Inspection·August 27, 2021

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few tray down in front of the dresser to assist with eating. The roommate of the resident, Resident #67, had her meal delivered at 5:41 p.m., eleven minutes after Resident #14 received her meal. 6. On 8/25/21 at 5:39 p.m., a meal tray was delivered to Resident #97. Resident #97 was lying in bed and the over-bed table was across the room in front of the dresser and television. The meal tray was seen without a covered dinner plate but did have hydration items on the tray. The resident was awake and looking towards the dresser. At 5:49 p.m., a C.N.A (Certified Nursing Assistant) carried a covered dinner plate into the resident's room, pulled the privacy curtain around the bed, and sat down next to the resident. 7. An interview was conducted on 8/25/21 at 5:51 p.m., with Staff Member B, Licensed Practical Nurse/Unit Manager (LPN/UM). The staff member reported that staff should be sitting down to assist residents with eating, roommates should be served dinner together, and that the tray in Resident #97's room should never have been taken into his room until staff were ready to assist him. She stated that Resident #97 had been in the hospital recently and had returned more dependent on assistance. On 8/26/21 at 8:35 a.m., Staff Member B stated that the facility implemented a new (dietary) ticket system this week and that she had spoken with the Dietary department regarding the need for trays to come out together (rooms). The Unit Manager reported that Resident #97's meal was delivered to the room with an incorrect diet type (on 8/25/21) so the plate was removed and since the tray was contaminated it could not be removed from the room so staff left it there. She stated that she discussed with staff that, if this happened again, they should start assisting the resident with hydration and have another staff member order the correct diet, and by the time hydration was completed, the new meal could be arriving. 8. An interview was conducted, on 8/27/21 at 1:46 p.m., with the Food Service Director and Staff Member N, Dietician. The Director stated her expectation was that the meal trays for the same room were to be on the same tray cart and the roommates meals should be served within a minute or two of each other. She reported that meal trays for roommates come out of the kitchen on the same tray cart and it does not matter if one roommate was an independent diner and the other roommate was a dependent diner. The Director stated the facility had initiated new menus and there had been three people serving and the last staff on the line should have ensured that the meal was correct (for Resident #97). Staff Member N stated that the meal tracker was attached to the Electronic Medical Record system, used by nursing, and if the residents rooms were changed the change would transfer automatically to the meal tracker. Staff Member B stated, on 8/27/21 at 2:35 p.m., that the process of passing trays was reviewed and staff educated on passing from one side of the tray cart and then the other side. 9. The policy, Dining Environment, dated 1/12/21, identified that staff shall strive to create an appropriate homelike dining environment. The Interpretation and Implementation of the policy indicated that: - The direct care staff, Dietitian/Dietetic Technician, and Food Service Director will collaborate in developing a homelike dining environment. - All residents maintain their choice as to where and when they would like to eat, if feasible. - All residents seated at a table will be served together. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105544 If continuation sheet Page 2 of 9 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 105544 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/27/2021 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Solaris Healthcare Bayonet Point 7210 Beacon Woods Dr Hudson, FL 34667 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 0550 Level of Harm - Minimal harm or potential for actual harm The policy, Assistance with Meals, dated 1/12/21, identified that Residents shall receive assistance with meals in a manner that meets the individual needs of each resident. The policy indicated that if dining was to occur in the residents room: - The Food Services Department will deliver resident meal trays to appropriate location. Residents Affected - Few - The Nursing staff will prepare residents for meal. - The Nursing staff will deliver meal trays to resident rooms. The policy identified that residents who cannot feed themselves will be fed with attention to safety, comfort, and dignity. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105544 If continuation sheet Page 3 of 9 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 105544 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/27/2021 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Solaris Healthcare Bayonet Point 7210 Beacon Woods Dr Hudson, FL 34667 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 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Based on observation, interview, and record review the facility failed to implement care plan interventions for one (Resident #137) of four residents sampled for falls related to placement of floor mats for safety. Residents Affected - Few Findings included: Resident #137's Resident Face Sheet . revealed on page 2 medical diagnoses of hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side, muscle weakness, unspecified dementia with behavioral disturbance, and mood disorder due to known physiological condition with depressive features. Resident #137's record titled MDS [Minimum Data Set] Nursing Home Quarterly, dated 06/29/21, revealed under Section C: Cognitive Patterns a BIMS [Brief Interview for Mental Status] Summary Score of 9, indicating impaired cognition. Section G: Functional Status revealed Resident #137 had total dependence on staff for transfer, locomotion on and off the unit, and bathing. Resident #137 had functional limitations of range of motion in both the upper and lower extremities. Resident #137's record titled Observation