Inspection·October 4, 2023

F 0622 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few (SSD), she stated that she only dealt with Resident #1 minimally and that she was the one who handled his discharge paperwork. She revealed that Resident #1 was a Creole speaker and that she used Staff F, Licensed Practical Nurse (LPN) to assist her in translating the discharge information to Resident #1 in Creole. According to the SSD, Resident #1's home situation was not conducive but that his plan was to go home. Knowing that Resident #1 was unable to speak, the SSD stated she sat with him and Staff F to explain to him that she had found a new facility that would be more suitable for him. When asked to clarify, she stated the new facility had like minded residents and residents who speak Creole. She provided him the paperwork, which the surveyors noted was in English and not in Creole, which she agreed was Resident #1's native language. In this interview, the SSD stated she did not tell Resident #1 that he had a choice to appeal this discharge decision but that she just asked him to sign the paperwork. When asked by surveyors if he made his own decisions and signed the paperwork, she said yes. When asked if she should have marked a Reason for discharge on the Nursing Home Transfer and Discharge Notice, she stated yes and acknowledged that it was not marked, indicating there was no reason for the discharge. In an interview conducted on 10/03/23 at 2:34 PM with Staff F, LPN, she confirmed that she assisted the SSD in translating Resident #1's discharge paperwork to him in Creole. She stated when she told Resident #1 that he was discharging to another facility, he nodded his head yes in agreement and signed the paperwork. A secondary interview was conducted with Staff F on 10/04/23 at 8:45 AM. She was asked to clarify what she told Resident #1 when she assisted the SSD in translating the discharge information. She revealed that she told Resident #1 he would be going to a facility in the Miami area and shortly after that he would be going home. She stated that is what the SSD asked her to translate. She said she further asked Resident #1 if he was ok with the transfer and he nodded his head yes. When asked if Resident #1 was told that he had the option to appeal the transfer, Staff F stated no. Staff F further reported that she did not tell Resident #1 the reason he was leaving the facility. In an interview conducted on 10/04/23 at 1:31 PM with the facility's Administrator, she reported that the facility made the decision to start the discharge process for Resident #1. She stated that they thought that a smaller facility would be better for him. She further stated that she was concerned with the circumstances where he was living before, and she was unsure if he could go back there. In an interview conducted on 10/04/23 at 1:41 PM with the facility's Social Services Assistant, he stated that Resident #1 did not understand English but only Creole. He further stated he was unable to communicate with him, so he spoke with Resident #1's emergency contact upon his admission. The emergency contact stated the plan was to have Resident #1 fly back to Haiti upon discharge. When asked what appropriate discharge reasons are, he stated the following: progressing in therapy, family request for discharge, and insurance ceasing to cover services. He was asked by surveyors who made the decision to discharge Resident #1. He stated he did not know, but then stated he heard it was due to the elopement but was unsure as to why. When asked about any progress notes or admission notes regarding Resident #1's discharge planning, he stated that he did not follow up on Resident #1's progress or complete any notes regarding the discharge planning. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105298 If continuation sheet Page 2 of 8 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 105298 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE FT Lauderdale Health & Rehabilitation Center 2000 East Commercial Blvd Fort Lauderdale, FL 33308 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 - Few 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 interviews and record reviews, the facility failed to prevent elopement by not educating staff in identifying residents at risk for elopement for 1 of 2 sampled residents reviewed for elopement (Resident #1). The findings included: Review of the facility's policy titled Wandering, Unsafe Resident, revision date October 2023 revealed the following: The staff will identify residents who are at risk for harm because of unsafe wandering (including elopement). The staff will assess at-risk individuals for potentially correctable factors related to unsafe wandering. If the resident was not authorized to leave, page CODE PINK, initiate a search of the building and premises. Review of the facility's policy titled Elopements, revision date October 2023 revealed the following: Staff shall promptly report any resident who tries to leave the premises or is suspected of being missing to the Charge Nurse or Director of Nursing. Resident #1 was admitted to the facility on [DATE] for rehabilitation services. Resident #1 had a medical history of Stroke, Non-Verbal, and Weakness. Review of the Comprehensive Nursing Evaluation, Elopement Evaluation documented on 08/30/23 at 11:12 PM showed Resident #1 was not at risk for elopement. Review of the Care Plan initiated on 09/25/23 revealed that Resident #1 was at risk for elopement and that he displayed exit seeking behaviors. It further showed the staff would make sure he does not leave the facility without supervision, keep a photo with a copy of his face sheet located at the reception