Health inspection·April 8, 2022

F 0565 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few grievances. They had concerns about the timing for the call lights. I explained that they were going to do in-services with the staff. During an interview, on 04/08/22 at 10:38 AM with the Social Services Director, when asked how the grievances from Resident Council regarding staffing were resolved, the Director of Social Services replied, I didn't know about the smoking and the restorative aide that was assigned to the smoking was off. For the staff on the 11-7 shift, we did in-services with staff about answering the call lights, making sure that the call lights were in place, knocking on the door before entering, introducing before entering and repositioning. I will have to go to the DON to find out how to fix this. During the interview with the Social Services Director, this surveyor reported that the grievances reported by the Resident Council had not been resolved, as reported by the members of the Resident Council. The Social Services Director acknowledged understanding of the concerns. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105837 If continuation sheet Page 2 of 8 Printed: 05/28/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 105837 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/08/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Boynton Beach Rehabilitation Center 9600 Lawrence Rd Boynton Beach, FL 33436 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on policy review, interview and record review, the facility failed to conduct a thorough investigation; by failure to report abuse allegations to state Agency involving 1 of 1 resident reviewed for abuse (Resident #106). The findings included: The Policy for abuse and Neglect prohibition recorded abuse means the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting harm, pain, or mental anguish. Mental abuse includes, but is not limited to, humiliation, harassment, threats of punishment or deprivation, humiliating or demeaning photography and use of social media. Verbal abuse is defined as the use of oral, written, or gestured language that willfully includes disparaging and derogatory terms to residents or their families, or within their hearing distance regardless of their age, ability, to comprehend, or disability. The procedure included: screening, training, prevention, identification, investigation, protection, reporting and response. The reporting and response indicated: the facility will report all allegations and substantiated occurrences of abuse, neglect, and misappropriation of property to the state/federal agency and law enforcement officials as designated by state/federal law. On 04/04/22 at 12:08 PM during an interview with Resident #106, he voiced, one time , a male nurse (staff D) brought his medications to him, he had asked staff D to verify the pills that were in the medicine cup, staff D refused, and stated if you don't want to take them I don't care this is your life. Staff D started arguing with him, Staff D called him a drug addict, saying all you do is lay here and beg for pain pill, you're an addict. Resident #106 voiced he felt verbally abused by staff D. Resident #106 revealed the facility had talked to him about the incident. Resident #106 voiced concern regarding the facility has allowed Staff D to work with him after the incident has occurred to the point Staff D had another argument with him. Resident #106 voiced he is not afraid of Staff D. Upon reviewing Resident #106's grievance, dated 03/28/22, it was revealed that Resident #106 recorded a handwritten statement. He indicated on 11:00 PM -7:00 AM shift on Wed 03/16/22 and 03/17/22 I requested medication, when I got it, I could not identify the pills as it was not the same as the one, I was given hours earlier. I asked the nurse (Staff D) for clarity as to if it was correct. He said it was and he knowns what he's doing. I then said it doesn't look the same and asked him to check. He then yelled at me if I take it or not, he doesn't care, he said I am not an addict like you, you just lay in bed and beg for pain pills all day. The only thing I said after that to Staff D was I am not taking it, you can come and take it back please. He came in a short time later and shoved the card with the pills on it in my face and said to me you read English. I did look at the card and took the pill after I identified it. Staff D, the nurse never said that it was different because it was from a new supplier or another supplier. Anyway, this behavior and verbal attack, defamation, humiliation, helplessness that I felt, and total disrespect is inexcusable. On 04/05/22 at 9:15 AM, an interview was conducted with the Director of Nursing (DON), regarding the abuse allegation Resident #106 have made, The DON stated, this is a situation with many dynamics, and there was a grievance in place for it. On 04/07/22 at 10:33 AM, an interview was held with the Nursing Home Administrator (NHA), when asked if the abuse allegation was reported to the agency, the NHA voiced that the facility did not feel (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105837 If continuation sheet Page 3 of 8 Printed: 05/28/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 105837 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/08/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Boynton Beach Rehabilitation Center 9600 Lawrence Rd Boynton Beach, FL 33436 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few that Resident #106 was abused, and that Resident #106 had voiced it was a customer service concern. When asked if the facility did not go by Resident #106's initial handwritten statement of abuse allegation to report it, he voiced he will get back to the surveyor and he left. On 04/07/22 at 11:21 AM, an interview was held with the NHA and the DON, the DON revealed she did not feel that Resident #106 was abused