Inspection·December 15, 2022

F 0550 Level of Harm - Minimal harm or potential for actual harm listen and respond to voiced concerns regarding Resident #26's bed, failure to respond appropriately to voiced request by Resident #55; and failure to speak to resident's in a dignified manner related to assistance, food and care (Resident #32 and Resident #56). The findings included: Residents Affected - Some 1) During observations on 12/14/22 at 9:50 AM, as the Surveyor was interviewing an aide in the hallway by the nurse's station by the 300 unit, the Surveyor overheard the aides talking very loud in a foreign language through the break room door. During observations on 12/15/22 at 10:03 AM, another surveyor stated that she was standing at the nurse's station and heard staff speaking a foreign language on the 200-unit hallway. Review of the resident council minutes on 12/13/22 revealed during the resident council meeting on 09/19/22, residents stated that staff is not speaking English and speaking loudly at night in the hallways. Follow-up to that meeting Administration addressed with staff in an all staff meeting on 09/20/22 at 3:00 PM they were advised that this is against company policy and if they are observed speaking another language with co-workers' disciplinary action will be taken. During a resident council meeting on 11/21/22 it was brought up again by resident's that the CNA's (Certified Nursing Assistant) are not speaking English in hallways and rooms. During a resident council meeting task with the Surveyor on 10/14/22 at 10:00 AM, with 10 residents, the Surveyor asked the residents about their concerns they had with residents hearing staff speaking a foreign language in front of them or in hallways. Residents stated they continue to do it as well as in their rooms. They went on to say that they understand that they speak a different language other then English, but that they are so loud at night talking in the hallways and it wakes them up. Resident #84 stated it bothers her. Resident #54 stated that this has been going on for 3 years which is as long as he has been in the facility. During an interview on 12/12/22 at 11:20 AM, Resident #211 stated staff are so loud in hallway at night, they keep me up. During an interview on 12/12/22 at 02:22 PM with Resident # 70, she stated that the staff that are from another country are talking a different language in the hallway right outside her door and when they are in her room. During an interview on 12/15/22 at 2:23 PM with Staff H, LPN (Licensed Practical Nurse), she was asked if she ever hears the aides talking a different language other then English near the residents. She stated, I sometimes hear the aides talking their language in hallways, I make great attempts to tell them they can't talk in a foreign language but when I say something to them, they give me a look, sometimes the residents will complain. Don't get me started, they are very loud. 2) During an observation and interview on 12/12/22 at 10:15 AM, with Resident #26, it was observed that he was lying in bed which was angled left towards the window. The Surveyor asked him is that how he likes his bed, he then stated No, watch what happens. He began to use the bed controls which were making a loud squealing noise and when he was in the lowest position of the bed, it began to move and shake. He stated that he has been complaining to the staff in the facility since he was admitted on [DATE]. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 2 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 Residents Affected - Some During an interview on 12/14/22 at 9:50 AM, with Staff D, CNA (Certified Nursing Assistant), she stated, when Resident #26's bed goes to the floor it is on wheels and the be moves. I reported it to maintenance. She was asked if she documented it somewhere and she stated, 'I just told him, we do not have a maintenance book. During a tour on 12/15/22 at 8:50 AM, with the Maintenance Supervisor, he was taken to Resident #26's room and shown his bed, which was angled towards the window. He then stated that he is aware of the problem and changed out his wheels today, but will change out his bed. The resident then asked him to straighten his bed for him. 3) During observations of Resident #55 on 12/13/22 at 2:08 PM, the resident was observed licking his creamer cups, he was asked why, and he said he wanted coffee. The Surveyor asked him to push his call light, he did, and a CNA came into the room. The Surveyor told her that he is wanting coffee, she stated he had some this morning during breakfast. The Surveyor then said, well he wants more. Surveyor looked at his cup and it was bone dry. Surveyor said he is licking his creamer cups and she stated, he always does. She then left with his cup and a few minutes later came back with coffee. During an interview on 12/13/22 at 2:42 PM with Staff I, CNA she stated she is agency staff and has been here for a couple of weeks. The Surveyor asked if a resident asked for coffee can they get it anytime, she stated a resident is able to have it, we will get it for them. It is his right to have coffee. 5) Record review revealed Resident #56 was admitted to the facility on [DATE] with diagnoses included: depression. The quarterly minimum data set (MDS) assessment, reference date 11/09/22, recorded a brief interview for mental status (BIMS) score of 15, indicated Resident #56 was cognitively intact. This MDS recorded moods of feeling down, depressed, or hopeless. No behavior concern was recorded in this MDS. This MDS additionally revealed, Resident #56 required extensive assistance by the staff with dressing herself and required supervision assistance with personal hygiene. On 12/12/22 at 12:41 PM, during the initial pool process, an interview was held with Resident #56, she revealed that a male certified nursing assistance (CNA) was providing her care, giving her a bed bath, during the care, Resident #56 mentioned that she needed to shave her face. Resident #56 stated The male CNA, replied no, you need to shave down there while pointed towards her pubic area. Resident #56 voiced, she felt that was inappropriate. Resident #56 was not able to identify the male CNA as the facility uses agency staff. On 12/15/22 at 9:08 AM, an interview was held with the Director of Social services (DSS), she revealed Resident #56 regularly receives psych services, SS see her regularly, talked to her often, the facility has a close relation with her family, SS was unaware of the gross inappropriate statement made by a male CNA. On 12/15/22 at 9:23 AM, the DSS voiced she spoke to the resident, she did confirm that a male CNA had made a grossly inappropriate statement towards her private area. On 12/15/22 at 10:01 AM, an interview was held with the Director of nursing (DON), she revealed that, Resident #56 did confirm a Male CNA did make an inappropriate statement towards her private area. The DON revealed the resident indicated; she did report the concern to a nurse. Resident #56 did not recall who she reported the concern to. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 3 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview the facility failed to notify the family of a significant change of 1 of 1 sampled residents, Resident #75. The findings included: During a telephone interview on 12/13/22 at 8:09 AM with Resident #75's daughter, she stated that she was very upset because she was never notified that her mother had declined and that they put a foley catheter and pic line in her. Record review for Resident #75 revealed she was admitted to the facility on [DATE] with a diagnosis to include Dementia, Hypertension, Acute Kidney Failure, Heart Failure, Major Depressive Disorder, Anxiety Disorder, Dysphagia, Cardiomegaly, Metabolic Encephalopathy and Cirrhosis of the Liver. A review of the MDS (Minimum Data Set) documents she has a BIMS (Brief Interview Mental Status) of a 1 which means her cognition is severely impaired. Her Power of Attorney is her daughter. A review of the progress notes documents the following and does not mention notifying the daughter of change in condition: On 11/06/22 at 6:53 AM, the nurse practitioner put a note in documenting that when she came in the nurse on 7-3 shift informed her that the resident's blood glucose was 68. The nurse hung a bag of D5 1/2 NS at 100mL/hour to help her blood glucose increase. The ARNP gave the resident some honey to help increase her blood glucose and her blood glucose was rechecked and it was 62. She gave the resident some orange juice with sugar and made a paste. When her blood glucose was rechecked, it was 123. On 11/06/22 documents by ARNP (Advanced Registered Nurse Practitioner) that she was being seen for lethargy and her blood glucose was 59, blood pressure 104/68 with a heart rate of 89. Patient was subsequently ordered to be given stat glucagon 1 mg now and to start D5 half normal saline at 75 mL at hour, check glucose every 4 hours. On 11/07/22 Resident #75 being seen today following nursing notification that patient is drowsy and lethargic, report given by weekend ARNP, patient was hypoglycemic and was started on D5W. On assessment, patient has no D5W running, appears to be drowsy, arousable with similar. Plan of care discussed with the patient's nurse. Patient will be restarted on D5W at 80 mL per hour. We will do a one-time glucose check in the morning to monitor early morning glucose. We will consult speech evaluation to evaluate swallow. As of now, nursing states patient unable to stay awake for safe swallowing. NPO orders initiated, nursing to notify dietician. Patient's blood pressure to be monitored close, metoprolol 12.5 mg taken twice a day would be on hold for now. We will continue to monitor patient and follow. On 11/10/22 Resident #75 being seen today following abnormal labs indicating acute kidney injury, elevated sodium, elevated liver enzymes, anemia, and thrombocythemia. On assessment, patient was seen in bed, awake, alert. Denies any chest pain or shortness of breath, denies abdominal pain. Speech therapist working with the patient states patient is tolerating honey consistency. We will continue following with the patient. Plan of care was discussed with the patient and patient's nurse. Repeat (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 4 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few labs ordered due to significant change. Patient was started on normal saline at 125 with a 500 mL bolus of normal saline. Speech therapist working with the patient states patient is able to tolerate honey consistency, meds to be crushed and mixed with applesauce. Patient seems to be improving, waiting on repeat labs as well as monitoring patient closely. If no great improvement in the next 12 hours or patient's labs remain the same, we will consider transferring patient to the hospital for further evaluation. Patient was started on vancomycin 1 g with pharmacy to monitor trough and adjust dose. Patient has allergies to penicillin and ciprofloxacin, considering to that cefepime 2 g, current lab results with normal white blood count. Above plan of care discussed with MD who will be seeing the patient for further evaluation. On 11/11/22 Resident #75 seen today by physician for follow-up of severe sepsis, likely secondary to pneumonia as well as decompensated heart failure and transaminitis and AKI. The patient this morning is seen at the bedside and is extremely lethargic, unable to communicate any medical complaints. Case discussed in detail with nursing staff, medical team, social work, and the patient's daughter who was present at the bedside. Given the patient's current clinical status, we are wishing to pursue aggressive treatment in-house. However, the patient's family has requested transfer to a local hospital given the acuity of the patient's illness and multiple laboratory abnormalities and current mental status. During an interview on 12/14/22 at 12:24 PM with the DON (Director of Nursing), she stated that notification to family is documented in Point Click Care progress notes. Surveyor asked her what they notify family on, she stated they should notify in change in condition, care plan, During an interview on 12/14/22 at 12:42 PM with the ARNP, she stated Resident #75 wasn't doing well and we put her on IV to rehydrate her. Surveyor asked if she notified the family in the change in condition.? The ARNP stated I did not notify her, I told the nurse to, but I don't know if it was done. She then stated that when the daughter came in in to see her mother she was upset because no one had notified her of the change in her condition, she was very upset. When the daughter came in the doctor was in the facility and had seen her mother, he felt she was stabilized but the daughter asked for her to be sent out to the ER (Emergency Room). During an interview on 12/15/22 at 2:23 PM with Staff H, LPN she was asked about who notifies the families of change in condition. She stated it is my responsibility to notify the family and doctor, the unit manager can also help do that. We would document a residents change in status, notification of family and physician in Point Click Care. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 5 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 - Some 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** 3) On 12/12/22 at 10:27 AM, the surveyor attempted to enter the room of Resident #71. Staff in the hallway saw the surveyor struggling with the door and stated, just push hard. Upon entering the room, Resident #71 explained he had been in that room for about a week and the door had been like that since his arrival. Resident #71 also voiced that the handheld shower was broken and the drain in the shower was not secure. When asked if he told anyone about the issues in the shower, Resident #71 stated he had mentioned it to staff, but could not recall to whom. An observation at that time revealed the plastic piece on the handheld shower that allowed it to hook to the metal bar was broken. During an interview on 12/12/22 at 10:56 AM, Staff J, Registered Nurse (RN), confirmed she worked on this same unit yesterday and last week. When asked if she had told anyone the issue with the door, the RN stated she told maintenance. When asked how and when she informed maintenance staff, the RN stated she verbally told maintenance staff yesterday and again today (after observing the surveyor having difficulty entering the room). On 12/12/22 at 12:09 PM, the maintenance assistant was observed working on the door to Resident #71's room. The maintenance assistant stated he did not work yesterday, but that his supervisor told him to get it fixed today. During an interview on 12/15/22 at 9:47 AM, the Maintenance Supervisor explained when there is a needed repair, the staff should enter the request in their TELS system (an electronic work order system), to notify him of any needed repairs. The Maintenance Supervisor stated he was not aware of the door issue until Monday and was unaware of the shower and drain issues in the room of Resident #71. 4) During an interview on 12/12/22 at 3:28 PM, Resident #52, who was currently on the 100 unit, was asked about the ability to take a shower. The resident explained she had just been transferred to the 100 unit, but while residing on the 300 unit, she would not take a shower because it was always cold. (Please refer to example #1, as Resident #52 previously resided in the room of Residents #82 and #84.) A tour was completed on 12/15/22 at 8:50 AM, with the Maintenance Supervisor, he acknowledged the following findings: 5) room [ROOM NUMBER] bathroom, the tile on back wall coming away from wall, dirt piled along back wall. room [ROOM NUMBER], the sink in the bathroom was dripping, dirt piled up along back wall, the door was warped hard to open. room [ROOM NUMBER]-B, the left and right wheelchair arm padding was cracked. room [ROOM NUMBER]-B, the right wheelchair arm is torn. room [ROOM NUMBER]-A, the air conditioning vent was built up with dust. room [ROOM NUMBER], shower head clip broken off, the door was sticking and difficult to close when (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 6 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 open and against wall and difficult to open when closed. Level of Harm - Minimal harm or potential for actual harm Based on facility policy, interview, and observation, the facility failed to provide hot water for showers for 3 Residents (#82, #84 and #52); failed to maintain resident room doors for 3 Residents (#71, #19, and #52); and failed to ensure a clean and comfortable environment on 3 of 4 resident units (unit 200, unit 300 and unit 400). Residents Affected - Some The findings included: Facility Policy titled TELS Policy on How to Submit a Work Order dated 08/01/2022 documents, It is the policy of [NAME] Rehab and Healthcare that in the event that a repair or routine maintenance needs to be made in the facility, staff members should fill out a work order in the TELS system for the Maintenance department to follow up with the repair. 1) On 12/12/2022 at 12:21 PM Resident #82 stated she wanted a shower, but the shower does not get warm. She stated it is ice cold and she cannot take a shower that way. On 12/13/2022 at 10:40 AM and 12/14/2022 at 1:00 PM Resident #82 stated they still do not have hot water in the shower, and they have not had hot water since she moved here. Record review for Resident #82 documented an admission date of 11/18/2022 with diagnoses that include cellulitis both lower extremities, history of bowel infection, and anxiety. Minimum Data Set (MDS) resident assessment dated [DATE] documented Resident #82 needed extensive assistance for all activities of daily living except eating requiring supervision only, was cognitively intact and it was very important to be able to choose between bath or showers. 2) On 12/12/2022 at 12:06 PM Resident #84 stated there is no hot water in the bathroom and she wants to take a shower. On 12/13/2022 at 10:45 AM she stated there was still no hot water and she misses taking a shower. She stated there has not been hot water since June and she has told many people, but nothing happens. Once she was trying to take a shower and the Certified Nurses Assistant felt bad for her and filled a basin in the outer room sink with hot water and came back to the bathroom shower and poured it on her head. She said the CNA did it twice and it felt so good, almost like a real hot shower. Record review for Resident #84 documented an admission date of 12/21/2021 with diagnoses that include Lung Disease, Heart Disease, Diabetes and Depression. An MDS resident assessment dated [DATE] documented Resident #84 as needing limited assistance for mobility on and off the unit and having moderate cognitive impairment with a previous preference assessment stating it was very important to be able to choose between bath or showers. On 12/14/2022 at 10:40 AM when asked by the surveyor if there was hot water in Resident #82 and #84's shower, Staff C turned on the hot water in the shower and waited. After 5 minutes she stated the hot water did not work. The maintenance director was then notified. On 12/14/2022 at 2:00 PM a plumbing company employee and the maintenance director stated the hot water in the shower for Residents #82 and #84 did not work and a new valve was needed. Further repairs were scheduled for the following day. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 7 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 3) Review of the record revealed Resident #52 was admitted to the facility on [DATE]. Further review revealed a Preadmission Screening and Resident Review (PASRR) form was completed for Resident #52 on 10/18/21, indicating the resident had a Serious Mental Illness (SMI) with the need for a Level II PASRR. Further review revealed the Level II PASRR was completed on 10/21/21. This Level II PASRR documented Resident #52 met the state definition of SMI, was appropriate for nursing facility placement, and did not need specialized services. Residents Affected - Some Review of the Modified admission Minimum Data Set (MDS) assessment dated [DATE] documented under section A1500 that Resident #52 was not considered by the stated Level II PASRR process to have a serious mental illness. During an interview on 12/14/22 at 3:07 PM, Staff F, the MDS Director, agreed with the findings and stated she would do an additional correction and assessment. Based on record review and interview, the facility failed to ensure accuracy of the MDS assessment for 3 of 5 sampled residents. This concern involved Resident #98, #21, and #52. The findings included: 1) Record review revealed Resident #21 was initially admitted to the facility on [DATE], with a re-admission on [DATE]. The 5-day minimum data set (MDS) assessment, reference date 12/05/22, indicated a brief interview for mental status score (BIMS) of 14, indicated Resident #21 was cognitively intact. Additional review of the MDS was conducted under section N for medication, subsection H for Opioid usage, it was revealed that the MDS was coded in error, the MDS coded 5, as an indication the Opioid was administered 5 times on the 7 days look back period. Review of the November and December medication administration records (MARs) showed the medication was administered 6 times on the 7 days look back period from 11/29-12/05/22. On 12/15/22 at 9:21 AM a side-by-side review of Resident #21's records and an interview were conducted with the MDS coordinators (Staff F and Staff G), they had confirmed the findings. 2) Record review revealed Resident #98 was admitted to the facility on [DATE]. The admission MDS assessment, reference date 10/13/22, indicated a brief interview for mental status score (BIMS) of 15, indicated Resident #21 was cognitively intact. Additional review of the MDS, under section N for medication, subsection C for antidepressant usage, it was revealed that the MDS was coded in error, the MDS coded 7, as an indication the antidepressant was administered 7 times on the look back period. Review of the October MARs showed the medication was administered 3 times on the 7 days look back period from 10/07-10/13/22. In addition, under subsection F for antibiotic usage, it was revealed that the MDS was coded in error, the MDS coded 7, as an indication the antibiotic was administered 7 times on the look back period. Review of the October MARs showed 0 administration of antibiotic on the 7 days look back period from 10/07-10/13/22. On 12/15/22 at 9:30 AM a side-by-side review of Resident #98's records and an interview were conducted with the MDS coordinators (Staff F and Staff G) had confirmed the findings. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 8 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 0679 Provide activities to meet all resident's needs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview, the facility failed to ensure activities were provided, failed to ensure an accurate activity care plan was completed, which the resident's may have benefited from one-on-one activities for 2 of 2 sampled residents reviewed for activities (Resident #55 and Resident #75). Residents Affected - Few The findings included: 1) During observations throughout the recertification survey from 12/12/22 through 12/15/22 Resident #55 and Resident #75 were never seen out of bed. There were no activities ever observed to be done with these residents. 1) Record review of Resident #55 revealed he was admitted to the facility on [DATE] and in November 2022 was placed on hospice services. His diagnoses to include Parkinson's Disease, Anxiety Disorder, Rhabdomyolysis, Cerebral Infarction, and Dysphagia. His most current MDS (Minimum Data Set) assessment for Significant Change for hospice services on 11/09/22 documented he has a BIMS (Brief Interview for Mental Status) score of a 4, which means his cognition is impaired. Further review for section F Preferences for Customary Routine and Activities documented having family or close friends involved in care decisions; keeping up with the news; to do favorite activity; and to get fresh air outside are very important to him. A review of his Care Plan documented Resident is alert, able to make leisure lifestyle choices and attends group programs as an active participant. Programs attending/preferring are: Listening to music and cards/games. His goals are that the Resident will continue to attend group programs of interest as able weekly as an active participant through next review; Resident will express satisfaction with leisure routine through next review. The interventions include to ask opinions and offer choices; Invite and escort to programs; Praise attendance and active participation; Provide Monthly calendar and remind of programs of interest; and respect leisure lifestyle choices. 2) Record review for Resident #75 revealed she was admitted to the facility on [DATE] with a diagnosis to include Dementia, Hypertension, Acute Kidney Failure, Heart Failure, Major Depressive Disorder, Anxiety Disorder, Dysphagia, Cardiomegaly, Metabolic Encephalopathy and Cirrhosis of the Liver. She was placed on hospice on 11/18/22. A review of the MDS (Minimum Data Set) assessment documented she has a BIMS (Brief Interview Mental Status) score of a 1, which means her cognition is severely impaired. Her Care Plan documents Resident #75 is alert, able to make leisure lifestyle choices and attends group programs as an active participant. programs attending/preferring are Music, cards/games, and art. Her goals are to continue to attend group programs of interest as able weekly as an active participant through next review, will express satisfaction with leisure routine through next review. Her interventions include to ask opinions and offer choices; Invite and escort to