desk, observe him for and report any elopement risk behaviors, and redirect him during inappropriate behavior episodes. Review of the Nursing Note dated 09/19/23 showed that Resident #1 was found in the lobby attempting to leave the facility. He was returned to his unit by the facility staff and the staff were instructed to place a Wanderguard. Review of Physician's orders revealed that an order was written on 09/19/23 for place Wanderguard per protocol for attempted elopement. In a telephone interview conducted on 10/03/23 at 10:55 AM with Staff A, the facility's weekend Receptionist, she stated that on the morning of 09/30/23 at approximately 8:15 AM, she noticed Resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105298 If continuation sheet Page 3 of 8 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 105298 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE FT Lauderdale Health & Rehabilitation Center 2000 East Commercial Blvd Fort Lauderdale, FL 33308 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 - Few #1 in the lobby area sitting at the right side of her desk on a chair. While sitting down, she said good morning to him, and he smiled at her but did not verbally respond. Resident #1 then walked to the Admissions Office (which was located next to the front desk) and attempted to open the door, but it was locked. She stated she recognized that he was a resident because of the band on his arm. She asked him to go back to his room and he left, taking the elevator up. When asked if she told anybody about Resident #1 wandering around the lobby near the front door, she said no. When asked about the Risk for Elopement binder that was located at the front desk, she said that it contains a picture of each resident in case they walk out and the picture needs to be used for identification. Staff A further reported that she did not know that Resident #1 was at risk for elopement. According to Staff A, Resident #1 went back down to the lobby area at approximately 10:20 AM. She stated she did not see Resident #1 initially. She stated she was in the process of buzzing a visitor out of the front door and Resident #1 came from the left side of her desk (where her view is obstructed) and he had reached the front door before she recognized him as the same resident who had been in the lobby earlier that morning. She stated she yelled for him to stop, but he pushed past the visitor and out the front door. She then ran outside and yelled for help and noticed that Resident #1 was running to the west. She reentered the facility to call the weekend supervisor to alert her of the situation while other staff members were looking for Resident #1. She was then asked by the surveyors if she thought that Resident #1 wanted to escape when she first noticed him in the lobby area that morning, she stated no. She further reported that that day was the first time she saw this resident and did not think there was anything unusual about him or that he intended to elope. According to Staff A, she did not know that Resident #1 was at risk for elopement and she said that if she knew that he intended to leave the facility earlier that day, she would have taken him by the arm and walked him back to his room and notified the supervisor of his behavior. In an interview conducted on 10/03/23 at 11:36 AM with Staff B, the facility's weekday Receptionist, he stated that when a resident elopes, he has been instructed to call a CODE SILVER to alert the rest of the facility staff of the elopement. When asked how he knew if a resident is at risk for elopement, he stated there is a binder located in the lobby that contains the resident's pictures and is to be updated on a weekly basis. Staff B was asked if he knew Resident #1 before his elopement on 09/30/23 and he stated he saw him in the past in the front lobby area near the Admissions Office but did not know what day. He recalled that time, Resident #1 did not have a Wanderguard bracelet on and he did not think he was at risk for elopement because he walked around looking as if he were lost. In an interview conducted on 10/03/23 at 12:14 PM with Staff E, Registered Nurse (RN), he stated he worked with Resident #1 on 09/19/23 when he attempted to elope the first time. He recalled that he received a call from the lobby on 09/19/23 letting him know that Resident #1 tried to leave the facility through the front door. He then asked the caller why Resident #1's Wanderguard did not go off. He was told by the caller that Resident #1 did not have a Wanderguard on. Staff E was then instructed to put a new Wanderguard in place on Resident #1. According to Staff E, the first Wanderguard was placed on Resident #1's right ankle prior to the elopement attempt on 09/19/23 and a second one was placed on 09/19/23 on his left ankle. When asked by surveyors why was the first Wanderguard placed shortly after Resident #1's admission, he stated he often wandered around and attempted to get into the elevator. When asked if there was an order for the first Wanderguard, Staff E stated there must have been. An Elopement Risk Evaluation done on 09/19/23 at 11:25 AM documented Resident #1 was at low risk for elopement. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105298 If continuation sheet Page 4 of 8 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 105298 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE FT Lauderdale Health & Rehabilitation Center 2000 East Commercial Blvd Fort Lauderdale, FL 33308 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 - Few Staff E further stated that he did not know there was an elopement binder in the lobby with a list of residents who have Wanderguards and he also stated he did not update the elopement binder letting the other staff members know that Resident #1 was at risk for elopement and that a new Wanderguard had been placed. Staff E stated the order for a Wanderguard to be placed would trigger an automatic updating of the elopement risk residents in the computer system. Staff E confirmed after the second Wanderguard was placed on Resident #1, he was observed wandering around the unit almost daily. He stated Resident #1 was watched by the staff to ensure he did not enter the elevator alone. In an interview conducted on 10/03/23 at 4:44 PM with the facility's Administrator, she stated there is an elopement binder located in the nursing supervisor's office and a second binder is located in the main lobby. She stated once a Wanderguard is placed on a resident, the elopement binders are updated and all staff members are notified immediately. In an interview conducted on 10/04/23 at 7:23 AM with the facility's Admissions Director, she stated that when Resident #1 eloped, she could hear Staff A yelling No in the lobby. She then asked Staff A who it was that just escaped through the main door, but Staff A did not know Resident #1's name. Staff A told her that Resident #1 was seen all morning in the main lobby walking back and forth and attempting to enter the Admissions Office which was locked. She stated she then went outside to look for Resident #1 and when she didn't see him, she reentered the building and asked Staff A again who the resident was that just escaped. Staff A again said, I do not know. She was then told by another staff member that it was Resident #1 who had eloped and a picture of him was taken out of the elopement binder located in the lobby, which was a bad copy. She then printed another copy so she could use it to identify Resident #1. The Admissions Director told the surveyor the fact that Resident #1 was seen in the lobby earlier that morning was a red flag indicating that Resident #1 wanted to leave the facility. Review of the facility's 5-day report revealed that Resident #1 was able to return to his personal apartment, change his clothes and shoes, and remove his Wanderguard while staff members were searching for him. He was later found by the facility's administration while he was walking to see his children in another apartment building. He was located by the facility's administration who picked him up in a personal vehicle and brought him back to the facility for assessment. Two days later, Resident #1 was discharged to another Skilled Nursing Facility. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105298 If continuation sheet Page 5 of 8 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 105298 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE FT Lauderdale Health & Rehabilitation Center 2000 East Commercial Blvd Fort Lauderdale, FL 33308 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 0940 Develop, implement, and/or maintain an effective training program for all new and existing staff members. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews, the facility failed to develop, implement, and maintain an effective elopement training program for all new and existing staff. The facility failed to have effective communication training on the appropriate steps to take if an elopement occurs for 1 of 2 sampled residents reviewed for elopement (Resident #1). Residents Affected - Few The findings included: Review of the facility's Elopement Guidelines for a missing resident who was seen leaving the premises provided by the facility's Administrator on 10/04/23 showed the following: Employees should attempt to prevent the departure courteously. Get help from other staff members in the immediate vicinity. Page CODE PINK to the designated area of the facility. Notify the Supervisor and Unit Manager that a resident left the premises. Print the Face sheet and picture of the resident. If the resident has already been identified to be at risk for elopement, obtain the copies from the Elopement Binder located at each nurse's station and on the 1st floor by the receptionist area. The nurse supervisor and Unit Manager will assign staff which area to search for: a. Description of what the resident was wearing. b. Walking the perimeter of the facility. c. Drive around the vicinty of the facility. d. Notify the Administrator, Director of Nursing and Risk Manager. Record review revealed that Resident #1 was admitted to the facility on [DATE]. A Wanderguard was placed for a risk of elopement on Resident #1. On 09/19/23, Resident #1 was observed attempting to leave the facility, and on 09/30/23, he successfully eloped through the front door of the facility and was out of the facility for approximately 9 hours until the facility's administration found him and brought him back to the facility. In a telephone interview conducted on 10/03/23 at 10:55 AM, Staff A, the facility's weekend Receptionist, stated that on 09/30/23, the morning of the elopement, she was working in the main lobby when Resident #1 was walking around the main entrance. She stated she did not know Resident #1 was at risk for elopement or that had a Wanderguard on his ankle. She further stated that around 10:20 AM, Resident #1 ran out of the main door, and she yelled after him to stop. When asked what he was wearing when he eloped, she stated she noticed he had a gray t-shirt on and was carrying a plastic bag. She (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105298 If continuation sheet Page 6 of 8 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 105298 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE FT Lauderdale Health & Rehabilitation Center 2000 East Commercial Blvd Fort Lauderdale, FL 33308 