Inspection·April 4, 2025

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some cognitively intact. The assessment noted no mood symptoms but did report verbal and behavioral symptoms. On 03/31/25, at 11:29 AM, during an interview with Resident #55, he expressed that staff sometimes do not speak English while providing care, which he found rude. He wished he could understand what they were saying. 5) The clinical record for Resident #83 indicated admission to the facility on [DATE], with diagnoses including anxiety and depression. The admission assessment, reference date 02/08/25, recorded a brief interview with a mental status score of 12, indicating that Resident #83 was cognitively intact. The assessment did not note any mood or behavioral symptoms. On 03/31/25, at 11:41 AM, during an interview with Resident #83, she stated the staff has a nasty attitude. They argue while caring for her and do not work together. 6) The clinical record revealed that Resident #250 was admitted to the facility on [DATE] with diagnoses including medically complex conditions. The admission assessment, reference date 03/28/25, recorded a brief interview for a mental status score of 15, which indicated Resident #250 was cognitively intact. This assessment recorded no mood or behavior concerns. This comprehensive assessment recorded under section GG for functional abilities and goals that Resident #250 required partial/moderate assistance with toileting hygiene, upper body dressing, rolling left and right, lying to sitting on the side of the bed, sit to stand, chair/bed-to-chair transfer, and toilet transfer. She required substantial/maximal assistance with showering/bathing, dressing her lower body, and putting on/taking off footwear. She needed supervision or assistance with personal hygiene. The care plan initiated on 03/26/25 indicated Resident #250 had an ADL self-care deficit related to ADL needs and participation varying, fatigue, and chronic medical conditions. Interventions included encouraging and assisting with all ADL tasks as indicated and tolerated by the resident, including locomotion/ambulation, bathing, bed mobility, transfers, toileting tasks, meals, and personal/oral hygiene. On 03/31/25 at 11:55 AM, during an interview with Resident #250, she revealed the aides don't usually show up when she calls, and when they finally do come, they have an attitude. She explained that last week, she needed a diaper change with all the diuretics she had taken, makes her pee a lot. She called an aide to change her and the aide said, I did it an hour ago. She said, I know, but I want to be changed again. The aide said, Well, I don't want to right now. She filed a complaint with the facility. They did not talk to her about the resolution. Resident #250 explained that this morning (on 03/31/25), an aide came in; she asked for a diaper change, the aide said, I am the only one here right now; I will try to get to you sometime later, and left the room without changing her. She finally got up and went to the bathroom by herself. 7) The clinical record revealed that Resident #23 was admitted to the facility on [DATE] with diagnosis including respiratory failure. The annual comprehensive assessment, reference date 12/18/24, recorded a brief interview for a mental status score of 15, which indicated Resident #23 was cognitively intact. This assessment recorded no mood or behavior concerns. This comprehensive assessment was recorded under the section GG for functional abilities and goals. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 2 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Resident #23 required substantial/maximal assistance with toileting hygiene, showering/bathing, lower body dressing, putting on/taking off footwear, and chair/bed-to-chair transfer. She required partial/moderate assistance with upper body dressing and sitting to stand. She needed supervision or touching assistance to roll left and right and sitting on the side of the bed. The care plan revised on 12/24/24 indicated Resident #23 had an ADL self-care deficit related to chronic medical conditions, extensive assistance in more than five areas of ADLs. Interventions included encourage and assist with all ADL tasks as indicated and tolerated by the resident, including locomotion/ambulation, bathing, bed mobility, transfers, toileting tasks, meals, and personal hygiene. On 03/31/25 at 12:04 PM, an interview was conducted with Resident #23. She stated this is a pretty place, but the care is no good; the staff doesn't care about the residents. She explained there was no hot water in her bathroom. One time, during care, a certified nursing assistant (CNA) poured cold water on her; it took her breath away; she was shocked, and she stopped breathing for a few seconds. At 12:20 PM, the surveyor checked the water temperature of the shower and sink. The surveyor let the water run until 12:23 PM (about 3 minutes); the surveyor placed her hand under the running water; there was no hot water. On 04/01/25, at 11:46 AM, the surveyor turned on the water and let it run until 11:49 AM; the water was cold. On 04/04/25, the Director of Nursing was interviewed from 11:55 AM to 12:14 PM, with a follow-up discussion at 2:00 PM. During these sessions, the Director was made aware of the concerns residents and their families raised. Each problem was articulated to her. On 04/04/25 at 2:11 PM, an interview was conducted with Staff E, a nurse. During the discussion, Staff E expressed concerns regarding instances in which staff members communicated in a foreign language in the presence of residents. She noted that this practice occasionally makes her uncomfortable, leading her to believe the conversation may be about her. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 3 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 11) Review of the record revealed Resident #27 was admitted to the facility on [DATE]. Review of the current Minimum Data Set (MDS) assessment dated [DATE] documented the resident had a Brief Interview for Mental Status (BIMS) score of 14, on a 0 to 15 scale, indicating the resident was cognitively intact. During an interview and observation 03/31/25 at 10:51 AM, when asked if there was an issue with the provision of hot water, Resident #27 stated, They haven't had hot water for about a month. Have you ever taken a cold shower? It's not fun! The surveyor ran the hot water faucet in the resident's bathroom sink, which was located next to the shower, for several minutes, and the water did not get warm. 12) Review of the record revealed Resident #29 was admitted to the facility on [DATE]. Review of the current MDS assessment dated [DATE] documented the resident had a BIMS score of 15, on a scale of 0 to 15, indicating the resident was cognitively intact. During an interview on 03/31/25 at 11:28 AM, when asked if there was any problem with the provision of hot water, Resident #29 stated, There is no hot water. It has been an issue for at least two months. The resident then volunteered, about two or three weeks ago a nurse came in and told me, good news they are coming to fix the hot water, but it didn't get fixed. Resident #29 confirmed direct care staff knew about the cold water as the aides would comment about it during care. During an interview on 04/02/25 at 6:06 PM, when asked about any problems with hot water, Staff J, Certified Nursing Assistant (CNA) stated, They fixed it today. When asked if there were issues previously, the CNA would not respond directly, but kept saying, they fixed it. When told a resident had said there had been no hot water for a month or two, the CNA stated, No, maybe two weeks. During an interview on 04/02/25 at 6:09 PM, when asked if there had been any problems with the hot water, Staff K, Licensed Practical Nurse (LPN) stated, They were here today and fixed it. When asked if it had been a problem in the past, the LPN would not say. When told residents were saying there have been problems for a month or two, the LPN stated, I heard it happened before, and they fixed it. I really don't have any more information than that. Based on observations, record reviews and interviews the facility failed to follow their policy for loss of hot water and ensure sufficient hot water was available to the residents in their rooms and showers for 8 of 34 sampled residents (Residents #29, #27, #13, #301, #302, #303, #68, #23). The findings included: 1) Review of a policy titled, Water Temperatures Safety Checks documented that the facility will make every effort to provide water tempeatures between 105 and 115 degrees Fahrenheit. Water temperatures are checked every morning at different locations in the facility and documented. There is no date or policy number for this policy. Review of a policy titled, Loss of Hot Water revised 01/25 documented the facility is committed to maintaining a safe and comfortable environment for all residents. In the event of a hot water loss, prompt actions will be taken to ensure resident needs are met ad compliance with Florida regulations (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 4 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0584 is maintained. Level of Harm - Minimal harm or potential for actual harm Procedure: Residents Affected - Some 1. Immediate response; Assessment: Upon discovering a loss of hot water, the maintenance supervisor will assess the cause and estimated time for repair. 2. Personal Hygiene: Use alternative methods such as pre-warmed water from external sources or no-rinse bathing products to maintain hygiene. 3. Regulatory Compliance: Water temperature are maintained between 105 to 115 degrees F. 4. Residents and families: Provide timely updates regarding the situation and expected resolution. 5. Maintain detailed records of the outage, actions taken and communications made. 2) On 04/01/25 at 8:50 AM the surveyor randomly began checking water temperatures from the faucet using a dial stem thermometer' (after the thermometer was calibrated). The following rooms had temperatures that were below 105 degrees. room [ROOM NUMBER]- 80 degrees room [ROOM NUMBER]- 80 degrees room [ROOM NUMBER]- 80 degrees room [ROOM NUMBER]- 90 degrees room [ROOM NUMBER]- 80 degrees room [ROOM NUMBER] 90 degrees The Administrator showed the surveyor several texts regarding the hot water issue. One text was dated 02/25/25, which said, FYI we are still having issues, no hot water on the 3rd floor. Another text dated 03/20/25, from the Maintenance Director, said we have hot water issues here in the SNF (Skilled Nursing Facility). Unit 127-138. It takes a long time for the water to get hot. We had to run the water for 45 minutes in each room to get hot water. The administrator also gave the surveyor several texts wanting to know why they are getting complaints of no hot water. Review of an email dated 01/30/25 from previous Maintenance Director stated, the circulation pump that pushes hot water to the west side of the third floor is down. I called Roto Rooter which came out, the tech called a few parts shop but they do not have in storage, will have to call a few plumbing companies to see if they have in stock. On 01/31/25, The circulation pump on the third floor is being worked on. Ordering pump today and will be repaired as soon as it arrives. A review of a Resident Council grievance on 01/30/25 documented that a resident on the third floor complained that there was no hot water for days. Under resolution, dated 02/10/25, it documented that a pump was replaced. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 5 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 3) Review of Resident #302's medical records revealed resident was admitted on [DATE]. He has diagnoses to include Visual Loss, Hypertension, Type II Diabetes Mellitus, Delirium, COPD (Chronic Obstructive Pulmonary Disease). His BIMS score was not completed since he was a new admission, but the resident was alert, oriented and able to answer all questions by the surveyor. During an interview on 03/31/25 at 1:15 PM, Resident #302 stated that the water is cold, he can't take a shower or shave. The surveyor felt water and it was cold, ran it for several minutes and it did not get warm. 4) Review of Resident #301's medical records revealed that the resident was admitted [DATE] and was discharged [DATE]. Resident stated that the water is cold in her room and she can't shower or wash up. 5) Review of Resident #68's medical records revealed that the resident was admitted to the facility on [DATE] with diagnoses to include Multiple Sclerosis, Essential Hypertension, Spondylolosthesis, Fusion of the Spine-Lumbar Region, Major Depressive Disorder and Anxiety. During an observation and an interview with Resident #68 on 04/01/25 at 9:20 AM, the surveyor went into resident's room and observed the water running with no one near the faucet. The resident stated she didn't do it, the CNA (Certified Nursing Assistant) did it. She is waiting for the CNA to change her. Staff P, CNA came in and stated she turned the water on, she has to let it run for 15-45 minutes until it gets warm. She thinks they told her it was a water pump that was bad. 6) Review of Resident #303's records revealed that Resident #303 was admitted to the facility on [DATE] and discharged [DATE]. The resident had diagnoses to include Type II Diabetes Mellitus, Hypertension, and Dysphagia and Aphasia Following a Cerebral Infarction. During an interview on 04/04/25 at 12:50 PM with Staff H, CNA she was asked if she had taken care of Resident #303 before. She stated yes. She was then asked if this resident ever had any complaints and she said yes, he complained the water was not hot. The surveyor asked what did she do. She stated she had notified the Maintenance Director. 7) On 03/31/25 at 12:04 PM Resident # 23 voiced her concerns to a surveyor. She stated she has no hot water. The staff poured cold water on her during care, it took her breath away, she was shocked. She hasn't been able to take a shower due to the lack of hot water. At 12:20 PM the surveyor proceeded to check the water (shower and sink) and let the water run until 12:23 PM, and there was no hot water. 8) During an interview on 04/02/25 at 10:17 AM with Resident#3, who had a BIMS of 15, she stated that there is no hot water, you can't take a shower, and she was not sure how long it has been out. 9) During a telephone interview on 04/03/25 at 10:08 AM with the owner of Plumbing Company he stated a supervisor had been onsite as well as a few of their plumbers to service and inspect the nursing home facility. He stated that the facility does have hot water but it is taking too long to reach their rooms. We found a few check valves for cold water supply not functioning. The problem is the disproportion of cold water getting into the water supply piping. I don't remember replacing a circulation pump. The first service we did was changing the check valves. We are still replacing them. We have replaced 4 check valves and the mixing valve needs to be replaced. I have only been on this project since the middle of February. I wasn't doing this in January. A month ago we did check valves at (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 6 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some the ALF( Assisted Living) but this week we have been doing checks valves at the SNF. Did 4 checks valves at SNF waiting on mixing valves to come in. The check valves were faulty and the cold water was over powering the hot water to come through. 10) During an interview on 04/04/25 at 10:27 AM with the Maintenance Director he stated that this is the first week that the plumbing company has been here. I've been here for 3 weeks and the second day I found out that there was an issue with water but on the ALF side. On the SNF side it was this past Saturday 03/30/25 that hot water was not up to correct temperatures. Randomly I do weekly temps in different rooms on each floor. It depends maybe 4-5 on each floor, depends on time of day and if I don't get pulled away. I document that. I get a weekly task and monthly task. Not sure why the higher number rooms are having an issue. The surveyor asked about the text that he sent on 03/20/25 but he had no response. The surveyor reviewed the employee roster and showed that the Maintenance Director's hire date was 02/11/25. 13) A record review revealed that Resident #13 was admitted on [DATE] with diagnoses that included Cerebrovascular Accident, Hemiplegia or Hemiparesis. The brief interview of mental status score per the minimum data set completed on 01/14/25 was 14. This indicated that Resident #13 was cognitively intact. During an interview on 03/31/25 at 03:37 PM, Resident #13 complained about no hot water. He said he needed hot water to shower and to shave. When asked for how long this problem had occurred, Resident #13 said it felt like there hasn't been hot water for a year. During an observation on 03/31/25 at 03:40 PM, the surveyor turned on the hot water and let the water run for approximately three minutes. The water felt a little warm and then it felt cool. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 7 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. 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 care and services for 5 of 34 sampled residents, as evidenced by the failure to implement the bowel program for Resident #44, failure to follow blood pressure parameters for Resident #10 and #23, failure to ensure the provision of a urology appointment for Resident #62, and failure to notify the physician of blood sugar levels as per physician order for Resident #303. Residents Affected - Few The findings included: 1) Review of the record revealed Resident #44 was admitted to the facility on [DATE]. Review of the current Minimum Data Set (MDS) assessment dated [DATE] documented the resident had a Brief Interview for Mental Status (BIMS) score of 13, on a 0 to 15 scale, indicating the resident was cognitively intact. Review of the current care plan initiated on 08/26/24 revealed Resident #44 was at risk for bowel irregularity related to decreased mobility, and potential side effects of medications. The documented goal was that the resident would have a bowel movement at least once every three days. One of the interventions was to administer the medications as per physician orders. Review of the current physician orders revealed Resident #44 was on two routine medications daily for constipation. The resident also had three orders for medications as needed, to include Milk of Magnesium for Constipation Bowel Protocol, a Bisacodyl (a laxative) suppository as needed for constipation, and a Fleet Enema to be administered if no bowel movement in 5 days. Review of the documented bowel management in the resident's record, along with the corresponding Medication Administration Records (MARs) for Resident #44 revealed the following: On 02/10/25 on the day shift (7 AM to 7 PM) through 02/14/25 on the day shift, a total of 4 1/2 days, the record lacked any documented bowel movement or the administration of any as needed medication for constipation. On 02/22/25 on the night shift (7 PM to 7 AM) through 02/25/25 on the night shift, a total of 3 1/2 days, the record lacked any documented bowel movement or the administration of any as needed medication for constipation. On 03/16/25 on the night shift through 03/19/25 on the day shift, a total of 3 days, the record lacked any documented bowel movement or the administration of any as needed medication for constipation. During an interview on 04/01/25 at 10:34 AM, Resident #44 stated she gets constipation and had an issue with it every month. The resident stated the pain she gets when constipated was horrible. Resident #44 confirmed she was taking something every day, but did not think it was enough. When asked if she gets anything as needed or upon her request, the resident stated once in a while she gets Milk of Magnesia. During an interview on 04/04/25 at 12:37 PM, when asked to explain the Bowel Protocol, Staff L, Licensed Practical Nurse (LPN), explained that the electronic dashboard would notify the nurse when a (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 8 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0684 Level of Harm - Minimal harm or potential for actual harm resident does not have a bowel movement in three days. The LPN stated when notified, she would confirm the lack of a bowel movement with the resident and or staff. The LPN explained that when she is notified, she would provide the as needed dose of Milk of Magnesium to the resident listed on the dashboard. When asked specifically about Resident #44, the LPN agreed the resident had an issue with constipation. During a side-by-side review of the record at this time, the LPN agreed with the findings. Residents Affected - Few 2) Review of the record revealed Resident #10 was admitted to the facility on [DATE]. Review of the current orders revealed the order initiated on 09/30/24 for the blood pressure medication Metoprolol 25 milligrams, to give two tablets twice daily. This order further documented the physician ordered parameters that the resident was not to receive the medication if his systolic blood pressure (SBP/upper number) was less than 110 or his heart rate was less than 60. Review of the December 2024 Medication Administration Record (MAR) documented the Metoprolol was administered to Resident #10 on 12/06/24 at 9 AM with a heart rate of 54. During a side-by-side review of the record and interview on 04/04/25 at 12:22 PM, Staff L, LPN, agreed with the findings and stated the medication should have been held. 4) Review of Resident #62 records revealed that Resident #62 was admitted to the facility on [DATE]. He has diagnoses to include Chronic Kidney Disease, Acute Kidney Failure, Malignant Neoplasm of Prostate, Retention of Urine, Obstructive and Reflux Uropathy. A review of the physician's orders revealed that the resident has an indwelling urinary catheter. A review of a physician's progress note dated 04/02/25 documents that he palpable hardened mass to right side of scrotum. Another progress note dated 02/19/25 patient seen today in bed prior to going to Urology appointment. Earlier this week he complained of pain and swelling to scrotum. Palpable hardened mass noted to right side of scrotum along with scrotal swelling. Patient report that pain has improved. He also continues to have penile discharge. Spoke with him about ensuring these issues are addressed with Urology today. He returned with an order for a scrotal ultrasound scheduled for 03/31/2025. at 11:00 AM. Surveyor reviewed the Physician's order and did see an order for a Urology appointment on 03/31/2025 at 11:00 AM. During an interview on 03/31/25 at 10:30 AM, Resident #62 stated to the surveyor that he was upset, he is waiting to be picked up to go to the Urologist at 11:00 AM for a test. He said he mentioned it to the nurse, but she said he did not have one and no one appeared to be taking him. During an interview on 03/31/25 at 10:45 AM, with Staff M, RN she was asked about a medical appointment today 03/31/25 at 11:00 AM She stated, he is confused, I don't see an appointment. During an interview on 04/02/2025 at 8:58 AM with Staff M, RN, she was asked again about Resident #62's Urology appointment that was scheduled for Monday 03/31/25. She stated she wasn't aware he had an appointment until the Surveyor brought it to her attention. She had texted the Activities Director around 10:45 AM asking if he had one. She said usually if they have an appointment it will pop up on the computer as a one-time order but for him it wasn't put in correctly, so it didn't pop up. She said that Activities will set up the transportation. During an interview on 04/02/25 at 9:05 AM with Staff N, Unit Manager, she stated that she spoke to the resident yesterday and she called the Urologist to find out about his appointment but have not heard back from them yet. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 9 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During an interview on 04/02/25 at 9:45 AM with the Activities Director she remembers the text the nurse sent her about this resident on Monday 03/31/25. The Activities Director stated we will set up the residents' transportation if they are long-term care residents. The surveyor then stated that this resident is long term care. During a subsequent interview on 04/02/25 with Staff N, Unit Manager, she stated the resident was communicating with the doctor's office and had changed his appointment himself. The surveyor stated that it has been on the computer since 02/20/25. Staff N then stated the resident told someone and they put it on the computer but did not put it in correctly and since he made the appointment we were not aware that he needed transportation. The surveyor stated that this appointment has been scheduled for over a month and they had an opportunity to get transportation scheduled, which she acknowledged. During an interview with Staff N, Unit Manager, on 04/04/25 at 11:50 AM she was asked about this resident transportation for the upcoming appointment. She said the Activities driver was going to pick him up. During a telephone interview on 04/04/25 at 12:50 PM with the Activities Director she stated she only oversees transportation for outings and ALF. The unit manager would take care of the resident going to the doctor's appointment. 5) Review of Resident #303 records revealed Resident #303 was admitted to the facility on [DATE] and discharged [DATE]. The resident had diagnoses to include Type II Diabetes Mellitus, Hypertension, and Dysphagia and Aphasia following a Cerebral Infarction. A review of the Physician's Order revealed Accu-Chek twice daily; If blood sugar is above 250 to notify the MD/ARNP start date 03/05/25 0630. A review of the MAR (Medication Administration Record) revealed 3 days that the Accu-Chek was taken, and the blood sugar was above 250 but the physician or ARNP was not notified. On 03/17/25 Blood Sugar 301 at 06:30 AM. On 03/16/25 Blood Sugar 295 at 4:30 PM. On 03/08/25 Blood Sugar 252 at 4:30 PM. The resident is also on Glucophage Tablet 1000 MG (Metformin HCl) Give 1 tablet by mouth two times a day for Diabetes; Insulin Glargine Solution 100 UNIT/ML Inject 15 unit subcutaneously at bedtime for diabetes. During an interview on 04/04/25 at 3:39 PM with the DON (Director of Nursing) the Surveyor asked her where the nurses document when they notify the physician or ARNP. She stated they are documenting either in the computer on the MAR which sometimes floats over to Progress Note or putting it in the progress note. The surveyor requested to pull up Resident #303's MAR and progress notes. She reviewed them and acknowledged that she does not see any notes that the physician or ARNP was notified and should have been per the order. 3) Resident #23 was admitted to the facility on [DATE] with diagnoses including respiratory failure and hypertension (high blood pressure). An annual comprehensive assessment on 12/18/24 included a (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 10 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few brief interview with a mental status score of 15, indicating that Resident #23 was cognitively intact. This assessment did not record any concerns related to mood or behavior. According to the physician's order from 12/14/23, Amlodipine was prescribed to be administered one tablet by mouth every 12 hours for the management of hypertension, with the stipulation to hold the medication if the systolic blood pressure was below 110. However, a review of the March 2025 medication administration record (MAR) evidenced the lack of adherence to these parameters. Amlodipine was administered outside of the established parameters on several occasions: - On 03/05/25, at 9 PM, the recorded blood pressure was 98/67, and the medication was administered. - On 03/18/25, at 9 AM, the blood pressure was 102/65, and the medication was again given. - On 03/25/25, at 9 AM, the blood pressure was noted as 107/63, and the medication was administered. - On 03/25/25, at 9 PM, the blood pressure was recorded at 109/64, and the medication was administered. During an interview with the Director of Nursing (DON) on 04/04/25, at 11:55 AM, the DON was made aware of the issue regarding the noncompliance with the physician's orders concerning blood pressure medication administration and the associated parameter. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 11 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews, record review, and policy review, the facility failed to ensure supervision and staff training for 1 of 4 sampled residents (Resident #19), reviewed for falls. The findings included: Review of the policy titled, Falls - Managing, Preventing, and Documentation revised 01/2024, documented, in part, Resident-Centered Approaches to Managing Falls and Fall Risk: 1. The staff will implement a resident-centered fall prevention plan to reduce the specific risk factor(s) of falls for each resident at risk or with a history of falls. Documentation: . 2. The resident's care plan should be updated timely with the new interventions determined by the interdisciplinary team. Review of the record revealed Resident #19 was admitted to the facility on [DATE]. Review of the current Minimum Data Set (MDS) assessment dated [DATE] documented Resident #19 had a Brief Interview for Mental Status (BIMS) score of 6, on a 0 to 15 scale, indicating the resident was cognitively impaired. Review of the current care plan initiated 11/13/24 revealed Resident #19 was at risk for falls related to cognitive deficit, use of psychotropic medications, decreased endurance, and a history of falls. Review of progress note dated 03/17/25 written by Staff A, Licensed Practical Nurse (LPN) revealed that Resident #19 was in her room and observed lying on the floor on her right side. A fall risk evaluation was completed after care was provided and family was notified. The fall risk evaluation revealed that Resident #19 was oriented to self, not place and time and had periods of confusion. She presented with an altered awareness of physical environment and lack of understanding of physical limitations. During a family interview on 04/01/25 at 9:42 AM, Resident #19's husband stated that his wife fell out of the wheelchair when she was left alone in her room. During an interview on 04/02/25 at 12:10 PM, Staff A, LPN stated that a staff member from the Activities department pushed Resident #19 in her wheelchair back into her room and left her alone and did not notify the nursing staff that Resident #19 was back in her room. During an interview on 04/02/25 at 12:47 PM, the Activities Director stated that it was Staff G, a part time Activity Assistant, who brought Resident #19 back to her room on 03/17/25 as Staff G did not know that the resident should be taken to the nursing station instead of her room. When asked how Staff G, would've known which residents need to be brought to the nursing station instead of their rooms and if there was a policy for that she replied, I am not sure, but I think it is in the resident's care plan. Review of the current care plan initiated on 03/03/25 that includes interventions carried over from 2024, lacked any intervention related to the need to always keep Resident #19 with staff while positioned in her wheelchair. Furthermore, the list of interventions and approaches did not include training for all facility staff to communicate with the nursing staff when Resident #19 is positioned in her wheelchair and returned to her room after attending activities, an outing or therapy. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 12 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0689 Review of the facility investigation completed after Resident #19's fall on 03/17/25, revealed education only to Staff G, the Activity Assistant involved in the incident, and lacked education to all staff. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 13 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to follow the physician's order for the administration of enteral feeding for 1 of 2 sampled residents (Resident #31), reviewed for enteral feeding. The findings included: A record review revealed Resident #31 was admitted to the facility on [DATE]. Diagnoses included Traumatic Subarachnoid Hemorrhage without loss of consciousness, Unspecified Protein Calorie Malnutrition, Major Depressive Disorder, Dementia, and Muscle Wasting in Multiple Sites with Atrophy. This resident's Brief Interview for Mental Status (BIMS) score, per Minimum Data Set (MDS) assessment dated [DATE] was 4. This indicated that Resident #31 had severe cognitive impairment. A record review revealed Resident #31's most recent weight on 03/09/25 was 93.8 pounds. Her Body Mass Index (BMI) was 18.3. This indicated that Resident #31 was underweight. She lost 8 pounds in six months from 101.8 pounds on 09/02/24 to 93.8 pounds. The MDS quarterly assessment completed on 02/20/25 documented that Resident #31 received 51% or more of the calories ingested daily via percutaneous endoscopy gastrostomy (PEG) tube enteral feedings, and 51% or more fluids from PEG tube enteral feedings. Resident #31 was dependent on enteral feeding to meet her daily needs for nutrition. This included hydration. A record review of Resident #31's care plan for nutrition last revised on 03/31/25, documented that the resident was at risk for malnutrition because she had inadequate intake of nutrition by mouth. Enteral PEG tube feedings was her primary source of nutrition. She had a history of weight loss, and in addition to receiving feeding by PEG tube, Resident #31 also received food by mouth. Her food by mouth diet order dated 03/31/2025 was for a regular diet, with a mechanical soft texture, and thin consistency fluids. A record review showed that Resident #31's current enteral feeding diet order dated 03/10/25 was for a continuous feeding of Jevity 1.5 to be administered at 85 milliliters per hour for 12 hours daily between 7:00 PM and 7:00 AM. The doctor's order specified that the total amount of 1,020 ml of Jevity was to be infused. There was another active order for a bolus feeding (administered all at the same time) of 237 milliliters to be administered at 5:00 PM daily. A record review of the Registered Dietitian's (RD) progress note on 03/10/25 revealed Resident #31 often refused the 5:00 PM bolus feedings. The RD recommended increasing the rate of Jevity 1.5 from 80 milliliters per hour to 85 milliliters per hour. This increase in rate also increased the volume of Jevity to be administered. In addition, the RD's progress note documented Resident #31's difficulty swallowing and poor intake of foods by mouth. An observation during the initial screening activity on 04/01/25 at 09:39 AM revealed that Resident #31's tongue was dry, and the tip of her tongue was deep red. A vertical crevice was observed on the tip of her tongue. The surveyor offered the resident water from the cup that was on her tray table. The resident accepted the cup in her hand and drank some water. During an observation on 04/02/25 at 6:12 PM, Resident #31 was lying down in bed. The surveyor asked the resident to stick out her tongue and Resident #31 complained that her tongue was dry. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 14 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few During an interview with Staff Q (Registered Nurse) on 04/03/25 at 2:12 PM, the surveyor shared her concern about Resident #31's dry mouth. Staff Q said that Resident #31's lips were dry, and she liked to drink water with ice. An observation on 04/04/25 at 7:04 AM revealed Resident #31 was in bed, receiving enteral feeding. The rate of feeding was 80 milliliters per hour. The total amount of Jevity that was administered, based on the amount of formula that remained in the plastic 1000 ml bottle, was approximately 540 ml. The doctor's order specified the total volume to be administered between 7:00 PM and 7:00 AM was 1,020 ml. Approximately 460 ml of Jevity 1.5 remained in the plastic bottle. An interview on 04/04/25 at 7:15 AM was conducted with Staff C, the nurse who provided Resident #31 with care during the night shift. The surveyor asked Staff C to view the tube feeding pump and to describe the rate of administration of the Jevity formula that was in progress. Staff C said that the rate was 80 milliliters per hour. When asked to check the doctor's order in Resident #31's medical record, Staff C said that the order specified 85 milliliters per hour. The surveyor asked why she provided the Jevity at 80 milliliters per hour, and Staff C said that she didn't open and check the order for the administration of Jevity. She also said she wasn't informed of the change in the administration rate during the change of shift report. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 15 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0694 Provide for the safe, appropriate administration of IV fluids 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** Based on policy review, observation, record review, and interview, the facility failed to ensure timely IV (intravenous) dressing changes for 1 of 1 sampled resident, Resident #29. Residents Affected - Few The findings included: Review of the policy titled, IV Dressing Change revised 11/2024 documented in part, Standard: This purpose of this procedure is to minimize catheter-related infections associated with contaminated, loosened, or soiled catheter-site dressings. Procedure: 1. Dressing changes to be completed if it becomes damp, loosened or visibly soiled and at least every 7 days. Review of the record revealed Resident #29 was admitted to the facility on [DATE]. Review of the current orders revealed a midline IV catheter was ordered on 03/20/25 for the resident to receive IV medications. These orders also contained instructions to flush the IV before and after two current antibiotics that were being administered via the IV line, to include daptomycin and meropenem. These orders lacked any instructions for the nursing staff to change the IV dressing. A wound culture dated 01/03/25 revealed the resident had a wound that was infected with a multi-drug resistant organism (MDRO). During an interview on 03/31/25 beginning at 11:31 AM, when asked why he was on contact precautions, Resident #29 stated he had a wound infection. A mid-line catheter was noted to the resident's right arm. The dressing was lose all around the perimeter and dated 03/20. When asked about the dressing changes, Resident #29 stated, It wouldn't have been changed then (03/20/25) if I wouldn't have said anything. I have to beg them to change it. Then when the nurses do finally change it, they complain the whole time. During an interview on 04/03/25 at 2:08 PM, when asked if she does the IV dressing changes for a mid-line IV, Staff L, Licensed Practical Nurse (LPN) stated she does not, but would as the Unit Manager or another Registered Nurse (RN) to complete the task. When asked how she knows when it is due, the LPN stated it would pop up on her computer. When asked if she had noticed the mid-line for Resident #29, the LPN stated, Yes, it was dated 03/20 and I corrected that on 04/01/25. The LPN agreed it was completed late. When asked to locate and provide the order for the mid-line dressing change, the LPN stated she did not see it in the computer, but it should be changed every 7 days. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 16 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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** Based on observation, interview, and record review, the facility failed to properly administer oxygen therapy for 2 of 2 sampled residents, as evidenced by failure to ensure proper physician orders for oxygen use for Resident #302, and that the prescribed physician order for oxygen was followed for Resident #54. Residents Affected - Few The findings included: Review of the Policy titled, Standards and Guidelines for Oxygen Administration revised 12/2023, documented, in part, Oxygen therapy is administered by way of an oxygen mask, cannula or other device per physicians' orders with the appropriate flow of oxygen. 1) Observations of Resident #302 from 03/31/25 to 04/03/25 revealed that the resident is on oxygen by nasal cannula. The setting of his oxygen is set at 4.5 LPM (liters per minute). A review of Resident #302's records revealed Resident #302 was admitted to the facility on [DATE] with diagnoses to include COPD (Chronic Obstructive Pulmonary Disease) with Acute Exacerbation, Chronic Respiratory Failure with Hypercapnia, Dependent on Oxygen, Hypertension, and Type II Diabetes Mellitus. A review of the Physician's Orders documented continuous O2 (Oxygen) will tolerated every shift start 03/20/25. It does not state the LPM nor what type of device the resident should be using. During an interview on 04/02/2025 with Staff N, Unit Manager/RN she was asked what the process is for a resident on oxygen. She stated they check the O2 every shift, he has COPD and the O2 is set at 3 LPM, every Thursday they change his cannula. She was asked to review the resident's O2 orders. She read off that it showed continuous O2 will tolerated every shift start 03/20/25. She said OK and didn't seem concerned that the order did not have how many LPM nor by what method. We went into resident's room and to observe the oxygen rate. She stated it was at 4.5 LPM. The resident interjected and stated that he always has it at 4 LPM at home but because he is more active here at the facility it is at 5 LPM. The Unit Manager stated she will call the physician to get orders updated. On 04/02/25 it now reads Respiratory-Oxygen: Continuous. Encourage and assist resident to use O2 @ 4.5L via NC continuously as tolerated for COPD every shift for COPD and Respiratory-Oxygen Tubing Change: Change O2 tubing/mask/bag Q week and PRN every night shift every Thursday for monitoring. Photographic evidence obtained. 2) Review of record revealed Resident #54 was admitted to the facility on [DATE]. On 03/14/25, Resident #54 was admitted to the hospital with diagnosis of Acute Respiratory Failure, and was readmitted to the facility on [DATE] with a respiratory care order for Oxygen at 2 liters via nasal cannula as needed for shortness of breath/dyspnea on exertion every 24 hours. Observation on 04/01/25 at 8:10 AM, Resident #54 was in bed awake on oxygen on 4 liters via nasal cannula. Observation on 04/01/25 at 11:15 AM, Resident #54 was in bed and awake on 4 liters of oxygen via nasal cannula. During an interview on 04/02/25 at 11:07 AM, Staff A, Licensed Practical Nurse (LPN) was asked about Resident #54's oxygen order as she was leaving resident #54's room. Staff A checked her computer (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 17 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 stating the order is for 2 Liters. Level of Harm - Minimal harm or potential for actual harm During an observation after the interview with Staff A, on 04/02/25 at 11:10 AM, Resident #54 was in bed awake with 4 Liters of oxygen via a nasal cannula. Residents Affected - Few Photographic evidence obtained. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 18 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0700 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interview the facility failed to ensure an assessment and an order for side rails for 1 of 1 sampled resident reviewed for side rails (Resident #302). The findings included: Observations were made from 03/31/25 to 04/02/25 of Resident #302's bed. He has 2 metal side rails up on the right side and 1 metal side rail up on the left side. On 04/02/25-04/04/25 observations were made of a larger bed in Resident #302's room with 1 side rail up on each side of the bed by the head of the bed. A review of Resident #302's records revealed Resident #302 was admitted to the facility on [DATE] with diagnoses to include Visual Loss, Hypertension, Type II Diabetes Mellitus, Unspecified Delirium, and COPD (Chronic Obstructive Pulmonary Disease). A review of the admission Assessment for bed rails dated 03/18/25 documents that side rails are not needed. There was no Physician Orders or documentation on further assessing the resident for side rails. During an interview on 04/04/25 at 4:40 PM with the ADON (Assistant Director of Nursing), the surveyor asked who is responsible for doing assessments for side rails. She stated Rehab does it. During an interview on 04/04/25 at 4:45 PM with the Rehab Director he was asked who is responsible for doing assessments for bed rails. He stated Nursing. During an interview on 04/04/25 at 4:50 PM with Staff O, LPN (Licensed Practical Nurse), she was asked who does bed rail assessments? she stated Nursing and Rehab do the bed rail assessments. If the admission Assessment documents that the resident needs bed rails then we put an order in. She acknowledged that this resident does not have an order for bed rail and the assessment says no rails needed. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 19 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 10) An observation of wound care was made on 04/02/25 beginning at 10:06 AM. The wound care nurse was accompanied by the regional nurse for that facility. When asked if she usually helps out with the wounds, the Regional nurse stated that she did as she was in the building Monday through Thursday. During an interview on 04/03/25 at 11:22 AM, when asked if she normally has a second staff member to assist her with wound care, especially for the residents who are totally dependent upon staff for their care, the wound care nurse shook her head no. When asked if the regional nurse who helped her the previous day had ever helped her, the wound care nurse stated, not really. When asked if she does the wounds by herself, the wound care nurse stated, Yes, but they are supposed to be getting me someone to help on the days the wound care physician is in the building for rounds. During a supplemental interview on 04/03/25 at 2:19 PM, when asked if she does the wound care for all the wounds in the facility, the wound care nurse stated she did all the care except for the residents with surgical wounds. When asked if she works 7 days a week, she stated no and explained she worked Monday through Friday, and she believed the weekend supervisor completed the care over the weekends, but she was not sure. When asked how she completes the care for the residents who are totally dependent upon care by staff, the wound care nurse stated, It's hard. There are not enough CNAs (Certified Nursing Assistants) and they are busy. I usually have to tell them to come get me when they are ready to do care or have time to help me, which means I'm all over the place. The wound care nurse stated she has requested assistance for the wound care. Review of the list of residents with wounds revealed there were 18 current residents with wounds that would be treated by the wound care nurse, including sampled Residents #254, #11, #46, #62, #29, #27, #55, #73, #68, and #45. Of those 18 