Inspection·August 24, 2023

F 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few apparent to me that anyone was impaired. It was just the smell. It is an on-going problem. The ADON stated the facility policy prohibits drug use in the facility. On 08/24/23 at 12:18 p.m., an interview was conducted with the Director of Nursing (DON). She stated someone from the Department of Children and Families (DCF) had come to the facility the previous week and reported an allegation of drug use in the facility. The DON stated that was how she learned there was a complaint filed with DCF about three employees smoking drugs in the facility's parking lot. She stated about two weeks prior the ADON had reported she smelled marijuana in the facility's elevator. The DON stated the following Monday they did not address the drug issue allegation in their morning meeting. She stated she had taken it upon herself to check cars when she arrived at the facility but had not encountered anyone smoking of marijuana in the parking lot. The DON stated she, Did not interview the three employees who were named in the allegation (Staff C, LPN [Licensed Practical Nurse], Staff D, CNA and Staff E, CNA). She stated she had not interviewed any staff members or residents. She stated she thought the NHA might have initiated the investigation. The DON stated the facility has policy about coming to work while impaired. She said, our policy prohibits employees from reporting to work while under the influence of any mood-altering substances. On 08/24/23 at 1:22 p.m., an interview was conducted with the NHA. She stated DCF had come to the facility the previous week and reported staff were using drugs at the facility's premises. She stated the allegation did not allege drug use inside the building. She stated the DCF representative had come to investigate the three staff members who were allegedly smoking marijuana in the parking lot. The NHA stated DCF spoke with each of the staff members. The NHA confirmed she did not initiate her own investigation. She said, I was communicating with DCF based on their conversation. She stated she did not speak with the three employees because she thought the DON would. The NHA stated their policy was to drug test employees based on reasonable suspicion and evidence of impairment. The NHA confirmed she had received a text message from the ADON regarding the smell of marijuana inside the facility. The NHA said, It was on a weekend. I did not respond to the test message. I don't know why. Multiple interviews conducted with employees on 08/24/23 revealed staff had not received in-services related to drug use in the facility. Interviews further confirmed that none of the staff had been part of the investigation. The staff further confirmed they did not know the facility's policy on drug use. On 08/24/23 at 1.24 p.m. an interview was conducted with Staff E, CNA. She stated she did not know of the facility's policy on drugs. She stated she had not heard that there was a DCF allegation. She said, No one spoke with me. I don't do drugs you can ask my residents if I smell like marijuana. Staff E confirmed she did not write a statement related to the allegation. On 08/24/23 at 1.50 p.m., an interview was conducted with Staff D, CNA. She stated she had not participated in any investigation and had not heard of allegations of drug use in the facility. Staff D said, I don't use any drugs. On 08/24/23 at 1.54 p.m. an interview was conducted with Staff C, LPN. She stated the issue of drug use was brought up to her when DCF was at the facility. She stated the DON said DCF reported 3 staff went out to the parking lot and were smoking marijuana. She stated the report showed staff were coming back from break smelling like marijuana. She stated she was told it was herself, [Staff D] and [Staff E] that were allegedly smoking in the facility's parking lot. Staff C said, We don't hang out. There was no investigation that I knew of. No one asked me any questions. I did not give a statement, they did not ask anything. I was not drug tested. I would have given a urine sample to clear my (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 2 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 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 0610 name. Level of Harm - Minimal harm or potential for actual harm On 08/24/23 at 1:30 p.m., an interview was conducted with Staff F, an NHA from a sister facility. She said, Yes, they should have conducted interviews to narrow down the problem staff. Staff F stated the NHA was trying to prioritize impact on residents and the drug use compliant was not directly related to resident's care. Staff F said, We do not drug test all staff. We could if we witnessed any signs of impairment. We should have interviewed staff and residents. Staff F stated they follow their Human Resources (H/R) policy. Residents Affected - Few An interview was conducted on 08/24/23 at 2:13 p.m. with the facility's H/R Manager. She stated per their policy, they do not drug test employees unless they are injured or if there is suspicious behavior, or if there was a reason. She stated she was not notified there was an allegations of drug use on the facility premises. She stated that would have been a reason to send the individuals involved out to be drug tested. She stated she was not aware DCF was at the facility related to use of drugs. The H/R Manager said, If they are using while on the clock, that is a problem. They can't come in high or smelling like alcohol or any kind of drugs. That is against facility policy. Review of a facility policy titled, Substance Abuse, Revised July 2014, revealed the following: Our work environment must be free from the effects of drugs, alcohol, or other intoxicating substances. Compliance with our substance abuse policy is made a condition of employment. 