Inspection·May 12, 2022

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few On 5/10/22 at 1:44 p.m., Registered Nurse Manager, Staff M confirmed Resident #4's fingernails were long with a black /brown substance under some of the fingernails on both hands. Staff M said she would clean and trim Resident #4's fingernails. Review of the Certified Nursing Assistant (CNA) daily charting for February, March and April 2022 showed Resident #4 was scheduled to receive showers every Wednesdays and Saturdays. There was no documentation Resident #4 received her scheduled showers on 2/2/22, 2/9/22, 2/16/22, 2/23/22, 2/26/22, 3/2/22. 3/9/22, 3/16/22, 3/19/22, 3/23/22, 3/26/22, 3/30/22, 4/2/22, 4/6/22, 4/13/22, 4/20/22, 4/27/22. The CNA documentation showed Resident #4 received two bed baths in February, one bed bath in March, and three bed baths in April. The CNA's daily charting for February, March and April lacked documentation Resident #4 received assistance with personal hygiene 41 of 84 scheduled shifts in February 2022, 64 of 93 scheduled shifts in March 2022, and 55 of 90 scheduled shifts in April 2022. On 5/11/22 at 8:45 a.m., in an interview CNA Staff N said she provided care for Resident #4 on 5/10/22 but did not cut or trim her fingernails. She said only the nurse can do that. CNA Staff N confirmed she did not clean Resident #4 fingernails. On 5/11/22 at 9:49 a.m., in an interview Licensed Practical Nurse Staff O said looking at the CNA documentation for February and April 2022, she was not able to verify if Resident #4 received showers or personal hygiene on the days that were not documented by the CNA. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 2 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of the clinical record, resident and staff interviews, the facility failed to provide the necessary care and services to maintain ambulation status for 1(Resident #16) of 1 resident reviewed with a restorative ambulation program. Review of Resident #16's clinical record showed an admission date of 9/4/21. The Quarterly Minimum Data Set (MDS) assessment dated [DATE] documented Resident #16 required limited physical assistance of one person for transfers, walking in room and corridor. The Certified Nursing Assistant [NAME] (form used to communicate resident's care needs) documented Resident #16 required assistance with ambulation. A fall risk evaluation dated 3/8/22 documented Resident #16 scored an 11 indicating a high risk for falls. On 5/9/22 at 2:41 p.m., Resident #16 said she was supposed to receive restorative nursing (program to promote improvement in function and minimize deterioration) but said I only get it one day a week if someone is here. The aides and nurses say they can't ambulate me with the four wheeled seated walker. Resident #16 reported generalized weakness. The resident said, I'm not supposed to walk by myself outside of the room, but they don't have the time to walk me, I understand they are busy. I am trying to get stronger. I am a former Registered Nurse and I know therapy is important. Once you reach your goal you want to maintain and not slip back. Resident #16 said, I would like to have someone ambulate me more frequently, at least from my room to the dining area, but they say it is better if I use the wheelchair. A review of the Restorative Nursing Program referral for Resident #16 dated 12/8/21 and signed by the therapist, and the restorative aide on 2/16/22 documented Resident #16 was referred to the program for ambulation with a goal to maintain/improve current level of function. The referral documented, Pt [Patient] is at risk for decline and increased level of care. The listed interventions were for gait as tolerated or 50 feet using a four-wheel walker and wheelchair to follow with three liters of oxygen. Rest as needed, assist with the oxygen tubing. The frequency of the ambulation program was three times a week. Review of the Certified Nursing Assistant (CNA) documentation for March 2022, and April 2022 failed to show documentation Resident #16 received the restorative ambulation on scheduled days, nine times in March, and seven times in April. On 3/2/22, 3/4/22, 3/7/22, 3/11/22, 3/16/22, 3/21/22, 3/23/22, 3/25/22, 4/6/22, 4/13/22, and 4/20/22 NA [Not applicable] was entered. On 3/18/22, 4/8/22, 4/11/22, 4/15/22 and 4/29/22, the form was left blank, making it impossible to determine if the resident received the restorative program. On 3/28/22, 3/30/22, 4/4/22 and 4/18/22 the form noted Resident #16 refused to participate in the restorative program. On 5/11/22 at 8:37 a.m., the Director of Rehab (DOR) said the facility had one restorative aide, and she was often pulled to work on the floor providing patient care. The DOR said no one was available to do the restorative programs when the Restorative CNA was pulled from her assignment. