Inspection·August 17, 2023

F 000 A complaint survey for complaint number 2023011960 was conducted on 8/17/2023 at Rosewood Health and Rehabilitation Center. The facility was in compliance with Code of Federal Regulations (CFR) 42, Part 483.73, Requirements for Long-Term Care Facilities. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE Electronically Signed 08/22/2023 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 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 of survey these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. FORM CMS-2567(02-99) Previous Versions Obsolete Event ID:P36V11 Facility ID: 11704 If continuation sheet Page 1 of 1 Agency for Health Care Administration PRINTED: 10/10/2023 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA AND PLAN OF CORRECTION IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION A. BUILDING: _______________ B. WING _______________ (X3) DATE SURVEY COMPLETED 08/17/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE ROSEWOOD HEALTHCARE AND REHABILITATION CI 3107 NORTH H STREET PENSACOLA, FL 32501 (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES ID PROVIDER'S PLAN OF CORRECTION (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE REGULATORY OR LSC IDENTIFYING INFORMATION) TAG CROSS-REFERENCED TO THE APPROPRIATE DEFICIENCY) (X6) COMPLETE DATE

N 000 INITIAL COMMENTS N 000 A complaint investigation for complaint number 2023011960 was conducted at Rosewood Health and Rehabilitation Center on 8/17/2023. The provider had no deficiencies at the time of the visit. AHCA Form 3020-0001 LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X8) DATE Electronically Signed 08/22/23 STATE FORM 6809 P38V11 If continuation sheet 1 of 1