1) employees are prohibited from illegally . possessing or using alcohol or illegal drugs in the workplace. 2.) Employees may be subject to random drug testing at any time. 5.) In the employee reporting to work under the influence of alcohol, drugs or other intoxicating substances will not be permitted to work his/her assigned shift. 7.) The facility may inspect the contents of any package brought on to or taken from the premises. 11.) Employee of this facility will receive a copy of this substance abuse policy. 12.) Documentation of any and all violations of this policy must be made by the supervisor of the employee committing the violation(s). A copy of the documentation must be filed in the employees personnel record. 13.) All workplace incidents involving alcohol or drugs among our employees must be reported to the administrator. Review of a facility document subtitled, 3.4 Drug and Alcohol Policy, dated January 1, 2021, showed the following: The company has a longstanding commitment to provide a safe and productive work environment and to minimize the risk of accidents and injuries. Alcohol and drug abuse pose a threat to the health and safety of employees and to the security of our equipment and facilities. For these reasons, the company is committed to the elimination of drug and/or alcohol use in the workplace. This policy outlines the practice and procedure designed to correct instances of identified alcohol and/all drug use in the workplace. This policy applies to all employees and all applicants for employment. The human resource department and/or the administrator is responsible for policy administration. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 3 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Based on observations, interviews, and policy review the facility failed to ensure a system was being utilized to accurately account for all controlled substances (narcotics) related to Controlled Drugs Shift Audits not being completed on five out of five medication carts in the facility. Findings included: On 8/24/23 the Controlled Drugs Shift Audits on the 2 [NAME] medication cart were observed to be incomplete. The July 2023 Controlled Drugs Shift Audit form showed 44 out of 62 possible shifts were not signed properly by two nurses when counting narcotics at shift change. The August 2023 Controlled Drugs Audit form showed 36 out of 48 possible shifts were not signed properly by two nurses when counting narcotics at shift change. The Controlled Drug Shift Audit are where the off-going and on-coming nurse sign to confirm together they have counted the narcotics in a medication cart to ensure the number of pills are correct before handing off the keys to the medication cart. On 8/24/23 the Controlled Drugs Shift Audits on the 2 East medication cart were reviewed and observed to be incomplete. The July 2023 Controlled Drugs Shift Audit form showed 54 out of 62 possible shifts were not signed properly by two nurses when counting narcotics at shift change. The August 2023 Controlled Drugs Audit form showed 43 out of 48 possible shifts were not signed properly by two nurses when counting narcotics at shift change. On 8/24/23 the Controlled Drugs Shift Audits on the 1 East medication cart were reviewed and observed to be incomplete. The July 2023 Controlled Drugs Shift Audit form showed 45 out of 62 possible shifts were not signed properly by two nurses when counting narcotics at shift change. The August 2023 Controlled Drugs Audit form showed 39 out of 48 possible shifts were not signed properly by two nurses when counting narcotics at shift change. On 8/24/23 the Controlled Drugs Shift Audits on the 1 Center medication cart were reviewed and observed to be incomplete. The August 2023 Controlled Drugs Audit form showed 43 out of 48 possible shifts were not signed properly by two nurses when counting narcotics at shift change. On 8/24/23 the Controlled Drugs Shift Audits on the 1 [NAME] medication cart were reviewed and observed to be incomplete. The August 2023 Controlled Drugs Audit form showed 48 out of 48 possible shifts were not signed properly by two nurses when counting narcotics at shift change. The form contained no signatures for the month. On 8/24/23 at 10:28 a.m. an interview was conducted with Staff K, Licensed Practical Nurse (LPN.) She stated the Controlled Drugs Shift Audit should be signed by both nurses when narcotic counts are done every shift change. On 8/24/23 at 10:45 a.m. an interview was conducted with Staff L, LPN. She said narcotics counts are done every shift change or anytime there is a change in nurse and the form should be signed by both nurses. On 8/24/23 at 11:09 a.m. an interview was