Inspection·July 13, 2023

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete of the shift, at about 10:00 PM. CNA N stated she did not see what happened inside resident #252's room last night, but she described CNA L as being in a little rush as the residents might have been changed too early for her. Review of the facility's policy and procedure for Resident Rights, Dignity, and Visitation Rights, issued on 4/01/22, revealed staff would treat residents with kindness, respect, and dignity. Event ID: Facility ID: 105251 If continuation sheet Page 2 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 4. Review of the medical record revealed resident #250 was admitted to the facility on [DATE] with diagnoses including brain cancer, left side paralysis, and generalized muscle weakness. Review of the Nursing admission assessment dated [DATE] showed resident #250 was oriented to person, place, time, and situation. The document indicated the resident expressed personal care and lifestyle preferences that the facility would honor as able. The assessment showed resident #250 required assistance from staff for toileting. On 7/10/23 at 5:35 PM, resident #250 explained he was continent of urine and said, I would like to use the urinal instead of a diaper. He stated on admission to the facility, he informed staff he required assistance with placement of the urinal as his left arm was paralyzed. However, resident #250 stated since being in the facility, CNAs informed him he needed to use an incontinence brief and they would change him after he urinated in the brief. On 7/10/23 at 5:47 PM, resident #250 informed the [NAME] Wing Unit Manager (UM) that CNAs had not been offering him a urinal per his request on admission. He reiterated his preference to not urinate in an incontinence brief. The [NAME] Wing UM retrieved the resident's urinal from the bathroom and held it for him to void. He verified the resident urinated readily, and voided approximately 500 milliliters (ml) of urine. For most people, the bladder holds between 500 and 700 ml of urine, but the urge to urinate usually occurs when it fills with 200 to 350 ml of urine (retrieved on 7/20/23 from www.my.clevelandclinic.org/health/body/25010-bladder). On 7/12/23 at 9:28 AM, resident #250 stated despite the discussion with the [NAME] Wing UM on 7/10/23, he still had not received assistance with the urinal as requested. He said, One lady came in yesterday and said she would help me. She must have got pulled off because she never came back. The resident stated when he was in the hospital he used the call light and staff came to his room to assist him with the urinal. The resident said, I have tried that here and it just doesn't happen.I know when I need to go. Sometimes it takes a minute to get started, but I know. Resident #250 emphasized he did not like to urinate in a brief as the bed got wet and it was just not what he was accustomed to doing. On 7/12/23 at 12:44 PM, the [NAME] Wing UM recalled he met with resident #250 on the morning after he was admitted to the facility. He stated the resident expressed a preference to be assisted to use a urinal and he assured him staff would be able to do that. The [NAME] Wing UM acknowledged he was aware this aspect of care was important to the resident. 5. Review of the medical record revealed resident #252 was admitted to the facility on [DATE] with diagnoses including fracture of the sacrum or tailbone, Multiple Sclerosis, Parkinson's Disease, spinal stenosis, generalized muscle weakness, and a history of falls. Review of the Minimum Data Set (MDS) admission assessment with assessment reference date of 6/30/23 revealed resident #252 had a Brief Interview for Mental Status score of 13 which indicated she was cognitively intact. The document showed the resident required extensive assistance from two staff members for dressing, extensive assistance from one staff member for personal hygiene, and she was totally dependent on one staff member for bathing. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 3 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Resident #252 had a care plan for self-care deficit with grooming and bathing initiated on 6/30/23. The interventions instructed staff to provide hands on assistance with dressing, grooming, and bathing as needed. Review of the [NAME] Wing shower schedule revealed resident #252 was scheduled for showers during the day shift on Mondays, Wednesdays, and Fridays. On Monday, 7/10/23 at 5:27 PM, resident #252 stated in over two weeks since admission to the facility, she received one shower and one complete bed bath. She said, That's it since I've been here. She stated on admission, she was informed she would be able to have a shower or bed bath on Mondays, Wednesdays, and Fridays. The resident explained the extent of daily care besides those two occasions was just help with changing her incontinence brief and wiping that area. She pointed to a package of disposable wipes on her overbed table and stated she used them to clean her underarms. On 7/11/23 at 11:10 AM, the resident was in bed and confirmed she wore the same T-shirt from the previous afternoon. She said, No shower yet. On 7/12/23 at 1:03 PM, the Director of Nursing stated her expectation was staff would offer either bed baths or showers according to the resident's preference on the scheduled days of the week, and additional baths as needed or requested. Review of the facility's Welcome Guide dated 1/01/23 revealed every resident had the right to self-determination and would be treated in a manner that promoted quality of life and recognized individuality. Review of the facility's policy and procedure for Resident Rights, Dignity, and Visitation Rights, issued on 4/01/22, revealed the facility would assist each resident to exercise his or her rights and provide care that was .consistent with his/her normal life habits, observing the resident's choices whenever able. Based on observation, interview and record review, the facility failed to honor the right to make choices about significant aspects of activities of daily living related to preferred method of toileting (#250), and frequency and preferred method of bathing, (#9, #28, #307, #308, #252) for 6 of 8 residents reviewed for choices of a total sample of 44 residents. Findings: 1. Resident #9 was admitted to the facility on [DATE] with diagnoses to include depression, bipolar disorder, sleep apnea. The resident's quarterly Minimum Data Set (MDS) assessment with Assessment Reference Date (ARD) of 2/14/23 revealed the resident's cognition was intact, with a Brief Interview for Mental Status (BIMS) score of 15 out of 15. Resident #9 required limited assistance with one person for dressing, personal hygiene, and one-person physical assist for bathing. On 7/10/23 at 1:50 PM, resident # 9 stated she had not had a shower since she moved to this room. She said they brought a towel and wash cloth in for her to wash herself. Review of the medical record revealed the resident transferred to her current room on 6/25/23 and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 4 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0561 had one shower since the move with no other type of bathing noted. Level of Harm - Minimal harm or potential for actual harm 2. Resident #28 was admitted to the facility on [DATE] with diagnoses of encephalopathy, and history of falls. Residents Affected - Some The resident's modified quarterly MDS assessment with ARD of 5/19/23 revealed the resident was cognitively intact with a BIMS of 15 out of 15. She required limited assistance of one person for bed mobility, transfers, dressing, person hygiene, and one-person physical assist for bathing. On 7/13/23 at 4:41 PM, resident #28 stated she preferred showers but was always given a bed bath. Review of the record revealed resident #28 received a bed bath on 6/30/23, 7/03/23, 7/05/23, and 7/10/23. There was no documentation for showers noted. 3. Resident #307 was admitted to the facility on [DATE] with diagnoses of end stage renal disease, with dependence on dialysis. On 7/11/23 at 2:00 PM, the resident stated she had not been offered a shower since admission, nor was she offered a bed bath. She said, I take myself in the bathroom and wash off. A care plan dated 7/03/23 noted resident #307 had a self-care deficit with dressing, grooming, and bathing related to generalized weakness, and limited endurance. 4. Resident #308 was admitted to the facility on [DATE] with diagnoses of encephalopathy, history of falls, and artificial hip joint. On 7/11/23 at 2:14 PM, resident #308 stated she had her first shower yesterday. She said, I have not been offered a bed bath or shower since admission. I take myself to the bathroom and wash up. The resident said it felt so good to get a shower. A care plan dated 6/30/23 read resident #308 has a self-care deficit with dressing, grooming, and bathing related to generalized weakness. On 7/12/23 at 5:18 PM, the [NAME] Wing Unit Manager stated his expectation was that residents received showers on their shower days. He stated he would also expected the Certified Nursing Assistant (CNA) be truthful about showers. He explained, In the future I will be checking behind the CNA to ensure the showers are done. He noted he spoke to residents daily and none of them told him they were not getting showers. On 7/13/23 at 1:17 PM, CNA J stated when a resident was ready to get up in the morning and it was not their shower day, she would wash them up and get them dressed. She said, if they get around independently, I give them a towel and washcloth so they can wash up. If they need help, they will ask. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 5 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure a bathroom shared by residents in 1 of 18 bathrooms on the East Wing (room [ROOM NUMBER]) and 2 of 29 rooms on the [NAME] Wing (rooms #154 & #156) were maintained in a clean and homelike condition. Findings: 1. Observations conducted on 07/10/23 at 3:10 PM, 07/11/23 at 12:17 PM, 7/12/23 at 9:29 AM, 12:52 PM, and 5:44 PM and on 07/13/23 at 10:27 AM and 1:24 PM revealed room [ROOM NUMBER] bathroom (East Wing) with 7 pink plastic wash basins stacked inside each other on the bathroom floor under a white plastic shower/commode chair. The basins were not labeled with resident names and they were not covered. A pink plastic bedpan (not labeled with resident name or covered) was inside the top wash basin. A yellow plastic fracture bedpan (not labeled with resident name or covered) had been placed in the pink bedpan. On 07/13/23 at 10:27 AM and 1:24 PM, there was a small plastic laboratory specimen collection bag with a biohazard symbol inside of the yellow fracture bedpan. The resident in room [ROOM NUMBER]-B used the bathroom. On 07/13/23 at 1:25 PM, an interview with the East Wing Unit Manager and the Assistant Director of Nursing (ADON) was conducted. The East Wing Unit Manager said she had been conducting resident room rounds which included observations of the resident's room and bathroom. She said she observed for safety issues, checked if the rooms were neat, clean, and uncluttered and were free of trash. She explained there was a Guardian Angel Rounds program in place where management staff were assigned to resident rooms and completed a form which indicated what areas were to be observed. The ADON explained the resident room rounds were conducted daily, and issues were documented on the form then submitted to the Administrator. The ADON stated, All staff are responsible for insuring the resident rooms and bathrooms are clean. Observation of room [ROOM NUMBER]'s bathroom was then conducted with the East Wing Unit Manager and the ADON The East Wing Unit Manager and the ADON confirmed the findings and they stated, Nothing is to be stored on the floors and all resident care items are to be labeled with the resident's name, placed in a plastic bag, and stored in the resident's area to prevent cross-contamination. On 07/13/23 at 1:59 PM, the Administrator identified the East Wing Unit Manager was assigned and responsible for rounds in room [ROOM NUMBER] on the East Wing. The ADON said the East Wing Unit Manager was a new employee and she had just received her room assignment on 07/13/23. Review of the Observation For Action Rounds Guardian Angel Program form revealed room and bathroom were clean and odor free, nothing was stored in bathroom (unless separated and labeled with resident/roommate identifier i.e. urinal/bedpan/graduate). Review of the facility's Disposable Resident Care Product Utilization Policy, dated 4/1/2022, read, Policy: It is the policy of the facility to ensure products utilized for the provision of personalized resident care are available, utilized appropriately and discarded when no longer needed. Procedure: . 3. Disposable resident care products can be stored in resident bedside dressers, cabinets, closets and bathrooms. If a room has more that one resident that utilizes the same disposable care product, that is reusable, it is permissible to store in the same location if the item is labeled or otherwise indicates for which resident the item is to be used. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 6 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 Review of the Facility Assessment last updated 10/31/2022 under General Care: revealed the facility is responsible for infection identification, containment and prevention. 