted pipes on the wall behind toilet, and a rusted three-in-one toilet. room [ROOM NUMBER] had visible brownish discoloration in three different areas on ceiling tiles in the bathroom.
An interview was conducted with the Environmental Services Manager on 05/28/2026 at 11:00 AM.
He described the job duties of housekeepers and duties of housekeeping staff. He explained they had a routine cleaning schedule but that they target rooms for residents who tend to have more messes due to dropping food and snacks and spilling drinks on the floor. He further stated if a room required repairs, if it was minor, he would try and help fix those items.
The Environmental Manager stated room [ROOM NUMBER] was an example of a target room.
When asked about the leaks throughout the facility, he stated the leaks occurred around the AC returns, mostly on the 400 and 600 units. He stated the AC returns had been leaking a while.
Probably I would say about 6 months, they have replaced two of the units on the roof, but the new company has yet to replace the others.
The roof is flat and the roof-top units leak are not working correctly, also when it rains a lot we get leaks.
Upon asking about the foul smell he stated, The pipes are cast iron, there used to be a restroom next door to this conference room, however, it was converted into a nutrition room. If the pipes have an air leak or gas leak, the odor you are smelling is coming from that.
An interview was conducted with the Maintenance Director on 05/28/2026 at 12:30 PM. He stated one of the roof-top AC units needed to be replaced. He stated, We are waiting for the final approval from corporate.
The PTACs (personal air conditioning units in each room) are working overtime causing water leaks in the facility, mainly on the 400, 500, and 600 units.
When asked about the foul sewage smell, he stated he believed it's from a leak from the pipes. He did not offer a solution or repair plan about this issue.
105601 05/28/2026
Grand Boulevard Health and Rehabilitation Center 138 Sandestin Lane Miramar Beach, FL 32550
During review of Resident #9's plan of care, it was noted that an alteration in metabolic balance related to diabetes was initiated on 12/13/2021 with interventions dated for revision on 07/26/2025.
Further review of the record indicated that Resident #9 was under the care of an endocrinologist and was started on insulin coverage in April 2026 due to elevated labs and blood sugars.
This change in status was not reflected in the plan of care.
Additionally, a plan of care was initiated on 12/10/2021 for alteration in activities of daily living (ADL) with interventions that included per therapy [Resident #9] is independent with standby assist by staff for all transfers and ambulation with a walker or cane.
The last revision date for this plan of care was 07/26/2025.
Therapy notes revealed that on 12/19/2025 through 01/17/2026, Resident #9 received physical therapy services due to a noted decrease with functional capacity, decrease in bilateral lower extremity strength, decline in ambulation and transfer ability, a decrease in balance and coordination impairing safety. On 02/17/2026 through 03/18/2026, a therapy evaluation was completed, and it was documented that therapy was needed for teaching adapting techniques to promote safety awareness, minimize falls, increase lower extremity strength and range of motion, and to decrease level of assistance from caregivers to enhance quality of life.
This was not reflected in Resident #9's plan of care.2. A record review was conducted on for Resident #4.
Documentation revealed Resident #4 was admitted to the facility on [DATE] with the diagnoses of a wedge compression fracture of the lumbar and thoracic spine, diabetes, and below the knee amputation. A plan of care was initiated for Resident #9 on 08/25/2025 for potential for adverse side effects of psychotropic medications, antidepressants, and antianxiety medications, with no revision date beyond 08/25/2025 for interventions and plan of care.
According to the current physician orders, Resident #9 was not prescribed to take antipsychotic medications at the time of the survey.A plan of care was initiated on 08/25/2025 for alteration in ADL function and indicated that Resident #4 required assistance from staff with bed mobility, transfers, dressing, eating, and personal hygiene due to decreased mobility and above knee amputation bilaterally, with current interventions that included weight bearing as tolerated of 2 for bed mobility and weight bearing assist of 2 plus mechanical lift for all transfers initiated on 12/09/2025. A plan of care was initiated on 08/28/2025 with a revised date of 12/09/2025 that stated Resident #4 was at risk for falls related to assistance with transfers, had unsteady gait (ambulation) with the intervention to observe residents' ambulation for steadiness, balance, muscle coordination, and ability to reposition and turn.During observations and interviews conducted on 05/26/2026, 05/27/2026, and 05/28/2026, Resident #4 was not able to ambulate, he did not have any prosthetics available in his room, and he stated he preferred not to get out of bed most days.An interview was conducted with the facility Regional Nurse on 05/28/2026 at 10:02 AM.
She stated the Minimum Data Set Coordinator was responsible for gathering data with the clinical team to ensure each resident's functional and cognitive abilities were accurate prior to completing an annual or quarterly assessment.
Given the time to independently review the care plans for Residents #9 and #4, the Regional Nurse acknowledged that the current care plans did not reflect the current care status of these two residents.
105601 05/28/2026
Grand Boulevard Health and Rehabilitation Center 138 Sandestin Lane Miramar Beach, FL 32550
During the care, Staff G was noted only wearing gloves, not a gown.
Staff G stated she was unaware of what Enhanced Barrier Precautions meant.
Staff G further stated she performed hand hygiene and only wore gloves when providing urinary catheter or wound care to residents.
A follow up observation was conducted with Staff H, Unit Manager on 05/27/2026 at approximately 11:45 AM.
Staff H confirmed signage for EBP along with PPE needed to be placed outside the doors of Resident #38 and Resident #48.
Staff H stated a sign would be posted.
Review of Resident #38's clinical record revealed they were admitted to the facility on [DATE].
Further review revealed an active physician's order for Enhanced Barrier Precautions.
The Comprehensive Care Plan included a care plan focus area for Enhanced Barrier Precautions with interventions. (Photographic evidence obtained.) Review of Resident #48's clinical record revealed they were admitted to the facility on [DATE].
Further review revealed an active physician's order for Enhanced Barrier Precautions.
The Comprehensive Care Plan included a care plan focus area for Enhanced Barrier Precautions with interventions. (Photographic evidence obtained.) A review of facility's policy titled Enhanced Barrier Precautions (dated 4/1/24) indicated the EBP referred to an infection control intervention designed to reduce transmission of MDRO that employs targeted gown and glove uses during high contact resident care activities.
Enhanced barrier precautions will be initiated for residents with any of the following: wounds (chronic wounds such as pressure ulcers) and/or indwelling medical devices (central lines, urinary catheters, feeding tubes, tracheostomy/ventilator tubes) even if the resident is not known to be infected or colonized with a multidrug resistant organism.
Make gowns and gloves available immediately near or outside of the resident's room. (Photographic evidence obtained.)
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.