Suite Living of Brooklyn Park.

correction orders issued pursuant to the November 7, 2025 survey. The Department of Health concludes the licensee is in substantial compliance. State law requires the facility must take action to correct the state correction orders and document the actions taken to comply in the facility's records. The Department reserves the right to return to the facility at any time should the Department receive a complaint or deem it necessary to ensure the health, safety, and welfare of residents in your care. In accordance with Minn. Stat. § 144G.31 Subd. 4 (a), state correction orders issued pursuant to the last survey, completed on November 7, 2025, found not corrected at the time of the December 17, 2025, follow-up survey and/ or subject to penalty assessment are as follows: 2310-Appropriate Care And Services-144g.91 Subd. 4 (a) The details of the violations noted at the time of this follow-up survey completed on December 17, 2025 (listed above) , are on the attached State Form. Brackets around the ID Prefix Tag in the left hand column, e.g., {2 ----} will identify the uncorrected tags. In accordance with Minn. Stat. § 144G.31 Subd. 4, MDH may assess fines based on the level and scope of t he violati ons ; however, no immediate fines are assessed for this survey of your facility. DOCUMENTATIO ONF ACTION TO COMPLY In accorda nce with Min n. Stat. § 144G.30, Sub d. 5(c), th e lic ens ee mus t docum ent ac tions taken t o comply with the correction orders outlined on the state form; however, plans of correction are not required to be submitted for approval. CORRECTIO NORDER RECONSIDERATIO PNROCESS In accordance with Minn. Stat. § 144G.32, Subd. 2, you may challenge the correction order( s) issued, An equal opportunity employer. Letter ID: 8GKP Revised 04/14/2023 Suite Living Senior Care of Brooklyn Park January 21, 2026 Page 2 including the level and scope, and any fine assessed through the correction order reconsideration process. The request for reconsideration must be in writing and received by MDH within 15 calendar days of the correction order receipt date. To submit a reconsideration request, please visit: https: / / forms. web. health. state. mn.us/ form/ HRDAppealsForm We urge you to review these orders carefully. If you have questions, please contact Jess Schoenecker at 651-201-3789. You are encouraged to retain this document for your records. It is your responsibility to share the information contained in the letter and/ or state form with your organization’s Governing Body. Sincerely, Jess Schoenecker, Supervisor State Evaluation Team Email: Jess.Schoenecker@state. mn.us Telephone: 651-201-3789 Fax: 1-866-890-9290 CLN PRINTED: 01/ 21/ 2026 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/ SUPPLIER/ CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ R B. WING _____________________________ 36600 12/ 17/ 2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 8500 REGENT AVENUE NORTH SUITE LIVING SR CARE OF BP BROOKLYN PARK, MN 55443 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER' S PLAN OF CORRECTION (X4) ID ID (X5) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS- REFERENCED TO THE APPROPRIATE DATE TAG TAG DEFICIENCY) {0 000} Initial Comments {0 000} ******ATTENTION****** Minnesota Department of Health is documenting the State Correction Orders ASSISTED LIVING PROVIDER FOLLOW UP using federal software. Tag numbers have SURVEY WITH RE- ISSUE OF ORDERS been assigned to Minnesota State Statutes for Assisted Living Facilities. The INITIAL COMMENTS assigned tag number appears in the SL36600016- 1 far-left column entitled "ID Prefix Tag. " The state Statute number and the On December 16, 2025, through December 17, corresponding text of the state Statute out 2025, the Minnesota Department of Health of compliance is listed in the "Summary conducted a follow-up survey at the above Statement of Deficiencies" column. This provider to follow-up on orders issued pursuant to column also includes the findings which a survey completed November 7, 2025. At the are in violation of the state requirement time of the survey, there were 27 residents; 27 