2. On 7/10/23 at 1:18 PM, during tour of the [NAME] Wing, a large puddle of yellow liquid with an odor of urine was noted on the floor to the left of the toilet, in the shared bathroom between rooms #154 and #156. Residents Affected - Few On 7/10/23 at 1:24 PM and 1:34 PM, the Environmental Services Director inspected the shared bathroom and confirmed there appeared to be urine on the floor. He stated he was not aware of any ongoing concerns regarding the cleanliness of the bathroom. The Environmental Services Director explained he conducted daily rounds of the facility but never noticed a problem with the bathroom. On 7/10/23 at 1:31 PM and 7/12/23 at 1:16 PM, Certified Nursing Assistant (CNA) H verified there was a problem with the cleanliness of the shared bathroom for approximately the past two weeks. She explained one of the four residents who used the shared bathroom regularly urinated everywhere. She recalled during one particular shift she had to clean up urine on the bathroom floor three times. CNA H stated the residents in room [ROOM NUMBER] used urinals at bedside to avoid using the bathroom as much as possible, and they also sometimes walked to the shower room at the end of the hallway to use the toilet. On 7/10/23 at 1:36 PM and 1:44 PM, Housekeeper M stated earlier that morning, CNA O expressed concerns about the shared bathroom and she cleaned it. Housekeeper M stated her supervisor, the Environmental Services Director, never instructed her to monitor that bathroom more closely. She explained the facility's housekeepers worked from 7:00 AM to 3:00 PM and the CNAs were responsible for cleaning up after the housekeepers left for the day. On 7/13/23 at 10:00 AM, CNA O verified on the morning of Monday 7/10/23 she informed Housekeeper M there was feces on the floor of the shared bathroom. She explained the urine noted later that day was a separate incident. On 7/10/23 at 1:38 PM, the facility's Concierge explained rooms #154 and #156 were assigned to her for Guardian Angel Rounds. Review of the form utilized for the task revealed the Concierge was responsible for identifying any concerns related to cleanliness and odors of the rooms and bathrooms. The Concierge stated during rounds, one of the residents in room [ROOM NUMBER] complained about the state of the bathroom and she told the housekeeper who cleaned it. The Concierge could not recall the date of the reported concern, nor the name of the housekeeper, but she denied it was Housekeeper M. On 7/10/23 at 1:40 PM, the [NAME] Wing Unit Manager (UM) stated he was aware one of the residents in room [ROOM NUMBER] urinated on the floor in the shared bathroom. He acknowledged the situation warranted more frequent monitoring and cleaning of the floor. The facility's policy and procedure for Environment of Care, issued on 4/01/22, revealed the facility would provide residents a safe, clean, comfortable, and homelike environment. The document indicated the facility would provide adequate housekeeping services to ensure sanitary surroundings. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 7 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to appropriately record and investigate a grievance to ensure resolution in a timely manner for 1 of 1 resident reviewed for grievances, of a total sample of 44 residents, (#71). Findings: Review of the medical record revealed resident #71 was admitted to the facility on [DATE] with diagnoses including left shoulder osteoarthritis, aortic stenosis, generalized weakness, and chronic kidney disease. Review of the Minimum Data Set (MDS) Quarterly assessment with assessment reference date of 6/23/23 revealed resident #71 had a Brief Interview for Mental Status score of 15 out of 15 which indicated he was cognitively intact. The MDS assessment showed the resident was independent with all activities of daily living, except for supervision with dressing, and he was always continent of bowel and bladder. On 7/10/23 at 1:18 PM, resident #71 explained the main concerns that affected his life in the facility was the bad condition of his bathroom. He said, It's never clean. Since the new guy came in, none of us can really use it. Everybody knows about it. Resident #71 stated he reported the situation to Certified Nursing Assistants (CNAs) and the Concierge much more than once. He explained the CNAs knew about the problem because they saw it all the time, in addition to his complaints. Resident #71 explained the bathroom was shared by four residents including himself, and they were all affected by its condition. Observation of the shared bathroom revealed a large puddle of yellow liquid with an odor of urine on the floor to the left of the toilet. The resident said, It's like that all the time. It might not be normal to you, but I'm accustomed to it. On 7/10/23 at 1:24 PM and 1:34 PM, the Environmental Services Director inspected the shared bathroom and confirmed there appeared to be urine on the floor around the toilet. Resident #71 informed him the bathroom was like that very often and he had reported it to multiple staff including the Concierge and CNAs. The Environmental Services Director stated he was never made aware of the resident's grievance regarding the bathroom. On 7/10/23 at 1:31 PM, CNA H stated resident #71 and the other residents who used the shared bathroom complained to her and stated they were upset about the condition of the bathroom. She confirmed she reported the situation to the [NAME] Wing Unit Manager (UM) and nurses assigned to the residents. On 7/10/23 at 1:38 PM, the facility's Concierge confirmed resident #71 complained to her about the condition of his bathroom and she asked a housekeeper to clean the floor. The Concierge could not recall the date of the reported concern, nor the name of the housekeeper. She acknowledged she did not complete a grievance form regarding the issue as she believed it was resolved once the bathroom was cleaned. On 7/12/23 at 2:59 PM, the Social Services Director (SSD) explained grievance forms were accessible to anyone as they were placed in multiple locations throughout the facility. She provided a Grievance-Complaint Report dated 7/1 written by the Concierge regarding resident #71's complaint about the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 8 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0585 Level of Harm - Minimal harm or potential for actual harm condition of his bathroom. The SSD stated she received the form yesterday, 7/11/23, and was not aware the resident reported concerns prior to that day. She was informed the resident stated he complained to multiple staff about the issue which began soon after a new resident was admitted to the adjoining room in the past month. The SSD acknowledged if staff followed the grievance process, the interdisciplinary team would have been notified of the concerns and conducted an investigation. Residents Affected - Few On 7/12/23 at 3:02 PM, the Concierge validated she wrote the grievance form yesterday, 7/11/23. She explained she did not remember the actual date resident #71 complained about the shared bathroom so she tried to back date the document and meant to put a question mark following the date of 7/1. The Concierge stated she believed the resident expressed his concerns possibly around the first of July. On 7/12/23 at 6:06 PM, the facility's Executive Director stated the Concierge wanted to clarify her previous statements regarding resident #71's grievance about the condition of his bathroom. The Concierge stated the date of 7/1 on the grievance form she wrote was wrong and it was supposed to be 7/10, the past Monday, as that was the day she informed the housekeeper the bathroom needed to be cleaned. The Executive Director and Concierge were informed the correction would be added to the survey documentation but interviews with resident #71 and staff indicated the problem existed prior to Monday 7/10/23. They were told Housekeeper M was the staff who worked on 7/10/23, not potential housekeepers named by the Concierge, and Housekeeper M stated she discussed resident #71's bathroom with a CNA that day. Review of the facility's Grievance Log for June and July 2023 revealed no entries regarding resident #71's grievance. Review of the facility's policy and procedure for Grievances, issued on 4/01/22, revealed staff would assist residents to write formal grievances, and if expressed verbally, staff would record the grievance on the appropriate form. The policy indicated the individual who filed a grievance had the right to resolution in a reasonable timeframe, and the facility would document a written decision to include investigation findings, conclusions, and corrective actions if indicated. Review of the undated job description for Concierge revealed duties and responsibilities included reporting all complaints and grievances made by residents to a nursing supervisor or any member of management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 9 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to implement its policy and procedures for prohibition of Abuse for 1 of 4 residents reviewed for Abuse, of a total sample of 44 residents, (#252). Residents Affected - Few Findings: Review of the medical record revealed resident #252 was admitted to the facility on [DATE] with diagnoses including fracture of the sacrum or tailbone, Multiple Sclerosis, Parkinson's Disease, spinal stenosis, generalized muscle weakness, and a history of falls. Review of the Minimum Data Set admission assessment with assessment reference date of 6/30/23 revealed resident #252 had a Brief Interview for Mental Status score of 13 which indicated she was cognitively intact. On 7/11/23 at 1:12 PM, resident #252 expressed concerns regarding a bad experience with staff on her first night in the facility that made her feel afraid. The resident stated in the morning she informed the [NAME] Wing Unit Manager (UM) that she was scared and staff were mean to her. On 7/11/23 at 1:27 PM, the [NAME] Wing UM confirmed resident #252 told him about an incident with staff which caused her to feel afraid. The [NAME] Wing UM stated he felt the Certified Nursing Assistants (CNAs) treated residents well and resident #252's fear might have been caused by her perception of the way people of other cultures expressed themselves. He explained he interviewed the resident and she clarified she did not feel like there was a physical threat to her well being. The [NAME] Wing UM stated what he understood from the resident was that the CNA was probably a little gruff. He recalled he mentioned the issue at the daily clinical meeting and it was discussed briefly, but the team decided it did not meet the criteria for Abuse or Neglect. He explained the incident was not investigated as it did not arise to the level of Abuse. On 7/11/23 at 1:33 PM, the Director of Nursing (DON) confirmed she was the facility's Abuse Coordinator but she was not sure if an allegation of Abuse for resident #252 was investigated as she had not yet started work in her current position on the day the resident was admitted . Review of the facility's log of Abuse, Neglect, and Misappropriation allegations for June and July 2023 revealed no documentation of an Abuse allegation by resident #252. On 7/11/23 at 1:41 PM, the Executive Director, Corporate Nurse, DON and the [NAME] Wing UM were informed of concerns related to the absence documentation of resident #252's allegation of possible Abuse in her medical record or on the log of reportable incidents. The Corporate Nurse was informed the resident informed the [NAME] Wing UM she felt afraid on her first night in the facility, and although he notified the interdisciplinary team (IDT), an investigation was not initiated. The Corporate Nurse validated if the resident expressed fear of an employee, the facility should conduct an investigation. On 7/13/23 at 12:05 PM, the [NAME] Wing UM was informed resident #252's electronic medical record was updated on 7/12/23 to reflect an Interdisciplinary Plan of Care Review Meeting Summary dated 6/23/23. He stated he wrote the note after the IDT discussion. The [NAME] Wing UM was reminded both he and resident #252 stated they discussed the incident on 6/24/23, the morning after she was admitted . (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 10 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0607 He explained he was not aware the allegation was reportable, but had since been made aware. Level of Harm - Minimal harm or potential for actual harm Review of the job description for Unit Manager dated 1/01/15 revealed he/she would review complaints and grievances made by residents and make written and oral reports to the DON. The UM was expected to report and investigate all allegations of Abuse and/or Neglect. Residents Affected - Few Review of the facility's policy and procedures for Abuse, Neglect, Exploitation and Investigations, issued on 4/01/22, revealed all alleged violations of Federal or State laws would be reported immediately to the facility's Executive Director, DON, or Abuse Coordinator. The document defined Abuse as inclusive of intimidation with resulting mental anguish. The policy indicated all staff would be trained to recognize and report possible Abuse to the appropriate staff and the facility would notify State agencies and file required Federal reports. The facility would notify the attending physician and the resident's representative, and involved staff would be removed from the schedule while the facility conducted a thorough internal investigation. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 11 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0645 PASARR screening for Mental disorders or Intellectual Disabilities Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to conduct a Level 1 Preadmission Screening and Resident Review (PASARR) for 1 of 4 residents reviewed for PASARRs of a total sample of 44 residents, (#26). Residents Affected - Few Findings: Review of the medical record revealed resident #26 was admitted to the facility on [DATE] with diagnoses including post-traumatic stress disorder, epilepsy, recurrent mild depressive disorder, dementia, and traumatic brain injury. Review of the Minimum Data Set (MDS) admission assessment with assessment reference date of 5/22/23 revealed resident #26 was admitted to the facility from another nursing home or swing bed. The MDS assessment indicated the resident was not evaluated by a Level 2 PASARR and determined to have a serious mental illness and/or mental retardation or a related condition. PASARR is a federal requirement to help ensure that individuals are not inappropriately placed in nursing homes for long term care and that they receive necessary services in the most appropriate setting. PASARR requires that Medicaid-certified nursing facilities conduct a preliminary assessment called a Level 1 screen prior to admission, to determine whether the potential resident might have a serious mental illness or intellectual disability. Those individuals who test positive at Level I are then evaluated in depth with a Level 2 screen to determine appropriate placement and recommended services (retrieved on 7/20/23 from www.medicaid.gov/medicaid/long-term-services-supports/institutional-long-term-care/preadmission-screening-and-resident Review of scanned documents in resident #26's electronic medical record showed no PASARR form. On 7/12/23 at 2:33 PM, the Social Services Director (SSD) was asked if she could assist in locating resident #26's PASARR form in the electronic medical record. She reviewed the scanned documents and validated the PASARR form was not scanned into the medical record. The SSD explained the resident was admitted from another skilled nursing facility and a PASARR form should have been generated by the current facility. The Medical Records staff who shared the SSD's office was asked to check unscanned paperwork for the resident's PASARR form. The Medical Records staff searched through her papers, was not able to find the document, and left the office. On 7/12/23 at 3:34 PM, the SSD provided a PASARR Level 1 form for resident #26. The document listed the name and address of the current facility as the present location of the individual being evaluated. The form indicated the resident had mental illnesses or suspected mental illnesses (depressive disorder and post-traumatic stress disorder) and a related condition (epilepsy). The document read, Incomplete forms will not be accepted. By signing this form below, I attest that I have completed the above Level I PASARR screen for the individual to the best of my knowledge. The PASARR form was signed by Registered Nurse (RN) K and the line designated for the date was incomplete and read, 1. Review of the facility's active staff list revealed RN K was not listed as a current employee. On 7/13/23 at 9:33 AM, the Human Resources staff confirmed RN K no longer worked at the facility. She stated RN K used to be the facility's Assistant Director of Nursing (ADON) and Staff Educator before she was terminated on 1/17/21. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 12 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0645 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few On 7/13/23 at 9:37 AM, the Admissions Director explained residents who were admitted from other skilled nursing facilities, home or assisted living facilities (ALFs) would have PASARR forms complete in-house. She stated when resident #26 was admitted from an ALF in May 2023, the facility did not have an ADON, so the Director of Nursing (DON) would have completed the form. The Admissions Director showed an email dated 5/15/23 at 1:46 PM that she sent to all department heads including the Executive Director, the DON, and SSD, with detailed information regarding the resident's transition to long-term care. The email read, He will need a PASARR. The Admissions Director stated when the Medical Records staff informed her yesterday that there was no PASARR form for resident #26, she told her she sent the email to the DON. On 7/13/23 at 10:30 AM, the DON verified resident #26's PASARR Level 1 form was not dated and never uploaded into the electronic medical record. She was asked if she could explain how the document was signed by RN K who was terminated more than two years prior to the resident's admission. The DON stated she had no idea how old the form was or where it came from. On 7/13/23 at 11:08 AM, the SSD stated she found the PASARR form in a box on the [NAME] Wing nurses' station, The facility's policy and procedure for Role of Admissions and Social Services in PASARR, issued on 4/10/22, revealed the facility would ensure each resident was screened for a mental disorder or intellectual disability prior to admission. The policy indicated the PASARR Level 1 form would be scanned into the electronic medical record or maintained in a specified tracking mechanism. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 13 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0655 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to develop and implement a baseline care plan that reflected person-centered care related to assistance with toileting for 1 of 3 residents reviewed for activities of daily living (ADLs), of a total sample of 44 residents, (#250). Findings: Review of the medical record revealed resident #250 was admitted to the facility on [DATE] with diagnoses including brain cancer, left side paralysis, and generalized muscle weakness. Review of the Nursing admission assessment dated [DATE] showed resident #250 was oriented to person, place, time, and situation. the document indicated the resident expressed personal care and lifestyle preferences that the facility would honor as able. The assessment showed resident #250 required assistance from staff for toileting and did not have a urinary catheter. On 7/10/23 at 5:35 PM, resident #250 explained he was continent of urine and on admission to the facility, he informed staff he required assistance with placement of the urinal as his left arm was paralyzed. Resident #250 stated since being in the facility, Certified Nursing Assistants (CNAs) informed him he needed to use an incontinence brief and they would change him after he urinated in the brief. Review of resident #250's medical record revealed a baseline care plan for assistance with ADLs was initiated on 7/03/23. The goal noted the resident would have his ADL needs met. The interventions instructed nursing staff to assist and provide ADL care and support as needed. The baseline care plan did not include information regarding the resident's request to use a urinal instead of an incontinence brief for voiding. A baseline care plan for expressed personal care and lifestyle preferences was initiated on 7/03/23, but was noted to be resolved, and it had no interventions listed. Review of the CNA care plan or [NAME] showed at the time resident #250 was interviewed on 7/10/23, there were no person-centered care instructions regarding use of a urinal for toileting. On 7/12/23 at 12:44 PM, the [NAME] Wing Unit Manager (UM) recalled he met with resident #250 on the morning after he was admitted to the facility. He confirmed the resident expressed a preference to be assisted to use a urinal and he thought he updated the [NAME] with that information on the same day. Review of the [NAME] with the [NAME] Wing UM and the Director of Nursing (DON) revealed the document now included instructions for a toileting plan that involved prompting the resident every two hours and cuing him with a urinal. The DON was asked to review the baseline nursing care plans for this intervention and she was not able to locate it. On 7/13/23 at 3:36 PM, the Minimum Data Set (MDS) Licensed Practical Nurse (LPN) validated resident #250 never had a person-centered baseline care plan developed for incontinence and/or toileting. She was informed a new intervention regarding use of a urinal was discovered on the CNA [NAME] although there was no related baseline care plan. The MDS LPN reviewed the resident's electronic medical record and noted the intervention was added to the [NAME] by the Regional Nurse on 7/10/23. The MDS LPN explained if staff placed items on the [NAME] without entering an order, progress note, other documentation, or verbally communicating with her, she would not be aware of the need to include it in the baseline care plan. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 14 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0655 Level of Harm - Minimal harm or potential for actual harm Review of the facility's policy and procedures for Baseline Care Plans, issued on 4/01/22, revealed the facility would develop and implement a baseline care plan within 48 hours of admission that included instructions necessary to meet residents' person-centered care needs. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 15 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to develop a comprehensive, person-centered care plan to address dental care and services required by 1 of 2 residents reviewed for dental services, out of a total sample of 44 residents, (#26). Findings: Review of the medical record revealed resident #26 was admitted to the facility on [DATE] with diagnoses including arthritis of both knees, type 2 diabetes, legal blindness, and a history of falls. Review of the Minimum Data Set (MDS) admission assessment with assessment reference date of 5/22/23 revealed resident #26 had a Brief Interview for Mental Status score of 14 which indicated he was cognitively intact. The document showed the resident had no obvious or likely cavity or broken natural tooth. On 7/11/23 at 11:18 AM, resident #26 pointed to his left lower jaw and stated he had a broken tooth. The brown, jagged surface of an obviously broken and possibly decayed lower left tooth was clearly visible during conversation with the resident. Review of the resident's comprehensive care plan as of 7/11/23 revealed no care plan focus, goals, or interventions related to dental issues. On 7/12/23 at 2:33 PM, the Social Services Director (SSD) stated she was not aware of any dental concerns for resident #26. She reviewed the resident's medical record and confirmed the admission nursing assessment and the initial MDS assessment showed resident #26 had no dental issues. When the SSD was informed the resident did not have a dental care plan, she began to type on her computer keyboard and said, He did not have a dental care plan, but I just put one in. On 7/13/23 at 3:16 PM, the MDS Licensed Practical Nurse (LPN) stated resident #26's broken tooth should have been identified by the admission nurse and/or the MDS nurse who conducted the admission assessment. She verified if nurses had noted the resident's broken tooth, an appropriate care plan would have been initiated. Review of the facility's policy and procedure for Comprehensive Assessments and Care Plans, issued on 4/01/22, revealed the facility would conduct a comprehensive and accurate assessment of a resident's needs and goals which would include his/her dental status. The policy indicated the results of the assessment would be used to develop and implement a comprehensive person-centered care plan for the resident. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 16 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to provide activities of daily living (ADL) care related to shaving, bathing, and nail care to maintain good grooming and personal hygiene for 2 of 3 residents reviewed for ADL care, out of a total sample of 44 residents, (#26 & #250). Residents Affected - Few Findings: 1. Review of the medical record revealed resident #26 was admitted to the facility on [DATE] with diagnoses including arthritis of both knees, type 2 diabetes, legal blindness, and a history of falling. Resident #26 had a care plan for self-care deficit with dressing, grooming, and bathing initiated on 5/17/23. The goal was the resident would have a clean, neat appearance. Interventions instructed staff to assist the resident with keeping his nails short, shaped, and clean, and provide hands on assistance with dressing, grooming, and bathing as needed. Review of the Minimum Data Set (MDS) admission assessment with assessment reference date of 5/22/23 revealed resident #26 had a Brief Interview for Mental Status score of 14 which indicated he was cognitively intact. The document revealed the resident required extensive assistance from one staff for personal hygiene tasks. The MDS assessment indicated during the look back period, resident #26 did not reject care such as assistance with ADLs that was necessary to achieve his goals for well being. Review of the [NAME] Wing shower schedule showed resident #26 was scheduled for baths during the evening shift on Mondays, Wednesdays, and Fridays. On 7/11/23 at 9:46 AM, resident #26 stated his last shower was about two weeks ago and he did not receive regular full bed baths as an alternative. When asked if staff provided sponge baths to include his face and underarms, he said, Nothing like that. Resident #26 stated he did not know if there were scheduled shower days as the staff told residents when it was time for a shower. He said, The last time somebody told me about a shower I waited, but they never came back. On 7/11/23 at 9:50 AM, resident #26's fingernails on both hands were noted to be approximately one third of an inch long and dirty. There was dark brown material noted underneath all fingernails. The resident stated he did not like his fingernails long and wanted staff to keep them trimmed. The resident had a significant amount of long, curly, unkempt facial hair and he confirmed he did not like his beard to look the way it did. On 7/11/23 at 9:52 AM, the [NAME] Wing Unit manager (UM) confirmed resident #26's fingernails were dirty and too long. He acknowledged the resident's nail care should have been completed by staff. Resident #26 informed the [NAME] Wing UM that when his nails were long, they get nasty. The resident told the [NAME] Wing UM he did not like to have that much facial hair. He explained he would like the hair on his cheeks and under his neck to be shaved, but he wanted to keep a neatly trimmed moustache and beard. The [NAME] Wing UM acknowledged it was within a CNA's job description to perform those ADL tasks for resident #26. Review of resident #26's medical record revealed documentation by the [NAME] Wing UM related (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 17 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few showers and ADL care. Progress notes dated 6/12/23 and 7/01/23 revealed the resident was showered by CNA and nail care was performed. On 7/12/23 at 2:24 PM, the [NAME] Wing UM validated he documented on showers and nail care provided by staff although he did not observe completion of the tasks. He explained his documentation reflected information provided by CNAs. The [NAME] Wing UM acknowledged CNAs could not have provided scheduled showers and nail care based on his observations of resident #26. On 7/13/23 at 3:16 PM, the MDS Licensed Practical Nurse (LPN) reviewed CNAs' documentation regarding baths on resident #26's ADL flowsheets. She explained between 6/14/23 and 7/07/23, staff documented the resident received four bed baths and one shower in the 3-week period. The MDS LPN confirmed on 7/11/23, she