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 3 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete On 5/11/22 at 9:32 a.m., the Assistant Director of Nursing (ADON) said she was responsible for the Restorative program. She said the facility was experiencing staffing issues and often has to pull the restorative CNA to the floor to help. On 5/11/22 at 11:56 a.m., the Restorative CNA said she was the only restorative aide for the facility. The CNA said Resident #16 was on a restorative ambulation program to be done three times a week. The CNA said she was often pulled to work the floor to provide resident care and then no one was available to do the restorative program. Event ID: Facility ID: 106098 If continuation sheet Page 4 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, clinical record review, review of facility policies and procedure, resident and staff interviews, the facility failed to provide the necessary care and services to maintain continence for 2 (Resident #16 and #75) of 2 residents reviewed for incontinence. The findings included: The facility policy titled Restorative Nursing - Bowel and Bladder Program (undated) specified residents who have had any episodes of incontinence will be assessed for the need of a bowel and bladder program upon admission, quarterly, upon removal of an indwelling catheter, or with a significant change. The procedure noted, To begin the evaluation of the resident's bowel and bladder function. The Restorative Nurse/designee will: Complete the first 3 sections of the Bowel and Bladder Evaluation. If the resident is to proceed to the 3-Day Bowel & [and] Bladder Patterning Diary, instruct the CNAs that a 3-Day bowel and bladder patterning diary has been implemented. Instruct the CNAs to cue and assist the resident to toilet and to check the resident for episodes of incontinence and mark the diary as indicated. On day 4 when the diary is completed, the Restorative nurse or designee will review the 3-day patterning. The nurse will check for patterns of continence and incontinence to determine if a resident is eligible for retraining, prompted voiding, scheduled toileting, or placed in the incontinent care (check and change program). 1. A review of Resident #16's clinical record showed an admission Minimum Data Set (MDS) assessment dated [DATE] and a Quarterly MDS assessment dated [DATE], which documented Resident #16 required limited physical assistance of one for transfers, ambulation, toileting, and personal hygiene. The MDS documented Resident #16 was frequently incontinent of bowel and occasionally incontinent of bladder. The assessment documented a toileting program was not currently being used to manage the resident's bowel continence. The clinical record lacked documentation of a bowel and bladder patterning and evaluation to address the specific incontinence needs of Resident #16. The care plan initiated on 9/3/21 and revised on 10/6/21 noted Resident #16 required assistance of one person for transfer and toilet use, had functional incontinence (Incontinence occurs when an individual has difficulty getting to the toilet on time) due to having decreased mobility with weakness. The goal was for the resident to remain free from skin breakdown due to incontinence and brief use. The interventions included to offer and assist with toileting. Check for incontinence, wash, rinse, and dry perineum. Clean peri-area with each incontinence episode. On 5/9/22 at 2:24 p.m., Resident #16 said she was not able to get up on her own and required assistance to go to the bathroom. Resident #16 said sometimes she is incontinent because the staff do not come when she needs to be toileted, and she has to wait for staff to assist her on the toilet. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 5 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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 0690 Level of Harm - Minimal harm or potential for actual harm Review of the Certified Nursing Assistant (CNA) documentation for March and April 2022 failed to show Resident #16 received assistance with toileting on the night shift (10:00 p.m. to 6:00 a.m.) on 3/3/33 through 3/6/22, 3/9/22 through 3/12/22, 3/14/22, 3/16/22, 3/17/22, 3/19/22, 3/23/22, 3/26/22, 3/29/22 through 3/31/22, 4/1/22 through 4/7/22, 4/9/22 through 4/13/22, 4/15/22 through 4/21/22, 4/23/22, 4/24/22, 4/26/22 through 4/28/22 and 4/30/22. Residents Affected - Few There was no documentation Resident #16 received assistance with toileting during the day shift (6:00 a.m. to 2:00 p.m.) on 3/24/22, 3/30/22, 4/7/22, 4/14/22, 4/17/22, 4/24/22 and 4/29/22. There was no documentation Resident #16 received assistance with toileting during the evening shift on 3/5/22, 3/6/22, 3/17/22, 4/7/22, 4/14/22, 4/17/22, 4/24/22 and 4/29/22. On 5/11/22 at 3:00 p.m., in an interview Registered Nurse (RN) Staff M confirmed Resident #16 was not on a bowel and bladder program. On 5/12/22 at 9:41 a.m., CNA Staff K said she was assigned to Resident #16 and knew her care needs. CNA Staff K said Resident #16 used a walker and sometimes needed help since she was incontinent of loose stool. 