after the statement, "This Minnesota receiving services under the Assisted Living requirement is not met as evidenced by." Facility with Dementia Care license. As a result Following the evaluators' findings is the of the follow-up survey, the following order was Time Period for Correction. reissued. PLEASE DISREGARD THE HEADING OF THE FOURTH COLUMN WHICH STATES, "PROVIDER' S PLAN OF CORRECTION. " THIS APPLIES TO FEDERAL DEFICIENCIES ONLY. THIS WILL APPEAR ON EACH PAGE. THERE IS NO REQUIREMENT TO SUBMIT A PLAN OF CORRECTION FOR VIOLATIONS OF MINNESOTA STATE STATUTES. THE LETTER IN THE LEFT COLUMN IS USED FOR TRACKING PURPOSES AND REFLECTS THE SCOPE AND LEVEL ISSUED PURSUANT TO 144G. 31 SUBDIVISION 1-3. {0 510} 144G. 41 Subd. 3 Infection control program {0 510} SS= E (a) All assisted living facilities must establish and LABORATORY DIRECTOR' S OR PROVIDER/ SUPPLIER REPRESENTATIVE' S SIGNATURE TITLE (X6) DATE STATE FORM 6899 QN1D12 If continuation sheet 1 of 10 PRINTED: 01/ 21/ 2026 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/ SUPPLIER/ CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ R B. WING _____________________________ 36600 12/ 17/ 2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 8500 REGENT AVENUE NORTH SUITE LIVING SR CARE OF BP BROOKLYN PARK, MN 55443 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER' S PLAN OF CORRECTION (X4) ID ID (X5) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS- REFERENCED TO THE APPROPRIATE DATE TAG TAG DEFICIENCY) {0 510} Continued From page 1 {0 510} maintain an infection control program that complies with accepted health care, medical, and nursing standards for infection control. (b)The facility's infection control program must be consistent with current guidelines from the national Centers for Disease Control and Prevention (CDC) for infection prevention and control in long- term care facilities and, as applicable, for infection prevention and control in assisted living facilities. (c) The facility must maintain written evidence of compliance with this subdivision. This MN Requirement is not met as evidenced by: Not reviewed during this survey. {0 775} 144G. 45 Subd. 2. (a) Fire protection and physical {0 775} SS= F environment Each assisted living facility must comply with the State Fire Code in Minnesota Rules, chapter 7511, and: This MN Requirement is not met as evidenced by: Not reviewed during this survey. {0 810} 144G. 45 Subd. 2 (b-f) Fire protection and {0 810} SS= F physical environment (b) Each assisted living facility shall develop and maintain fire safety and evacuation plans. The plans shall include but are not limited to: (1) location and number of resident sleeping rooms; (2) staff actions to be taken in the event of a fire or similar emergency; (3) fire protection procedures necessary for STATE FORM 6899 QN1D12 If continuation sheet 2 of 10 PRINTED: 01/ 21/ 2026 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/ SUPPLIER/ CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ R B. WING _____________________________ 36600 12/ 17/ 2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 8500 REGENT AVENUE NORTH SUITE LIVING SR CARE OF BP BROOKLYN PARK, MN 55443 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER' S PLAN OF CORRECTION (X4) ID ID (X5) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS- REFERENCED TO THE APPROPRIATE DATE TAG TAG DEFICIENCY) {0 810} Continued From page 2 {0 810} residents; and (4) procedures for resident movement, evacuation, or relocation during a fire or similar emergency including the identification of unique or unusual resident needs for movement or evacuation. (c) Staff of assisted living facilities shall receive training on the fire safety and evacuation plans upon hiring and at least twice per year thereafter. (d) Fire safety and evacuation plans shall be readily available at all times within the facility. (e) Residents who are capable of assisting in their own evacuation shall be trained on the proper actions to take in the event of a fire to include movement, evacuation, or relocation. The training shall be made available to residents at least once per year.

