Inspection·March 9, 2023

F 0625 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some of condition dated 6/19/2022 at 9:47 PM documented the resident was unresponsive with low bp (blood pressure), low O2 sat (oxygen saturation) with a recommendation from doctor to send to ER for evaluation. Review of Resident #191's medical records revealed no evidence the facility provided the resident or resident representative with written information that specified the duration of the bed hold policy upon transfer to the hospital. During a telephone interview on 3/8/2023 at 8:35 AM, Resident #191's representative stated, I was not provided any bed hold policy or paperwork from the nursing home. I don't even know what that is. During an interview on 3/8/2023 at 11:30 AM, the DON stated, I don't see any evidence or documentation that we provided the resident or his wife the bed hold policy. 3. Review of the admission record for Resident #54 revealed the resident was admitted to the facility on [DATE]. Review of the nursing progress note for Resident #54 dated 1/14/2023 at 5:39 PM reads, Resident sent out to ER for abnormal labs hemoglobin 6.1. Review of Resident #54's medical record revealed no evidence the facility provided the resident or resident representative with written information that specified the duration of the bed hold policy upon transfer to the hospital. During an interview on 3/7/2023 at 10:22 AM, Resident #54 stated, I went to the hospital in January. I wasn't given any kind of notice about my bed hold. I'm not sure what you are talking about. During an interview on 3/8/2023 at 11:35 AM, the DON stated, There is no bed hold in his chart. It appears we did not give him one. It is the responsibility of the nurses to do this. On 3/8/2023 at 11:35 AM, the DON was requested the facility bed hold policy. No documentation was received. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 2 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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** Based on record review and interview, the facility failed to ensure the assessment accurately reflected the resident's status for 1 of 3 residents reviewed for oxygen administration, Resident #65. Residents Affected - Few Finding include: Review of the admission record for Resident #65 revealed the resident was admitted to the facility on [DATE] with diagnoses including primary generalized (osteo) arthritis, age-related osteoporosis without current pathological fractures, chronic pain, cough, insomnia, major depressive disorder, hyperkalemia, and anxiety disorder. Review of the physician order dated 12/9/2022 for Resident #65 reads, Oxygen 2 L [Liter] with humidifier via nasal cannula at night one time a day for oxygen use. Review of Resident #65's Medication Administration Record reads, Oxygen 2 L with humidifier via nasal cannula at night on time a day for oxygen use. Start Date: 12/09/2022 2000 [8:00 PM], The staff initialed the MAR for administration of oxygen from 12/10/2022 through 12/31/2022. Review of Resident #65's Weights and Vital Summary for O2 Saturation revealed 97% (Oxygen via Nasal Cannula) on 12/11/2022 at 11:38 PM and 96% (Oxygen via Nasal Cannula) on 12/7/2022 at 6:16 PM. Review of Resident #65's Quarterly Minimum Data Set (MDS) dated [DATE], reads Section O. Special Treatments, Procedures, and Program . C. Oxygen, 2. While a Resident: No. Review of Resident #65's Quarterly Minimum Data Set (MDS) dated [DATE], reads, Section O. Special Treatments, Procedures, and Program . C. Oxygen, 2. While a Resident: Yes. During an interview on 3/8/2023 at 1:12 PM, the MDS Consultant stated, Oxygen was not coded. Let me look if [Resident #65's name] received oxygen in the lookback. He did get oxygen at night. She missed this one. We will change it now. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 3 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 0645 PASARR screening for Mental disorders or Intellectual Disabilities Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure a Level I Preadmission Screening and Resident Review (PASARR) was completed to determine whether the resident required special services exceeding those provided by the nursing facility for 2 of 6 reviewed residents, Residents #30 and #123. Residents Affected - Few Findings include: 1. Review of the admission record for Resident #30's revealed the resident was admitted on [DATE] with diagnoses including generalized anxiety, depression, and major depressive disorder. Further review revealed no Level I PASARR. During an interview on 3/7/2023 at 12:33 PM, the Director of Nursing (DON) stated, I was not able to locate a Level I screening for [Resident #30's name]. 