Inspection·August 28, 2025

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few slightly dry. On 08/27/25 at 12:38 PM, an interview was conducted with Staff A, Licensed Practical Nurse (LPN), who stated the last time the Speech Therapist saw Resident #1 she was going to start her on pleasure food. Staff A stated the resident was NPO (nothing by mouth) and could not have ice ships. On 08/27/25 at 1:32 PM, an interview was conducted with the Rehabilitation Director who stated Resident #1 was out of it when she came in to the facility, now she is more alert and asking for water and food, but her swallowing is profound, and the water and food will go to her lungs as per the Speech Language Pathologist (SLP). The Rehabilitation Director stated the resident was currently receiving ST (speech therapy). On 08/27/25 at 3:15 PM, a joint interview with the Rehabilitation Director and Staff B, SLP, was conducted. Staff B stated she was waiting for Resident #1's MBSS [Modified Barium Swallow Study] results, added she spoke to the nurse recently who asked for when they can give her ice ships and told her she was waiting for the test results. Staff B stated she did a thermal / tactile stimulation and did not hear any wet vocal quality, the time of her swallow trigger was very quick, meaning that they progress to ice ships, for trial. Staff B stated she had Resident #1 brush her teeth, the Frazier free water protocol, she cleaned in her checks with a sponge and under her lips and gave her ice chips; the resident tolerated that well. Staff B stated the Frazier free water protocol is a safe way to test that would not cause pneumonia. The Rehabilitation Director was asked how long it takes to scheduled and get an MBSS done and stated the therapy department give the referral to nursing and nursing do the scheduling, added that therapy did not schedule the study. During the joint interview, the Director and Staff B were apprised that the referral for the MBSS was dated 07/29/25. Staff B stated she has inquired about the MBSS results asked the nurse and told her she was going to inquired about it and have not heard back. Staff B stated Resident #1 was receiving ST visits five days a week to do thermal/tactile stimulation, communicating using simple sentences, the resident is confused but much alert, more intelligent speaking. Staff B was asked for the goal of care and stated eventually to get the resident on a diet and added the MBSS results will let her know who she can proceed, be more aggressive with therapy. On 08/27/25 at 5:07 PM, an interview was conducted with the Assistant Director of Nursing (ADON) who stated whenever the therapy department give her a referral, she calls the doctor for an order then they call to make an appointment either at the hospital or ambulatory. The ADON added that the facility was not doing mobile Swallowing test, it was started back on last month. An inquiry was made regarding Resident #1's MBSS ordered on 07/29/25 that had not been done as of 08/27/25. The ADON responded that she was not sure why it had not been done and added she needed an actual written script and will get it from the doctor tomorrow. The ADON stated the doctor comes to the facility every Monday and Thursday. On 08/28/25 at 9:21 AM, an interview was conducted with the Director of Nursing (DON) who stated that if a MBSS is ordered and recommend by ST, they will get it done. The DON was asked how long it take to get it done and stated it depends and added Resident #1 had some recent transfer to hospital, pulled out of her trach, her cognition had changed, at those times, she was not at her best to take the test, now she is more aware and cognitively intact. The DON stated the facility was doing the MBSS test at a local Hospital and added, it has been a process to schedule. The DON was asked to submit written documentation regarding attempt to schedule the resident's MBSS and stated there was none. The DON stated the facility has recently contracted with diagnostics, stated Resident #1's MBSS is scheduled for next Tuesday and is on standby to do today if there is a cancellation. Consequently, a side-by-side review with the DON of Resident #1's revealed a transfer to the hospital on [DATE] due to the resident pulling her trach, returned to the facility on [DATE] and an emergency room visit on 08/02/25 due to a fall. The DON was apprised of the delayed on providing Resident #1's MBSS and the resident's begging for (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105572 If continuation sheet Page 2 of 5 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 105572 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/28/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pompano Health and Rehabilitation Center 51 W Sample Road Pompano Beach, FL 33064 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 ice chips. 