created a care plan for resident #26's refusal of showers and nail care at the request of facility management staff. The MDS LPN stated in the last two weeks, since she had returned to work, she was not made aware there was a concern with resident #26 regarding refusal of ADL care until she was asked to update the care plan. The MDS LPN validated resident #26's most recent MDS assessment showed he did not reject care. 2. Review of the medical record revealed resident #250 was admitted to the facility on [DATE] with diagnoses including brain cancer, left side paralysis, and generalized muscle weakness. Review of the Nursing admission assessment dated [DATE] showed resident #250 was oriented to person, place, time, and situation. The document indicated the resident expressed personal care and lifestyle preferences that the facility would honor as able. Resident #250 had a baseline care plan for assistance with ADLs, initiated on 7/03/23, which instructed nursing staff to assist and provide ADL care and support as needed. Review of the [NAME] Wing shower schedule showed resident #250 was scheduled for baths during the evening shift on Mondays, Wednesdays, and Fridays. On 7/10/23 at 5:43 PM, resident #250's hair appeared greasy and limp. He stated during the week he had been a resident of the facility he had not yet received a shower nor had his hair properly washed. He recalled on one occasion a staff member used a washcloth to wipe through his hair. The resident said, I would love to have a shower. He explained he understood the difficulty involved with transfers due to his disability and paralysis on one side, so he would accept regular bed baths as an alternative. The resident had a significant amount of long facial hair and stated he would like to be shaved. He explained he was not accustomed to a full-bearded look and he preferred a goatee with no hair on his cheeks. Resident #250 stated if that was a problem, he preferred to be clean-shaven. Observation of the resident's fingernails revealed they were approximately one third inch long and had a significant amount of black and dark brown substances tightly packed underneath each fingernail. Resident #250 looked at his right hand, frowned, and emphatically stated he did not like it. The resident stated when he was in the hospital he was told nursing facility staff would assist with his ADL care needs. On 7/10/23 at 5:47 PM, the [NAME] Wing UM confirmed resident #250's fingernails were too long and very dirty. He validated the resident required nail care. Resident #250 informed the [NAME] Wing UM he had not received a shower or regular baths since admission. On 7/12/23 at 12:44 PM, the Director of Nursing stated her expectation was staff would offer (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 18 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few showers or bed baths on scheduled days and as needed. She validated the facility had equipment that made it was possible for resident #250 to have showers even if he could not stand and transfer without assistance. On 7/13/23 at 3:36 PM, the MDS LPN stated CNAs' flowsheets in resident #250's medical record showed during seven days in the facility, he had two bed baths and no showers. Review of the job description for a Certified Nursing Assistant dated 1/01/15 revealed duties and responsibilities included following work assignments and/or schedules, and assisting residents with daily bath functions, hair care, nail care, and shaving male residents. Review of the facility's policy and procedures for ADL Care and Assistance, issued on 4/01/22, revealed the facility would provide residents with ADL care and assistance to include personal hygiene and bathing, while attempting to maintain the highest practicable level of function. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 19 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, and record review, the facility failed to ensure surgical wound treatments were initiated and provided for 1 of 1 resident reviewed for non-pressure skin out of a total sample of 44 residents, (#298). Residents Affected - Few Findings: Review of resident #298's medical record noted he was admitted to the facility on [DATE] with diagnoses of Open Reduction and Internal Fixation (ORIF) of right lower leg fracture following motor vehicle accident, cardiac and vascular implants and grafts, metabolic encephalopathy, pain, indwelling urinary catheter, and major depressive disorder. Review of the admission Minimum Data Set assessment dated , 02/02/22 noted he was cognitively intact, having mood issues related to feeling down, depressed, hopeless, tired, and trouble concentrating. He required extensive assistance with activities of daily living, was independent with eating, had impairment with lower extremity and used a walker/wheelchair for mobility. He had an indwelling urinary catheter, no scheduled pain medications, and rarely had pain. The acute care hospital 3008 form dated 01/17/22 documented right leg surgical incision. Review of the admission Nursing assessment dated [DATE] read right ankle fracture and surgical site with ace wrap. Resident #298's plan of care initiated 01/27/22 revealed a care plan for skin impairment for surgical wound to right lower leg which was casted. The goal included healing without complications. The interventions directed nursing staff to perform wound treatments as ordered, obtain wound care physician services, and to observe wound for signs/symptoms of infection and for significant decline, and to update physician if noted. Review of the resident's physician orders dated 02/03/22 noted Orthopedic consult per patient request for right lower extremity cast. A physician order dated 02/16/22 directed staff to monitor right leg incision for signs of infection and drainage. Another physician order dated 02/16/22 read, follow up with Orthopedic Clinic (name) in 2 weeks and to fit patient with a CAM boot (According to www.physicalhealthcare.com a CAM or Controlled Ankle Moon boot is an adjustable device that limits ankle and foot movement) to right lower extremity upon back to rehabilitation. Review of the Orthopedic note dated 03/03/22 read, resident was seen in our clinic today, 03/03/22 for his orthopedic injuries. Impression: removal of external fixator right ankle, fixation right ankle, date of service 01/03/22. Plan: 1. WBAT (weight bearing as tolerated) RLE (right lowered extremity. 2. Pain control as tolerated,. 3. Physical Therapy: range of motion, gentle strengthening progressing as tolerated, and gait training with appropriate gait aids. 4. Discontinue CAM boot. 5. It appears that surgical incision is stable however patient does need daily dressing changes. He needs the wound appropriately cleansed to help with scabbing. 6. Okay to shower, 7. Follow up in clinic in 6 weeks with. A physician order dated 03/08/22 noted weight bearing as tolerated to right lower extremity. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 20 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few An order for wound care treatment was not written until 03/18/22, 14 days after the orthopedic recommendation. The order noted cleanse right lower extremity wounds daily with normal saline, pat dry, apply Calcium Alginate, cover with abdominal pad, wrap in rolled gauze, change daily, observe for redness, drainage, increased pain, odor, increased warmth and notify physician. Review of resident #298's March 2022 Medication Administration Record (MAR) noted wound care to right lower extremity wounds was initiated on 03/19/22, 15 days after Orthopedic recommendations. On 07/13/23 at 5:30 PM, the Regional Nurse Consultant (RNC) reviewed resident #298's Orthopedic recommendations, physician orders and MAR. She explained the process for all consults was for nurses to review all recommendations from consulting provider and to call the attending physician for approval of recommendations and initiate orders. The RNC confirmed the 03/03/22 Orthopedic recommendation for wound care had not been initiated until 03/18/22. The RNC acknowledged surgical wound treatment should have been started on 03/03/22 as per Orthopedic recommendations but were not started until 3/19/23. Review of the Facility Assessment, updated 10/31/2022, revealed the facility is competent to provide care and services for residents requiring surgical wound care. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 21 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 - Minimal harm or potential for actual harm Residents Affected - Some Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure residents who smoked did not keep lighters or ignition materials on their person for 6 of 7 residents reviewed for smoking and failed to identify an accident hazard of a wet floor for 1 of 1 residents reviewed for accidents, out of a total sample of 44 residents,(#6, #69, #75, #50, #303, #73, #26). Findings: 1. Resident #50 was admitted to the facility on [DATE] with diagnoses to include Chronic Obstructive Pulmonary Disease, atrial fibrillation, anxiety disorder, and type 2 diabetes. The resident's quarterly Minimum Data Set (MDS) assessment with Assessment Reference Date (ARD) of 6/12/23 revealed the resident's cognition was intact, with a Brief Interview for Mental Status (BIMS) score of 14/15. On 7/10/23 at 1:33 PM, resident #50 said, I do smoke and I keep my cigarettes and lighter with me. On 7/11/23 at 12:51 PM, the resident stated she kept her cigarettes and lighter in her room in the drawer of the bedside table. She opened the drawer and a pack of cigarettes with a lighter were noted inside. Review of resident #50's smoking assessment dated [DATE] indicated resident #50 may smoke unsupervised in designated smoking areas. The resident may maintain own smoking material (per facility policy). Resident /resident representative/family have been informed of smoking policies and procedures. Resident #50's smoking care plan reflected the following, focus: Resident has been assessed as able to smoke independently. Resident/responsible party have been informed of the facility smoking policy. Goal: resident will adhere to the smoking policy daily through the next review date. Interventions: maintain smoking materials in designated area. 2. Resident #303 was admitted to the facility on [DATE] with diagnoses to include cerebral infarction, chronic respiratory failure, depression, and anxiety. On 7/10/23 at 2:00 PM, resident #303 said, I keep my cigarettes and lighter with me all the time. My nurse took them one time and now I keep them with me. On 7/11/23 at 1:24 PM, resident #303 was seen in the smoking area as she took cigarettes and a lighter out of a bag kept in her walker. Resident #303's smoking care plan reflected the following, focus: Resident has been assessed as able to smoke independently. Resident/responsible party have been informed of the facility smoking policy. Goal: resident will adhere to the smoking policy daily thru the next review date. Interventions: maintain smoking materials in designated area. On 7/12/23 at 05:22 PM, the [NAME] Wing Unit Manager (UM) stated the facility had confiscated so many lighters and vape pens and they end up back in here. The UM said families continued to bring them (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 22 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 - Minimal harm or potential for actual harm to the residents. The UM explained families and residents were educated to the smoking policy. In the past we would lock up all the cigarettes and lighters and keep them in a box and hand them out when the residents would come out to smoke but the families still brought cigarettes and lighters and gave them to the residents. Now they allow the residents to keep their cigarettes, but they are supposed to return the lighters when they come inside, but that does not always happen and again the visitors bring them. Residents Affected - Some On 7/13/23 at 12:12 PM, the Administrator stated a resident was identified as a safe smoker if they could light and hold their own cigarette. He noted the smoking porch was open from 7 AM to 8 PM and residents could go out whenever they wanted during that time. The Administrator explained there was always a staff person outside, primarily assigned to the smoking porch. The cigarettes and lighters are collected and put in a bag labeled with the resident's name and are kept on the unit. He indicated the smoking material were collected because they want to be compliant with the smoking policy. It is a struggle to keep residents who smoke from getting extra cigarettes. We monitor the residents and educate the families and residents. He noted the nursing team was ultimately responsible for residents smoking and there had not been any changes to the policy in the past 90 days. Administration is ultimately responsible for making sure the policies are followed. He said there was a guardian angel program and administrative staff were assigned a group of rooms. They do daily room rounds and they look at the rooms for smoking material. Both the Director of Nursing (DON) and the Administrator stated it would be concerning if a resident had a lighter in the room as some roommates had oxygen and confused residents could access the lighters. The DON stated she did rounds on all units. On 7/13/23 at 1:09 PM, Registered Nurse (RN) G stated smoking materials were kept on the East Wing because that is where the residents go to smoke. On 7/13/23 at 1:23 PM, Licensed Practical Nurse (LPN) F stated cigarettes and lighters were kept in a lock box in the medication room. She stated if a resident wanted to smoke, they took the box outside and gave them their cigarettes and lighter if they were a safe smoker. If a resident needed assistance, we give them a cigarette and we light it for them. If they require a smoking blanket, we put it on before they smoke. She noted there was usually someone assigned to the smoking porch but if that staff person was on break, other staff took turns to supervise the residents who smoked. If they have a lighter when they come out to the porch, we are supposed to take it from they when they finished smoking. If they refuse to give it to us, we should notify the DON or Administrator. 