2. Review of the admission record for Resident #123 revealed the resident was admitted on [DATE] with diagnoses including hypothyroidism, hyperlipidemia, dementia, major depressive, and anxiety disorder. Further review of medical records revealed no PASARR for Resident #123. During an interview on 3/8/2023 at 11:49 AM, the DON stated, I am unable to locate a PASARR for [Resident #123's name]. Review of the facility policy and procedure titled Role of admission and Social Services in PASRR with a last review date of 1/11/2023, reads, Policy: The facility will ensure each resident in a nursing facility is screened for a mental disorder (MD) or intellectual disability (ID) prior to admission and that individuals identified with MD or ID are evaluated and receive care and services in the most integrated setting appropriate to their needs by coordinating with the appropriate , State-designated authority . Procedure: I. Preadmission Screening: 1. The External Liaison or Internal admission Staff /Designee or [Sic.] will obtain a completed pre-admission screen (PASRR Level I) on all individuals being admitted to the SNF [Skilled Nursing Facility] prior to admission. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 4 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0656 Level of Harm - Minimal harm or potential for actual harm Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Based on observation, record review, and interview, the facility failed to ensure a comprehensive person-centered care plan was implemented for 1 of 3 reviewed residents, Residents #77. Residents Affected - Few Findings include: During an observation on 3/6/2023 at 3:42 PM, Resident #77 was lying flat on his back while resting in bed. There were no pressure relieving cushions observed to float resident's heels. During an observation on 3/7/2023 at 10:05 AM, Resident #77 was laying on his back in bed, wearing yellow nonskid socks. No pressure-relieving cushions were in place to float resident's heels. Review of Resident #77's care plan initiated on 12/28/2022 reads, [Resident's name] has the potential for skin impairment/ pressure ulcers r/t [related to]: impaired mobility, h/o [history of] pressure ulcer. Care plan interventions include float heels while in bed. During an interview on 3/8/2023 at 12:51 PM, Staff E, Certified Nursing Assistant (CNA), acknowledged that Resident #77 did not have heels floated. During an observation on 3/8/2023 at 1:03 PM, Staff F, Licensed Practical Nurse (LPN), acknowledged that Resident #77 did not have heels floated. Review of the facility policy and procedure titled Comprehensive Assessments and Care Plans issued on 4/1/2022 and annually reviewed on 1/11/2023 reads, Guidelines: 1. The facility will conduct initially and periodically a comprehensive, accurate, standardized reproducible assessment of each resident's functional capacity . 8. The facility will develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights set forth at 483.10 c (2) and 483.10 c (3), that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 5 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 0658 Ensure services provided by the nursing facility meet professional standards of quality. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure medications were administered according to professional standards of practice for 1 of 6 residents with gastrostomy tubes, Resident #31, and failed to ensure follow-up appointments were scheduled for 1 of 3 reviewed residents, Resident #189. Residents Affected - Few Findings include: 1. During an observation of medication administration on 3/9/2023 at 5:34 AM, Staff I, Licensed Practical Nurse (LPN), crushed two medications and placed them in a medication cup and poured five milliliters of water into the medication cup from the water pitcher. Staff I mixed the medication with a spoon and removed two large pieces of ice that were heavily coated with medication and threw the ice into the garbage. Staff I then administered the medications leaving a large amount of medication residual in the medication cup. Staff I did not administer a water flush before administering the medications. During an interview on 3/9/2023 at 6:05 AM, Staff I, LPN, stated, I should not have thrown out the ice. It did have a lot of medication on it. I should have flushed the resident's tube before I gave the medication and should have made sure all the medication was administered by adding more water to the cup. I should not have mixed the medications together in the same cup. During an interview on 3/9/2023 at 8:30 AM, the Director of Nursing (DON) stated, I expect that the nurses will verify that medications were actually administered and have not fallen out of their mouths or onto the floor. Medications administered through a gastrostomy tube should be administered separately with water flushes in between and all of the medication should be administered. Review of the facility policy and procedure titled, Medication Administration issued on 4/1/2022 reads, Policy: It will be the policy of this facility to administer medications in a timely manner and as prescribed by the physician, unless otherwise clinically indicated or necessitated by other circumstances such as lack of availability of medication or refusals of medication by the resident. Procedure . 