programs; Praise attendance and active participation; Provide Monthly calendar and remind of programs of interest; and respect leisure lifestyle choices. During an interview on 12/12/22 at 2:52 PM, with the Resident #55's daughter, she stated he does not go to activities at all but wishes he can go but they (staff) never get him out of bed. During an interview on 12/13/22 at 8:13 AM, with Resident #75's daughter she stated, the aides do not get her out of bed, she wants her mother to go to activities. During an interview on 12/13/22 at 2:07 PM, with Resident #55, he was asked if he goes to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 9 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 0679 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few activities, he stated no, he was then asked would he go if they took him, he said yes, he was asked if the activity staff do any activities with him in his room, he said no. During an interview on 12/14/22 at 9:50 AM, with Staff D, CNA (Certified Nursing Assistant). She was asked if Resident #55 gets out of bed she stated no he does not get out of bed. When asked why not she stated, he does get out of bed but not every day. He will go to activities about every other day. Nothing is done in his room, he just watches tv. During an interview on 12/14/22 at 1:07 PM, Staff L, CNA/Activities, she was observed inputting information in a binder. She was asked what she was doing, and she stated she was putting information in resident's documents for in room visits. She went through 4 binders with the surveyor for in-room visits. During review of the records, th Surveyor did not see Resident #55 or Resident #75 listed in the book. During an interview on 12/14/22 at 2:48 PM with Activities Assistant Director, she stated, I have been here for 7 years. She was asked if Resident #55 comes to activities. She stated, he does not come to activities, we will do cart visits and ask if he wants anything. He is not signed up for room visits not in our books we do not document on paper. When asked why she said, the Activities Director is the one that care plans it. She said he does not come because the CNA do not get him up. We will go to the CNAs with a list for meet and greet-Sensory group, those are residents with a lower cognition, we will usually hold it in activities, but a lot of times can't use the room do it or find some where to do it. We try to do it every day. We will have only one or two show up because the aides don't get them up. During a telephone interview on 12/15/22 at 8:22 AM, with the Activities Director, he was asked if Resident #55 goes to activities. He reported, I go in everyday to see him, he prefers the independent way. I try to persuade him to come to activities, he says I don't know I know him that is his way. He stated for Resident #75 she is heavy to get in the wheelchair, she does go she is not an everyday activity person, she sometimes wants to get up, but she needs a Hoyer lift and is very heavy. There is a red binder that we document the meet and greets, and they are handwritten, the resident's will be in this book. Surveyor reviewed the red binder on 12/15/22 at 8:35 AM, that was given to her which is the same paper that the Activities Assistant Director gave to surveyor yesterday for a list for meet and greet-Sensory group, However, Resident #55, or Resident #75's names were not included on the sheet. The Surveyor went into Resident #55's room on 12/15/22 at 9:30 AM and asked him if he wanted to get up and go to activities today. He said no, he wants to pick and choose what he wants to go to. The Surveyor then asked if he wanted to get out of bed, he said no. The Activities Assistant Director came to see Surveyor on 12/15/22 at 10:30 AM, she stated that she went to ask if the resident wanted to go to activities, he stated he did along with his roommate. She further said that when the CNA went into the room to get him up, he refused and didn't want to go, but his roommate still did. During an interview on 12/15/22 at 2:18 PM with Staff N, CNA (Certified Nursing Assistant) she stated that Resident #75 gets out of bed but not every day. I asked her if she wants to go to activities, she said she can tell me if she wants to go. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 10 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 0679 During an interview on 12/15/22 at 2:32 PM with Staff H, LPN (Licensed Practical Nurse), she stated Resident #75 can communicate, but she does not go to activities, which is her choice. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 11 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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** 5) During an interview on 12/12/22 at 10:34 AM, Resident #71 stated his indwelling blood sugar monitoring device has not been working and none of the staff can figure out how to fix it. Resident #71 pointed to the monitoring device on his upper right arm, placed his personal cell phone next to the device to get a blood sugar reading, and an error message popped up on the cell phone screen. Resident #71 stated he had (diabetic) neuropathy (nerve damage that can lead to pain) in his fingertips and that it is very painful when the staff prick his fingers to get a blood sugar reading. Residents Affected - Some Review of the record revealed Resident #71 was admitted to the facility on [DATE] with diagnoses to included diabetes with neuropathy and long-term use of insulin. Review of the current Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #71 had a Brief Interview for Mental Status (BIMS) score of 15, on a 0 to 15 scale, indicating the resident was cognitively intact. Review of the orders revealed the indwelling blood sugar monitoring device was originally ordered for Resident #71 on 10/31/22, reordered again on 11/09/22, and again on 11/25/22, with no gap in the time frames of the orders. The orders were for both the sensor, that attaches to the resident's arm, and a reader device. Review of the corresponding Medication Administration Records (MAR) and progress notes revealed the following: On 10/31/22 the MAR lacked any documented evidence of the provision of the sensor and reader device as noted by a blank. On 11/07/22 the MAR indicated the sensor was not applied and rescheduled for tomorrow. On 11/08/22 the MAR was left blank indicating the sensor was not provided. On 11/09/22 the MAR documented the sensor was not provided, and the subsequent