Detail List Report . Morse Fall Scale, dated 07/02/21, revealed the Resident has a history of falling and a fall score of 60, indicating a High Risk for Falls status. Resident #137's record titled Care Plan, revealed on page 65 under the column titled Problem, started on 01/11/2021, Category: Falls . FALLS, @ [at] risk for as evidenced by: personal history of falls, decreased endurance,pain that worsens with movement . transfers-will lean backwards during transfers & [and] buckling of knees at times . Approaches to the identified problem area, as listed on page 66, included . Low bed to be kept in lowest position @ all times w/ [with] wedge in bed for positioning, & floor pads [floor mats] next to bed . An observation on 08/24/21 at 10:40 a.m. revealed Resident #137 lying in bed under the bed covers with the bed in the low position. A floor mat was seen folded in the back corner of the Resident's room. No floor mats were observed in place on either side of the Resident 's bed. The Resident was non-responsive to attempted communication. A follow up observation on 08/24/21 at 2:00 p.m. revealed Resident #137 in an unchanged position with no floor mats in place. An observation on 08/25/21 at 3:22 p.m. found Resident #137 lying in bed with no floor mats in place. During an interview on 08/25/21 at 3:30 p.m. Staff C, Certified Nursing Assistant (CNA) stated assignment sheets are provided to the aides which explains what each resident may require in terms of assistance or interventions that are needed. Aides can also check the online medical system or the nurse regarding resident needs. Staff C, CNA reviewed the assignment sheet, which revealed no indication Resident #137 required floor mats. During this interview, an observation was conducted around Resident #137's room, and inside of the Resident's closet, which revealed no floor mats were available. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105544 If continuation sheet Page 4 of 9 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 105544 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/27/2021 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Solaris Healthcare Bayonet Point 7210 Beacon Woods Dr Hudson, FL 34667 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 During an interview on 08/25/21 at 3:40 p.m., Staff D, Licensed Practical Nurse (LPN) stated Resident #137 does not require floor mats due to him being spatially aware of where the edge of the bed is. On 08/24/21 at 3:45 p.m., an interview with the Director of Nursing (DON) revealed creating care plan interventions are a team effort. After getting input from staff, the information . goes into the chart. The interventions are then verbally reported to staff and placed onto the assignment sheets. The point of care (POC) responses are loaded into the online system for CNAs and once a task is completed, the CNA will check off the task as done. A review of Resident #137's Point of Care History revealed under Miscellaneous Tasks the task to . Floor pads next to bed. [Every Shift]. The task was marked as completed on 08/24/21 at 8:51 p.m. and 11:27 a.m., and on 08/25/21 at 10:27 a.m. An interview on 08/25/21 at 3:52 p.m. with the MDS Coordinator and the DON revealed Resident #137 was a fall risk and the care plan was created after working . closely with restorative and the CNAs . The MDS Coordinator stated Resident #137 does require floor mats to be in place, which is a chartable task in the POC system. This means that the CNAs must sign off on the task after it has been completed. The MDS Coordinator reviewed the Resident's online medical chart and confirmed the task of placing the floor mats by the Resident's bed side was marked as done. The DON stated it would be restorative that would evaluate the Resident to determine if the floor mats were no longer needed. Any new interventions or interventions determined to be no longer needed and thus discontinued, would be updated in the care plan and the POC tasks within 24 hours. The MDS Coordinator reviewed Resident #137's online medical chart to reveal no restorative notes which indicated the removal of the floor mats. During the interview on 08/25/21 at 3:52 p.m., the DON confirmed the expectation was to implement all care plan interventions. A policy review of Care Planning- Interdisciplinary Team, with a most recent revision date of 01/07/2020, revealed . Our facility's Care Planning/Interdisciplinary Team is responsible for the development of an individualized comprehensive care plan for each resident . The care plan is based on the resident's comprehensive assessment and is developed by a Care Planning/Interdisciplinary Team which includes, but is not necessarily limited to the following personnel . The Director of Nursing (as applicable) . the Charge Nurse responsible for the resident care Nursing Assistants responsible for the resident's care . A policy review of Baseline Care Plan and Summary, with a most recent revision date of 1/7/2020, revealed . It is the policy of [Facility Name] to develop a Baseline Care Plan that identifies the needs of and instructions for how to care for the resident within 48-hours of admission . Develop and implement a baseline care plan for each that includes the instructions needed to provide effective and person-centered care of the resident that meets professional standards of quality care. The baseline care plan will . Include the minimum healthcare information necessary to properly care for a resident . A policy review of Care Plans- Comprehensive, with a most recent revision date of 1/7/2020, revealed . An individualized comprehensive care plan that includes measurable objectives and timetables to meet the resident's medical, nursing, mental and psychological needs is developed for each resident . Each resident's comprehensive care plan is designated to: . Incorporate problem areas . (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105544 If continuation sheet Page 5 of 9 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 105544 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/27/2021 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Solaris