by Staff D, as after the incident the management team had spoken to Resident #106, he had voiced it was a customer service issue, he did not mentioned abuse. When asked whether Staff D had worked with Resident #106 following the incident, the DON voiced that her intention was to remove Staff D from the assignment, but since Resident #106 did not mention he was abused by Staff D, therefore she did not remove Staff D from the assignment. She had offered Resident #106 to move to another unit and Resident #106 declined. She further added that after the surveyor informed her of the abuse allegation (on 04/05/22), she then called Staff D on the phone and told him, he cannot work with Resident #106 anymore. On 04/08/22 at 10:50 AM, an additional interview was held with the DON, she confirmed that she did not report the abuse allegation, even after the surveyor had told her about it on Tuesday (04/05/22). She stated, because the facility already had a survey team in the building for the recertification survey, she was under the impression, she did not have to submit a report. She voiced that she would report it today (on 04/08/22). During the interview process the corporate nurse who was in the room, she read Resident #106's statement regarding the abuse allegation, she agreed that the abuse allegation should have been reported to the agency. Clinical record review revealed Resident #106 re-admitted to the facility on [DATE] with diagnoses included: arthritis, and status post knee replacement surgery. The Annual minimum data set (MDS) assessment, reference date 03/22/22, indicated Resident #106 had a Brief Interview for Mental Status (BIMS) score of 15, indicating Resident #106 was cognitively intact. Resident #106 is located at the 300 unit. Review of staffing schedule and assignment revealed that Staff D had worked with the resident on the 11PM - 7AM shift on the following days: On 03/30/22, 03/31/22, 04/01/22, 04/02/22 and 04/05/22. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105837 If continuation sheet Page 4 of 8 Printed: 05/28/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 105837 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/08/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Boynton Beach Rehabilitation Center 9600 Lawrence Rd Boynton Beach, FL 33436 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** Based on observation, interviews, record review and policy review, the facility failed to provide services to prevent significant weight loss for 1 of 5 residents sampled for nutrition (Resident #10). Residents Affected - Few The findings included: The facility's policy titled Weight Measurements reveals Any significant or progressive weight loss or gain is noted and reported to the resident's attending physician, family, or responsible party, and documented in the medical record. Resident #10 was admitted to the facility on [DATE] from an acute care facility. Resident #10 has a primary diagnosis of Multiple Sclerosis with additional diagnoses that include Depression, Muscle spasm, and Paraplegia. Resident #10 was interviewed during the initial pool process on 04/04/22 at 1:06 PM. The Resident stated that he has a good appetite but thinks he lost muscle weight. He stated that he doesn't remember what he weighs but he feels like he lost weight. Review of weights in the Electronic Health Record (EHR) revealed an 18.0% weight loss in 90 days. Resident #10 weighed 143 pounds (lbs) on 12/15/21 and 117 pounds on 03/23/22. A weight for February 2022 was not found in the EHR. The following weights for Resident #10 were located in the weight section of the EHR: 04/05/2022-112.4 Lbs; 03/30/2022-111.6 Lbs; 03/23/2022-117.0 Lbs; 01/19/2022-143.6 Lbs; 12/15/2021- 143.7 Lbs; 11/10/2021-144.6 Lbs; 10/18/2021-143.0 Lbs; 09/30/2021-138.6 Lbs. An interview was conducted with Staff E, dietary tech, on 04/04/22 at 3:00 PM who stated that she was told that Resident #10 refused to be weighed in February 2022. She stated that she did not ask him herself but that she was told this. Since she did not see any weights, she did not put any interventions in place. An interview was conducted on 04/05/22 at 10:00 AM with Staff F, restorative aide who does monthly weights and submits to Staff E. This surveyor asked Staff F what happens if a resident refuses to be weighed. She stated that if that happens she will go back and if they refuse to be weighed three (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105837 If continuation sheet Page 5 of 8 Printed: 05/28/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 105837 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/08/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Boynton Beach Rehabilitation Center 9600 Lawrence Rd Boynton Beach, FL 33436 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 times she will let the dietician know and tell the unit managers. Staff F then showed this surveyor the weights she had taken for Resident #10. Staff F had recorded weights for Resident #10 of 113.4 pounds for 02/21/22, 108.0 pounds for 03/15/22, 111.6 pounds for 03/28/22 and 113 pounds for 04/05/22. She stated that these weights were all reported to Staff E when they were taken. An additional interview was conducted with Resident #10 on 04/05/22 at 11:00 AM. He was asked if he ever refused to be weighed and he responded that he did not. He said that he would like to know how much he weighs because no one has discussed his weights with him or his wife. An interview was conducted with Staff G, Registered Dietician on 04/06/22 at 12:47 PM. He stated that he started working in the facility at the end of February. He is in the facility once a week and Staff E is in the facility twice a week. If the dietary tech wants a re-weigh, it could be another week to see that re-weigh. On 12/11/21 a supplement called Ready Care 2.0 was ordered at 120 milliliters (ml) twice a day. On 03/23/22 a nutritional evaluation was done for Resident #10 and notes state to recommend increasing Ready Care 2.0 to 120 ml three times a day, adding house shake with meals and adding weekly weights x 4 weeks as tolerated. Per review of the resident's orders, the House Shake was not ordered until 04/05/22. On 04/05/22 a house shake was ordered with meals for nutritional support and Ready Care was increased to 120 ml four times a day. Review of the EHR revealed the physician was not notified of the significant weight loss. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105837 If continuation sheet Page 6 of 8 Printed: 05/28/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 105837 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/08/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Boynton Beach Rehabilitation Center 9600 Lawrence Rd Boynton Beach, FL 33436 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 - Some Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews, record review and policy review; the facility failed to remove narcotics from 3 of 6 medication carts for residents who have no current orders for the narcotics. The findings included: The facility's policy titled Disposal/Destruction of Expired or Discontinued Medication effective [DATE] reveals Once an order to discontinue a medication is received, Facility staff should remove this medication from the resident's medication supply. On [DATE] at 11:00 AM, Cart #2 in the 300 unit was reviewed with Staff C, Registered Nurse(RN). Resident #23's medication card for Oxycodone 5 milligrams (mg) was in the narcotic locked box with no current order and last given on [DATE]. The order ended on [DATE]. On [DATE] at 11:21 AM, Cart #1 in the 300 unit was reviewed with Staff H, Licensed Practical Nurse (LPN). Resident #415's medication card for Alprazolam 0.25 mg was in the locked medication cart. Resident #415 was discharged from the facility on [DATE]. Also in Cart #1 was the medication card for Resident #103. This was Alprazolam 0.25mg. The order expired on [DATE]. The last time the medication was given was on [DATE]. This was discussed with Staff B, unit manager of the 300 unit, on [DATE] at 12:05 PM who stated that the medication should not be in the cart without an order. On [DATE] at 12:30 PM, Cart #1 in the 200 unit was reviewed with Staff I, LPN. Resident # 9's medication for Temazepam was in the locked medication cart without a current order. The order expired on [DATE]. Also in Cart #1 in the 200 unit was the medication card for Resident #17. This medication was for Clonazepam 0.5mg and the order expired on [DATE]. Discussed with Staff J, unit manger for 200 unit on [DATE] at 12:45 PM who said the medication should not have been in the cart without a current order. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105837 If continuation sheet Page 7 of 8 Printed: 05/28/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 105837 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/08/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Boynton Beach Rehabilitation Center 9600 Lawrence Rd Boynton Beach, FL 33436 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 - Few 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. Based on observation, interviews, record review; the facility failed to assess 2 of 4 residents observed during medication administration for self administration of medication (Resident #10 and #65), and failed to secure 2 of 6 medication carts. The findings included: 1) During a medication administration observation on 04/06/22 at 8:50 AM, this surveyor entered the room of Resident #10 with Staff K, Registered Nurse. On the resident's overbed table was Proventil HFA Aerosol Solution (inhaler). This surveyor asked Staff K why this inhaler was in the resident's room and not in the medication cart. Staff K responded that the resident is allowed to use it on his own. Resident #10 stated that he needs to have it with him so he can use it quickly if he needs it. After the medication administration was completed for Resident #10, this surveyor asked Staff J, unit manager, for the self administration assessment for Resident #10. Staff J stated that there was no order for the resident to self administer the inhaler and no evaluation was done. On 04/06/22 at 10:24 AM the Director of Nurses stated that there is no assessment that was done to self administer the inhaler and it should not have been on the bedside table. 2) On 04/05/22 at 9:50 AM during observation of medication administration with Staff C, a Registered Nurse (RN), Resident #65, was noted coughing, when asked whether she had nebulizer treatment ordered, Resident #65 stated she does her own nebulizer herself. She further stated she kept 5 vials of albuterol, nebulizer treatment in a Qtip box, on the bedside table to use as needed. She continued to state, she kept the vials in the Qtip box to hide it, because her friend who is cognitively impaired, has come to her room had tried to take them. During that time the nurse confirmed the resident administers her own nebulizer treatment, she stated the nurses give it to her, and she administers it as needed. At 10:00 AM when asked whether Resident #65 was assessed for self-administration, the nurse stated the resident had not been assessed for self-administration. 3) On 04/07/22 at approximately 11:00 AM, an observation was made at the 300 unit, whereas the treatment cart was observed unlock and unattended. The Infection preventionist was present during the observation. On 04/08/22 at 9:57 AM, an observation was made at the 100 unit, whereas the treatment cart was observed unlock and unattended, with the key attached to the knob. 4) On 04/04/22 at 9:32 AM the 300-unit medication cart, cart 2, was left unlock and unattended. Staff B was made aware, she then locked the medication cart. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105837 If continuation sheet Page 8 of 8