6. Review of the medical record revealed resident #73 was originally admitted to the facility on [DATE] with diagnoses including muscular dystrophy, right side paralysis, generalized muscle weakness, and muscle spasms. Review of the MDS Annual assessment with ARD of 4/28/23 revealed resident #73 required limited assistance from one person for transfers and supervision for locomotion off the unit. He used a wheelchair for mobility, was only able to stabilize with staff assistance when he moved from a seated to standing position, and functional limitation in range of motion related to impairment on one side of his upper and lower extremities. The MDS assessment showed resident #73 currently used tobacco. Resident #73 had a care plan for smoking, initiated on 7/11/22, which indicated he was assessed as able to smoke independently and was informed of the facility's smoking policy. The goals were that he would demonstrate safe smoking practices and adhere to the smoking policy. The interventions included maintain smoking materials in the designated area and nursing staff were to redirect the resident if they observed unsafe smoking practices. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 23 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 - Minimal harm or potential for actual harm Review of a Smoking Evaluation form dates 6/14/23 revealed the resident smoked cigarettes and had the cognitive, visual, and physical ability to smoke safely. The document indicated the facility deemed resident #72 as able to smoke unsupervised in the designated smoking area and he could maintain his own smoking material according to the facility's policy. The form showed the resident was informed of smoking policies and procedures. Residents Affected - Some On 7/11/23 at 11:31 AM, resident #72 sat in his wheelchair on the facility's smoking porch. He stated he received education on the smoking policy when he was admitted to the facility. The resident explained his son provided cigarettes and lighters for him and he kept these items in his room. On 7/11/23 at 3:52 PM, resident #72 was in his room and showed a green and white box with cigarettes and a tan-colored lighter in the top drawer of the bedside table. On 7/12/23 at 11:06 AM, the DON explained there was always an assigned staff member on the smoking porch to hand out cigarettes and lighters. She explained the staff member would either give lighters to the residents or assist them to light their cigarettes. The DON verified residents should return lighters to the staff member and not retain lighters after smoking. On 7/12/23 at 1:01 PM, the [NAME] Wing Unit UM stated he was aware some residents had access to lighters. He explained the problem was they got lighters from outside. The UM stated when staff found residents with lighters, they retrieved them and placed them in a bag with the resident's name, which was kept on the East Wing. Review of the facility's policy and procedure for Safe Smoking, issued on 4/01/22, read, Residents that are smokers may not keep lighters/ignition material on their person or in their room unless provided by a nurse to be used during smoking opportunities. Lighters/ignition materials must be maintained at the resident's designated nurse's station or other centralized location specific for this purpose. 7. Review of the medical record revealed resident #26 was admitted to the facility on [DATE] with diagnoses including arthritis of both knees, abnormality of gait and mobility, legal blindness, and a history of falling. Review of the 5-day scheduled assessment for Medicare Part A Stay with ARD of 6/07/23 revealed resident #26 had a Brief Interview for Mental Status score of 14 which indicated he was cognitively intact. He required supervision for walking, extensive assistance for toilet use and personal hygiene, and used a walker and wheelchair for mobility. The MDS assessment indicated the resident was always continent of bowel and bladder. He had one fall with no injury since admission. Resident #26 had a baseline care plan initiated on admission, 5/15/23, for risk for falls. The interventions included checking the environment for trip hazards, encouraging the resident to wear well-fitting, non-slip footwear, and ensuring the CNA care plan or [NAME] reflected any special interventions needed to prevent falls, and that those approaches were implemented. The baseline care plan was resolved, and a comprehensive care plan for risk for falls related to generalized weakness, seizures, and legal blindness was initiated on 5/17/23. The goals included minimizing the resident's risk for falls with staff intervention. The interventions directed staff to keep the resident's environment clean and walkways free of clutter, and observe for use of appropriate footwear and assist as needed. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 24 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 - Minimal harm or potential for actual harm Residents Affected - Some On 7/10/23 at 1:18 PM, during tour of the [NAME] Wing, resident #26's bathroom revealed a large puddle of yellow liquid with an odor of urine on the floor to the left of the toilet. On 7/10/23 at 1:31 PM, CNA H was informed of the large puddle of urine on resident #26's bathroom floor. She explained there was a problem with that bathroom as it was shared by four residents in adjoining rooms, one of whom, resident #26's roommate, had dementia and would not use an incontinence brief. CNA H stated the roommate regularly went into the bathroom and urinated everywhere. She stated she had reported the situation to all the nurses she worked with and also informed the [NAME] Wing UM. She recalled during one particular shift she had to clean up urine on the floor three times. CNA H stated on two separate occasions she walked into the bathroom and almost slipped and fell in the urine on the floor. She validated resident #26 had to use that bathroom. On 7/10/23 at 1:40 PM, the [NAME] Wing UM stated residents' rooms and bathrooms were cleaned daily and as needed as any concerns were brought to the attention of staff. The [NAME] Wing UM stated he was aware resident #26's roommate urinated on the floor in the shared bathroom and he acknowledged the situation warranted more frequent monitoring and cleaning of the floor. On 7/11/23 at 11:16 AM, resident #26 stated his roommate made a mess of the bathroom. The resident explained since his roommate was admitted there was often a significant amount of urine on the floor. Resident #26 stated he did not like to walk in the urine it, but his sandals were very hard to put on without assistance so he ended up going to the bathroom without shoes. The resident stated he slipped and fell in urine on the bathroom floor within the last two to three days, and required assistance from staff to get up off the floor. Review of the Situation, Background, Appearance, Review and Notify Communication form dated 7/09/23 revealed resident #26 had a change in condition related to a fall as he was observed on his buttocks on the bathroom floor. The document indicated there was urine on the bathroom floor and to make the situation better, he was encouraged to use the urinal. On 7/12/23 at 12:29 PM, the Assistant Director of Nursing stated she was on call on 7/09/23 and received notification from resident #26's assigned nurse via text message regarding resident #26's fall in urine on the floor. She explained the resident was not injured and she verified staff cleaned up the urine. On 7/12/23 at 1:11 PM, the DON and [NAME] Wing UM stated the facility was not aware there was a fall and accident hazard related to urine on the resident #26's bathroom floor prior to his fall on 7/09/23. The DON reviewed the medical record and stated resident #26's roommate was admitted to the facility on [DATE]. On 7/12/23 at 1:16 PM, CNA H joined the interview and informed the DON and [NAME] Wing UM that over the last two weeks she had informed the nurses assigned to resident #26 and his roommate about the concern regarding urine on the bathroom floor. On 7/13/23 at 9:58 AM, resident #26 was told review of the facility's fall investigation revealed information that conflicted with his statement during an interview on 7/11/23 at 11:16 AM, in which he stated he slipped and fell in urine on the bathroom floor. The resident smiled and stated after he spoke with facility staff yesterday, he recalled that his fall occurred as a result of his knee buckling. The facility's policy and procedure for Falls, issued on 4/01/22, revealed the facility would attempt to prevent falls and injuries related to falls by identifying possible causes that were (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 25 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 associated with or directly result in a fall. Level of Harm - Minimal harm or potential for actual harm Review of the undated job description for Concierge revealed duties and responsibilities included keeping floors dry and reporting any hazardous conditions to a nursing supervisor or member of management. Residents Affected - Some 3. Review of the medical record revealed resident #69 was admitted to the facility on [DATE], with diagnoses of chronic respiratory failure, congestive heart failure, chronic kidney disease and dependency on supplemental oxygen. Review of the MDS annual assessment with assessment reference date of 10/29/22 showed resident used tobacco products. Further review of MDS quarterly assessment with assessment reference date of 04/26/23 showed the resident's Brief Interview for Mental Status score was 15 which indicated she was cognitively intact, independent with supervision and set up for activities of daily living. A care initiated 10/07/22 and revised on 4/12/23 showed the resident had been assessed as able to smoke independently. Intervention revealed maintain smoking materials in designated area. A careplan focus initiated 10/30/21, revised on 02/13/23 for potential for complications of respiratory distress related to dependence on supplemental oxygen, resident chooses to smoke cigarettes with an intervention dated 10/30/21 to administer oxygen as ordered. Review of the physician order dated 8/11/22 showed oxygen at 3 liters per minute via nasal cannula every shift. Review of smoking evaluation dated 06/14/23 at 2:52 PM, revealed under maintenance of smoking materials resident#69 must request smoking materials from staff. On 07/11/23 at 11:12 AM, resident #69 was noted smoking in close proximity to Certified Nursing Assistant (CNA) P who monitored residents smoking. Resident #69 stated, she had her own cigarettes and lighter. Further observation of the smoking area did not reveal a smoking box or secure container for storage of resident's cigarettes or lighters. On 07/12/23 at 12:28 PM, resident #69 was lying in bed with oxygen infusing via nasal cannula at 3 liters per minute. She stated she had her lighter and cigarettes. She then pointed to a little black pouch on top of the small refrigerator across from the foot of her bed. She gave permission for this surveyor to look inside at the cigarettes and lighter. The pouch contained cigarettes in a green box and a lighter. She stated she kept her cigarettes and lighter with her. 07/12/23 at 10:54 AM, the DON stated a staff member was assigned to supervise the smoking area. She said resident smoking evaluation were completed quarterly, and some residents did not need to be supervised. She stated staff assisted residents with cigarettes and lighters, and no resident should have cigarette lighter with them. She stated she would have to get clarification from the regional nurse if residents could keep cigarettes and emphasized residents could not keep lighters with them. 4. Review of the medical record showed resident #75 was admitted to the facility on [DATE] with diagnoses of diabetes type 2, depressive disorder, hypertension, and nicotine dependence. Review of the MDS admission assessment with assessment reference date of 12/15/22 revealed current tobacco use. The MDS quarterly assessment with assessment reference date of 06/07/23 showed the resident's Brief Interview for Mental Status score of 13 which indicated she was cognitively intact, independent, set up only, of one person for assistance with activities of daily living. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 26 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 - Minimal harm or potential for actual harm Residents Affected - Some Care plan initiated 12/12/22 and revised on 4/12/23 showed focus for resident desires to smoke, has been assessed as able to smoke independently with intervention indicating smoking materials were to be maintained in designated area. Review of smoking evaluation dated 6/14/23 at 2:43 PM, showed resident must request smoking materials from staff located under maintenance of smoking materials. On 07/11/23 at 11:09 AM, resident #75 was in wheelchair at a table outside, smoking. She stated she had her own cigarettes and lighter and staff did not give them to her. 07/12/23 12:06 PM, resident was in the smoking patio. Certified Nursing Assistant (CNA) A stated less than a month ago, the facility stopped doing the smoke box for storage of residents' cigarettes and lighters. He stated yes, now we are passing out the cigarettes and lighters to the residents. 5. Review of the medical record reflected resident #6 was admitted to the facility on [DATE] with diagnoses of chronic obstructive pulmonary disease, nicotine dependence, hypertensive heart disease with heart failure, anxiety disorder, and osteoporosis. Review of the MDS admission assessment with assessment reference date of 01/13/23 revealed current tobacco use. The MDS quarterly assessment with assessment reference date of 04/10/23 revealed Brief Interview for Mental Status score of 15 which indicated she was cognitively intact. The assessment noted the resident required extensive to total assistance of one person with activities of daily living. A Care plan initiated 10/7/22 and revised on 7/11/23 revealed resident #6 desired to smoke, had been assessed and was able to smoke independently with intervention dated 6/16/23 to accompany resident to designated smoking area and provide supervision. A smoking evaluation dated 6/14/23 at 2:49 PM, indicated resident #6 must request smoking materials from staff. On 07/11/23 at 11:09 AM, resident #6 was in her wheelchair in the smoking patio, smoking. She stated she had her own smoking material. On 07/13/23 at 12:12 PM, the Administrator stated everyone should be following the smoking policy and there had been no changes in the policy. He stated he was not aware staff had not been collecting cigarettes and lighters from residents after they finished smoking. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 27 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to obtain physician orders and follow professional standards of practice related to oxygen use, monitoring oxygen levels, and replacing respiratory supplies for 1 of 3 residents reviewed for respiratory care, of a total sample of 44 residents, (#27). Residents Affected - Few Findings: Review of the medical record revealed resident #27 was originally admitted to the facility on [DATE] and re-admitted on [DATE]. His diagnoses included respiratory failure with low oxygen levels, pneumonitis or inflammation of lung tissue due to inhalation of food or vomit, shortness of breath, and heart disease. Review of the Minimum Data Set (MDS) Quarterly assessment with assessment reference date of 6/06/23 revealed resident #27 had a Brief Interview for Mental Status score of 15/15, which indicated he was cognitively intact. The document showed the resident required extensive assistance from two staff members for bed mobility, dressing, and personal hygiene, and was totally dependent for transfers. The MDS assessment indicated resident #27 did not use oxygen. Review of resident #27's medical record revealed a care plan was initiated on 6/09/23 for potential for respiratory distress related to his diagnosis of chronic respiratory failure. The interventions directed nurses to check the resident's oxygen levels and administer oxygen as ordered. A care plan for potential for alteration in cardiac function, initiated on 3/29/22, indicated nurses should check the resident's oxygen levels and administer oxygen as ordered to prevent cardiovascular complications. On 7/10/23 at 1:06 PM, resident #27 was in bed with oxygen infusing at 2 liters per minute (L/min) through a nasal cannula and tubing connected to an oxygen concentrator. The resident stated he utilized oxygen at 2 L/min continuously, 24 hours daily. Observation of the oxygen tubing revealed it was not dated, and the empty humidifier bottle attached to the concentrator was dated 6/28/23. Resident #27 looked at the humidifier bottle, acknowledged it was empty, and explained he always had to remind nurses to replace the bottles when they were empty. On 7/10/23 at 1:09 PM, the [NAME] Wing Unit Manager (UM) confirmed resident #27's humidifier bottle was empty. He validated the bottle was dated 6/28/23 and the oxygen tubing was not dated. The [NAME] Wing UM explained nursing staff should replace and label oxygen tubing once weekly, and replace and date humidifier bottles once weekly and as needed when empty. On 7/10/23 at 1:11 PM, the [NAME] Wing UM stated oxygen supplies were scheduled to be replaced on Sunday nights. He was asked to review resident #27's medical record for nursing documentation from the previous shift, which was a Sunday night, related to oxygen use and supplies. The [NAME] Wing UM checked the resident's physician orders and Treatment Administration Record and stated there were no physician orders for continuous oxygen use, monitoring of oxygen levels, or for replacing oxygen supplies. The UM explained resident #27 was readmitted from the hospital on 5/30/23, but his previous oxygen orders were never resumed and there were no revised orders transcribed into the medical record. He stated either a nurse, a manager, or a supervisor would enter physician orders on readmission and he was responsible for reviewing the medical record to ensure the orders were in place. The UM said, I reviewed his orders but missed that the oxygen was missing. He stated it was unacceptable that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 28 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0695 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few three different nurses were in the resident's room daily and none of them checked or verified orders related to oxygen use and notes they were absent. Review of resident #27's physician orders revealed prior to observation of the resident on 7/10/23, there were no orders in place related to continuous use of oxygen at 2 L/min, the need for humidification, changing oxygen tubing weekly and as needed, and monitoring the resident's oxygen levels. On 7/12/23 at 11:29 AM, the Director of Nursing (DON) stated the facility obtained orders from the hospital when a resident was admitted , and the nurse was responsible for entering them into the electronic medical record. She explained on the morning after a resident was admitted , both UMs would reconcile the hospital discharge orders with the facility medical record to ensure accuracy. The DON confirmed humidifier bottles should be replaced when empty, and oxygen tubing should be changed every seven days. She explained in addition to nurses, a member of management staff was responsible for checking that oxygen tubing was labeled appropriately, but resident #27's missing label had not been identified. The DON stated the resident used oxygen as needed prior to his hospitalization and the concentrator had remained in his room. The DON validated oxygen use required appropriate physician orders. Review of signage posted at the [NAME] Wing nurses' station revealed instructions for nurses on the 11:00 PM to 7:00 AM shift regarding changing oxygen tubing and nebulizer equipment every Sunday night. Review of the Guardian Angel Program form which was used my management staff to identify issues during daily rounds of assigned rooms, revealed tasks included observation of oxygen tubing to ensure it was dated within the previous seven days and that concentrators were clean. The Facility assessment dated [DATE] revealed the facility could care for residents with respiratory conditions who required oxygen therapy. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 29 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0697 Provide safe, appropriate pain management for a resident who requires such services. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to administer pain medication in a timely manner for 1 of 3 residents reviewed for pain management, (#92). Residents Affected - Few Findings: Review of the medical record revealed resident #92 was admitted to the facility on [DATE] with diagnoses including wedge compression fractures of the lumbar and thoracic spine, and muscle spasms. Review of the resident's Minimum Data Set (MDS) admission assessment with assessment reference date (ARD) of 6/14/23 revealed he received pain medication on schedule and as needed. The resident reported occasional pain in the previous five days, and the worst pain intensity was level 6 on a 0 to 10 scale. The document showed he received opioid pain medication on 6 of 7 days in the look back period. Review of the MDS Discharge-Return Anticipated assessment with ARD of 6/24/23 revealed resident #92 continued to receive pain medication on schedule and as needed. The document showed he received opioid pain medication every day during the 7-day look back period. Review of the medical record revealed an Order Summary Report that showed resident #92 had physician orders for two tablets Acetaminophen 325 milligrams (mg) every four hours as needed for mild pain, and Hydrocodone-Acetaminophen 10-325 mg every six hours as needed for severe pain, levels 7 to 10 on a 0 to 10 scale. Resident #92 had a care plan initiated on 6/08/23 for potential or actual alteration in comfort related to muscle spasms and a history of compression fractures. The document indicated the resident was able communicate pain to staff. The goal was resident #92 would verbalize an acceptable level of comfort. The interventions included administer medication for discomfort as ordered, observe for medication effectiveness, observe for non-verbal signs and symptoms of discomfort, and evaluate the resident's pain level as needed. On 7/10/23 at 12:17 PM, resident #92 explained sometimes he had to lie in bed in pain when nurses did not administer his pain medication in a timely manner. He said, They tell me the cart is down the bottom and she is coming up the hall. I don't think I should have to wait. They should bring it in at the right time. On 7/12/23 at 9:33 AM, resident #92 stated he woke up in pain at 7:00 AM this morning. He explained his pain was so severe that he could not move. The resident stated although he asked for a pain pill at that time, he had to wait for a long time, and did not receive the medication until approximately 8:20 AM. On 7/12/23 at 10:04 AM, Registered Nurse (RN) B confirmed she was resident #92's assigned nurse. She recalled earlier that morning, the resident's assigned aide, Certified Nursing Assistant (CNA) I informed her the resident was in pain. RN B stated she completed change of shift report, counted a large number of narcotic medications in the medication cart and the medication room while she dealt with multiple interruptions, before she attended to the resident. RN B explained she got to resident #92's room at approximately 8:30 AM. She verified she did not pause during report to address resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 30 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0697 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few #92's report of pain, nor ask the [NAME] Wing Unit Manager (UM) for assistance. RN B acknowledged it was not reasonable for the resident to wait more than one hour for pain medication. On 7/12/23 at 11:46 AM, the Director of Nursing (DON) stated she expected nurses to administer pain medications as ordered and when the resident needed them. The DON stated in this case, the resident was in pain, and if change of shift report was taking too long, RN B should have utilized the [NAME] Wing UM to either administer resident #92's pain medication or continue the count of narcotic medications while she did so. On 7/12/23 at 12:04 PM, CNA I recalled at about 7:00 AM that morning, resident #248 informed her he was in pain and wanted the medication hydro-something. CNA I stated she waited until the nurses were finished their report and she informed RN B of the resident's request at about 7:15 AM. Review of resident #92's Medication Administration Record revealed RN B administered Hydrocodone-Acetaminophen 10-325 mg on 7/12/23 at 8:23 AM for a pain level of 8. The facility's policy and procedure for Pain Management, issued on 4/01/22, revealed the facility would attempt to provide effective pain and comfort management. The document indicated nurses would administer pain medications according to physician orders and as requested by residents as needed. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 31 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to provide pharmaceutical services to maximize the effectiveness and promote optimal therapeutic effect of medication for 1 of 5 residents reviewed for medication administration, of a total sample of 44 residents, (#248). Findings: Review of the medical record revealed resident #248 was admitted to the facility on [DATE] with diagnoses including hypertension, type 2 diabetes, adult failure to thrive, and pancreatic cancer. The resident also suffered from exocrine pancreatic insufficiency, a deficiency of the pancreatic enzymes that results in the inability to digest food properly (retrieved on 7/18/23 from www.webmd.com/digestive-disorders/exocrine-pancreatic-insufficiency). On 7/10/23 at 4:50 PM, resident #248 explained some of her medications had to be given with meals. She stated her physician emphasized the importance of taking her pills at the right time, particularly those that she needed to take with meals. Resident #248 expressed concerns regarding often not receiving her medication with food. She gave the example of the medication Creon, which her physician told her to take in the middle of her meals. Review of resident #248's medical record revealed a physician's order for Creon oral capsule Delayed Release Particles 36000-114000 units, an enzyme supplement, to give one capsule with meals for exocrine pancreatic insufficiency. Review of the manufacturer's website revealed instructions to Always take Creon with a meal or snack.Take Creon exactly as your doctor tells you. (Retrieved on 7/18/23 from www.creoninfo.com/creon-dosing). The resident had a physician order for Metoprolol Tartrate 50 milligrams (mg) twice daily for high blood pressure, to be administered with or immediately following meals. The drug manufacturer's package insert read, Advise patients to take Metoprolol regularly and continuously, as directed, with or immediately following meals. (Retrieved on 7/17/23 from www.drugs.com/pro/metoprolol-tartrate-tablet.html). A physician order for Nateglinide 60 mg related to type 2 diabetes instructed nurses to administer the drug with meals. Review of the manufacturer's instructions indicated the drug should be taken exactly as directed, .usually taken 3 times daily, within 1 to 30 minutes before a meal. (Retrieved on 7/18/23 from www.drugs.com/mtm/nateglinide.html). An order for Metformin Hydrochloride 500 mg for type 2 diabetes, to be administered twice daily with food. Instructions from the manufacturer included take the drug exactly as prescribed by the physician, follow all directions on the drug label, and take Metformin with a meal (retrieved on 7/18/23 from www.drugs.com/metformin.html). Review of a posting on the [NAME] Wing indicated meal times were as follows: breakfast at 7:15 AM, lunch at 11:30 AM, and dinner at 5:15 PM. On 7/13/23 at 6:10 PM, the Certified Dietary Manager stated the meal times posted on the [NAME] Wing were actually delivery times for the main dining room. She explained meals arrived on the [NAME] (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 32 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0755 Wing about 15 minutes after posted time, and later if there were no complications in the dining room. Level of