note documented, no [sig] working yet, expected for today. The MAR documented the reader device was provided. On 11/23/22 the MAR and progress notes documented that neither the sensor or reader device was provided, with corresponding documentation, device malfunction . waiting for delivery. On 11/25/22 the MAR documented both the sensor and the reader device were not provided, as indicated by a blank. On 12/09/22 the MAR documented both the sensor and reader device was provided to Resident #71. A new sensor was scheduled for 12/23/22. During an observation and interview on 12/15/22 at 2:24 PM, Staff M, Licensed Practical Nurse (LPN) was asked about the indwelling blood sugar monitoring device for Resident #71. The LPN was unaware of the device, looked in the medication cart, and unable to find any sensor devices. The LPN was asked to look in the other medication carts as Resident #71 had resided on three different units during his stay at the facility. At 3:05 PM Staff M stated she was unable to find any sensor devices for Resident #71, and referred the surveyor to Staff B, Unit Manager, who had told her the device was malfunctioning. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 12 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 During an interview on 12/15/22 at 3:09 PM, Staff B, Unit Manager, explained they have had trouble with the sensor and device linking, and tried to use a downloaded app on the resident's phone. The Unit Manager explained they had gotten a new sensor and device at least once. The Unit Manager stated she knew Resident #71 had problems with the device in the past but was not made aware of this week's issue until surveyor intervention. Residents Affected - Some 6) On 12/12/22 at 9:36 AM, during the initial pool process, an interview was held with Resident #93 (in his native language), Resident #93 stated, the nurses were not cleaning the left heel wound or change the dressing timely. He added, sometimes he can go 2 or 3 days without care to the wound, and the wound was getting worse. During that time, an observation was made of the left foot. The left foot was wrapped with a white bandage, with a copious amount of brown like drainage, and the bandage was dated 12/10 7-3 (shift). The wound had a foul odor. Record review revealed Resident #93 was admitted to the facility on [DATE] with diagnosis included: fractures and other multiple traumas. The 5 Day minimum data set (MDS) assessment, reference date 11/17/2022, recorded a BIMS score of 12, which indicated Resident #93 was cognitively intact. This MDS recorded no mood or behavior concern. Additionally, it was revealed that, Resident #93 required extensive and limited assistance by the staff with activities of daily living. Review of physician orders dated 12/01/22 indicated to cleanse the left heel with normal saline, pat dry, apply Hydrofiber with silver then cover with dry dressing every day shift for wound and as needed. Additional physician orders dated 12/06/22, revealed Cefepime (antibiotic) HCl Intravenous Solution 1 GM/50ML, every 8 hours for osteomyelitis (bone infection) for 6 Weeks. Another physician order dated 12/07/22 indicated Vancomycin (antibiotic) HCl Intravenous Solution reconstituted 1 GM two times a day for Osteomyelitis for 6 Weeks. The care plan with a review completed date of 11/30/2022, indicated Resident #93 had actual skin alteration related to left heel diabetic ulcer. Intervention included: administer treatments as ordered and monitor for effectiveness. Review of progress note dated 12/10/2022 written at 4:26 PM, revealed dressing change done to Resident left heel, wound observed with heavy fouled smelling drainage. Resident remains on IV antibiotic for osteomyelitis. Review of the wound care doctor notes and assessment revealed the following wound measurements of the left heel: 11/16/22 1.3 x 1.7 x 0.3, 11/23/22 1.3 x 1.8 x 0.3, 11/30/22 1.6 x 2.1 x 0.3, 12/7/22, 1.5 x 1.4 x 0.3. On 12/15/22 at 10:15 AM, an interview was held with the Director of Nursing (DON) and she was made aware of the lack of wound care concern Resident #93 revealed, and the observation that was made on 12/12/22 of the left foot dressing dated 12/10 7-3, she acknowledged the findings. Based on facility policy, observation, interview, and record review, the facility failed to provide quality of care for 6 of 29 sampled residents reviewed. The facility failed to investigate conflicting medication orders on admission for Resident #92, failed to obtain stool for occult blood for Resident #82, failed to obtain consults in a timely manner for Resident #84 and #20, failed to maintain and utilize an indwelling blood sugar monitoring device as ordered for Resident #71, and failed to ensure diabetic ulcer wound care for Resident #93. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 13 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 The findings included: Level of Harm - Minimal harm or potential for actual harm Facility policy, titled, admission Criteria dated 11/30/22 documented, Our facility admits only residents who's medical and nursing care needs can be met. Prior to or at the time of admission, the resident's attending physician provides the facility with information needed for the immediate care of the resident, including orders covering at least: medication orders, including (as necessary) a medical condition or problem associated with each medication; Residents Affected - Some 1) On 12/12/22 at 3:05 PM Resident #92 stated he is supposed to be on blood thinners because he had an aortic valve replacement. He stated he was on it before and has not received it since he returned from the hospital. Record review of Resident #92 documented an admission date of 06/22/22 with diagnoses that included Heart Disease, Aortic Valve Replacement, Lung Disease and Anxiety. A Minimum Data Set (MDS) resident assessment dated 09/22 documented Resident #92 as cognitively intact requiring supervision only for all activities of daily living. Resident #92 was transferred to the hospital for advanced care on 11/04/22 at 10:26 AM and returned to the facility on [DATE] at 4:48 PM. The facility medication administration record documented the resident received Plavix and Aspirin (anticoagulant medications) daily prior to transfer, with the daily dose given on 11/04/22 (day of transfer) at 9:00 AM. Pre-admission Documentation received by the facility on 11/08/22 from the hospital attending physician documented resume