Finding: Inconclusive Nature of Investigation: The Minnesota Department of Health investigated an allegation of maltreatment, in accordance with the Minnesota Reporting of Maltreatment of Vulnerable Adults Act, Minn. Stat. 626.557, and to evaluate compliance with applicable licensing standards for the provider type. Initial Investigation Allegation(s): The alleged perpetrator (AP), who was an unknown facility staff member, abused the resident when they restricted his movement by taking away his wheelchair and locking his room. As a result, the resident could not access his bathroom, bedroom, or personal property. Investigative Findings and Conclusion: The Minnesota Department of Health determined abuse was inconclusive. It could not be determined if staff encouraged the resident to stay out of his room for his safety or if staff consistently locked the resident’s door to prevent him from entering due to conflicting information. The resident fell fifteen times within three months while unattended in his room self-transferring. Additionally, the resident was observed sitting in a chair with his wheelchair out of reach, however nursing staff indicated that was not a directive given to the unlicensed personnel (ULP). The investigator conducted interviews with facility staff members, including administrative staff, nursing staff, and unlicensed staff. The investigation included review of the resident records, facility incident reports, personnel files, staff schedules, law enforcement report, and related facility policy and procedures. Also, the investigator toured the facility and observed the memory care unit, medication administration, video footage, and documentation systems. The resident resided in an assisted living facility. The resident’s diagnoses included ataxia (impaired balance), dementia, and Parkinson disease. The resident’s service plan included assistance with meals, medication administration, toileting, bathing, transfers, and walking. The resident’s nursing assessment indicated he moved himself around the unit independently when he was in his wheelchair, but required assistance for transferring. The resident’s nursing assessment indicated he was confused, had poor judgement, and required reminders. The nursing assessment indicated he was at risk of falling, and staff members were to encourage him to call them for assistance. Other interventions included staff members were to ensure his environment was free from clutter, all his personal items were within his reach, and to put his bed in the lowest position. The fall interventions lacked indication the staff were to remove his wheelchair, or lock his bedroom door. Incident reports indicated the resident fell fifteen times within three months. Fourteen of these falls occurred within the resident’s room when he was unattended by staff. While the surveyor toured the memory care unit, the surveyor observed the resident wheeling himself around the unit in his wheelchair. The surveyor observed an unlicensed personnel (ULP) tell him not to enter his room and to remain in the hallway. The resident did not appear distressed, and continued to wheel himself around the unit. The ULP told the surveyor the staff try to keep him out of his room because he falls frequently. A short time later, the surveyor observed the resident sitting in a reclining chair in the lounge area. The resident’s wheelchair was in the hallway, apart from him. The same ULP told the surveyor, they keep his wheelchair away from him because he required assistance with transferring, and if left within his reach, he would attempt to self-transfer and fall. During an interview, a facility nurse said the resident’s health declined. The nurse said the resident’s ability to walk was poor and he fell frequently. The nurse said the resident had poor insight into his physical abilities. The nurse said they told staff members to keep the resident in the common areas/lounge as much as they could to prevent him from falling, but they did not tell ULP to remove his wheelchair or lock his bedroom door. During an interview, another nurse said the resident was able to go into his room, however often fell while in there unattended. The nurse said they did not tell the ULP’s to lock his room, or remove his wheelchair. During an interview, a ULP said she observed the resident trying to get into his room, but he could not because staff locked the door. The ULP said she heard the resident holler in an angry voice for staff to unlock his door. The ULP said the resident was repetitious about this until a staff member arrived approximately five minutes later. The ULP said she asked another ULP why they locked the resident’s doors, and the ULP told her it was because the residents were “naughty” (referring to all residents, not just this resident). The ULP said she asked a nurse if this action was on the resident’s care plan, but the nurse did not give a definitive answer. The ULP said she continues to observe staff lock the resident’s bedroom door. The ULP said she observed staff members place the resident’s wheelchair away from him when he sits in the reclining chair in the lobby area, so it is not within his reach. During multiple investigative interviews, some ULPs acknowledged they moved the resident’s wheelchair away from him and/or locked his door for safety reasons because he fell frequently. Other ULP’s indicated they did not lock his door, or remove his wheelchair. In conclusion, the Minnesota Department of Health determined abuse was inconclusive. Inconclusive: Minnesota Statutes, section 626.5572, Subdivision 11. "Inconclusive" means there is less than a preponderance of evidence to show that maltreatment did or did not occur. Abuse: Minnesota Statutes section 626.5572, subdivision 2. "Abuse" means: (a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate, or aiding and abetting a violation of: (1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224; (2) the use of drugs to injure or facilitate crime as defined in section 609.235; (3) the solicitation, inducement, and promotion of prostitution as defined in section 609.322; and (4) criminal sexual conduct in the first through fifth degrees as defined in sections 609.342 to 609.3451. A violation includes any action that meets the elements of the crime, regardless of whether there is a criminal proceeding or conviction. (b) Conduct which is not an accident or therapeutic conduct as defined in this section, which produces or could reasonably be expected to produce physical pain or injury or emotional distress including, but not limited to, the following: (1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable adult; (2) use of repeated or malicious oral, written, or gestured language toward a vulnerable adult or the treatment of a vulnerable adult which would be considered by a reasonable person to be disparaging, derogatory, humiliating, harassing, or threatening; (3) use of any aversive or deprivation procedure, unreasonable confinement, or involuntary seclusion, including the forced separation of the vulnerable adult from other persons against the will of the vulnerable adult or the legal representative of the vulnerable adult; and (4) use of any aversive or deprivation procedures for persons with developmental disabilities or related conditions not authorized under section 245.825. (c) Any sexual contact or penetration as defined in section 609.341, between a facility staff person or a person providing services in the facility and a resident, patient, or client of that facility. (d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the vulnerable adult's will to perform services for the advantage of another. Vulnerable Adult interviewed: Attempted. Unable to participate. Family/Responsible Party interviewed: Attempted. Did not respond. Alleged Perpetrator interviewed: Not Applicable. Action taken by facility: The facility leadership staff told ULPs to keep the resident’s wheelchair next to him. Action taken by the Minnesota Department of Health: The facility was found to be in noncompliance. To view a copy of the Statement of Deficiencies and/or correction orders, please visit: https://www.health.state.mn.us/facilities/regulation/directory/provcompselect.html If you are viewing this report on the MDH website, please see the attached Statement of Deficiencies. You may also call 651-201-4200 to receive a copy via mail or email cc: The Office of Ombudsman for Long Term Care The Office of Ombudsman for Mental Health and Developmental Disabilities PRINTED: 10/15/2025 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ C B.