residents, 5 of the 18 residents had between 2 and 4 wounds each. 11) During the survey conducted from 03/31/25 through 04/04/25, nine residents complained of cold food, including Residents #75, #83, #23, #251, #10, #29, #50, #27, and #85. Some of the residents stated the food sits in the carts out in the hallways too long before being delivered. Refer to citation at F804. During an interview on 04/04/25 at approximately 2:00 PM, when told of the numerous cold food complaints, the Registered Dietitian (RD) stated she was aware of the complaints and had done numerous temperatures in the kitchen with no concerns identified. The RD agreed it was more than likely due to the trays sitting in the hallway for an extended time, and possibly due to a staffing issue. Based on observation, interview and record review, the facility failed to ensure sufficient staffing to provide timely and appropriate care and services as evidenced by verbal complaints from residents, family, and staff, which resulted in dignity concerns, the lack of call light response, wound care and activity of daily living (ADLs) care concerns. This concerned multiple residents, including Residents #256, #250, #72, #10, #23, #254, #11, #46, #62, #29, #27, #55, #73, #68, #45, #75, #83, #23, #251, #10, #50, and #85. The findings included: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 20 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 1) The clinical record for Resident #256 indicated admission to the facility on [DATE]. The care plan initiated on 03/21/25 noted that Resident #256 had the potential for an ADL self-care deficit due to varying participation, fatigue, and chronic medical conditions. On 03/31/25, at 11:16 AM, Resident #256 was observed at the nursing station alongside two family members. He was noted to have facial hair that needed to be shaved, and he appeared confused. An interview with his wife revealed concerns about his care; she indicated that aides had refused to shave him when she requested it. She stated the aides told her they don't do that. Although she brought a razor to help shave him, the aide did not do a good job. 2) The clinical record revealed that Resident #250 was admitted to the facility on [DATE] with diagnoses including medically complex conditions. The admission assessment, reference date 03/28/25, recorded a brief interview for a mental status score of 15, which indicated Resident #250 was cognitively intact. This assessment recorded no mood or behavior concerns. This comprehensive assessment recorded under section GG for functional abilities and goals that Resident #250 required partial/moderate assistance with toileting hygiene, and toilet transfer. She needed supervision or assistance with personal hygiene. The care plan initiated on 03/26/25 indicated Resident #250 had an ADL self-care deficit related to ADL needs and participation varying, fatigue, and chronic medical conditions. Interventions included encouraging and assisting with all ADL tasks as indicated and tolerated by the resident, including bed mobility, transfers, toileting tasks, and personal/oral hygiene. On 03/31/25 at 11:55 AM, during an interview process with Resident #250, she revealed the aides don't usually show up when she calls, and when they finally do come, they have an attitude. She explained that last week, she needed her adult brief changed because all the diuretics she had taken, made her urinate a lot. She called an aide to change her and the aide said, I did it an hour ago. She said, I know, but I want to be changed again. The aide said, Well, I don't want to right now. Resident #250 explained that this morning (on 03/31/25), an aide came in; she asked her to change her adult brief, the aide said, I am the only one here right now, I will try to get to you sometime later, and left the room without changing her. 3) The clinical record revealed that Resident #23 was admitted to the facility on [DATE] with diagnosis including respiratory failure. The annual comprehensive assessment, reference date 12/18/24, recorded a brief interview for a mental status score of 15, which indicated Resident #23 was cognitively intact. This assessment recorded no mood or behavior concerns. This assessment recorded under the section GG for functional abilities and goals that Resident #23 required substantial/maximal assistance with toileting hygiene, showering/bathing, lower body dressing, putting on/taking off footwear, and chair/bed-to-chair transfer. She required partial/moderate assistance with upper body dressing and sitting to stand. The care plan revised on 12/24/24 indicated Resident #23 had an ADL self-care deficit related to chronic medical conditions, extensive assistance in more than five areas of ADLs. Interventions included encourage and assist with all ADL tasks as indicated and tolerated by the resident, including locomotion/ambulation, bathing, bed mobility, transfers, toileting tasks, meals, and personal hygiene. On 03/31/25 at 12:04 PM, an interview was conducted with Resident #23; she stated, This is a pretty (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 21 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some place, but the care is no good; the staff doesn't care about the residents. She expressed her concerns about the lack of staff, mentioning that it often takes the caregivers 45 minutes to an hour to respond to her call light. She added, The CNAs don't have time to take her outside even for 15 minutes. She doesn't get visitors often, so it would be nice to go outside occasionally. On 04/01/25, at 2:42 PM, a follow-up interview was conducted with Resident #23. She reiterated that when she calls for assistance to be changed, it took a long time for the staff to come-ranging from 45 minutes to an hour. She desired to be able to get out of bed at least three times a week, but when she requested this, the CNAs have informed her that they cannot assist her due to concerns about her safety if she falls. Some have also mentioned that there were not enough staff available to help them. On 04/04/25, the Director of Nursing was interviewed from 11:55 AM to 12:14 PM, with a follow-up discussion at 2:00 PM. During these sessions, the Director was made aware of the concerns residents and their families raised. Each problem was articulated to her. 4) A review of the clinical record revealed that Resident #73 was admitted to the facility on [DATE], with a diagnosis that included cancer. The admission assessment, dated 02/25/25, indicated a brief interview during which the resident scored 15 on the mental status assessment, which indicated she was cognitively intact. This assessment noted no concerns regarding mood or behavior. This assessment recorded under the section GG pertaining to functional abilities and goals, that Resident #73 required substantial to maximal assistance with tasks such as toileting hygiene, showering, and lower body dressing. She needed partial to moderate assistance with upper body dressing and transitioning from lying to sitting. Additionally, she required supervision or minimal assistance to roll from side to side. Resident #73 depended on staff for assistance putting on and taking off footwear, standing from a sitting position, and transferring between the chair and bed. The care plan, dated 02/26/25, indicated that Resident #73 experienced ADL (Activities of Daily Living) self-care deficit related to chronic medical conditions. Interventions included encouraging and assisting with all ADL tasks tolerated by the resident, such as locomotion, bathing, bed mobility, transfers, toileting, meals, and personal hygiene. The care plan also noted that Resident #73 was at risk for complications related to bowel and bladder incontinence. Suggested interventions included encouraging, offering, and assisting with toileting tasks and the use of adaptive equipment as needed. Incontinence care was to be provided with each incident, as tolerated. The plan further indicated that Resident #73 had pressure ulcers in the sacral and bilateral buttock areas and was receiving oral antibiotic therapy for bacteriuria (the presence of bacteria in urine). During an interview with Resident #73, she expressed concerns regarding insufficient staff availability, lack of assistance with ADLs, and inadequate responses to call lights. She stated, The facility is gorgeous, but I have concerns about communication. She explained that the volume of the call system in her room is too faint, making it difficult for her to hear staff and for them to hear her. She reported that staff often turned it off when she pressed the call button without responding or checking on her. She emphasized that her many life-threatening conditions necessitate prompt staff response. In one instance, she revealed that staff had left her sitting in a soiled adult brief for over an hour. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 22 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some On 04/03/25 at 1:22 PM, and again at 4:13 PM, a follow-up interview with Resident #73 was conducted. She reiterated that when she calls staff for incontinent care, their response time ranges from one hour to an hour and a half. She described an experience from the previous night where she activated the call light, but the staff turned it off without speaking or coming to her room to address her concerns. 5) On 03/31/25 at 10:31 AM, the nurse practitioner (NP) at the Emerald [NAME] unit told the surveyor, Staff F, a Registered Nurse, is brand new and was given a difficult assignment, which is not fair to this nurse. The surveyor informed the NP that she was not an employee of the facility but a state surveyor. 6) On 04/02/25 at 9:13 AM, a nurse, Staff I, was interviewed regarding staffing levels. She expressed concern about the facility's insufficient staffing. She mentioned that when the first floor is fully occupied, she is responsible for 21 residents at the Emerald [NAME] unit, while another nurse managed another 21 residents at the East unit. Staff I highlighted that the residents on the first floor have high acuity levels, (explained they require more complex and frequent care). She explained that multiple residents sometimes call for assistance simultaneously, making it difficult for her to promptly attend to their needs. This situation has led to delays in their care and medication administration. Sometimes, a single resident may require her attention for an extended period, leaving other residents waiting for help. In long-term care settings, resident acuity refers to the level of care and support a resident need based on their medical, physical, and cognitive conditions. High acuity indicates that residents have complex or chronic health issues, which require continuous medical supervision or frequent assistance with daily living tasks and often necessitate specialized care and resources. 