2. A review of Resident #75's clinical record showed an admission date of 4/18/22. The admission MDS assessment dated [DATE] documented Resident #75 was frequently incontinent of bladder and always incontinent of bowel. Resident #75 required extensive assist of one for bed mobility, toileting, and dressing. The MDS assessment also noted Resident #75 was not on a bowel and bladder program to maintain or restore continence. On 5/9/22 at 11:39 a.m., Resident #75 said when she needs to be toileted no one comes and if she wets herself, she will wait for someone to change her. Resident #75 said the prior week she had to call her spouse in the middle of the night to come to the facility and change her because no one would answer the call light. On 5/10/22 at 8:51 a.m., Resident #75 said when she puts her call light on for toileting assistance the staff tell her, It's not my job or I can't help you because it will hurt my back. On 5/10/22 at 2:03 p.m., Resident #75's spouse said his wife had called him in the middle of the night to come and help her because she had her light on and no one would answer it. The resident's spouse said, I have her on speaker phone and as I'm driving there, I can hear the call light on for 20 minutes and I hear someone in the room with her arguing with her and telling her we can't hurt our backs with you, you are not wet. He said by the time he got there the staff were leaving the room and had changed her. A review of the CNA documentation from 4/18/22 through 4/30/22 showed no documentation staff assistance for personal hygiene was provided to Resident #75 for 25 CNA scheduled shifts. The CNA documentation showed no documentation Resident #75 was assisted to use the toilet on 23 CNA scheduled shifts. On 5/11/22 at 10:33 a.m., Registered Nurse (RN) Staff P said Resident #75 required the assistance of two persons with incontinent care and toileting. RN Staff P said the CNAs get information on the care needs of the resident from the CNA [NAME] (form used to communicate resident's care needs) and documents in the CNA electronic records. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 6 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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 0690 Level of Harm - Minimal harm or potential for actual harm On 5/11/22 at 2:57 p.m., RN Staff M reviewed Resident #75's CNA documentation for April and confirmed there was missing documentation of care. RN Staff M said she would not be able to say if Resident #75 received toileting and hygiene assistance since it was not documented. RN Staff M said, I believe she received the care because she would not be able to go for an extended period without toileting or receiving incontinent care. Residents Affected - Few On 5/11/22 at 3:26 p.m., the Director of Nursing confirmed a lack of CNA documentation for Resident #75's toileting and personal hygiene and said without the documentation there was no way to know if Resident #75 had received the toileting and personal hygiene care. On 5/12/22 at 10:45 a.m., CNA Staff Q said Resident #75 required physical assistance of two with incontinent care and toileting. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 7 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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 0726 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Based on personnel file review, resident medical record and staff interview, the facility failed to ensure 2 (Licensed Practical Nurses (LPN) E, and F) of 7 Licensed Practical Nurses, who are assigned to the medication carts, had the required Certification to administer Intravenous Medication. The findings included: Record review of the Medication Administration Record (MAR) for May 2022 for Resident #437 revealed LPN Staff E administered the antibiotics Vancomycin and Rocephin on 5/7/22 and 5/8/22 via the intravenous route. Record review of the MAR for May 2022 for Resident #62 revealed LPN Staff F administered the antibiotic Cefazoline on 5/1/22, 5/5/22 and 5/6/22 via the intravenous route. On 5/10/22 review of the personnel files revealed an annual task competency completed respectively on 2/6/21 and 2/12/21 for Staff E and F, including infusing IV (intravenous) medications. The files lacked documentation Staff E and Staff F had completed the required Intravenous certification for LPNs. On 5/10/22 at 4:25 p.m., in an interview, the facility Regional Clinical Consultant confirmed the lack of Intravenous certification for LPN Staff E and Staff F. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 8 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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 0760 Ensure that residents are free from significant medication errors. Level of Harm - Minimal harm or potential for actual harm Based on record review and staff interview, the facility failed to ensure 1 resident (resident #83) of 5 sampled residents for drug regimen review was free from a significant medication error. Residents Affected - Few The findings included: The Policy for Medication Dispensing System provided by the Director of Nursing states: Verify that the Medication Administration Record reflects the most recent medication order . Follow appropriate medication administration guidelines . Document necessary medication administration/treatment information (e.g., medications are administered, medication injection site, refused medications and reason, prn medication, etc.) on appropriate forms. Record review of Resident #83's clinical record revealed a physician's order to administer Metoprolol Tartrate (Blood pressure medication) 25 milligrams via feeding tube twice a day. The order specified to hold the Metoprolol if the systolic (top number) blood pressure was below 110. Review of the Medication Administration Record for May 2022 showed on 5/11/22 at 8:00 a.m., the nurse documented administering the Metoprolol. The systolic blood pressure documented was 97. On 5/11/22 at 2:16 p.m., Licensed Practical Nurse (LPN) Staff O verified she administered the Metoprolol as documented on the Medication Administration Record despite the documented systolic blood pressure of 97. On 5/12/22 at 10:03 a.m., the Director of Nursing said if a medication like Metoprolol is administered outside of the physician's specified parameters, they would notify the physician, monitor the blood pressure for signs and symptoms of adverse effects of the medication, and it would be a medication error. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 9 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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, record review and staff interview, the facility failed to ensure medications remained locked and inaccessible to unauthorized personnel when out of sight on 3 (Independence Place, Liberty Lane, Bounce Back Lane) of 4 units. The facility failed to discard expired medication in 1 (Bounce Back Lane) of 4 medication carts reviewed, and failed to ensure safe storage of medications at the bedside for 2 (Resident #24 and #44) of 2 residents observed with unsecured medications at the bedside. The findings included: The facility's Medication Storage Policy provided by the Director of Nursing (DON) noted Medications will be stored in a manner that maintains the integrity of the product and ensures the safety of the residents and is in accordance with Florida Department of Health guidelines. With the exception of Emergency Drug Kits, all medications will be stored in a locked cabinet, cart or medication room that is accessible only to authorized personnel, as defined by the facility's policy. Expired, discontinued and/or contaminated medications will be removed from the medication storage areas and disposed of in accordance with the facility policy. The Medication Dispensing System Policy provided by the Director of Nursing (DON) Medications, biologicals, or chemicals of any kind are never to be left unattended on top of medication cart. The Policy also noted Medication carts are always to be locked when out of sight or unattended. On 5/10/22 at 9:30 a.m., a Medication Cart at the nurse's station on Independence Place on the second floor was observed unlocked, unattended, and unsecured. Licensed Practical Nurse (LPN) Staff O approached the cart, retrieved some medications and walked into Resident #44's room, and closed the resident's door. The medication cart remained unlocked. LPN Staff O returned shortly to the cart without any medications. On 5/10/22 at approximately 9:35 a.m., a cup of pills was observed on Resident #44's bed. The Resident said the nurse had just handed her the cup of pills and left the room. Resident #44 said she had to wait and take the medications with food at lunch time. She said she usually took the medications with breakfast, but the nurse was late administering her medications. On 5/10/22 at 9:40 a.m., LPN Staff O said it was her first day working at the facility and she had the whole floor. She verified she left the cup of medications with Resident #44 because the resident was with it and could administer her own medications. She said they were just vitamins anyway. LPN Staff O said she did not know if Resident #44 was assessed to safely self-administer medications. She said, That's just the way we do it here. On 5/10/22 at 10:10 a.m., a review of Resident #44's Medication Administration Record showed the following medications were signed off as administered on 5/10/22 at 9:40 a.m.: Acetaminophen, Aspirin, Calcium Carbonate - Vitamin D3, Poly Iron, Vitamin C, Zinc, and Risperidone. On 5/11/22 at 8:45 a.m., a Medication Cart on