Finding: Inconclusive Nature of Investigation: The Minnesota Department of Health investigated an allegation of maltreatment, in accordance with the Minnesota Reporting of Maltreatment of Vulnerable Adults Act, Minn. Stat. 626.557, and to evaluate compliance with applicable licensing standards for the provider type. Initial Investigation Allegation(s): The facility neglected a resident when staff did not administer her prescribed medication for several days. The resident was hospitalized with abdominal pain and distention. Investigative Findings and Conclusion: The Minnesota Department of Health determined neglect was inconclusive. Although the resident may not have received all her scheduled doses of a prescribed medication during approximately two weeks, there was conflicting staff member documentation on the medication’s availability and administration. The facility had a process in place for unlicensed staff members to notify nurses when a medication was low and needed to be refilled. Nursing and unlicensed staff members gave conflicting information during interviews on when the nurse was notified about the medication needing to be refilled. The resident was hospitalized for one week for treatment of abdominal pain. In addition, the hospital physician and primary physician had conflicting causes of the resident’s hospitalization. An equal opportunity employer. The investigator conducted interviews with facility staff members, including administrative staff, nursing staff, and unlicensed staff. The investigator contacted the physician. The investigation included review of medical records, hospital records, policies and procedures, personnel files, and facility incident reports. Also, the investigator observed medication administration and the medication refill process. The resident resided in an assisted living facility. The resident’s diagnoses included cirrhosis of the liver (liver damage), diabetes and multiple sclerosis (MS). The resident’s service plan included assistance with medication administration. The resident’s assessment indicated she was able to make her needs known. The resident’s medication management plan indicated facility staff was responsible for monitoring and ordering resident medications. The resident’s medication orders included an order for lactulose scheduled twice a day for cirrhosis of the liver. The resident’s medication administration record (MAR) indicated over a two-week span of time the resident missed 17 out of 24 doses of lactulose. The staff indicated on the MAR drug “not available” as the reason why the medication was not given. The resident’s progress noted indicated the resident presented to the nurse crying and complaining of abdominal pain. The nurse assessed the resident, contacted the physician and sent the resident to the hospital for evaluation and treatment. The resident admitted to the hospital for about one week for treatment of neurogenic bowel (the loss of normal bowel function caused by a nerve problem) and then discharged back to the facility. The resident’s hospital record indicated the gastroenterologist (stomach/digestion doctor) reviewed the resident’s bowel imaging, laboratory results and clinical presentation. The gastroenterologist indicated the neurogenic bowel was likely the complication of the resident’s MS. A few weeks later, the resident’s physician contacted the resident’s family member and the facility’s nurse about the resident’s hospitalization. The physician indicated the hospitalization most likely due to missed doses of her prescription lactulose. (Lactulose is a medication that increases bowel movements and lowers the body’s ammonia production.) During an interview, the nurse said when she was contacted by the resident’s physician about the medication error, she was shocked because there was a process in place for staff to let her know if a medication was running low or out. Staff were to check the overstock storage first, and then let her know if a medication needed refilling by placing the empty medication package in specifically marked gray bins in the nursing office. The nurse checked the bins daily. The nurse said she never had any empty packaging or bottles of the resident’s medications in the bins. The nurse checked the resident’s medication records; there were days where staff members documented the resident’s lactulose was given at both scheduled times, days when staff documented it was not available during either scheduled time, and days when it was documented as given during one of the scheduled times, but not the other. The conflicting documentation involved experienced