8. After successfully identifying the resident to receive medication administration, the individual administering the medication should ensure that the right medication, right dosage, right time, and right method of administration are verified. 2. Review of the admission record for Resident #189 documented an admission date of 9/16/2022 and the diagnoses including unspecified fracture of lower end of left tibia and displaced comminuted fracture of shaft of left fibula. Review of the after hospital visit summary dated 9/14/2022 for Resident #189 revealed instructions to schedule an appointment with orthopedic surgery as soon as possible for a visit in 1 day. Review of the physician orders for Resident #189 revealed no orders for follow-up appointments. Review of the facility records revealed no documentation of orthopedic surgery appointment for Resident #189. During an interview on 3/9/2023 at 1:15 PM, the Director of Nursing stated, I would expect the admitting nurse to document any appointments the resident needed. As a back-up, our transportation (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 6 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 0658 Level of Harm - Minimal harm or potential for actual harm department would also check admissions for needed appointments. The resident had a diagnosis of COVID-19, but it looks like that was resolved before she came here. She was not on isolation and the appointments should have been arranged. I do not know why the appointments were not made. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 7 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 Based on record review and interview, the facility failed to ensure that residents maintained an acceptable parameter of nutritional status and were offered intravenous hydration for 2 of 4 residents reviewed for nutrition and hydration, Residents #191 and #13, in a total sample of 62 residents. Residents Affected - Few Findings include: 1. Review of the admission record for Resident #191 documented an admission date of 4/10/2022 with the diagnoses including cerebral infarction (stroke) due to unspecified occlusion or stenosis of left cerebellar artery, nonrheumatic aortic (valve) stenosis without insufficiency, cerebral infarction, unspecified atrial fibrillation (irregular heartbeat), status gastrostomy (a tube placed in the stomach to provide food), essential (primary) hypertension, altered mental status, hyperlipidemia (high cholesterol), other seizures, mild protein calorie malnutrition, and pneumonitis due to inhalation of food and vomit (aspiration into the lungs). Review of the physician orders for Resident #191 dated 4/10/2022 reads, Nothing By Mouth diet. Nothing By Mouth texture. Nothing by mouth consistency. Review of the physician order for Resident #191 dated 4/10/2022 reads, Flush feeding tube with 150 cc [cubic centimeter] water 5 times daily, five times a day for flush. Review of the physician order for Resident #191 dated 6/13/2022 reads, Enteral Feed Order three times a day Jevity 1.5 carton (237 cc) bolus 3 x [times] per day flush with 50 cc of water pre/post bolus. Review of Resident #191's weight summary documented weights of 205.8 pounds on 4/20/2022, 205.8 pounds on 4/23/2022, no weight in May 2022, 185.2 pounds on 6/12/2022, and 176 pounds on 6/16/2022. Review of the nutritional progress note for Resident #191 dated 6/13/2022 reads, Resident triggers for a significant weight loss of 10% in approximately 2 months since initial admit. Current weight is 185.2# [pounds] and BMI is 26.6 [overweight], usual weight greater than 200# per records. Resident remains NPO [Nothing By Mouth] with TF [tube feeding] for nutrition/hydration. He has been having behaviors of agitation and disconnecting TF when being administered- may account for some weight decline. No current wounds identified at this time by nursing. No recent labs available for review. Current TF regime Jevity 1.5 at 75 milliliters per hour times 20 hours with free water flushes of 300 mils [milliliters] Q [every] 6 hours (1200 mils/d) higher orders are providing 1500 milliliters/day of formula 2250 kcals, (27 kcals/kg), 96 g pro (1.1g/kg) and 1140 mils free water. Due to resident disconnecting TF and weight showing a decreasing trend, will recommend: 1. Change TF to nocturnal feedings