Harm - Minimal harm or potential for actual harm Review of Medication Administration Audit Reports for 7/09/23, 7/10/23, and 7/11/23 revealed resident #248's medications were either not scheduled or not administered according to meal times as ordered by the physician, per pharmacy instructions, and consistent with professional standards. Residents Affected - Few The audit forms showed Creon capsules were scheduled for 8:00 AM, 12:00 PM, and 6:00 PM. The morning doses were administered on 7/09/23, 7/10/23. and 7/11/23 at 8:28 AM, 9:01 AM and 9:06 AM, approximately 1 to 1.5 hours after breakfast. On 7/10/23 and 7/11/23, the lunchtime doses were given at 12:42 PM and 2:04 PM respectively, approximately 1 to 2 hours after that meal. On 7/09/23, the resident received the Creon capsule at 6:46 PM, over 1 hour after dinner; and on 7/11/23, the drug was administered at 5:08 PM, before dinner. Resident #248's Nateglinide tablets were scheduled for 9:00 AM, approximately 1.5 hours after breakfast, 12:00 PM, and 5:00 PM. On 7/09/23, she received the drug at 9:08 AM, 11:46 AM, and 4:23 PM. On 7/10/23, she received the medication at 9:02 AM, 12:42 PM, and 4:37 PM. On 7/11/23, the administration times were 8:29 AM, 2:04 PM, and 5:07 PM. The resident's Metformin Hydrochloride tablets were scheduled for 9:00 AM, approximately 1.5 hours after breakfast and 5:00 PM, approximately 30 minutes before dinner. The drug was administered on 7/09/23 at 9:08 AM, on 7/10/23 at 9:01 AM, and on 7/11/23 at 8:31 AM, 1 to 1.5 hours after the meal was to be delivered. On the three dates shown on the audit reports, resident #248 received Metformin tablets approximately 0.5 to 1 hour before dinner at 4:22 PM, 4:33 PM, and 5:07 PM. The resident's Metoprolol tablets, also scheduled at 9:00 AM and 5:00 PM, were administered with the Metformin at the above times, with similar concerns related to inappropriate scheduling and/or administration relative to meal times. Review of resident #248's medical record revealed she had care plans initiated on 6/05/23 for risk for complications related to type 2 diabetes and risk for complications related to altered cardiac function. The interventions directed nurses to administer her medications as ordered. The care plans did not indicate the resident was assessed for the possibility of self-administration of medication or educated regarding keeping snacks at bedside to ensure she took her medications with food. The facility's policy and procedure for Medication Administration, issued on 4/01/22, revealed the nurses would administer medication in a timely manner and as prescribed by the physician, unless otherwise necessary. The policy indicated if a drug was given other than at the scheduled time, the nurse would document the occurrence in the medical record. On 7/12/23 at 11:22 AM, the Director of Nursing (DON) stated she expected nurses to follow physician orders and pharmacy recommendations during medication administration. She explained it was important to give medications at the correct time to ensure the worked as intended and most effectively. The DON explained on 7/10/23 when she was notified resident #248 received her medications before dinner, she had to go to the kitchen to get her a tray at about 5:15 PM as the meal cart was not yet on the [NAME] Wing. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 33 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0759 Ensure medication error rates are not 5 percent or greater. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to prevent medication errors for 1 of 5 residents reviewed during the Medication Administration task, of a total sample of 44 residents, (#248). There were 2 errors in 25 opportunities for a medication error rate of 5%. Residents Affected - Few Findings: Review of the medical record revealed resident #248 was admitted to the facility on [DATE] with diagnoses including hypertension, type 2 diabetes, adult failure to thrive, and pancreatic cancer. On 7/10/23 between 4:35 PM and 4:45 PM, Registered Nurse (RN) D was observed during medication administration for resident #248. She removed the resident's pills from blister packs stored in the medication cart and administered medication including one tablet Metformin 500 milligrams (mg), one tablet Metoprolol Tartrate 50 mg, and one tablet Nateglinide 60 mg. On 7/10/23 at 4:50 PM, resident #248 explained some of her medications had to be given with meals. She stated her physician emphasized the importance of taking her pills at the right time, particularly those that she needed to take with meals. On 7/10/23 at 4:55 PM, RN D provided resident #248's medication blister packs for review. The label for Metformin 500 mg tablets indicated the drug was to be given twice daily for blood sugar control related to type 2 diabetes, and read, Take with meals. The label for Metoprolol Tartrate 50 mg tablets revealed the medication was to be administered twice daily for high blood pressure, .with or immediately following meals. The blister pack for Nateglinide 60 mg tablets indicated the medication was prescribed for high blood sugar related to type 2 diabetes and should be administered with meals, between one and thirty minutes before a meal. On 7/10/23 at 5:02 PM, RN D acknowledged she gave resident #248's medications before the evening meal and she was not sure exactly when dinner trays would arrive. RN D explained she read the medication dosage instructions as she prepared the tablets for administration, but did not read other information including instructions and warnings. On 7/10/23 at 5:03 PM, the [NAME] Wing Unit Manager (UM) was informed RN D administered resident #248's medications contrary to instructions. He reviewed the blister packs and validated Metformin and Metoprolol should be given with meals, not before. He stated the Nateglinide should be ok as dinner should arrive by 5:30 PM. On 7/10/23 at 5:55 PM, resident #248 stated she was confused because she got an early dinner tray without a meal ticket and then about 15 minutes later she received a second tray with her meal ticket. On 7/12/23 at 11:22 AM, the Director of Nursing (DON) stated she expected nurses to follow physician orders and pharmacy recommendations during medication administration. She explained it was important to give medications at the correct time to ensure the worked as intended and most effectively. The DON explained on 7/10/23 when she was notified resident #248 received her medications before dinner, she had to go to the kitchen to get her a tray at about 5:15 PM as the meal cart was not yet on the [NAME] Wing. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 34 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0759 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Review of resident #248's medical record revealed a care plan for risk for complications related to type 2 diabetes was initiated on 6/05/23. The interventions directed nurses to administer her oral medication as ordered. A care plan for potential complications related to alteration in cardiac function dated 6/05/23, indicated nurses would administer medications as ordered. The facility's policy and procedure for Medication Administration, issued on 4/01/22, revealed nurses would administer medications in a timely manner and in accordance with physician orders. The document read, .the individual administering the medication should ensure that the right medication, right dosage, right time and right method of administration are verified. Event ID: Facility ID: 105251 If continuation sheet Page 35 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure a prescribed ointment was appropriately labeled, and failed to maintain medication and supplies securely to prevent unauthorized access in 1 of 1 treatment cart and 1 of 2 medication carts on the [NAME] Wing. Findings: 1. On 7/10/23 at 3:06 PM, an unlocked treatment cart was observed to the left of the [NAME] Wing nurses' station. The treatment cart faced the hallway and all drawers were easily opened. Residents and staff were noted in the hallways and common area in front of the nurses' station. A staff member who worked at a computer in the nurses' station confirmed she was the Wound Nurse. On 7/10/23 at 3:09 PM, the Wound Nurse, Licensed Practical Nurse (LPN) C, stated she unlocked and checked the treatment cart at the start of the 3:00 PM shift. She acknowledged the treatment cart was supposed to be locked to prevent unauthorized access. LPN C looked around the area and stated there were four confused residents in the vicinity who could either walk or self-propel in wheelchairs. She demonstrated that the lock functioned, but she was unable to unlock the treatment cart for further review as she did not have a key. LPN C explained she had to ask one of the nurses assigned to a medication cart to unlock the treatment cart for her as Wound Nurses did not have keys. On 7/13/23 at 1:02 PM, LPN C was asked to explain her process for managing the treatment cart during wound care rounds. She stated if there was enough space in a resident's room, she took the cart inside the room. LPN C explained if there was not enough space in a room, she would leave the unlocked cart outside the room in the hallway. She acknowledged the resident's door had to be closed for privacy during wound care, so the treatment cart was not monitored if left in the hallway. Observation of the treatment cart with LPN C revealed prescription ointments intended for topical use only, and alcohol-based hand sanitizer and antiseptic skin cleansers, Hibiclens and Dakins solution, that could damage healthy skin and mucous membranes if used incorrectly. The third drawer of the treatment cart contained a partially used unlabeled tube of Santyl Collagenase ointment 250 units / gram. LPN C confirmed all ointments in the treatment cart should be appropriately labeled with a resident's name, a physician's order, and pharmacy instructions. 2. On 7/12/23 at 10:16 AM, a medication cart was observed on the [NAME] Wing in the hallway between rooms [ROOM NUMBERS]. A medication blister pack with 30 tablets of Methocarbamol 500 milligrams, a muscle relaxer, was noted on top of the cart. There were no nurses on the hallway and the medication blister pack was clearly visible and easily accessible. On 7/12/23 at approximately 10:19 AM, Registered Nurse (RN) G appeared at the far end of the hallway by the [NAME] Wing nurses' station and walked towards the medication cart. She was informed the blister pack of Methocarbamol was discovered on top of the unattended medication cart. RN G acknowledged she left the medication there as it had been discontinued and needed to be taken to the medication room. She explained she was trying to avoid making several trips to the medication room and planned to go when she had a few items. RN G verified medications should never be left unattended as anyone could pass by and take them. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 36 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete On 7/12/23 at 11:27 AM, the Director of Nursing stated the facility's policy regarding medication storage included never leaving medications unsecured. She confirmed medication and treatment carts should be locked at all times if the nurse is not present. Review of the facility's policy and procedure for Medication / Biological Storage, issued on 4/01/22, revealed the facility would store medications, drugs, and biologicals in a safe, secure, and orderly manner. The document indicated drug containers with missing labels should be returned to the pharmacy for replacement labels. The policy revealed compartments that contained medications and/or drugs should be locked when out of the nurse's view. Event ID: Facility ID: 105251 If continuation sheet Page 37 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0791 Provide or obtain dental services for each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to provide routine dental services for 1 of 2 residents reviewed for dental care, (#26). Residents Affected - Few Findings: Review of the medical record revealed resident #26 was admitted to the facility on [DATE] with diagnoses including arthritis of both knees, type 2 diabetes, legal blindness, and history of falls. A Nursing admission assessment dated [DATE] showed the admission nurse evaluated resident #26's oral status and noted he wore a dental appliance and had no dental problems. A physician order dated 5/15/ 23 indicated the resident could obtain a dental consult as needed. Review of the Minimum Data Set (MDS) admission assessment with assessment reference date of 5/22/23 revealed resident #26 had a Brief Interview for Mental Status score of 14 which indicated he was cognitively intact. The document showed he required extensive assistance from one staff member for personal hygiene such as brushing his teeth, and he did not reject care. The MDS assessment revealed resident #26 had no obvious or likely cavity or broken natural tooth. On 7/11/23 at 11:18 AM, resident #26 stated he had never heard about the facility's dental program but would like to be seen by a dentist. He pointed to his left lower jaw and stated he had a broken tooth. The brown, jagged surface of an obviously broken and possibly decayed lower left tooth was clearly visible during conversation with the resident. On 7/12/23 at 2:33 PM, the Social Services Director (SSD) stated she was not aware of any dental concerns for resident #26 . She explained the admission nurse usually went over any dental needs that residents had, and she relied on all staff to identify new dental issues and bring them to her attention. The SSD reviewed the medical record and confirmed the admission nursing assessment and the initial MDS assessment showed resident #26 had no dental issues. On 7/12/23 at 2:49 PM, the facility's Discharge Planner interviewed resident #26, verified he had a broken left lower front tooth, and stated she would start the process of arranging dental services. Review of documents provided by the SSD revealed resident #26 was seen by a dentist on the evening of 7/12/23. The dentist wrote that resident #26's tooth #22 was broken, with approximately 75% of the tooth missing, and he required a temporary filling. On 7/13/23 at 3:16 PM, the MDS Licensed Practical Nurse (LPN) verified the admission nurse should assess new residents and identify any immediate dental needs. She explained the MDS nurse was responsible for conducting an in-person assessment within every resident's first three to five days. The MDS LPN acknowledged resident #26's broken tooth should have been identified by both nurses. Review of the facility's policy and procedure for Dental Services, issued on 4/01/22, revealed the facility would ensure dental services were made available to meet residents' needs. The document indicated dental status should be established on admission and updated periodically during a resident's stay in the facility through assessments or per resident report. The policy revealed the Director of Nursing or his/her designee was responsible for notifying the SSD of the need for dental services. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 38 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0812 Level of Harm - Minimal harm or potential for actual harm Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation, and interview, the facility failed to ensure food was safely stored to prevent foodborne illness for residents residing in the facility. Residents Affected - Few Findings: On 7/10/23 at 10:30 AM, during the initial tour of the kitchen, the upright double door refrigerator contained three plated salads wrapped in plastic with no date and a potato (maybe baked) on a plate wrapped in plastic with no date. [NAME] E stated she made the salads that morning but did not have time to put a date label on them. She did not have a comment about the potato. On a rack in the dry storage area, an opened bag of cornbread mix was wrapped in plastic and had no open/use-by date and the expiration date could not be seen. On 7/13/23 the Certified Dietary Manager stated her expectation was that any food prepared ahead of time or left over needed to be labeled with the date before it was placed in the refrigerator.If dry food was opened, it should be dated before it is put back on the shelf. She noted that all dietary staff had been educated in the past regarding labeling food with the date. Policy and Procedure for Refrigerated Storage, dated 1/01/22: Policy: Refrigerated items should be properly stored, labeled, and maintained by dietary staff. Procedure: Dietary staff will label, date, and monitor refrigerated food, including but not limited to leftovers to ensure use by use-by dates, or frozen (where applicable) or discarded. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 39 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0835 Administer the facility in a manner that enables it to use its resources effectively and efficiently. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility's administration failed to effectively utilize its resources to implement its smoking policy and procedures to provide adequate oversight of 16 smokers and ensure the safety of all residents in the facility. Residents Affected - Some Findings: Cross reference F689. On 7/13/23 at 12:11 PM, the facility's Executive Director and Director of Nursing (DON) discussed the facility's protocols for safe smoking. The Executive Director explained residents who were identified as smokers on admission were evaluated by the nursing department to determine if they were physically and cognitively able to smoke safely. He stated the facility maintained an open smoking porch from 7:00 AM to 8:00 PM daily. The Executive Director stated a staff member was always assigned to the designated smoking area to attend to and monitor the smokers. He explained the assigned staff member was responsible for retrieving smoking materials when residents finished smoking and he/she would place the items in a bag labeled with the resident's name which was kept on the resident's unit. The Executive Director confirmed the staff members who were assigned to the smoking area were educated regarding collecting smoking items as the facility wanted to ensure compliance with the smoking policy. He stated nursing staff were responsible for ensuring the smoking rules were enforced. The Executive Director verified there was no change in the facility's smoking policy in the last 60 to 90 days. On 7/13/23 at approximately 12:17 PM, the survey team informed the Executive Director and DON that facility staff stated there was a change in the smoking policy that occurred less than a month ago. The Executive Director stated he was not aware of any changes. The Executive Director and DON were informed that observations and interviews conducted during the recertification survey revealed residents who smoked kept their cigarettes and lighters on their person and in their rooms, and assigned staff in the the smoking area were not collecting smoking paraphernalia. The DON stated it was concerning that residents with lighters might be in rooms with residents who utilized oxygen. The Executive Director concurred. The Executive Director denied knowledge of the information provided regarding the facility's smokers not adhering to policy and procedures. He said, That's news to me. The Executive Director validated the facility's administration was ultimately responsible for ensuring the safe smoking policy and procedures were implemented. Review of the Facility assessment dated [DATE] revealed the facility would provide person-centered care while identifying hazards and risks for residents. Review of the job description for the Administrator, revised on 1/01/15, revealed he/she was primarily responsible for the day-to-day functions of the facility to assure the highest degree of quality care was provided for residents. The Administrator was responsible for safety in the facility to include ensuring staff, residents and visitors followed established safety regulations such as smoking regulations. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 40 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0865 Have a plan that describes the process for conducting QAPI and QAA activities. Level of Harm - Minimal harm or potential for actual harm Based on interview, and record review, the facility failed to demonstrate the effectiveness of the performance improvement plan for education of nursing staff and implementation of following physician orders for oxygen for 1 of 3 residents reviewed for oxygen therapy out of a total sample of 44 residents. Residents Affected - Some Findings: Cross reference to F695 On 7/13/23 at 7:40 PM, during an interview with the Executive Director, and Director of Nursing (DON), the Executive Director stated that on 6/26/23, they implemented a Performance Improvement Plan (PIP) to ensure proper oxygen use. He stated education was started on 6/26/23 with nursing staff and had been ongoing along with conducting random audits. A request was made to review the in-service training along with subject matter covered and signature records of nursing staff from 6/26/23. The DON stated education was provided to nursing staff verbally on 6/26/23 and 6/27/23. The DON added that education was provided on a one to one basis with each nurse on all shifts for a total of 8 nurses. She reported there were no sign in sheet, and education was ongoing. The Executive Director stated there was a systematic change and they now have guardian angels to ensure oxygen tubing was labeled with date. He explained nursing was conducting random audits. Review of the facility Performance Improvement Plan revealed, QAA Ad Hoc meeting dated 6/6/23, initiated on 6/28/23 for systemic issue regarding physician orders not being followed for oxygen dosage administration, and oxygen tubing not changed. There was documentation of a second Ad Hoc meeting dated 7/6/23. Further review of the facility's PIP revealed Director of Nursing Services/designee target date 6/26/23 with nursing education ongoing, no ill effects of residents from audits completed on 6/26/23. Quality review of oxygen initiated on 6/26/23 with ongoing monitoring of tubing dated, bagged, changed weekly, oxygen orders entered into computer, oxygen set on correct liters, and physician orders followed (liters on device match the physician orders). Review of audits showed 15 residents audits completed with no resident name or room numbers on the audit. The Executive Director stated they only used medical record numbers on the audits. The audits were dated on 6/26/23 with sections checked for oxygen orders to be entered into the computer, oxygen saturation for shortness of breath as needed, resident care plans in place, visualize oxygen tubing bagged, dated, changed weekly, and as needed. The audit also noted, ensure oxygen is set on correct liter, device match physician order, and physician order for oxygen. The Executive Director provided one partial page of nursing signatures for education in service regarding oxygen dated 7/10/23 with subject matter for oxygen orders to be entered in the computer, oxygen saturation as needed for shortness of breath, oxygen tubing should be bagged, dated, changed weekly, & as needed, ensure the oxygen is set on the correct liter per physician order. Review of the facility employee list showed 25 LPNs and 13 RNs for total of 38 nursing staff. The DON stated she (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 41 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0865 educated 8 nurses which was less than 25% of nursing staff. Level of Harm - Minimal harm or potential for actual harm The Executive Director and DON stated there were no issues with the audits for residents with oxygen. Investigative findings during the week of 7/11/23-7/14/23 identified concerns regarding resident #27's readmission to the facility on 5/30/23. The resident received continuous oxygen without a physician's order and the oxygen tubing was not dated. Residents Affected - Some Review of 2023 Quality Assurance and Performance Improvement (QAPI) Plan showed the purpose is to provide excellent quality care and services to the residents. The facility has a performance improvement program which systematically monitors, analyzes, and improves its performance to enhance resident quality of care and quality of life. The QAPI program focuses on systems and processes. It strives to identify gaps within these systems and processes, rather than placing blame on an individual. The plan showed under feedback, data systems, and monitoring that education and training will be offered during regularly scheduled meetings, new hire orientation, performance improvement plan development, and as needed. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 42 of 43 Printed: 05/28/2026 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 105251 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockledge Healthcare & Rehabilitation Center 587 Barton Blvd Rockledge, FL 32955 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 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review the facility failed to ensure a safe and sanitary environment in the laundry department to prevent cross-contamination of facility equipment and facility linens. Residents Affected - Some Findings: An observation of the laundry department was conducted with the Housekeeping/Laundry Manager, Regional Housekeeping/Laundry Manager and Administrator In Training. The laundry's soiled linen sorting area had 6 covered bins containing soiled linen, an outdoor leaf blower, a floor cleaning/buffer machine which was plugged into the electrical socket, and battery and battery charger. The Laundry Manager explained it was a soiled room used for sorting the facility's soiled linens prior to washing. The Laundry Manager and Administrator in Training stated the leaf blower, the floor machine and battery charger should not be in the soiled room to prevent cross contamination. On 07/11/23 at approximately 12:50 PM, the laundry area containing the facility's 3 washing machines revealed all 3 washing machines were currently in process of washing soiled laundry. Approximately 4 feet directly across from the washing machines were 2 uncovered soiled laundry bins which were full of soiled linens and 1 uncovered soiled laundry bin which contained residents' soiled resident personal clothing. The Laundry Manager said the laundry staff had been using the washing area to sort the soiled linens and these soiled linens were just waiting to go into the washers. The Laundry Manager explained that when the wash had completed we would bring the large blue cart from the dryer/folding room and empty the clean laundry in to the bin and take it to the dryers for processing. On 07/11/23 at 12:45 PM, the Laundry Aide explained that for efficiency she had completed pre-separation in the room with the washing machines because the other soiled room was full of new soiled bins which had just come to the department. She said she would empty the clean laundry from the washing machines and bring it in the bin to the dryers. We really should not be doing the separation in this room because we are mixing the clean laundry with the dirty laundry. Facility's (Contractor Name) Chapter 2, Linen Operations and Management Policy, not dated, read, . How the Laundry Works . Cross-contamination should be a concern in areas containing clean or soiled linen . Transporting Linen - Soiled Soiled linen mush be kept in a container and covered at all times, this includes soiled utility rooms, sorting areas, and transportation to and from those areas . Separation and Sorting of linen Separation of linen is key to preventing cross-contamination . Soiled and clean linen need to be separated from each other at all times . Sorted soiled linens enters the wash area only after making sure any clean linen is first removed from washers and taken into dryer area . Remember that soiled linen cannot be in the wash area at the same times as clean . Review of the Facility's Infection Prevention and Control Program Policy, dated 11/28/2022, read, Policy: The primary mission is to establish and maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. Procedure: . 5. A system for linen handling to prevent the spread of infection to include handling, storing, processing and transporting linens . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105251 If continuation sheet Page 43 of 43