Healthcare Bayonet Point 7210 Beacon Woods Dr Hudson, FL 34667 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 FORM CMS-2567 (02/99) Previous Versions Obsolete Incorporate risk factors associated with identified problems . Reflect treatment goals, timetables and objectives in measurable outcomes . Aid in preventing or reducing declines in the resident's functional status and/or functional levels . Reflect currently recognized stands of practice for problem areas and conditions . Care plan interventions are designed after careful consideration of the relationship between the resident's problem areas and their causes. When possible, interventions address the underlying source(s) of the problem area(s), rather than addressing only symptoms or triggers Event ID: Facility ID: 105544 If continuation sheet Page 6 of 9 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 105544 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/27/2021 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Solaris Healthcare Bayonet Point 7210 Beacon Woods Dr Hudson, FL 34667 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 0825 Provide or get specialized rehabilitative services as required for a 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 specialized rehabilitation services related to physical therapy, for one (Resident #418) of 32 residents sampled. Residents Affected - Few Findings Included: On 08/24/21 at 11:34 a.m. an interview was conducted with Resident #418. She stated she was admitted to the facility about six weeks ago. Resident #418 had a goal of completing physical therapy and being discharged home. Resident #418 stated her therapy services ended over three weeks ago. Staff informed her that it was due to her insurance coverage ending. Resident #418 stated she asked staff to speak to the facility social worker, to no avail. Resident #418 stated her son would not allow her to come back home until she was able to transfer safely to the bathroom. Resident #418 stated since she was not receiving physical therapy, she was unable to achieve that goal. A review of Resident #418's admission Record revealed an initial admission date of 07/13/21 with a diagnosis of Sepsis, unspecified organism. The Resident's Minimum Data Set (MDS), dated [DATE], under Section C (Cognitive Patterns) revealed a Brief Interview for Mental Status (BIMS) score of 13, indicating Resident #418 was cognitively intact. Section G (Functional Status) revealed Functional Rehabilitation Potential, Resident and direct care staff believe that resident is capable of increased independence. A review of Resident #418's Care Plan, dated 07/14/21, revealed a focus area of ADL (Activities of Daily Living) Functional/Rehabilitation Potential. Physical Therapy: Impaired transfers related to decreased strength, decreased balance, decreased safety precautions, pain left hip. Resident #418's goal was to complete functional transfers with supervision. A review of Resident #418's Care Plan, dated 07/14/21, last revised 08/02/21, revealed a focus area related to discharge planning. Patient's plan was to return home with her son once rehabilitation is complete. Resident #418's goal was to be discharged home with necessary support service to ensure continuity of care. A review of Resident #418's active physician orders, dated 07/13/21, revealed Physical Therapy (PT) to evaluate and treat as indicated. Rehab potential (Fair). A review of Resident #418's physical therapy discharge summary revealed dates of service, 07/14/21-08/11/21. Discharge reason, referred to Restorative Nursing Program. Upon review of the Restorative Nursing Program's documentation it was revealed Resident #418 was not receiving restorative therapy services, as evidenced by her name not being included on the list of residents actively receiving services. On 08/26/21 at 11:20 a.m. a follow up interview was conducted with Resident #418. She stated that she had not heard from the social worker and wanted to know what was going on. She also stated that her son had been trying to reach the social worker by phone but was unable to reach them. On 08/26/21 at 04:30 p.m. an interview was conducted with Staff F, Certified Nursing Assistant (CNA). She stated that she was not aware of Resident #418 wanting to speak with the social worker. If a (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105544 If continuation sheet Page 7 of 9 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 105544 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/27/2021 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Solaris Healthcare Bayonet Point 7210 Beacon Woods Dr Hudson, FL 34667 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 0825 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few resident asks to speak to a Social Worker, she would tell her charge nurse because she did not want to give the residents the wrong answer. Staff F was unaware of a certain process to notify the social worker. On 08/26/21 at 04:35 p.m. an interview was conducted with Staff G, CNA. Staff G stated if a resident asked to speak to the Social Worker (SW), she would ask if there was something she could help with, and if not, she would just tell her nurse that the resident would like to speak to the social worker. On 08/27/21 at 09:32 a.m. an interview was conducted with Staff H, Registered Nurse (RN). She stated that if a resident asked to speak to the social worker, they notify them by calling. If they are not available, they leave a message for them. There are communication boxes available at each nurse's station to notify the social worker if a resident wants to speak to them. On 08/27/21 at 12:01 p.m. an interview was conducted with Staff I, Social Worker. He stated that he was Resident #418's social worker but has not had much interaction with her. His partner completed Resident #418's initial mood interview and observations. He was aware that the resident was cut by her insurance. He was aware that her plan was to remain in the facility until she could stand and pivot, then she would discharge to her home. Medicaid was to cover the facility stay. Staff