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: 105572 If continuation sheet Page 3 of 5 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 105572 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/28/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pompano Health and Rehabilitation Center 51 W Sample Road Pompano Beach, FL 33064 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 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews and record review, the facility failed to maintain the residents' medical records that are accurately documented in accordance with accepted professional standards and practices for 1 of 3 sampled resident reviewed, Resident #1. The findings included: Review of Resident #1's clinical record revealed an admission to the facility on [DATE] and a readmission on [DATE]. The resident's diagnoses included Traumatic Hemorrhage of Cerebrum, Obstructive and Reflux Uropathy, Unspecified. Review of Resident #1's Minimum Data Set (MDS) quarterly assessment dated [DATE] documented a Brief Interview Mental Status (BIMS) score of 04 indicating severe cognition impairment. Review of Resident #1's clinical record documented a physician order dated 08/06/25 for remove foley catheter.Review of Resident #1's clinical record August 2025 Treatment administration Record (TAR) documented a foley catheter was removed on 08/07/25. On 08/28/25 at 9:21 AM, an interview was conducted with the Director of Nursing (DON) who stated that a Urology Nurse Practitioner (NP) comes to the facility every week to see residents on consultation basis. On 08/28/25 at 11:15 AM, a joint interview was conducted with the facility's Urology Nurse Practitioner (NP) and the Director of Nursing (DON). The NP stated he has been coming to facility for three (3) months, gets a consult from the facility nurses or the in-house NP. The NP was asked if he contacted the resident's family / representative to discuss the plan of care and responded if the patient/resident is alert, he will talk with the resident, will talk to the nurse, and will get a hold a family member if needed. The NP was asked if he get in touch with resident representative, especially those with a BIMS score of 4. The NP replied he never communicated with Resident #1's family / representative, did not talk to the family/representative related to a right kidney mass revealed on ultrasound done on 08/05/25. The NP stated it is important to communicate with the resident's family / representative. A side-by-side review of Resident #1's Urology-NP consult notes was conducted for the following notes:-Service date 06/24/25 documents .sex: female. Genitourinary: External Genitalia: foley catheter; Penis: normal, no lesions, no discharge; Scrotum: normal, no swelling, no tenderness; Testes: descended bilaterally, no masses, no tenderness; Spermatic Cord: no varicocele, no tenderness. Current assessment and plan discussed with patient and nursing staff.-Service date 07/22/25 documents .sex: female. Genitourinary: External Genitalia: foley catheter; Penis: normal, no lesions, no discharge; Scrotum: normal, no swelling, no tenderness; Testes: descended bilaterally, no masses, no tenderness; Spermatic Cord: no varicocele, no tenderness. Current assessment and plan discussed with patient and nursing staff.-Service date 07/30/25 documents .sex: female. Genitourinary: External Genitalia: foley catheter; Penis: normal, no lesions, no discharge; Scrotum: normal, no swelling, no tenderness; Testes: descended bilaterally, no masses, no tenderness; Spermatic Cord: no varicocele, no tenderness. Current assessment and plan discussed with patient and nursing staff.-Service date 08/05/25 documents .sex: female. GU (Genitourinary) + obstructive uropathy.Genitourinary: External Genitalia: Penis: normal, no lesions, no discharge; Scrotum: normal, no swelling, no tenderness; Testes: descended bilaterally, no masses, no tenderness; Spermatic Cord: no varicocele, no tenderness. assessment: unspecified urinary incontinence.Current assessment and plan discussed with patient and nursing staff.-Service date 08/13/25 documents .sex: female.foley catheter was removed.patient remains incontinent.GU: + foley catheter.Genitourinary: External Genitalia: Penis: normal, no lesions, no discharge, + foley catheter; Scrotum: normal, no swelling, no tenderness; Testes: descended bilaterally, no masses, no tenderness; Spermatic Cord: no varicocele, no tenderness. Current assessment and plan discussed with patient and nursing staff.During the review, the NP confirmed Resident #1 was a female (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105572 If continuation sheet Page 4 of 5 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 105572 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/28/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pompano Health and Rehabilitation Center 51 W Sample Road Pompano Beach, FL 33064 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 0842 and that external genitalia male information should have to be removed. The NP was apprised that his note dated 08/13/25 documented + foley catheter when the resident catheter was removed on 08/07/25. 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: 105572 If continuation sheet Page 5 of 5