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 0940 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few continued by stating that Staff J, a facility Housekeeper, and the facility's admission Director exited the building to attempt to locate Resident #1. Staff A stated she reentered the facility and called the weekend supervisor to tell her what had happened. When asked when she last received training on elopements, Staff A stated that she last participated in an elopement drill two years ago when she was a new employee. She stated she was told verbally what to do in case of an elopement and what steps to follow. She further stated she was told to call CODE SILVER, which, she said she was told, was the code for an elopement, and provide a picture of the missing resident from the binder in the main lobby so everyone can recognize the resident while they are looking for them. When asked if she knew how to identify residents at risk for elopement, Staff A said everyone was at risk and this was why the main front door needed to be locked. In an interview conducted on 10/03/23 at 11:36 AM with Staff B, the facility's weekday Receptionist, he stated that the last time he participated in an elopement drill was shortly after he was hired, which was around March of 2023. When asked what the steps are that the staff is supposed to follow in an elopement, Staff B said he would call CODE SILVER and alert the other staff members and the Administrator of the elopement. He stated he would also describe the missing resident and provide a print of the sheet with the resident's picture. When asked how he knows which residents are at risk for elopement, Staff B said that there was a binder in the main lobby with images of all residents at risk for elopement, which needs to be reviewed weekly. In an interview conducted on 10/03/23 at 12:14 PM, Staff E, Registered Nurse (RN), stated that there was an elopement binder on the 2nd floor (his unit). Staff E stated he knew Resident #1 was at risk for elopement and had a Wanderguard in place, but he never updated the binder on his unit with Resident #1's picture. When asked who was responsible for updating the elopement binder, Staff E stated he did not know. Staff E recalled participating in elopement education during his employment, but could not give the date of when it took place. Staff E was asked what the guidelines are to follow in an elopement of a resident who is seen leaving the facility, and he did not know. In an interview conducted on 10/03/23 at 4:44 PM, the facility's Administrator stated that there was an elopement binder in the Nursing Supervisor's office and another binder in the main lobby of the facility. The Administrator further stated when the staff visually sees a resident escaping the facility, the Supervisor oversees dispatching staff by foot or car to look for the eloped resident. When asked if they have a set of protocols to follow that is given to the staff members in case of an elopement, she said no and that it is only verbal instructions given to the staff. She stated elopement drills are done upon hire during orientation and again on a monthly basis by the facility's Staff Developer. In an interview conducted on 10/04/23 at 7:23 AM with the facility's Admissions Director, she stated that she started working in the facility approximately two months ago and had not received training in elopement education or an elopement drill since being hired. The morning of the elopement on 09/30/23, she heard Staff A screaming, and she went to the lobby area. She was told by Staff A that a resident had escaped, but she did not know who it was. She only knew that the resident was wearing a red t-shirt. The Admissions Director exited the facility to look for a resident with a red t-shirt and a plastic bag but she could not see him. She came back into the building and asked Staff A again as to who it was who eloped, and she did not know. The Admissions Director called the Administrator to let her know what had happened. At that point, other staff members were able to tell her which resident had escaped, and she printed a better copy of his picture from the medical records to distribute to the staff. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105298 If continuation sheet Page 7 of 8 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 105298 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/04/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE FT Lauderdale Health & Rehabilitation Center 2000 East Commercial Blvd Fort Lauderdale, FL 33308 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 0940 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few In an interview conducted on 10/04/23 at 8:14 AM with Staff J, a facility Housekeeper stated that he heard Staff A screaming in the lobby that a resident had escaped. He stated he entered the main lobby area and saw a resident leaving through the front door. He stated he initially ran after the resident but was told by another staff member (he did not know who) not to follow the resident but rather to go into the kitchen and ask for a Creole-speaking staff member. Staff J stated he went to the kitchen and tried to find a staff member who spoke Creole but was unsuccessful so he went outside again. He stated he ran around the perimeter of the building but did not find Resident #1. Staff J stated he was not given a picture of Resident #1, but when he saw him running out, he tried to follow him. In an interview conducted on 10/04/23 at 3:00 PM with the facility's Administrator, she was informed of the findings and areas of concern. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105298 If continuation sheet Page 8 of 8