and newer staff members. The nurse said when she interviewed them about the medication, they had no clear explanations on what happened. The nurse said she increased her medication cart audits and reviewed the resident’s medications and documentation process with staff members. One newer staff member was pulled from the medication cart for re-training. The nurse said she contacted the resident’s family member about the incident. During an investigative interview, an unlicensed staff member said she did not know when the resident’s lactulose was out, but she did leave the nurse a note about needing it refilled. Other unlicensed staff members said the medication refill process worked well and were not aware of missed medications. During an interview, a manager said the resident usually took any nursing concerns directly to the nurses. During an interview, the resident said when she asked staff members where her medication was, they told her they left the nurse notes about reordering the medication. The resident said she had no reason not to believe them and did not think they neglected her. The resident said she asked the nurse about her medication but was not sure when. The resident said she recovered but it took her a long time to feel well again. The resident’s family member said the nurse called her when the resident was sent to the hospital for abdominal pain. A few weeks later, the physician told her the missed lactulose was a primary reason for the resident’s hospitalization. The family member said the resident returned to her baseline health, but the family member still had concerns about the staff performing other cares and treatments. Therefore, the family member found a new facility for the resident. In conclusion, the Minnesota Department of Health determined neglect was inconclusive. Inconclusive: Minnesota Statutes, section 626.5572, Subdivision 11. "Inconclusive" means there is less than a preponderance of evidence to show that maltreatment did or did not occur. Neglect: Minnesota Statutes, section 626.5572, subdivision 17 “Neglect” means neglect by a caregiver or self-neglect. (a) "Caregiver neglect" means the failure or omission by a caregiver to supply a vulnerable adult with care or services, including but not limited to, food, clothing, shelter, health care, or supervision which is: (1) reasonable and necessary to obtain or maintain the vulnerable adult's physical or mental health or safety, considering the physical and mental capacity or dysfunction of the vulnerable adult; and (2) which is not the result of an accident or therapeutic conduct. Vulnerable Adult interviewed: Yes. Family/Responsible Party interviewed: Yes. Alleged Perpetrator interviewed: Not Applicable. the Action taken by facility: The nurse re-educated staff members on the resident’s lactulose, documentation expectations and the refill process. The nurse increased her medication cart audits and ensured competency testing of unlicensed staff. Action taken by the Minnesota Department of Health: The facility was found to be in noncompliance. To view a copy of the Statement of Deficiencies and/or correction orders, please visit: https://www.health.state.mn.us/facilities/regulation/directory/provcompselect.html If you are viewing this report on the MDH website, please see the attached Statement of Deficiencies. You may also call 651-201-4200 to receive a copy via mail or email. cc: The Office of Ombudsman for Long Term Care The Office of Ombudsman for Mental Health and Developmental Disabilities PRINTED: 09/22/2023 FORM APPROVED STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. BUILDING: ______________________ C B. WING _____________________________ 36600 07/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE 8500 REGENT AVENUE NORTH SUITE LIVING SR CARE OF BP BROOKLYN PARK, MN 55443 SUMMARY STATEMENT OF DEFICIENCIES PROVIDER'S PLAN OF CORRECTION (X4) ID ID (X5) PREFIX (EACH DEFICIENCY MUST BE PRECEDED BY FULL PREFIX (EACH CORRECTIVE ACTION SHOULD BE COMPLETE REGULATORY OR LSC IDENTIFYING INFORMATION) CROSS-REFERENCED TO THE APPROPRIATE DATE TAG TAG DEFICIENCY) 0 000 Initial Comments 0 000 ******ATTENTION****** Minnesota Department of Health is documenting the State Correction Orders ASSISTED LIVING PROVIDER CORRECTION using federal software. Tag numbers have ORDER been assigned to Minnesota State Statutes for Assisted Living Facilities. The In accordance with Minnesota Statutes, section assigned tag number appears in the far 144G.08 to 144G.95, these correction orders are left column entitled "ID Prefix Tag." The issued pursuant to a complaint investigation.