Inspection·December 10, 2025

F0000 12/10/2025 A revisit to the recertification survey was conducted by desk review on December 10, 2025. The previously cited deficiency was found to have been corrected as of October 5, 2025. The facility is in compliance with 42 CFR 483, Requirements for Long Term Care facilities. Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See reverse for further instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: 1D1509-H2 Facility ID: 35961021 If continuation sheet Page 1 of 1