conducted with the Director of Nursing (DON.) The DON (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 4 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0755 Level of Harm - Minimal harm or potential for actual harm confirmed narcotic counts should be completed every shift and both nurses should sign the Controlled Drugs Shift Audit form. She said she does not believe there have been any missing narcotics but she had noticed the forms were not being signed as they should have been. Review of a facility policy titled Controlled Substances, revised August 2019, showed the following: Residents Affected - Many The facility shall comply with all laws, regulations, and other requirements related to handling, storage, disposal and documentation of Schedule II and other controlled substances. Policy Interpretation and Implementation 3. Controlled substances to be counted upon delivery. The nurse receiving the medication, along with the person delivering the medication, count the controlled substances together. Both individuals sign the designated controlled substance record. 8. Licensed nurses are to count controlled medications at the end of each shift. The nurse coming on duty and the nurse going off duty count together. They must document and report any discrepancies to the Director of Nursing Services/designee at the time observed. 9. The Director of Nursing Services shall investigate any discrepancies in narcotics reconciliation to determine the cause and identify any responsibility parties and shall give the Administrator a written report of such findings. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 5 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and policy review the facility failed to properly store medication in three out of five medication carts, on one of two nursing units, and ensure medication were stored separate from food in one of two medication storage rooms. Findings included: On 8/23/23 at 9:21 a.m. a medication cart on the second floor was observed to be unlocked. There were no staff in sight and a resident was sitting five feet from the cart. At 9:41 a.m. the medication cart remained unlocked. Two staff members, including a nurse, were observed walking past the cart and not locking it. Photographic evidence obtained. On 8/23/23 at 9:38 a.m., a white, oval tablet was observed on the floor in room [ROOM NUMBER] suite A. Photographic evidence obtained. On 8/23/23 at 9:40 a.m. an observation was made of an orange tablet inscribed with a letter M on the floor in front of the resident's bed in room [ROOM NUMBER] suite B. Photographic evidence obtained. On 8/23/23 at 10:04 a.m., an observation was made of an orange gel tablet in a plastic medication up, stowed inside an open drawer in room [ROOM NUMBER]. Photographic evidence obtained. On 8/24/23 at 10:38 a.m., an observation was made of a white tablet in the doorway of room [ROOM NUMBER]. An immediate interview was conducted with Staff G, Licensed Practical Nurse (LPN)/Minimum Data Set (MDS.) She picked up the tablet and stated she would investigate whose it was and why it was on the floor. She stated she would expect residents to be supervised during medication administration. Photographic evidence obtained. On 8/24/23 at 10:41 a.m., a blue tablet was observed on the floor in the doorway of room [ROOM NUMBER]. An immediate interview was conducted with Staff H, Certified Nursing Assistant( CNA.) He stated he would notify the nurse the tablet was on the floor. He stated when he finds medications unattended, he notifies the Unit Manager. Photographic evidence obtained. On 08/24/23 at 10:52 a.m. an interview was conducted with Staff C, LPN/Unit Manager (UM.) She stated her expectation would be for the nurse to make sure the resident takes their medication. She stated she would expect the nurses to make sure tablets remain in the cup during preparation. She stated she would follow up. On 8/24/23 at 12:01 p.m. an interview was conducted with Staff I, LPN who was assigned the hallway the pills were found. She stated she did not know why the tablets were on the floor. She said, I do not have anything to do with that. How do you know it was my responsibility? Staff I stated she would speak to the Unit Manager. On 8/24/23 at 12.14 p.m., an interview was conducted with the Director of Nursing (DON.) She reviewed the photographic evidence and stated she had instructed the Unit Manager to go through the rooms (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 6 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some and make sure there were no medications on the floor. The DON said, We are doing an in-service for nurses to make sure they stay with the resident until they take their medications. On 8/24/23 at 10:28 a.m. an audit was completed on the 2 [NAME] medication cart with Staff K, LPN. The medication cart contained three loose pills, a phone charger, scissors, a sample collection cup, and two cookies. Staff K, LPN said she knows there should not be loose medication in the cart. She also said she does not know who cleans the medication carts. Photographic evidence obtained. On 8/24/23 at 10:45 a.m. an audit was completed on the 2 East medication cart with Staff L, LPN. The top drawer of the medication cart had at least 