J, Case Manager applied for Part B on behalf of the Resident. Resident #418 was supposed to be receiving therapy so she could go home. Staff I stated Resident #418 is receiving occupational and physical therapy. If she is not receiving therapy, they may be waiting for approval from the insurance company. Staff I called Staff J on the phone to see if they started the Medicaid process. Staff J confirmed that the Resident was already approved for Medicaid prior to being cut from her insurance on 08/13/21. The Resident has dual insurance coverage. Therapy must pick her up under Part B. Staff J usually submits the request for a therapy evaluation. Resident #418's family was very involved with her care, son said, as long as she can transfer, she can come back home. Staff J was going to put in the therapy request right now. Staff J could not provide an explanation as to why it was not done prior to the interview. On 08/27/21 at 01:30 p.m. an interview was conducted with Staff K, Physical Therapist. She stated that Resident #418 was discharged from therapy. Before the Resident was admitted to the hospital, she was living at home with her son and able to walk with a cane. When she was admitted to this facility, she required total assistance from staff. The mechanical lift was used to transfer a resident from the bed to a chair. Prior to being discharged from therapy, Resident #418 was able to use the sit to stand with parallel bars. She could not make any steps and leaned backwards when standing. She tried to get her to walk again but she was unable to make progress. The Resident was discharged from therapy on 8/11/21. She was informed the Resident was now under Part B insurance and it would not be necessary to reevaluate the Resident before picking her up again. Staff K stated she would ask the Resident if she wanted to participate in therapy again. If the Resident does not want to participate, they would re-approach. If the Resident wants to participate, they will give her another try. Yes, the Resident's insurance was cut but therapy can request if the therapy is medically necessary for the resident and physical therapy can request an order depending on where the resident is going to be living. The Resident's goal prior to being discharged was to start gait training with minimal assistance. The goal for each resident was to help them to reach their prior level of functioning unless they have an issue that would make reaching their prior level of functioning unrealistic. The reason for this Resident being discharged was a combination of both, insurance being cut along with not making progress. Staff K stated that Resident #418 was referred to the Restorative Nursing Program. Staff K was unable to locate the restorative therapy referral. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105544 If continuation sheet Page 8 of 9 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 105544 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/27/2021 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Solaris Healthcare Bayonet Point 7210 Beacon Woods Dr Hudson, FL 34667 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 0825 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few On 08/27/21 at 01:40 p.m. an interview was conducted with Staff L, Restorative Aide. She stated that Resident #418 has never been on her caseload. Staff L stated .I think . Resident #418 still receives therapy three days a week. On 08/27/21 at 02:36 p.m. an interview was conducted with Staff B, Registered Nurse (RN). She stated that the therapy department usually gives restorative a therapy sheet, showing the guidelines for the program and the process starts instantaneously. The staff should implement the order right away. They are using a new point of care (POC) system for charting. The process is that when the order is written, it is put in right away so that CNA's can look at it, see what the orders are, and sign into the POC. The restorative aide documents resident progress into the restorative book. When a referral is made to therapy, an evaluation is completed, the information is logged into the system. There is a restorative book kept at the nurse's station. When an order is provided from Physician for a resident to receive therapy, it is put into computer, then printed out and given to therapy. It is done within a few days, never takes a long period of time. If a resident is declining in ADL functioning, they request an order for therapy to the physician. Nurses cannot make a referral without a physician's order. The Physician is on board and pretty good about giving the ok for things. Typically, when a resident has insurance changes that interfere with therapy, the social worker comes to nursing first, then advises them that the resident needs to continue services under Part B. Does not know how long therapy will take, they usually do it fast, as soon as they receive an order, same day. A policy review revealed . 8. Following the screening, the therapist will document whether the resident may benefit from a more detailed rehabilitation evaluation or from unskilled therapy (e.g. restorative nursing services that can be provided by caregivers or exercises with which family members can assist). 9. If a potential to benefit from rehabilitation therapies (either skilled or unskilled) is identified, the attending physician will order a relevant therapy evaluation (for example, by a physical or occupational therapist). 10. The reason for ordering the evaluation should be documented . In conjunction with the physician and staff, therapists will propose a rehabilitation or restorative care plan that provides an appropriate intensity, frequency and duration of interventions to help achieve anticipated goals and expected outcomes efficiently using available resources . The staff will monitor and discuss with the physician the resident's functional progress, both while receiving therapy and in general while on the unit; for example, evidence of reduced ADL dependency, improved ambulation, fewer falls, etc. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105544 If continuation sheet Page 9 of 9