Inspection·September 25, 2025

DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED:10/20/2025 FORM APPROVED OMB NO.0938-0391 <table><tr><td colspan="2">STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTIONS</td><td colspan="2">(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 105089</td><td>(X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING</td><td colspan="2">(X3) DATE SURVEY COMPLETED 09/25/2025</td></tr><tr><td colspan="3">NAME OF PROVIDER OR SUPPLIER PEARL AT FORT LAUDERDALE REHABILITATION AND NURSIN</td><td colspan="4">STREET ADDRESS, CITY, STATE, ZIP CODE 1701 NE 26TH ST , FORT LAUDERDALE, Florida, 33305</td></tr><tr><td>(X4) ID PRIX TAG</td><td>SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION)</td><td>ID PRIX TAG</td><td colspan="3">PROVIDER&#x27;S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY)</td><td>(X5) COMPLETION DATE</td></tr><tr><td>F0000</td><td>INITIAL COMMENTS An unannounced complaint survey, complaint numbers 2025011427, 2025011667, and 2025013572 was conducted on 09/25/25 at The Pearl at Fort Lauderdale Rehabilitation and Nursing Center. The facility was in compliance with the CFR 42, Part 483, Requirements for Long Term Care Facilities.</td><td>F0000</td><td colspan="3"></td><td></td></tr></table> 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 disclosedable 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 disclosedable 14 days following the date of survey whether or not a plan of correction is provided. These documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. <table><tr><td>LABORATORY DIRECTOR&#x27;S OR PROVIDER/SUPPLIER REPRESENTATIVE&#x27;S SIGNATURE</td><td>TITLE</td><td>(X6) DATE</td></tr></table> FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID:1D792D-H1 Facility ID:100613 If continuation sheet Page 1 of 1 PRINTED:10/20/2025 FORM APPROVED Florida State Department of Health <table><tr><td colspan="2">STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTIONS</td><td colspan="2">(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: 16270961</td><td>(X2) MULTIPLE CONSTRUCTION A. BUILDING B. WING</td><td colspan="2">(X3) DATE SURVEY COMPLETED 09/25/2025</td></tr><tr><td colspan="3">NAME OF PROVIDER OR SUPPLIER PEARL AT FORT LAUDERDALE REHABILITATION AND NURSIN</td><td colspan="4">STREET ADDRESS, CITY, STATE, ZIP CODE 1701 NE 26TH ST , FORT LAUDERDALE, Florida, 33305</td></tr><tr><td>(X4) ID PRIX TAG</td><td>SUMMARY STATEMENT OF DEFICIENCIES (EACH DEFICIENCY MUST BE PRECEDED BY FULL REGULATORY OR LSC IDENTIFYING INFORMATION)</td><td>ID PRIX TAG</td><td colspan="3">PROVIDER&#x27;S PLAN OF CORRECTION (EACH CORRECTIVE ACTION SHOULD BE CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY)</td><td>(X5) COMPLETION DATE</td></tr><tr><td>N0000</td><td>INITIAL COMMENTS An unannounced licensure complaint survey, complaint numbers 2025011427, 2025011667, and 2025013572 was conducted on 09/25/25 at The Pearl at Fort Lauderdale Rehabilitation and Nursing Center. The facility had no deficiencies at the time of the survey.</td><td>N0000</td><td colspan="3"></td><td></td></tr></table> Office of Primary Care and Health Systems Management <table><tr><td>LABORATORY DIRECTOR&#x27;S OR PROVIDER/SUPPLIER REPRESENTATIVE&#x27;S SIGNATURE</td><td>TITLE</td><td>(X6) DATE</td></tr></table> STATE FORM Event ID:1D792D-H1 Facility ID: 100613 If continuation sheet Page 1 of 1