20 loose pills spilled inside. The bottom drawer had a liquid medication spilled and everything in the drawer was sticky. Behind the bottom medication cart drawer, a medication bubble pack, a box of medication and a loose pill were observed. Two other drawers contained four loose pills, totaling over 26 pills loose in the medication cart. The cart also was used to store a cell phone and a lighter. At interview was conducted with Staff L, LPN at that time. Staff L, LPN said there is no process in place to clean the medication cart and the cart had several things in it that don't belong there. Photographic evidence obtained. On 8/24/23 at 10:53 a.m. an audit was completed of the Unit 2 Medication Storage room with Staff M, Registered Nurse (RN)/UM. The medication refrigerator was observed to have an orange being stored with the medication. The cabinet in the medication storage room was dirty, appeared to have water damage and rust dripping down the cabinet. An interview was conducted with Staff M, RN/UM. She confirmed food should not be in the medication refrigerator and stated staff know that. Staff M, RN/UM said she had never looked in the cabinet to see how dirty it was. Photographic evidence obtained. On 8/24/23 at 11:01 a.m. an audit was conducted on the Unit 1 Center medication cart with Staff N, RN. The cart was being used to store a computer mouse, batteries, a hex tool and rubber bands. An interview was conducted with Staff N, RN. She said she is an agency nurse and doesn't know what the facility does for cleaning carts. Photographic evidence obtained. An interview was conducted with the DON on 8/24/23 at 11:09 a.m. The DON said she had only been in the facility a couple of weeks and had cleaned a couple of medication carts but had not gotten to the others. She said there should be a process in place to clean the carts and she is putting that in place. The DON said she is going to speak to maintenance about power washing the carts. On 8/24/23 at 11:35 a.m. an interview was conducted with the Maintenance Director. He said he was not aware of any leaks or issues with cabinets in the Unit 2 Medication Storage room. He looked at the pictures and said he would take care of it. On 8/23/23 at 11:39 a.m. an interview was conducted with the Assistant Director of Nursing (ADON.) The ADON looked at the picture of the Unit 2 Medication Storage room cabinet and said, That is disgusting. The ADON also said there had not been a process in place to clean medication carts. She confirmed carts should always be locked when unattended. The ADON said there are only six core nurses at the facility and a consultant is going to come and work on a process to clean carts. She said she was aware there had been issues with items being stored in medication carts that do not belong. Review of a facility policy titled Storage of Medications, revised April 2019, showed the following: The facility stores all drugs and biologicals in a safe, secure, and orderly manner. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 7 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0761 Level of Harm - Minimal harm or potential for actual harm 1. Drugs and biologicals used in the facility are stored in locked area, under proper temperature, light and humidity controls. 3. The nursing staff is responsible for maintaining medication storage and preparation areas in a clean, safe, and sanitary manner. Residents Affected - Some 8. Compartments (including, but not limited to, drawers, cabinets, rooms, refrigerators, carts, and boxes) containing drugs and biologicals are locked when not in use. 9. Unlocked medication carts are not left unattended. 11. Medications requiring refrigeration are stored in a refrigerator located in the drug room at the nurses' station or other secured location. Medications are stored separately from food and are labeled accordingly. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 8 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, record review, and policy review the facility failed to implement control measures to prevent the potential re-infection or transmission of scabies among residents in the facility related to four residents (#4, #10, #11, and #12) out of twelve sampled who were treated or exposed to scabies. Residents Affected - Few Findings included: Review of medical records showed Resident #10 was seen by a dermatology practice on 8/16/23 and treated for scabies on 8/16 and 8/17/23 with oral and topical medications. Review of admission records showed Resident #10 was admitted to the facility on [DATE] with diagnoses including osteomyelitis of vertebra, sacral and sacrococcygeal region, dementia, and disorder involving the immune mechanism. Review of Resident #10's August Orders and Medication Administration Record (MAR) showed the following: -Ivermectin 3 milligram (mg.) Give 4 tablets at morning medication pass. Start date 8/16/23. End date 8/17/23. The MAR shows medication was administered on 8/17/23. -Permethrin 5% topical cream. Apply head to toe once at bedtime. Rinse off 8-14 hours after. Start date 8/17/23. End date 8/18/23. The MAR shows the medication was applied on 8/17/23 and rinsed off on 8/18/23. No order was found for contact precautions since 8/16/23. A review of provider notes