of Jevity 1.5 at 80 milliliters per hour times 12 hours (6-6) with bolus feedings of 1 carton Jevity 1.5 TID with flushes 50 mils free water before and after bolus feedings while resident is awake. Continue 300 mils flushes Q 6 hours. New orders will provide 960 mills/d formula at nocturnal feedings 711 mills bolus feedings= 1671 mills/d, 2507 kcals (30 KCALS/kg), 170 G pro (1.3/kg) and 1270 mills free water plus 1500 mills flushes equals 2770 mills/d (33 mls/kg). New order should help better meet needs and allow for time detached from feeding during the day for quality of life. Will continue to monitor weights weekly and follow up with resident as needed. Review of Resident #191's Medication Administration Record (MAR) for June 2022 revealed no information for enteral feeding order for three times a day Jevity 1.5 carton (237 ml) bolus on 6/13/2022 at (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 8 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 6:00 PM, 6/14/2022 at 10:00 AM, 2:00 PM and 6:00 PM, and 6/15/2022 at 10:00 AM, 2:00 PM and 6:00 PM. The MAR had also no information for the order for flushing the feeding tube with 1500 cc water 5 times daily on 6/5/2022 at 2:00 PM, 6/10/2022 at 10:00 AM and at 2:00 PM, 6/12/2022 at 6:00 AM, 6/13/2022 at 2:00 PM, 6/17/2023 at 10:00 PM, 6/19/2022 at 10:00 PM, and 6/20/2022 at 6:00 AM. During an interview on 3/8/2023 at 9:54 AM, the Registered Dietician (RD) stated, This would have caused additional weight loss if the resident was not receiving additional bolus feedings. He would not have the needed calories and free water. I was not aware that he was not receiving his bolus feedings. During an interview on 3/8/2023 at 11:30 AM, the Director of Nursing (DON) stated, I see that he had a significant weight loss and we did a QAPI [Quality Assurance and Performance Improvement] around that time related to weights. There is no evidence in the chart that the doctor or the wife was notified of the significant weight loss. They both should have been notified. I do see that we did not give him the ordered bolus feedings on 6/13, 6/14 and 6/15/2022. I don't see that the nurses documented that they gave these. It would add to weight loss if residents aren't getting the calories to meet their needs. We should have administered the bolus feedings and we should have documented that we did it. Review of the facility policy and procedure titled Weights and Weight Loss issued on 4/1/2022 reads, Policy: It will be the practice of this facility to implement the following systems regarding weight documentation. Procedure . 4. Consistent weight loss noted during the admission weight process will be brought to the attention of the physician and/or RD [Registered Dietician] and responsible party. 5. Significant weight loss shall be addressed by the physician and/or RD through discussion with the resident and/or the resident representative for known preferences and desires and development and implementation of interventions to attempt to address the weight loss. 2. Review of the admission record for Resident #13 documented an admission date of 2/16/2023 with the diagnoses including osteomyelitis (an infection of the bone), unspecified hydronephrosis (swelling in the kidney), hypertensive chronic kidney disease with stage five chronic kidney disease or end stage renal disease, non-pressure chronic ulcer of right foot with unspecified severity, right lower limb cellulitis (infection), paroxysmal atrial fibrillation (irregular heartbeat), essential primary hypertension, hyperlipidemia, anemia and chronic kidney disease, chronic kidney disease, hypothyroidism, irritable bowel syndrome, unspecified osteoarthritis, rheumatoid arthritis, cerebral infarction (stroke) unspecified, gastroesophageal reflux disease, repeated falls, and major depressive disorder. Review of the physician order for Resident #13 dated 3/6/2023 at 3:22 PM reads, Sodium Chloride Solution 0.9%. Use 75 ml/hr [milliliters/hour] intravenously every shift for AKI [Acute Kidney Injury] for 4 days. During an observation on 3/7/2023 at 8:25 AM, Resident #13 had a right upper arm midline single lumen catheter with no intravenous fluids of Normal Saline infusing. During an interview on 3/7/2023 at 8:25 AM, Resident #13 stated, No one has put up any IV [intravenous]. They have given me my antibiotic. During an interview on 3/7/2023 at 8:40 AM, Staff G, Licensed Practical Nurse (LPN), stated, I see that there was an order for IV fluids on her [Resident #13] that was put in yesterday, but the nurse (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 9 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 did not acknowledge the order or hang the fluids. They are not being administered yet. I don't know why it wasn't started. During