Darcy Hall Of Life Care

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

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

entry system onto the memory care unit was replaced with the keypad the truth device. Audit reviewed. 40.

From 08/31/25 through 09/01/25 facility licensed nurses completed a review of the accuracy of 185 current residents elopement risk evaluations period of the 185 residents, 52 residents resided in the memory care unit and 51 of those who were already assessed to be at risk for elopement. The remaining 1 of 52 residents was originally placed on The [NAME] Wing unit for behavior management but has since become a risk for elopement. The residence assessment was updated to reflect the risk of elopement.Sample of 3 confirmed. 41. On 09 02/25 the care plans and CNA Kardexs' of 52 of 52 residents at risk for elopement were reviewed. All were found to be in compliance with risk for elopement identified.Audit verified. 42.

Director of Nursing /designee to complete monitoring of new admission evaluations to ensure risk for a low moment inaccuracy identified and care plan and Kardex are reflective of the risk, where appropriate.3 new admissions, 09/04/25 audited reviewed. 43. The Medical Director was informed of the citations and is in agreement with the removal plan. The following staff were interviewed for verification of staff education: Staff A, CNA was interviewed on 09/03/25 at 11:30 AM. Staff A stated she had recently completed elopement and abuse & neglect education after the incident with Resident #1; knowledge verified.Staff D, CNA was interviewed on 09/03/25 at 1:17 PM, Staff D stated she had recently completed elopement and abuse & neglect education after the incident with Resident #1; knowledge verified.Staff E, RN was interviewed 09/03/25 at 2:17 PM, Staff E stated a code silver which means a missing person in the facility, was called and every department participated in search. The education was provided after the incident occurred.The ADON was interviewed on 09/04/25 at 3:30 PM, the ADON had an elopement drill this morning. A written Elopement quiz was completed and stated some were done over the phone. She stated

on the [NAME] unit they changed the entrance touch pad to have a code residents have a wrist band on, and visitors wear red lanyard for identification. An elopement book is on every unit as well as at the receptionist's desk.Staff F, CNA was interviewed on 09/04/25 at 3:45 PM. Staff F gave examples of wandering behavior and elopement such as pushing doors and staying next to the exit. She stated they call

a code silver- missing person if they have an elopement and training included what to do if there is a missing resident. Staff F acknowledged the change of the lock system up[TRUN

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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

09/05/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Darcy Hall of Life Care

2170 Palm Beach Lakes Blvd West Palm Beach, FL 33409

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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few

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

period of the 185 residents, 52 residents resided on the memory care unit and 51 of those who were already assessed to be at risk for elopement. The remaining 1 of 52 residents was originally placed on The [NAME] Wing unit for behavior management but has since become a risk for elopement. The residence assessment was updated to reflect the risk of elopement. Audits reviewed. No concerns. 42. On 09 02/25

the care plans and CNA kardexes of 52 of 52 residents at risk for elopement were reviewed. All were found to be in compliance with risk for elopement identified.Sample of 3 residents reviewed with no concerns. 43.

Director of nursing/designee to complete monitoring of new admission evaluations to ensure risk for elopement inaccuracy identified and care plan and kardex are reflective of the risk, where appropriate. 3 admissions on 09/04/25 and audited (for west unit). 44. The Medical Director was informed of the citations and is in agreement with the removal plan. The following staff were interviewed for verification of staff education: Staff A, CNA was interviewed on 09/03/25 at 11:30 AM. Staff A stated she had recently completed elopement and abuse & neglect education after the incident with Resident #1; knowledge verified.Staff D, CNA was interviewed on 09/03/25 at 1:17 PM, Staff D stated she had recently completed elopement and abuse & neglect education after the incident with Resident #1; knowledge verified.Staff E, RN was interviewed 09/03/25 at 2:17 PM, Staff E stated a code silver which means a missing person in the facility was called and every department participated in search. The education was provided after the incident occurred.The ADON was interviewed on 09/04/25 at 3:30 PM, the ADON had an elopement drill

this morning. A written Elopement quiz was completed and stated some were do[TRUNCATE

Event ID:

Facility ID:

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