showed Resident #10 was visited by the Dermatology Physician Assistant (PA) on 8/16/23. The provider described the rash as erythematous macules in a linear distribution with scaling to skin folds and finger web spaces. A biopsy was performed to rule out scabies. The notes showed The day you start treatment, wash your clothes, bedding, towels, and washcloths. Mites can survive for a few days without human skin. If a mite survives, you can get scabies again. To prevent this, you must wash clothes, sheets, comforters, blankets, towels, and other items. Be sure to follow these instructions when washing: Wash all items in a washing machine and then dry it in a dryer, take it to a dry cleaner or seal in plastic bag for at least 1 week. On 8/23/23 at 2:19 p.m. an interview was conducted with the dermatology PA that visited Resident #10 on 8/16/23. She stated the biopsy came back and was unable to isolate but cannot exclude scabies. The PA explained scabies mites are difficult to isolate on a skin scraping and when they said they cannot exclude scabies it usually means they see the inflammation that indicates a mite passed through the area. The PA said the facility should have taken any clothes or sheets the resident had used for the past 7 days and washed them separately. She said items that could not be washed should have been bagged for 7 days. She stated she doesn't typically treat roommates unless they have a rash or have had known skin to skin contact. The roommate should be looked at for rashes. Record review showed Resident #11 is the roommate of Resident #10. She was admitted to the facility on [DATE] with diagnoses including displaced bimalleolar fracture of lower leg and atopic (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 9 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 dermatitis. Level of Harm - Minimal harm or potential for actual harm A Wound/Skin note, dated 8/17/23, showed the resident had a skin inspection and her skin was intact. There have been no further skin inspections done from 8/18/23 to 8/24/23. Residents Affected - Few On 8/23/23 at 12:13 p.m. an interview was conducted with the Housekeeping Account Manager. She stated the room of Resident #10 and #11 is getting their regular daily cleaning. She said she is aware of Resident #10 having scabies but has not done a deep cleaning of the room for scabies. She said when nursing tells housekeeping the resident has finished treatment, her staff deep clean the room and they had not notified her yet. She said the Certified Nursing Assistants (CNA) bag all the resident's personal items and housekeeping cleans, including changing the curtains, cleaning the mattress and beds. The housekeeping manager said according to her regular schedule for deep cleans Resident #10 and #11's room was last deep cleaned on 8/8/23. An observation was made on 8/23/23 at 12:30 p.m. of Resident #10 in the dining room for lunch, sitting with three other residents. Her room was observed to not have any precaution signs present. On 8/23/23 at 12:45 p.m. an interview was conducted with the Infection Preventionist (IP)/Assistant Director of Nursing (ADON.) She stated only one resident in the facility has had scabies recently and it stayed contained to only that resident, but she couldn't remember their name. She said she started in the facility in July and was handed a blank slate as far as tracking infections. The IP/ADON provided a map of the first floor with current infections being tracked. Resident #10 and #11's room was not marked on the map. On 8/23/23 at 2:33 p.m. the IP/ADON provided an Infection Control Surveillance Log for July 2023 but said for August she hasn't gotten it together yet. On 8/23/23 at 12:55 p.m. an interview was conducted with Staff O, Registered Nurse (RN.) Staff O, RN confirmed she was caring for Resident #10 and #11 on her current shift. She said she had no idea Resident #10 had scabies in the last week or that Resident #11 should be getting checked for scabies. Staff O, RN did say she was aware a resident on the second floor was treated for scabies recently but was unsure of who it was. On 8/23/23 at 12:58 p.m. an interview was conducted with Staff P, CNA. She stated she was caring for Resident #10 and #11 during her current shift and she also cared for her the week prior. She said the residents were not on precautions the week prior. She said she had no idea Resident #10 had scabies the week she was caring for her. On 8/23/23 at 1:03 p.m. an interview was conducted with Staff Q, CNA. She confirmed there was a resident on the second floor that was recently treated for scabies, but she hadn't heard of any other cases in the facility. She said the resident treated was Resident #4. Review of medical records showed Resident #4 was last admitted to the facility on [DATE] with diagnoses including metabolic encephalopathy, multiple sclerosis, dementia, history of rash and other nonspecific skin eruption, and artificial openings of urinary tract. Review of Resident #4's progress notes showed the following: 7/29/23 6:48 a.m. Writer called resident's POA (power of attorney) [name and #] to notify of resident having scabies. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 10 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 Writer got a voicemail and left a message. Level of Harm - Minimal harm or potential for actual harm 7/30/23 7:37 a.m. Residents Affected - Few Oral Ivermectin and Permethrin cream was applied neck to toes last night at bedtime and tolerated without difficulty. Resident has what appears to be scabies dermatitis from scalp to toes with scratch marks from head to mid thigh. Did provide resident with patient education regarding microbes underneath her fingernails and the potential for a skin infection and she verbalizes understanding. Remains on contact isolation due to exposure. Will have on coming shift give Resident shower upon arising for the day, strip and disinfect bed as well as provide clean linens. Will continue to monitor. Review of medical records showed Resident #12 is the roommate of Resident #4. Resident #12 was admitted on [DATE] with diagnoses including intervertebral disc degermation in lumbar region, Alzheimer's disease, and disorder involving the immune mechanism. Review of Resident #12's MAR showed an order for Permethrin 5% topical cream every 7 days. Treat at bedtime. Start date 7/29/23 Stop date 8/6/23. Review of progress notes showed the following: 8/7/23 at 6:30 p.m. Patient received 2nd shower today. Status post scabies treatment. No complaints of pain or discomfort. Patient is resting comfortably in bed throughout the shift. No issues or concerns at this time. Call light in reach. The Infection Control Surveillance Log for July 2023 provided by the IP/ADON did not show Resident #4 being tracked for having scabies. On 8/24/23 at 2:56 p.m. an interview was conducted with the Housekeeping Account Manager. She confirmed she had not been told to deep clean Resident #10 and #11's room. As far as the room of Resident's #4 and #12 she said it was not deep cleaned on 7/29 or 7/30/23 when they received treatment. She provided a checklist from 8/8/23 showing that was the day Resident #4 and #12's room was scheduled to be deep cleaned for scabies. She said it would be her staff that does the deep cleaning, and she schedules them. On 8/24/23 at 2:31 p.m. an interview was conducted with the Regional Nursing Home Administrator (NHA), who is also a nurse. She said a resident with scabies would go on isolation for 24 hours after treatment. She said the resident's personal items get bagged and everything gets cleaned, including bed, furniture, and curtains. She said the shower/treatment and cleaning should all happen together. She said housekeeping would do the cleaning because nurses and CNAs are not trained to do terminal cleans and they wouldn't be doing that. She said if a resident was treated for scabies the night of 7/29/23 their room should have been terminally cleaned the morning of 7/30/23. She said she would expect it to have been done before 8/8/23. The Regional NHA also said the roommate of the resident exposed should be getting daily skin checks and that order should have been put in by nursing management. She added this should have been talked about in the morning meetings. She stated, no question why this is an infection control concern. On 8/24/23 at 3:01 p.m. an interview was conducted with the Director of Nursing (DON.) She said for (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 11 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few a resident with scabies first we isolate them, then we treat and clean. She said they typically watch the roommate due to exposure but do not treat. She said the roommate should be getting daily skin checks. The DON said she knows they have been having issues with skin checks not being completed. As far as cleaning with scabies treatment, the DON said usually the room is cleaned while the resident is in the shower getting the first treatment and when the cream is washed off in the second shower, housekeeping comes back and terminally cleans the room. When told Resident #10 was treated on 8/18/23 and her room had still not been deep cleaned she said Wow, I will address. She said she would call the dermatologist to determine what they wanted to do as far as treatment for Resident #10 and #11. When asked about Resident #4 having scabies she said she had no knowledge that she had it. The DON said she had only been in the facility a couple of weeks. She said she would have expected the Infection Preventionist to have known Residents #4 and #12 were treated and to follow up with housekeeping. She said the IP should have known from her infection tracking. Review of a facility policy titled Scabies Identification, Treatment, and Environmental Cleaning, revised August 2016, showed the following: Purpose: The purpose of this procedure is to treat residents infected with and sensitized to Sarcoptes scabies and to prevent the spread of scabies to other residents and staff. General Guidelines 1. Scabies is an itching skin irritation caused by the microscopic human itch mite, which burrows into the skin's upper layers and eventually causes itching, tiny irregular red lines just above the skin and an allergic rash. 2. Secondary bacterial skin infections may result from untreated scabies. 3, Incubation period can be 2-6 weeks before onset of itching for persons with no previous exposure. Persons who have been previously infested develop more rapid symptoms, 1-4 days after re-exposure. . 