an interview on 3/7/2023 at 9:35 AM, the Director of Nursing (DON) stated, When nurses don't acknowledge orders in PCC [Point Click Care], they will not go over to the MAR. Until the order is acknowledged by a nurse, it isn't seen on the MAR. I don't know why the nurse did not hang the IV fluids. All physician orders should be followed. It is a professional standard of practice to follow a physician order or get it clarified. The nurse should have hung the IV saline and documented if she didn't and why she didn't hang it. The order did say for AKI and it's important to get the fluids up and running. During an interview on 3/8/2023 at 3:14 PM, Staff G, LPN, stated, I was the nurse taking care of her [Resident #13] on the 6th when the order was written. Well, I was not aware that the nurse practitioner wrote an order. Apparently the order was written about 3:15 PM, that is at shift change. The nurse practitioner did not tell me about the order for IV fluids, and it was a very busy evening, and I did not check her pending orders during the shift. I should have. If a patient has acute kidney injury and needs IV fluids, why shouldn't the practitioner have called me and let me know about the new orders. I should have checked my orders, but I had many residents to look after and give meds to, answer lights and do treatments. I just forgot to do it. I know that I should have checked the orders, but many times we have orders and don't know anything about them. I would have made sure that the IV fluids were hung if I knew. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 10 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Residents Affected - Some Based on observation, interview, and record review, the facility failed to ensure respiratory care services were provided consistent with professional standards of practice for 2 of 3 residents reviewed for respiratory care, Residents #4, and #65. Findings include: 1. During an observation on 3/6/2023 at 9:20 AM, Resident #4 was sitting in bed receiving oxygen through a nasal cannula. The oxygen concentrator was set on 2.5 liters of oxygen. Review of the admission record for Resident #4 revealed the resident was admitted to the facility on [DATE] with the diagnoses including pneumonia, unspecified organism, pulmonary fibrosis (a disease where the lungs become damaged and scarred), chronic respiratory failure with hypoxia (low oxygen levels), and chronic obstructive pulmonary disease. Review of the physician orders for Resident #4 revealed no written orders for administration of oxygen. During an interview on 3/6/2023 at 11:30 AM, Staff D, Licensed Practical Nurse (LPN), confirmed that Resident #4 was using oxygen through a nasal cannula with the concentrator set at 2 liters of oxygen and there were no orders for oxygen. During an interview on 3/6/2023 at 11:49 AM, the Director of Nursing (DON) stated, If patients need oxygen, a doctor should be called, and orders be written. My expectation of my staff is to follow the doctors' orders. 2. During an observation on 3/6/2023 at 9:40 AM, Resident #65 was resting in bed with oxygen being administered via nasal cannula at 2.5 liters per minute. During an observation on 3/7/2023 at 8:59 AM, Resident #65 was eating breakfast in his room independently, with oxygen being administered via nasal cannula at 2.5 liters per minute. During an observation on 3/8/2023 at 7:38 AM, Resident #65 was resting in bed with oxygen being administered via nasal cannula at 2.5 liters per minute. Review of the admission record for Resident #65 revealed the resident was admitted to the facility on [DATE] with diagnoses including primary generalized (osteo) arthritis, age-related osteoporosis without current pathological fractures, chronic pain, cough, insomnia, major depressive disorder, hyperkalemia, and anxiety disorder. Review of the physician order dated 12/9/2022 for Resident #65 revealed, Oxygen 2 L [liters] with humidifier via nasal cannula at night one time a day for oxygen use. During an interview on 3/8/2023 at 7:59 AM, Staff D, LPN, Unit Manager, stated, [Resident #65's name] oxygen is at 2.5 liters per minute. It should be at 2 liters. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 11 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 0695 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete During an interview on 3/8/2023 at 1:37 PM, the DON stated, Nurses should be checking that TAR [Treatment Administration Record] and verifying orders when doing medication rounds. The nurse should be checking oxygen level and getting down to eye level. My expectation is for them to follow orders that is why we put the order there. Review of the facility policy and procedure titled Oxygen Administration reviewed on 1/11/2023, reads, Procedure: 1. Verify that there is a physician's order for this procedure. Review the physician's orders or facility protocol for oxygen administration . 