Plavix and Aspirin daily. The Medication Summary documented the last dose for each medication was given 11/08/22 at 9:09 AM. No notation of the anticoagulant medications was noted on the transfer form. On 12/14/22 at 9:00 AM Staff B, Registered Nurse (RN) reviewed the Pre-admission Documentation from the hospital physician and the transfer form for return to the facility for Resident #92. She verified inconsistencies, as follows: one form stated the resident was to receive anticoagulant medications, one form without anticoagulants. She confirmed the resident was receiving anticoagulant medications prior to transfer to the hospital. She stated that due to Resident #92 having an aortic valve replacement, clarification should have been done on readmission. On 12/14/22 at 9:20 AM Staff A, Nurse Practitioner (NP) stated that Resident #92 has a prosthetic aortic valve, and it needed to be verified if he should be on anticoagulants. When informed the physician transfer form documented the need for anticoagulation but it was omitted on the transfer form, she stated she needed to clarify the medications with the cardiologist. On 12/14/22 at 1:42 PM Staff A (NP) stated the need for better collaboration with other facilities and physicians. She said she was waiting to hear back from Resident #92's cardiologist. On 12/14/22 at 4:34 PM Staff A (NP) documented the primary care physician at the hospital saw Resident #92 today and sent progress notes with prescriptions and orders to medicate patient as prescribed. On the prescription, Plavix and Aspirin and other medications were noted on hold and Staff A was calling to clarify. The nurse stated that is the same reason they sent him to cardiology, but the appointment had been rescheduled. Staff A documented the nurse will contact the cardiologist and get back with her and it was discussed with the supervising physician who agreed with the need for clarification. 2) During interview, on 12/12/22 Resident #82 stated her blood count was low. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 14 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 - Some Record review for Resident #82 documented an admission date of 11/18/22 with diagnoses that include anemia (low red blood count) cellulitis both lower extremities, history of bowel infection, and anxiety. A Minimum Data Set (MDS) resident assessment dated [DATE] documented Resident #82 as cognitively intact, requiring extensive assistance for all activities of daily living except eating, requiring supervision only. On 11/26/22 the physician ordered a stool for occult blood to check for bleeding. On 11/28/22 the physician ordered Retacrit injections (used to treat anemia) on Mondays, Wednesdays, and Fridays. A Complete Blood Count (CBC) for Resident #82 documented a hemoglobin of 7.2 (normal=12.0-15.6) and hematocrit of 21.2 (normal 35-46) indicating anemia. On 11/30/22 the physician ordered a stat CBC for acute anemia. Review of tasks documented 23 bowel movements since the stool for occult blood test was ordered. On 12/06/22 at 6:30 PM, Staff A documented in her progress note that Resident #82 hemoglobin was trending down, nursing counseled to find out if patient still getting Retacrit. Nursing to check and make sure it is given as scheduled. Will repeat labs. On 12/14/22 Staff B stated, the stool for occult blood ordered on 11/26/2022 had not been sent. On 12/14/22 Staff A, stated she was notified 12/13/2022 that the stool for occult blood had not been sent as ordered. 3) On 12/12/22 at 12:06 PM, Resident #84 stated she is waiting to see her consult doctors. She said her insurance had changed but thought it was fixed November 1, 2022. She is not sure what the hold-up is. Record review for Resident #84 documented an admission date of 12/21/21 with diagnoses that include Lung Disease, Heart Disease, Diabetes and Depression. An MDS resident assessment dated [DATE] documented Resident #84 as needing limited assistance for mobility on and off the unit and having moderate cognitive impairment. On 10/27/22 A physician's order for Pulmonary Consult for recurring asthma was documented. On 11/15/2022 a physician's order for Physiatry Consult for left shoulder pain was documented. On 11/20/22 a physician's order for Gastrointestinal Consult for recurring diarrhea was documented On 12/14/22 at 9:00 AM, Staff B stated the Pulmonary, Physiatry and Gastrointestinal consults for Resident #84 have not been completed. On 12/14/22 at 9:20 AM, Staff A stated the consults were delayed while Resident #84's insurance was changed but will check why it still has not been done. On 12/14/22 at 11:30 AM, the Unit Secretary stated that the consults for Resident #84 were scheduled today. 4) Record review for Resident #20 documented an admission date of 04/30/21 with diagnoses that include Lung and Breast Cancer, Stroke, and Depression. An MDS resident assessment dated [DATE] documented Resident #20 as severely cognitively impaired and requiring extensive assistance for all activities of daily living except eating, requiring supervision only. On 07/11/2022 a physician's order for an Oncology consult was documented. On 11/17/22 a physician's order for a Dermatology consult was documented. No documentation of the Oncology or Dermatology consult being completed was noted. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 15 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 - Some FORM CMS-2567 (02/99) Previous Versions Obsolete On 12/14/22 at 9:00 AM, Staff B stated the there was no documentation the dermatology and oncology consults for Resident #20 had been completed. On 12/14/22 at 11:30 AM the Unit Secretary stated that the dermatology and oncology consults for Resident #20 had been missed and they were going to come up with a plan to better track consults that are ordered. Event ID: Facility ID: 105555 If continuation sheet Page 16 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 0687 Provide appropriate foot care. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and interview, the facility failed to ensure the provision of podiatry services for 1 of 2 sampled residents (Resident #52). Residents Affected - Few The findings included: During an interview and observation on 12/12/22 at 3:45 PM, Resident #52 stated she had not seen the podiatrist in a few months. The resident stated she was a diabetic and needed her nails trimmed. With permission of the resident, an observation was made and all the resident's toenails were elongated and needed to be trimmed. Review of the record revealed Resident #52 was admitted to the facility on [DATE] with diagnosis to include diabetes with neuropathy. Further review of the record revealed the last podiatry visit for Resident #52 was on 05/27/22. The current Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #52 had a Brief Interview for Mental Status (BIMS) score of 15, on a 0 to 15 scale, indicating the resident was cognitively intact. This MDS also revealed the resident was a diabetic. During an interview on 12/15/22 at 10:57 AM, the Social Services Director (SSD) was asked the process for podiatry services. The SSD stated that diabetic residents could be seen every other month, otherwise the resident names are put on a log at the nurse's station and the podiatrist comes to the facility once a month. Review of this log revealed Resident #52 was last seen on 05/27/22. The SSD identified a second podiatry visit in the scanned record dated 09/19/22, but further review revealed that progress note was for another resident. When asked why the resident had not been seen since, the SSD was not sure. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 17 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 0692 Provide enough food/fluids to maintain a resident's health. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 2) Review of Resident #16's records revealed the resident was admitted to the facility on [DATE] with a diagnosis to include Dementia, Anxiety, Major Depressive Disorder, Type II Diabetes, and Dysphagia. Review of the resident's weights revealed on 09/09/22 the resident weighed 110 lbs. and on 12/06/22 she weighed 97 lbs. this was a 11.82 % weight loss. Review of the dietician notes on 10/10/22 and 11/04/22 documented weigh weekly for 3 weeks. This was not being completed. Residents Affected - Few During an interview on 12/15/22 at 11:40 AM with the Dietician, she stated that I spoke to nursing yesterday because I noticed the weekly weights were not being done. Based on interview and record review, the facility failed to ensure nutritional service (supplements and weight monitoring), as ordered by the physician and as recommended by the Registered Dietitian for 2 of 5 sampled residents reviewed. This involved Resident #97 and #16. The findings included: 1) Review of Resident #97's record revealed, she was admitted to the facility on [DATE], with diagnoses that included: Non-Alzheimer's Dementia, and Malnutrition. The modification 5 day minimum data set (MDS) assessment, reference date 11/08/22, recorded a brief interview for mental status score (BIMS) score of 04, indicating Resident #97 was cognitively impaired. This MDS showed documented evidence that Resident #97 had received Parenteral/IV feeding (IV fluids) while in the facility for low sodium level. The MDS recorded Resident #97 required extensive assistance with eating. Review of physician order dated 10/24/22 indicated to monitor weekly weight times 4, every Monday for 4 Weeks. Review of Resident #97's records lacked evidence of the weekly weights as ordered and recommended. The records showed the facility was monitoring Resident #97's weight monthly as follows: 10/22/2022 105.6 Lbs, 11/08/2022 102.6 Lbs, 12/02/2022 95.5 Lbs. Another physician order dated 11/08/22 indicated to administer Sodium Chloride Intravenous Solution 0.9 % (Sodium Chloride) use 80 ml/hr intravenously every shift for Hyponatremia (low sodium) for 3 Days. The Care Plan, with review and completion date of 11/10/2022, indicated Resident #97 was at high nutrition risk, with body max index (BMI) less than 21. She consumed less 1,000 mL/Day, intake was less than 50% estimated needs, malnutrition diagnosis, Needs Assistance/Cueing with feeding, she had significant Weight Loss. One of the interventions included: monitor weight monthly and weekly. Review of the admission nutritional assessment dated [DATE], documented Resident #97 was admitted to facility status post recent hospitalization for gastroenteritis and colitis, screened by registered dietitian for new admission. Resident #97 receiving regular diet, regular textures, thin liquids, consuming 50% of meals per chart. Will offer Ensure Plus 240mL by mouth twice a day (350kcal, 13g PRO per serv) to aid in meeting baseline needs. Will monitor weekly weights times 3 weeks to assess for significant changes. Review of Resident #97's records (medication administration and treatment records) lacked evidence of the Ensure Plus order or administration. Review of Nurse Practioner Progress note dated 11/08/2022 written at 9:01 AM, revealed, Resident #97 was seen for chief complaint of Hyponatremia, generalized weakness, and insomnia (inability to sleep), with multiple comorbidities. Being seen following abnormal lab result that revealed sodium of 133 (low sodium), Resident #97 was started on normal saline overnight. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105555 If continuation sheet Page 18 of 19 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 105555 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Jupiter Rehabilitation and Healthcare Center 17781 Thelma Ave Jupiter, FL 33458 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 0692 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete On 12/15/22 at 9:41 AM, an interview was held with the Registered Dietitian (RD), she revealed that Resident #97 was a good eater, she was underweight for her BMI based on her weight and diagnosis, she was at 105.6 when she came in, this month (December) she has triggered 6.9% weight loss. The RD added, in October 2022, she had recommended Ensure Plus 240mL by mouth twice a day (350kcal, 13g PRO per serv) to aid in meeting baseline needs, she doesn't see that the Ensure plus was ordered or confirmed by nursing, looks like the MAR was never updated to reflect her recommendation. The RD confirmed the order was not put in place and followed. The RD revealed she also recommended weekly weights times 3 weeks. The RD confirmed that 3 weights were missing for the following dates 10/31, 11/7 and 11/14/22. At 9:55 AM the RD searched for the weights in the weight book, she did not have the weights. At 10:00 AM the surveyor and RD searched for the weights in the resident physical chart, they were not there. At 10:07 AM the RD revealed that she did not find the weights after searching for them along with the DON. Event ID: Facility ID: 105555 If continuation sheet Page 19 of 19