7) On 04/04/25, at 2:57 PM, Staff E, a nurse, was interviewed. She stated that she primarily works on the first floor, specifically in the Emerald [NAME] unit, where staffing was inadequate, given the heavy assignments. She was responsible for 21 residents daily, most with high acuity levels. Staff E expressed concern that some of the residents were not ready for a skilled nursing facility and others would be better suited for memory care due to behavioral issues. During the interview, she mentioned having to keep Resident #256 at the nursing station to monitor him due to his behavioral issues and fall risk concerns, all while also administering medications to other residents. Often, she had to watch three fall-risk residents at the nursing station, and when she left the unit for medication administration, no one was available to supervise them. She noted that finding Certified Nursing Assistants (CNAs) to help watch residents was challenging, as they usually occupied with their tasks in the rooms. Staff E expressed frustration with the facility's staffing practices, stating, If they were to staff by acuity, we would have more help. At times, only three aides were assigned to the first floor, which complicated care. When the first floor was full, each CNA had 14 residents to manage. On some days, there was no wound care nurse available, so she had to take on wound care tasks, medication administration through G-tubes, intravenous treatments, and admissions. Additionally, she noted that residents had frequently complained about the lack of staffing. She reported this issue to the previous unit manager on the first floor, who voiced her frustration of being overwhelmed, and stated,the unit manager couldn't take it anymore, and resigned. Staff E mentioned that there was no unit manager on the first floor right now. She also pointed out that sometimes, only one nurse was responsible for 30 residents on the second floor, making timely care difficult. She stated, Then the managers wonder why the residents complain about waiting so long before someone attends to them. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 23 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 8) On 04/04/25 at 3:43 PM, a phone interview was conducted with Staff F, a nurse. She explained she had 21 residents sometimes, and it was challenging to attend to their needs on time; when a resident called, the expectation was to respond immediately, and if she did, it could cause a delay in the medication administration and care. There were some fall-risk residents on the first floor at the Emerald unit. Those residents were placed at the nursing station to be monitored by the nurse. Staff F stated, We were supposed to have a CNA staying at the nursing station to watch those residents, but most of the time, the CNAs were busy with their tasks in the rooms. She further stated, Staffing was short at the facility. She added that when she had to move to administer medication to the residents in their rooms, they didn't have people to watch the fall-risk residents at the nursing station, and they could get up and fall. She explained that the first floor was primarily the rehab unit. Stated, Everyone knows the first floor was difficult, especially at the Emerald [NAME] unit; this assignment was challenging. They usually assigned two nurses on the first floor, one for each unit (Emerald [NAME] and East), and since we don't have a unit manager on the first floor, it was more complex; when the unit manager was there, it helped. When a resident had an emergency or complaint, the unit manager could handle the resident; now, the floor nurse had to do everything. 9) On 04/04/25, at 3:58 PM, an interview and review of staffing assignments and schedules were conducted with the Staff Coordinator. She indicated that the first floor was supposed to be staffed with four CNAs and two nurses, while the second floor was meant to have four CNAs and two nurses. The second floor typically had the lowest number of residents, usually has the lowest amount of staffing based on census number. The third floor was to be staffed similarly: four CNAs and two nurses. The staffing coordinator explained, I don't staff by acuity, only by census. She mentioned that the clinical managers would inform her if staffing adjustments based on acuity were necessary. During the interview, she defined acuity as high-risk and very ill residents. She confirmed she often had high-risk residents on the first floor. If she overstaffed the facility, she needed to explain to the clinical management why. The clinical managers were responsible for notifying her if additional staff were required on a particular floor. The first floor frequently housed many residents requiring immediate rehabilitation services, and residents with respiratory conditions such as chronic obstructive pulmonary disease (COPD). She noted that nurses and CNAs often requested more staff, and she communicated this need to the Director of Nursing (DON) and the Assistant Director of Nursing (ADON). During the interview, specific days were selected for review, covering the period from March 2, 2025, to March 29, 2025. It was noted that on March 23, 2025, the staffing for the first floor during the first shift (7 AM - 7 PM) included two nurses and four CNAs, while the second shift (7 PM - 7 AM) had two nurses and three CNAs. For the second floor, the first shift had two nurses and three CNAs, and the second had two nurses and two CNAs. On March 26, 2025, on the first shift the first floor had two nurses and four CNAs; and the second floor had two nurses and three CNAs. On the second shift, first floor had one nurse and three CNAs; and the second floor second shift had one nurse, a supervisor, and two CNAs. On March 29, 2025, the first floor once again had two nurses and four CNAs during the first shift, and the second floor's second shift had two nurses and three CNAs. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 24 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0770 Provide timely, quality laboratory services/tests to meet the needs of residents. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, policy review and interview the facility failed to obtain an ordered laboratory result for a medication (Depakote) for 1 of 1 sampled Resident (Resident #61). Residents Affected - Few The findings included: The facility policy titled, Standards and Guidelines: Physician's Orders, revised on 01/2024 documented in part: Physician orders should be followed as prescribed, and if not followed, this should be recorded in the resident's medical record during that shift. The physician should be notified and the responsible party if indicated. Resident #61 was admitted to the facility on [DATE] with diagnoses to include in part Hypertension, Major depressive disorder, Congestive heart failure, Atrial fibrillation, Anemia, Protein calorie malnutrition and a brief psychotic disorder. On 11/27/24 Resident #61 was ordered 750 mg Depakote Sprinkles by mouth two times a day for mood disorder. The order was changed on 02/13/25 to read Depakote 500 mg 1 tablet two times a day for mood disorder. The facility has a pharmacist consultant who reviews all the medications for each resident once a month. This prevents under and over medications of the residents, and possible side effects from their medications. In January 2025, the pharmacist reviewed Resident #61's medications. The pharmacist had recommendations for the medication, Depakote. Part of the recommendation for Resident #61 was for the physician to order a serum level for the Depakote. The pharmacist stated they were unable to locate a serum level in the chart. The physician agreed and a serum level was ordered to be collected on 02/25 for the medication Depakote. The medication Depakote has a significant impact on brain chemistry. The right dosage is essential. If too little is given, then the symptoms may not be controlled, and too much of the medication can lead to toxicity. The laboratory results were reviewed for Resident #61. A Valproic Acid (Depakote) serum level could not be located in the resident's record. On 04/03/25 at approximately 5:00 PM, the findings were discussed with the ADON (Assistant Director of Nursing) and the Administrator. The laboratory result for the Depakote serum level was unable to be located. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 25 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0803 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to honor food preferences for 5 of 10 sampled residents, Residents #27, #29, #44, #50, and #85, who had food complaints, as evidenced by the failure to follow the meal ticket and menu. The findings included: 1) Review of the record revealed Resident #27 was admitted to the facility on [DATE]. Review of the Minimum Data Set (MDS) assessment dated [DATE] revealed the resident was cognitively intact as evidenced by a Brief Interview for Mental Status (BIMS) score of 14, on a 0 to 15 scale. Review of a dietary progress note dated 02/04/25, documented in part, Resident #27 would like to update her food preferences, to include a chef garden salad with ranch dressing as an entree every Monday, Wednesday, and Friday. A subsequent progress note dated 02/18/25 documented the resident was happy with the updated food preferences. Review of a dietary assessment by the Registered Dietitian (RD) on 02/27/25 revealed the resident now had wounds and nutritional interventions to include fortified foods was added. During an interview on 03/31/25 at 10:40 AM, Resident #27 stated she had lost 25 pounds and was too thin. Stated she recently spoke with someone and they added a chef salad, which she stated she really enjoyed. The resident showed the surveyor a recent menu ticket that documented the chef salad. This ticket also documented the intervention of fortified foods. When asked about oatmeal at breakfast, the resident stated she did not like their oatmeal because they put something in it that makes it gummy. Resident #27 also had the preference of whole milk at every meal, further stating, I don't always get it, but I'm happy if I get it twice a day. Resident #27 further stated they keep bringing her coffee that she does not like, she prefers hot tea, referring back to her menu ticket. An observation of Wednesday's lunch meal on 04/02/25 at 1:58 PM revealed Resident #27 did not get her chef salad. Photographic evidence obtained. When asked if she wanted to request one now, the resident provided half of her leftover salad from a previous day and stated, I knew I wouldn't get it so I saved this. An observation on 04/03/25 at 1:56 PM revealed a chef salad on the tray of Resident #27, although the menu ticket documented chef salad on Monday, Wednesday, and Friday. Photographic evidence obtained. During an interview on 04/04/25 at 2:06 PM, when shown the photo of the resident's Wednesday lunch meal, the Certified Dietary Manager (CDM) agreed. When asked why the salad on Monday, Wednesday, and Friday, the CDM stated, Resident preference. The CDM confirmed that anything extra on the menu ticket is resident preference. When told of the resident's complaint regarding the gummy oatmeal, the CDM explained the oatmeal becomes thicker as it sits. 2) Review of the record revealed Resident #29 was admitted to the facility on [DATE]. Review of the current MDS assessment dated [DATE] revealed the resident had a BIMS score of 15, on a 0 to 15 scale, indicating he was cognitively intact. This same MDS documented the resident weighed 232 pounds. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 26 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0803 Level of Harm - Minimal harm or potential for actual harm During an observation and interview on 04/02/25 at 2:02 PM, Resident #29 had finished his lunch and complained of the small portion. The resident provided a photo of his lunch meal that he had taken on his cell phone. Photographic evidence obtained. The resident stated that when he gets his money for the month he will need to supplement his intake by ordering some extra food. The resident stated he was a big guy and needed more. Review of his meal ticket documented double protein portion. Residents Affected - Few During an interview on 04/04/25 at 2:01 PM, when shown the photo of Resident #29's lunch from 04/02/25, both the RD and CDM agreed he was served a regular portion of meat instead of the requested double protein portion. 