4. Oxygen therapy is administered by way of an oxygen mask, nasal cannula, and/or nasal catheter as is ordered by the physician or required to provide for the needs of the resident. Event ID: Facility ID: 106003 If continuation sheet Page 12 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 observation, interview, and record review, the facility failed to ensure the drugs and biologicals used in the facility were stored and labeled in accordance with currently accepted professional principles in 3 of 5 medication carts and failed to ensure the medications were kept secured. Findings include: 1. During an observation of Medication Cart #1 on [DATE] at 8:55 AM with Staff A, Licensed Practical Nurse (LPN), there were two opened Humulin insulins with no opened or expiration dates, two opened Novolog Insulins with no opened or expiration dates, two Insulin Degludec pens with no opened or expiration dates, one opened Lantus insulin with no opened or expiration dates, two opened Novolog insulins with no opened or expiration dates, two opened bottles of artificial tears with no opened or expiration dates, and one bottle of artificial tears with an expiration date of [DATE] written on the bottle and on the box. There were two medication cups with unlabeled medications, one cup with nine medications and another cup with six medications. During an interview on [DATE] at 9:05 AM, Staff A, LPN, stated, I should not have unlabeled and pre-poured medications on the cart. The eye drops are expired and should be thrown away. All insulins should be labeled. During an observation of Medication Cart #2 on [DATE] at 9:15 AM with Staff B, Registered Nurse (RN), there were one opened Insulin Aspart with no opened or expiration dates and one opened insulin glargine with no opened or expiration dates. There was one cup of medications containing three medications with no label or resident identifier. During an interview on [DATE] at 9:20 AM, Staff B, RN, stated, All insulin should have the date they were opened. I don't know what these medications are. During an observation of Medication Cart #3 on [DATE] at 9:25 AM with Staff C, LPN, there was one medication cup containing nineteen medications with no label or resident identifier. During an interview on [DATE], Staff C, LPN, stated, I should not have pre-poured these medications. The resident was not available. Review of the facility policy and procedure titled Labeling of Medication Containers reviewed on [DATE] reads, Policy Statement: All medications maintained in the facility are properly labeled in accordance with current state and federal guidelines and regulations. Policy Interpretation and Implementation . 3. Labels for individual resident medications include all necessary information, such as . h. The expiration date when applicable. 2. During an observation on [DATE] at 9:16 AM, there was a bottle of Nystatin Topical Powder on top of Resident #27's bedside table. During an interview on [DATE] at 9:17 AM, Resident #27 stated, This [Nystatin Topical Powder] is an antifungal. The nurse will apply the medication under my armpits, under my chin and underneath my (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 13 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 skin folds. Level of Harm - Minimal harm or potential for actual harm Review of the medical records for Resident #27 revealed no physician orders for self-administration of medications. Residents Affected - Some During an observation on [DATE] at 9:40 AM, there was a bottle of Tums on top of Resident #134's left side night table. Review of the medical records for Resident #134 revealed no physician orders for self-administration of medications. During an observation on [DATE] at 10:00 AM, there was a container of Hydrophilic (EQV Eucerin) top cream dated [DATE] in Resident #341's room. During an interview on [DATE] at 9:20 AM, Staff A, License Practical Nurse (LPN), stated, A lot of family members will bring medication for residents that are in rehabilitation and will not let staff know. The medication should not be in [Resident #134's name and Resident #341's name] rooms. 3. During an observation on [DATE] at 9:14 AM, there was a medication cup containing multiple pills on Resident #103's bedside table. During an interview on [DATE] at 9:15 AM, Resident #103 stated, I don't know what these pills are. I don't want to take them because I don't know what they are. Review of the medical records for Resident #103 revealed no physician orders for self-administration of medications. During an interview on [DATE] at 9:30 AM, Staff A, LPN, stated, He [Resident #103] had the pills in his hand. I thought he took them, but he didn't. 4. During an observation on [DATE] at 9:37 AM, Resident #46 was in bed with two whole pills resting on his shirt and one capsule on the floor. During an interview on [DATE] at 9:45 AM, Staff A, LPN, stated, The pills on his shirt are the ones I gave him this morning. I do not know what that capsule is on the floor. That was not in the pills I gave him. He didn't swallow them. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 14 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Based on record review and interview, the facility failed to maintain accurately documented medical records for Residents #338 and 38. Residents Affected - Few Findings include: 1. During an interview on 3/6/2023 at 10:41 AM, Resident #338 stated, I do not use an apron to smoke. Normally, I will go outside whenever I like. For the most part, there is no staff outside, just other residents that smoke. During an observation on 3/7/2023 at 9:40 AM, Resident #338 was sitting in his wheelchair in the smoking designated area. Resident # 338 was smoking independently without wearing a smoking apron. Review of Resident #338's Smoking Evaluation with an effective date of 2/10/2023 reads, 03. Summary of Review: A. Based on resident evaluation, indicate need for assist with smoking: 2. Resident may smoke unsupervised in designated smoking areas. B. Indicate resident need for safe smoking aides: a. Resident must wear smoking apron at all times [not checked]. B. Resident requires use of cigarette holder [not checked]. Review of Resident #338's Smoking Evaluation with an effective date of 3/8/2023 reads, 03. Summary of Review: A. Based on resident evaluation, indicate need for assist with smoking: 2. Resident may smoke unsupervised in designated smoking areas. B. Indicate resident need for safe smoking aides: a. Resident must wear smoking apron at all times [not checked]. B. Resident requires use of cigarette holder [not checked]. Review of Resident #338's care plan initiated on 2/10/2023 reads, Focus: [Resident #338's name] desires to smoke. Resident has been assessed as able to smoke: independently . Interventions: Maintain smoking materials in designated area, provide assistance with lighting cigarette, apply/remove smoking apron. 2. During an observation on 3/6/2023 at 12:37 PM, Resident #38 was sitting in a wheelchair, smoking in designated area with another resident. No staff supervision noted. During an interview on 3/6/2023 at 12:38 PM, Resident #38 stated, I am able to smoke independently with no staff supervision. We are able to come smoke when we choose. During an observation on 3/8/2023 at 1:03 PM, Resident #38 was sitting in a wheelchair, smoking in designated area sitting next to another resident smoking. No staff was supervising the residents. Review of Resident #38 Quarterly Nursing Comprehensive Evaluation dated 12/12/2022 reads, 7. Smoking Evaluation . 03a. Summary of Review: A. Based on resident evaluation, indicate need for assist with smoking: 2. Resident may smoke unsupervised in designated smoking areas. B. Indicate resident need for safe smoking aides: a. Resident must wear smoking apron at all times [not checked]. B. Resident requires use of cigarette holder [not checked]. Review of Resident #38's Smoking Evaluation with an effective date of 3/8/2023 reads, 03. Smoking Evaluation . 03a. Summary of Review: A. Based on resident evaluation, indicate need for assist with (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 15 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 smoking: 2. Resident may smoke unsupervised in designated smoking areas. B. Indicate resident need for safe smoking aides: a. Resident must wear smoking apron at all times [not checked]. B. Resident requires use of cigarette holder [not checked]. Review of Resident #38's care plan initiated on 3/25/2023 reads, [Resident #38's name] desires to smoke. Resident has been assessed as able to smoke: with supervision . Interventions: Accompany resident to designated smoking area and provide supervision, provide assistance with lighting cigarette. During an interview on 3/8/2023 at 1:25 PM, the Director of Nursing (DON) stated, We will have to relook at all smokers and do a full smoking evaluation again to determine accuracy. During an interview on 3/8/2023 at 4:11 PM, the DON stated, The care plans did not correlate with the results of the smoking assessments. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 16 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 Based on observation, interview, and record review, the facility failed to ensure staff performed hand hygiene during medication administration to help prevent the possible development and transmission of communicable diseases and infections. Residents Affected - Some Findings include: 1. During an observation of medication administration for Resident #64 on 3/9/2023 at 5:05 AM, Staff J, Licensed Practical Nurse (LPN), prepared medications without performing hand hygiene, entered the resident's room, assisted the resident in repositioning in bed, administered the medications, exited the room and returned to the medication cart to prepare medications for another resident. During an observation of medication administration for Resident #88 on 3/9/2023 at 5:10 AM, Staff J, LPN, prepared medications without performing hand hygiene. Staff J entered the resident's room, touched the overbed table and siderails, and administered the resident's medications. Staff J exited the room and returned to the medication cart to prepare medications for another resident. During an observation of medication administration for Resident #49 on 3/9/2023 at 5:20 AM, Staff J, LPN, entered the resident's room, obtained the resident's personal accucheck machine, donned gloves without performing hand hygiene, cleansed resident's finger with alcohol, obtained blood sample and accucheck reading. Staff J doffed her gloves, exited the resident's room, and returned to the medication cart to prepare the resident's medications. Staff J entered the resident's room, administered the resident's medications, exited the resident's room and returned to the medication cart to prepare another resident's medications without performing hand hygiene. During an interview on 3/9/2023 at 6:50 AM, Staff J, LPN, stated, Oh, I didn't wash my hands. I should have. I did not wash my hands before or after I put on gloves or took them off. 2. During an observation of medication administration for Resident #31 on 3/9/2023 at 5:34 AM, Staff I, LPN, entered the resident's room, obtained the resident's personal accucheck machine, donned gloves without performing hand hygiene, cleansed the resident's finger with alcohol and obtained blood sample and accucheck reading. Staff I doffed gloves, exited the room without performing hand hygiene, returned to the medication cart and obtained medications. Staff I returned to the resident's room, did not perform hand hygiene, donned gloves and administered medications into Resident #31's gastrostomy tube. Staff I doffed gloves, exited the resident's room and returned to the medication cart to prepare insulin. Staff I unlocked the medication cart, obtained insulin, entered the resident's room and administered the insulin subcutaneously without performing hand hygiene. Staff I removed her gloves, left the room and returned to the medication cart and began to prepare another resident's medication. During an interview on 3/9/2023 at 6:05 AM, Staff I, LPN, stated, I should have washed my hands when I went into the room and when I put gloves on. I don't know why I didn't. I just got nervous I think. Review of the facility policy and procedure titled Medication Administration issued on 4/1/2022 reads, Procedure . 11. Established facility infection control procedures (e.g., handwashing, antiseptic technique, gloves, isolation precautions, etc.) must be followed during the administration of medications. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106003 If continuation sheet Page 17 of 18 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 106003 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/09/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lady Lake Specialty Care Center and Rehab 630 Griffin Avenue Lady Lake, FL 32159 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 - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Review of the facility policy and procedure titled Hand Hygiene issued on 4/1/2022 reads, Policy: This facility considers hand hygiene the primary means to prevent the spread of infections. Procedure . 2. All personnel shall follow the handwashing/hand hygiene procedures to help prevent the spread of infections to other personnel, residents, and visitors . 5. Use an alcohol-based hand rub containing at least 62% alcohol; or, alternatively, soap (antimicrobial or non anti-microbial) and water for the following situations . c. Before preparing or handling medications . e. Before and after handling an invasive device (e.g., urinary catheters, IV access sites) . l. After contact with objects (e.g., medical equipment) in the immediate vicinity of the resident; m. After removing gloves . 6. Hand hygiene is the final step after removing and disposing of personal protective equipment. 7. The use of gloves does not replace hand washing/hand hygiene. Integration of glove use along with routine hand hygiene is recognized as the best practice for preventing healthcare-associated infections. Event ID: Facility ID: 106003 If continuation sheet Page 18 of 18