Independence Place on the second floor, was observed (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 10 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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 unlocked, and unsupervised. The cart was not within direct observation of authorized staff. No staff was observed in the vicinity of the cart. On 5/11/22 at 2:06 p.m., LPN Staff O said she was aware she left the medication cart unlocked and unattended. She said she was busy. Residents Affected - Some On 5/11/22 at 9:07 a.m., a medication cart on Liberty Lane on the second floor was observed unattended in the dining room area. A clear plastic medicine cup with a mixture of crushed pills in applesauce was on the medication cart. LPN Staff B was observed approaching the cart. She verified the unattended medicine cup on the cart contained crushed medications mixed in apple sauce. LPN Staff B verified medications should not be left unattended and said she forgot to discard the medications. On 5/11/22 at 1:48 p.m., a Treatment Cart in Bounce Back Lane on the first floor was observed unlocked, and unattended. LPN Staff B emerged from a patient's room, moved the cart, and locked it. On 5/11/22 at 1:50 p.m., observation of the medication cart on Bounce Back Lane on the first floor with LPN Staff B showed a Humalog Kwik Pen (insulin pen) with a date opened of 4/7/22. LPN Staff B said once opened the Humalog's expiration date was either 28 or 30 days. LPN Staff B removed the Humalog pen from the cart. Review of the manufacturer's specification for Humalog kwik pen showed the pen must be used within 28 days or discarded, even if it still contains Humalog. On 5/12/22 at 10:03 a.m., the Director of Nursing said no medication should ever be left unattended on top of the medication cart, the medication carts should always be locked and never left unattended. The Director of Nursing said insulin should be disposed of after 28 to 30 days after the date opened. On 5/9/22 at 12:15 p.m., a bottle each of Super B complex vitamins, Vitamin D3, Tylenol 650 milligrams (mg), calcium 600 mg with Vitamin D and mega-reg (omega-3 [NAME] oil) were observed in an opened drawer of the night table of Resident #24. The resident said she has had the medications since her admission to the facility on 3/5/22 and took them daily. On 5/9/22 at 12:23 p.m., Registered Nurse (RN), Staff I said she had no idea Resident #24 kept medications at the bedside. On 5/9/22 at 12:35 p.m., Certified Nursing Assistant (CNA) Staff H said the medications have been in Resident #24's unlocked drawer for a while now. On 5/11/22 at 9:01 a.m., CNA Staff J said she knew residents were not to keep medications, ointments in their rooms since this unit was the dementia unit. She said other residents may wander and have access to those medications. On 5/11/22 at 12:55 p.m., the Director of Nursing confirmed the medications should be secured and kept with a nurse. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 11 of 12 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 106098 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hawthorne Center for Rehab & Healing of Sarasota 5381 Desoto Road Sarasota, FL 34235 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 0908 Keep all essential equipment working safely. Level of Harm - Minimal harm or potential for actual harm Based on record review and interviews, the facility failed to ensure nebulizer machines used for residents are maintained under safe operating conditions according with the manufacturer's recommendations. Residents Affected - Some The findings included: The compressor nebulizer (Machines that create a mist out of liquid medication for easier absorption into the lungs) manufacturer's manual for the nebulizers used at the facility noted, Filter change: . Do not wash or clean the filter. Only use filters supplied by your distributor. And do not operate without a filter. Change the filter every 30 days or when the filter turns gray . On 5/10/22 at 10:37 a. m., the housekeeping supervisor said the housekeepers were responsible to clean nebulizers The housekeeper assigned to the soiled utility room sprays the soiled nebulizer with a disinfecting solution, ensuring it stays wet for 10 minutes. The housekeeper takes the filter out and washes it. The housekeeping supervisor said they did not change the filters, they just washed it. She said the facility did not have a policy or a process for disinfecting nebulizers. The Director of Nursing and the Maintenance supervisor were present during the interview. On 5/10/22, at 12:20 p.m., the Director of Nursing said the facility had a total of 25 Nebulizers, 15 were in storage, and 10 were currently being used by residents. He said he heard about the housekeepers washing the nebulizer filters. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106098 If continuation sheet Page 12 of 12