3) Review of the record revealed Resident #44 was admitted to the facility on [DATE]. Review of the current MDS assessment dated [DATE] documented the resident was cognitively intact with a BIMS score of 13, on a 0 to 15 scale. Review of the current order dated 12/29/24 documented Resident #44 was ordered fortified foods at meals. During an observation and interview on 04/01/25 at 10:19 AM, the activity assistant entered the resident's room to pick up her breakfast tray. Resident #44 stated she was missing her peanut butter and jelly sandwich (PB&J), dry cereal and coffee that morning. The activity assistant stated she would inform the kitchen. Resident #44 stated she really enjoyed the uncrustables (a brand of sandwich) that they started giving her a few weeks ago but then stopped. When asked how often she would like them, the resident stated every morning. Resident #44 confirmed she had not gotten the PB&J sandwich that day or the previous. Resident #44 volunteered she had sugar that morning for her coffee, but no coffee, and milk for her cereal, but no cereal. An observation on 04/02/25 at 9:49 AM revealed Resident #44 did not receive a peanut butter and jelly sandwich as per her breakfast ticket menu. Photographic evidence obtained. An observation on 04/03/25 at 1:33 PM lacked the chef's soup as documented on her menu ticket. Photographic evidence obtained. During the continued interview on 04/04/25 at approximately 2:00 PM, the RD stated the residents love the uncrustables and it could be provided to Resident #44. The RD and CDM were shown the meal ticket and breakfast meal without any PB&J sandwich and agreed with the finding. 4) Review of the record revealed Resident #50 was admitted to the facility on [DATE]. Review of the current MDS assessment dated [DATE] documented the resident was cognitively impaired with a BIMS score of 03, on a 0 to 15 scale. Review of the current orders revealed as of 09/18/23 the resident was to receive both large portions and fortified foods with meals. Review of a progress note dated 12/10/24 by the RD documented the resident agreed to large portions, as he had lost weight in the past. A subsequent note dated 02/24/25 by the RD documented to continue large portions and fortified foods. An observation on 04/02/25 at 9:39 AM lacked fortified oatmeal. When asked if he wanted the oatmeal, Resident #50 stated, I stopped eating oatmeal as a kid. During a subsequent observation on 04/03/25 at 1:08 PM, a regular sized portion of meat was noted on the resident's lunch tray. When asked if the portion was a large meat portion, the RD shook her head no. Photographic evidence obtained. At 1:26 PM, upon completing the meat provided, when asked if (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 27 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0803 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few he would have eaten more meat if he had more, Resident #50 stated, I probably would have. When asked if he wanted more at that time, he stated, Not now since I've started my dessert. During a phone interview on 04/04/25 at 9:04 AM, when asked about the resident's previous weight loss, the resident's wife stated he had lost weight after being in the hospital and was initially put on a pureed diet. She stated when his diet was upgraded, his weight increased as well. The wife stated she would like him to maintain his weight. When asked if he likes oatmeal, the wife stated she had never seen him eat oatmeal, even prior to admission. On 04/04/25 at 1:52 PM, when asked if she asks residents who are ordered fortified foods if they like oatmeal, the RD stated she typically does, but if the resident had dementia or was asleep, she may not ask. 5) Review of the record revealed Resident #85 was admitted to the facility on [DATE]. Review of the current MDS assessment dated [DATE] documented the resident was cognitively intact with a BIMS score of 12. The resident was noted to have a current weight as of 03/06/25 of 137 pounds and was underweight as per his BMI (body mass index) score of 18.7. The resident had been underweight since admission. A nutritional evaluation by the RD on 02/03/25 documented the resident desired a gradual weight gain and that interventions would be put into place to include fortified foods. During an interview on 03/31/25 at 3:38 PM, Resident #85 stated he had lost weight. The resident explained he was supposed to be on fortified foods and that sometimes his ticket gets messed up. When asked if he has voiced his concerns, the resident stated he tries to speak with the RD about the food and she tells him to call the CDM, who doesn't answer the phone. Resident #85 further stated he doesn't always get his milk and that he received chocolate milk once or twice. Review of the resident's meal ticket documented fortified foods and chocolate milk on Monday, Wednesday, and Friday. An observation on 04/02/25 at 1:55 PM revealed a lack of any type of milk or fortified foods. Photographic evidence obtained. An observation on 04/03/25 at 2:04 PM revealed a lunch plate with meat and potatoes. The menu ticket documented, gravy on meat and starch. The potatoes lacked any gravy. Photographic evidence obtained. When asked if he would have liked the gravy on the potatoes he stated, Of course, but I just have to accept what I get at this point. During an interview on 04/04/25 at 2:09 PM, the CDM stated they did not have any chocolate milk this week, but he was sure the resident had received it in the past. The CDM and RD agreed with the other findings when shown the photos of the meal trays. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 28 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 7) Review of the record revealed Resident #10 was admitted to the facility on [DATE]. Review of the current Minimum Data Set (MDS) assessment dated [DATE] documented the resident was cognitively intact as evidenced by a Brief Interview for Mental Status (BIMS) score of 15, on a 0 to 15 scale. Residents Affected - Some During an interview on 03/31/25 at 3:33 PM, when asked about the care and services at the facility, Resident #10 stated his only concern was the food. The resident explained that he eats breakfast in his room and that the food trays sit out in the hall way too long. During a supplemental interview on 04/01/25 at 9:48 AM, Resident #10 stated the breakfast was an hour late and still cold. When asked what he had, Resident #10 stated, The same thing I always get . eggs and a piece of cold bread thrown on the plate that they call toast. On 04/02/25 at 9:17 AM, Resident #10 had just received his breakfast meal. He lifted the covering and stated, We've never had this before (as he held up the large portion of bacon). When you are not here I get eggs over easy and a piece of cold bread. 8) Review of the record revealed Resident #27 was admitted to the facility on [DATE]. Review of the MDS assessment dated [DATE] revealed the resident was cognitively intact as evidenced by a BIMS score of 14, on a 0 to 15 scale. During an interview on 04/02/25 at 9:59 AM, when asked the temperature of her breakfast, Resident #27 stated, barely warm. 9) Review of the record revealed Resident #29 was admitted to the facility on [DATE]. Review of the current MDS assessment dated [DATE] revealed the resident had a BIMS score of 15, on a 0 to 15 scale, indicating he was cognitively intact. During an interview on 03/31/25 at 11:29 AM, when asked about the food, Resident #29 stated the food was always cold. The resident stated he had complained about it and they told him they were going to get some type of warmer in the kitchen. Resident #29 stated if they got one, the food is still cold. The resident stated he eats in his room. On 04/03/25 at 1:59 PM, when asked about the temperature of his lunch, Resident #29 stated, Not hot, but better. The resident volunteered, I suspect the food is not sitting out in the hall as long this week since you all are here (referring to the State survey team). Observations during the survey week revealed Resident #29 was usually one of the last resident's served, if not the last. 10) Review of the record revealed Resident #50 was admitted to the facility on [DATE]. Review of the current MDS assessment dated [DATE] documented the resident was cognitively impaired with a BIMS score of 03, on a 0 to 15 scale. Although Resident #50 was cognitively impaired, the resident was conversational and able to make his needs known. On 04/02/25 at 9:39 AM, when asked the temperature of his food, Resident #50 stated, It's barely warm. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 29 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0804 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 11) Review of the record revealed Resident #85 was admitted to the facility on [DATE]. Review of the current MDS assessment dated [DATE] documented the resident was cognitively intact with a BIMS score of 12. During an interview on 03/31/25 at 3:38 PM, Resident #85 stated his food was always cold. The resident stated he eats all of his meals in his room. On 04/03/25 at 2:04 PM, Resident #85 stated he had received his meal about 5 minutes prior. The resident stated hot tea was not even warm and potatoes were luke warm. The resident volunteered that his eggs that morning were cold. 12) During an interview on 04/04/25 at approximately 2:00 PM, when told of the numerous cold food complaints, the Registered Dietician (RD) stated she was aware of the complaints and had done numerous temperatures in the kitchen with no concerns identified. The RD agreed it was more than likely due to the trays sitting in the hallway for an extended time, and possibly due to a staffing issue. Based on observations, interviews, and record reviews, the facility failed to provide food that was palatable and at acceptable food temperatures for 9 residents (Residents #75, #83, #23, #251, #10, #29, #50, #27, and #85) out of 10 residents investigated for food concerns. This had the potential to affect 111 out of 112 residents on PO (by mouth) diets. The findings included: 1) A record review revealed that Resident #23 was admitted to the facility on [DATE]. Her diagnoses included Acute Respiratory Failure with Hypoxia, Sjogren syndrome with Lung Involvement, Irritable Bowel Syndrome, and Gastro-esophageal Reflux Disease. Her diet order dated 03/31/25 was for a Regular diet. This resident's Brief Interview for Mental Status (BIMS) score, per Minimum Data Set (MDS) assessment dated [DATE] was 15. This indicated that Resident #23 was cognitively intact. During an interview with Resident #23 on 04/02/25 at 12:30 PM, when asked how her lunch was today, Resident # 23 said that the food was good today for a change. The green beans were cooked enough, and she could eat them. Usually, they were crunchy. Resident #23 also said that the temperature of the food was hot, and most of the time it wasn't hot. 2) A record review revealed that Resident #75 was admitted to the facility on [DATE]. His diagnoses included Heart Failure, Respiratory Failure, Gastro-esophageal Reflux Disease, and he was at risk for malnutrition. Resident #75's diet order as of 03/31/25 was for a Regular diet, with Regular texture, and thin consistency fluids. This resident's Brief Interview for Mental Status (BIMS) score, per Minimum Data Set (MDS) assessment dated [DATE] was 15. This indicated that Resident #75 was cognitively intact. During an interview on 03/31/25 at 4:30 PM, Resident #75 complained and said that every meal was served cold. He added that he voiced his complaint to the nursing aides, to nurses, and to the management. During an interview with Resident #75 on 04/03/25 at 9:39 AM, the resident said he was served scrambled eggs, waffles soaked in water, grits, and bacon for breakfast. He explained that every item on his meal tray was cold. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 30 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0804 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 3) A record review revealed that Resident #83 was admitted to the facility on [DATE]. Her diagnoses included Fracture of Shaft of Left Femur, Atherosclerotic Heart Disease, and Anxiety Disorder. Her diet order dated 02/01/25 was for a Regular diet, that was Regular texture, with Thin consistency fluids. During an interview conducted on 03/31/25 at 11:41 AM, Resident #83 voiced concern about the food. She said it was not served hot. During an interview conducted on 04/03/25 at 9:45 AM, the resident said she didn't eat breakfast at all. She added that it was cold even after they reheated it. 4) A record review of Resident #251 revealed that he was admitted to the facility on [DATE]. His diagnoses included Chronic Obstructive Pulmonary Disease, Adult Failure to Thrive, and Muscle Wasting to Multiple Sites. This resident's Brief Interview for Mental Status (BIMS) score, per Minimum Data Set (MDS) assessment dated [DATE] was 14. This indicated that Resident #251 was cognitively intact. During an interview with Resident #251 on 04/01/25 at 5:15 PM, the resident said that it bothered him when he received cold cabbage, cold meat, or anything that was supposed to be eaten hot. 5) During an interview with Resident #251 on 04/03/25 at 9:50 AM, when asked how his breakfast was this morning, he replied that he loved eggs, but the food was tasteless. Everything was so bland. He said he sent food back to the kitchen and when they brought him a new plate of food, the food was still tasteless. Resident #251 said that he could not eat food without spices. He compared food without spices to eating grass. 6) A test tray was requested from the kitchen on 04/02/25 at 1:20 PM, when the dietary aides had almost finished loading up the meal trays onto the cart for delivery to the 3rd floor. The two surveyors and the RD followed the meal cart to the 3rd floor. The test tray was tested on [DATE] at 1:55 PM after the last resident on the 3rd floor was served. The thermometer was calibrated. The temperatures of the foods were taken, and the foods were tasted. The food was warm. The temperature was acceptable to the surveyors. The surveyors tasted pasta, meat sauce, green vegetables, and peaches. The taste of the pasta and the taste of the green vegetables was unsatisfactory. These foods may have tasted better if they had some seasoning added. The taste of the meat sauce and the peaches was acceptable. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 31 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and policy review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety, sanitary conditions, and the prevention of foodborne illnesses. This had the potential to affect 111 of 112 residents on PO (by mouth) diets. The findings included: A. During the initial tour of the Main Kitchen on 03/31/25 at 9:15 AM, accompanied by the Kitchen Manager and the Regional Manager of Dietary, the following was observed: 1. The [NAME] microwave had light and dark brown debris on all sides of the interior of the microwave. The kitchen managers agreed with this finding and said they will clean it up right away. 2. To the right of the coffee station, 2 recessed circular insets were dirty. One had brown liquid on the bottom. The Kitchen Manager wiped it out. The plastic utensil holder close to the round insets had brown residue on the top and spots of black powdery residue. 3. The 2 [NAME] double-door ovens had black and brown residue on the exterior of the front of the ovens. There was a pool of brown fluid on the lower bottom right corner of the oven. [NAME] liquid drippings from the pool of liquid dripped onto the tiled floor. 4. The reach-in Delfield fridge had 3 plastic cups with fluid in them. They were not labeled. When the Kitchen Manager was asked what kind of juice or fluid was in the cup, the Kitchen Manager said they were thickened fluids. When asked how will the staff would know if a thick fluid was nectar thick or honey thick, the Kitchen Manager said I don't know how thick the fluids are. The Kitchen Manager took the cups of thickened fluid and said they will be thrown out. 5. The interior of Manitowoc ice machine had a thick white substance and a blue substance stuck on the area of the hinges that were directly above the ice. 6. A rack of metal shelves that stored small plastic cups, bowls, and glasses had tan, yellow, and brown residue on the bottom shelf. 7. The floor under the metal shelves was dirty. It had a plastic cap, a round foil cover, paper, and food on it. B. The nourishment room on the first floor was observed on 03/31/25 at 10:20 AM. The surveyor was accompanied by the Kitchen Manager, and the Regional Manager of Dietary. 1. A 1000 ml bottle of Jevity 1.5 (nutrition formula) was opened with yellow-tan liquid splattered on the exterior of the cap and bottle. Approx 200 milliliters remained. It was not dated to indicate when this item was opened. 2. A small Styrofoam cup with a plastic lid was on the shelves inside the door of the refrigerator. An orange disposable coffee cup from McDonald's was next to the Jevity on the shelves inside the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 32 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0812 door. These items were not labeled. Level of Harm - Minimal harm or potential for actual harm 3. The [NAME] Cottage Cheese was not labeled with a name, a date, or a room number. 4. A brown paper bag of food had no date on it. Residents Affected - Few A review of the policy title Outside Foods revised 04/30/2024 said that food and beverages will be discarded without a name or date, past package expiration dates, and all perishable items after 3 days. C) During an observation on 04/02/25 at 11:24 AM, the surveyor entered the kitchen and requested that temperatures be taken for the lunch meal. The garbage pail in the kitchen overflowed with garbage. The lid was not closed. The corporate RD instructed the staff to take the garbage outside immediately. The corporate RD told the surveyor that the garbage pail was in the process of being removed. D) During an observation on 04/03/25 at 9:17 AM , the surveyor requested to see the ice machine to determine if it had been cleaned up. Upon further observation, and a discussion with the Regional Manager of Dietary, it was discovered that the ice machine had a crack on the left side of the lid close to the door hinge. The Regional Manager of Dietary explained that the white and blue colored substances were used as sealants because of the crack. Rust was observed to the left of the cracked part. Photographic evidence obtained. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 33 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0847 Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse. Level of Harm - Potential for minimal harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and review of the client's Arbitration agreements, the facility failed to ensure the arbitration agreement is explained to the resident or representative in a manner they understand (Resident #306), and had a signature from the resident or representative if they agree to the arbitration agreement (Residents #87, #306, and #307). This is for 3 of 3 residents reviewed for arbitration. Residents Affected - Many The findings included: During the entrance conference on 03/31/25 at 9:47 AM, the surveyor requested a list of residents that currently reside in the facility since 09/16/19 that entered into a binding arbitration agreement. On 04/02/25 the Surveyor was given a list of residents that had a zero, 1 or 2 next to their name. Further review of the arbitration agreement revealed zero meant that the residents did not sign the arbitration agreement, the #1 they agreed to the arbitration agreement and signed the document one time and the #2 meant they have 2 or more arbitration agreements that they have signed. There are two areas the resident or representative sign. The first is acknowledgment of understanding of the Arbitration Agreement and the second part is agreeing to the arbitration agreement, and that the resident also received a copy of the agreement. The Surveyor chose three residents that had the number 1 next to their name and were recently admitted to the facility. A review of Resident #87's medical records revealed this resident was admitted to the facility on [DATE]. He has a BIMS (Brief Interview for Mental Status) of 15 out of 15, which meant his cognition is intact. Review of the Arbitration Agreement had Resident #87's name on the document as well as the name of a resident representative. There is no signature by the resident or representative in both areas that is supposed to be signed, but it documented an electronic signature by a staff representative. During an interview with Resident #87 on 04/04/25 at 1:10 PM, the surveyor asked if anyone from the facility spoke to him about the arbitration agreement. (Surveyor had this resident's documents in hand). The resident stated, he was so drugged up when he came from the hospital that he cannot recall anything. He said he is his POA (Power of Attorney). A review of Resident #306 medical records revealed this resident was admitted to the facility on [DATE]. The resident does not have a BIMS score due to just being admitted but is able to answer all questions asked by the surveyor. A review of the resident's Arbitration Agreement documents his name on the form. During an interview on 04/04/25 at 1:20 PM with Resident #306, the Surveyor asked this resident if anyone spoke to him and explained what the Arbitration Agreement was. He stated no. His wife was in the room and she was asked the same question and she stated no. The Surveyor asked the resident if he electronically signed the document agreeing to the Arbitration Agreement. He stated no. Asked if he received a copy of the agreement he stated no. A review of Resident #307 medical records revealed this resident was admitted to the facility on [DATE]. Resident does not have a BIMS score due to just being admitted . A review of the resident's Arbitration Agreement documents his name on the form along with a Resident Representative. There is no signature from Resident #307 or his Representative in the two required signature areas. During an interview on 04/04/25 at 1:35 PM with the Admissions Director she was asked if she does the arbitration agreements. She stated that the Concierge takes care of them, but she is the one who guided her. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 106148 If continuation sheet Page 34 of 35 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 106148 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Luxe at Jupiter Rehabilitation Center (the) 674 Pioneer Road Jupiter, FL 33458 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 0847 Level of Harm - Potential for minimal harm Residents Affected - Many FORM CMS-2567 (02/99) Previous Versions Obsolete During an interview on 04/04/25 at 1:40 PM with the Concierge she was asked if she does the Arbitration Agreements with the residents. She stated that she does the Admissions Packet and the Arbitration Agreements. The surveyor showed her the list of residents and she stated that it is not the right list. She obtained a list, said the residents that have a 1 next to their name signed the agreement and the one that have 0 next to their name did not sign. The Concierge stated that she does everything on a tablet and showed the surveyor. She gave an example and pulled up a resident and stated this resident refused to sign. He has 0 next to his name. She stated that she puts a note in that they do not want to sign. The resident and or representative do not sign the document when agreeing to the arbitration agreement. The Concierge just taps each section on the computer. Event ID: Facility ID: 106148 If continuation sheet Page 35 of 35