Aviata At Seminole

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

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

administration. Staff D said she does not notify the resident provider because once she reports the concern to a supervisor, it is up to them to handle the situation. Staff D said Resident #4 is very strong-willed and sometimes gets aggressive with staff. Staff D stated once he signs out on a leave of absence, then he is responsible for himself. Staff D said, We cannot control what he does once he signs out, even if he comes back to the facility smelling like marijuana. He goes outside on a leave of absence, which means he is his own person. Staff D said she reported the concerns regarding Resident #4 smoking marijuana to the supervisor before, and the supervisor addressed the issue with the resident. On 10/07/2025 at 12:20 p.m.,

an interview was conducted with Staff E, Registered Nurse, RN. Staff E said if a resident returned to the facility after a leave of absence smelling like marijuana, he would ask the resident about it. If the resident tells him no, they were not smoking an illegal substance, then there is nothing else he can do about it. Staff E said he was not allowed to search the resident even if they come back to the facility with a suspicious smell. He said the only thing he could do was to ask them if they smoked marijuana. Staff E stated Staff D had reported the concerns about Resident #4 smoking marijuana. He said when he questioned the resident about it, the resident told him he was not smoking marijuana. Staff E said Resident #4 did smell like marijuana, but there was nothing he could do if the resident tells him something different. Staff E said the only thing he could do was notify the provider, but he had not reached out to the Resident #4's provider about their concerns regarding drug use. Staff E said he thought Staff D had spoken to Resident #4's provider about the concern. On 10/07/2025 at 1:00 p.m., an interview was conducted with Staff F, Nurse Practitioner, NP. Staff F said she was the house provider, and she oversees all the residents at the facility.

Staff F said her expectations were that residents should not do illicit drugs. She said if she is made aware that a resident was doing illicit drugs, she would have the staff report the concern to psych, because she would not want any interactions with the resident's medications. Staff F said the facility had not reported to her any concerns regarding current residents using illicit drugs. On 10/07/2025 1:56 p.m., an interview was conducted with the Medical Director (MD). He said if any resident at the facility was using illicit drugs, him and the resident provider needed to be informed. He said he was never informed concerning any residents at the facility using illicit drugs. The MD stated if he was informed, he would make sure the residents know it was against the facility and federal policy. The MD said, If any resident's room smelled like Marijuana or staff sees signs of residents smoking Marijuana, then they needed to notify the residents' provider so immediate action can be taken. On 10/07/2025 at 2:00 p.m., an interview was conducted with the Director of Nurses (DON) and the Nursing Home Administrator, NHA. The DON said if a resident smelled like marijuana but did not look impaired, there was nothing they could do about it. The NHA said Nurses should contact the resident's provider if the resident was impaired or smelled like they had smoked marijuana.

Review of the facility policy titled, Notification of Change in Condition, Revision Date: 12/16/2020, Revealed Policy: The center to promptly notify the Patient/ Resident, the attending physician, and the Resident Representative when there is a change in the status or condition.

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

10/07/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Aviata at Seminole

9393 Park Blvd Seminole, FL 33777

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 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

On 10/07/2025 at 10:58 A.M. Resident #4 was observed in his wheelchair in the parking lot smoking. He said he goes to the west side of the parking lot for more privacy. He had a bottle of cologne on his lap and started spraying it on his body. Resident #4 said he was smoking marijuana (a psychoactive drug derived from the dried leaves, flowers, and stems of the Cannabis sativa or Cannabis indica plants, with effects Relaxation, Euphoria, Increased appetite, Altered perception, Impaired coordination, and Anxiety (in some users). Source:https://en.wikipedia.org/wiki/Cannabis. Resident #4 said some staff cared that he smoked and some staff did not.

On 10/07/2025 at 2:00 pm. Resident #4 was observed in room [ROOM NUMBER] sitting in his wheelchair watching television. The room was noted with a strong smell of marijuana. Resident #4 said the smell in his room comes from him smoking marijuana outside. He said he tried to spray cologne on so the smell would not be so bad.

On 10/07/2025 at 11:06 a.m. an interview was conducted with Staff C, Certified Nursing Assistant, CNA.

Staff C said Resident #4 always smells like marijuana after he comes back to the facility. She said staff, and most of the residents have complained about the smell to administration but nothing has been done about it.

On 10/07/2025 at 11:59 a.m., an interview was conducted with Staff D, License Practical Nurse, LPN. Staff D said, We cannot control what he does once he signs out, even if he comes back to the facility smelling like marijuana. He goes outside on a leave of absence, which means he is his own person. Staff D said she reported the concerns regarding Resident #4 smoking marijuana to the supervisor before, and the supervisor addressed the issue with the resident.

On 10/07/2025 at 12:20 p.m., an interview was conducted with Staff E, Registered Nurse, RN. Staff E said if a resident returned to the facility after a leave of absence smelling like marijuana, he would ask the resident about it. Staff E stated Staff D had reported the concerns about Resident #4 smoking marijuana.

Staff E said Resident #4 did smell like marijuana, but there was nothing he could do if the resident tells him something different.

On 10/07/2025 at 1:00 p.m., an interview was conducted with Staff F, Nurse Practitioner, NP. Staff F said

the facility had not reported to her any concerns regarding current residents using illicit drugs.

On 10/07/2025 1:56 p.m., an interview was conducted with the Medical Director (MD). The MD said, If any resident's room smelled like Marijuana or staff sees signs of residents smoking Marijuana, then they needed to notify the residents' provider so immediate action can be taken.

On 10/07/2025 at 2:00 p.m., an interview was conducted with the Director of Nurses (DON) and the Nursing Home Administrator, NHA. The DON said if a resident smelled like marijuana but did not look impaired, there was nothing they could do about it. The NHA said Nurses should contact the resident's provider if the resident was impaired or smelled like they had smoked marijuana.

The facility did not provide a policy on removal of odors.

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

Event ID:

Facility ID:

If continuation sheet