Deficiency Index

Every finding on record at Hospice of the Florida Suncoast Inc

Palm Harbor, Florida · CCN 101508

1 finding across 1 survey, in the inspector's own words.

The inspector’s own words from form CMS-2567, unedited, including CMS’s own spacing. Names and some dates are redacted by CMS.

Survey of March 4, 2025

1 finding
K0353

Based on record review and interviews, the facility failed to maintain the automatic fire sprinkler system (AFSS). This in the event of fire could delay or deny extinguishment of a fire. --- On 03/04/2025 between 9:15 AM and 11:50 AM during record review with the facility maintenance technician, it was revealed that the AFSS backflow failed a forward flow test on 04/10/2024. The test was provided by the municipalitys utilities water department. The report comments on 04/10/2024 at 9:36 AM ";back os&y will not close exercise multiple times gate wont close create work order to replace backflow and removing ground leak check". The instructions on the report stated, ";PLEASE REPLACE WITH NEW 8.00 IN DCDA ASSEMBLY, ALSO REMOVE IN-GROUND LEAK CHECK/LEAK METER AND NOTE ALL EQUIPMENT NUMBERS NEW AND OLD IN COMMENTS". The facility maintenance technician reached out to the municipality and an email response from them on the day of the survey (03/04/2024 at 11:44 AM) stated that the replacement for the backflow assembly that failed is being handled by a contractor at this time. In an interview concurrent with the record review, the facility maintenance technician said that he never realized the backflow assembly failed testing 9 months ago or had not been repaired since then. per NFPA 101 (2012 Edition) 19.7.6, 4.6.12 per NFPA 25 (2011 Edition) Chapter 13.6, 13.6.2.1, 13.6.3.1

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