6. Scabies is spread by skin to skin contact with the infected area, or through contact with bedding, clothing, privacy curtains and some furniture. 7. Diagnosis may be established by recovering the mite from its burrow and identifying it microscopically. Failure to identify scrapings as positive does not necessarily exclude the diagnosis. It is difficult to obtain a positive scraping because only one or 2 mites may cause multiple lesions. Often diagnosis is made from signs and symptoms and treatment followed without scrapings, although scrapings or preferred. . 11. A resident sharing a room with someone infected with scabies should be examined carefully for scabies. If signs and symptoms are present, the resident should be treated in accordance with these procedures. If symptoms are not present, daily assessments should be made until the case has resolved. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 12 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 12. Individuals who come into contact with the infected resident or with potentially contaminated bedding or clothing should wear a gown and gloves or other protective clothing as established by the facilities infection and exposure control programs. 13. During a scabies outbreak among residents and/or personnel, the Infection Preventionist or Committee will coordinate interdepartmental planning to facilitate a rapid and effective treatment program. Environmental Control: Typical Scabies 1. Place residence with typical scabies on contact precautions during the treatment; 24 hours after application of 5% Permethrin cream or 24 hours after last application of scabicides requiring more than one application. . 4. Place bed linens, towels and clothing used by an affected person during the 4 days prior to initiation of treatment in plastic bags inside the resident's room, handled by gloved and gowned staff without sorting, and washed in hot water for at 10-20 minutes. . 6. Place non-washable blankets and articles in a plastic bag for at least 72 hours. These items can also be dry cleaning or tumbled in a hot dryer for 20 minutes. . 10. Vacuum mattresses, upholstered furniture, and carpeting. Wrap vacuum cleaner bag in a plastic bag and discard. Review of a policy provided by the facility's housekeeping contract company titled Contaminated Isolation Room Cleaning-Scabies, undated, showed the following: Purpose: Review the process of cleaning an Isolation Room and preventing the spread of scabies. It is important that for each infectious disease an EPA approved solution is used to sanitize the patient room. Information on the EPA approved solution's use, preparation, and dwell time, also referred to as contact time, can be found on the Safety Data Sheet (SDS) and manufacturer's label. Isolation Room Cleaning Procedure . C. Begin the Isolation Room Cleaning using the guidelines below: 1. Empty Trash . 2. Horizontal Surfaces-disinfected . (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 13 of 14 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 105616 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Bay Center for Rehabilitation and Healing 10501 Roosevelt Blvd N Saint Petersburg, FL 33716 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0880 Level of Harm - Minimal harm or potential for actual harm c. Thoroughly clean ,disinfect and vacuum the patient bed area, including the headboard, footboard, front panel, mattress-with high focus on any seams or crevices-side rails, bed frame, over-bed table, and base of the over-bed table. e. Vacuum the interior of the dresser drawers with a high focus on corners and joints. Residents Affected - Few 3. Clean Walls . 4. Cubicle Curtains and Drapes a. Remove the cubicle curtains and drapes and double bag these items. Place inside room until you exit. 5. Clean and Disinfect Bathroom . 6. Dust Mop and Vacuum . 7. Damp Mop . 8. Exit Room . b. Take all double bagged linens, mops, and curtains to the dirty linen room and let the laundry employees know you have just completed an Isolation Room cleaning for scabies. Review of a facility job description titled Infection Preventionist, Revised July 2016, showed the following: The Infection Preventionist is responsible for coordinating the implementation and updating of our established infection prevention and controlled policies and practices. Policy Interpretation and Implementation 1. The Infection Preventionist (or designee) shall coordinate the development and monitoring of our facilities established infection prevention and control policies and practices. 2. The Infection Preventionist shall report information related to compliance with our facilities established infection prevention and control policies and practices to the Administrator and Quality Assurance and Performance Improvement Committee. 5. The Infection Preventionist will collect, analyze and provide infection and antibiotic usage data and trends to nursing staff and healthcare practitioners; consult on infection risk assessment and prevention control strategies; provide education and training; and implement evidence-based infection prevention and control practices FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105616 If continuation sheet Page 14 of 14