Health inspection·February 6, 2026

F 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Pharmacy manifest dated 1/5/2026 reflected 90 tablets of Hydrocodone-Acetaminophen Oral Tablet 10-325 MG were received for Resident #2 by LVN B. During an interview on 2/6/2026 at 9:30 am, the DON stated a nurse went to reorder Resident #1's narcotic medication and the pharmacy told her it was too soon. She investigated and discovered that LVN A had received the Hydrocodone-Acetaminophen Oral Tablet 7.5-325 MG on the narcotic count sheet, and the quantity was changed from 124 to 64 tablets. The facility suspects that LVN A was the one that made the change but there were no witnesses. She stated Resident #1 did not go without pain medication at that time. The DON stated while they were reviewing the narcotic count sheets, they discovered Resident #2 was missing 30 tablets of Hydrocodone-Acetaminophen Oral Tablet 10-325 MG. She stated there was no name written in the received box on the narcotic count sheet, just a date and an amount, but the handwriting looked like LVN A. Again, there were no witnesses. Resident #2 did not go without pain medication at that time either. She stated she interviewed LVN B, who received Resident #2's narcotic medication from the pharmacy and she stated she handed the medication off to LVN A. She stated nursing staff were following the existing policy at that time but since then, they have changed their policy on how narcotic medications will be received and distributed to the medication carts. The new process requires two nurses to receive medications and two nurses to put the medications in the cart - both nurses will sign and date the narcotic count sheets when received and put away. During an interview on 2/6/2026 at 1:51 pm, the ADM stated his expectations regarding the receipt of narcotics was that two nurses will sign for delivery, both nurses go to the cart and put meds away, then both log it, secure it and sign the sheet. They should make sure the count sheet was accurate with no cross outs and if there were any changes made to the narcotic label on the count sheet, they should immediately notify the DON or ADM. He stated when narcotic medications are not available for residents, they might be unable to control their pain or control their anxiety - they might need it to calm down. During an interview on 2/6/2026 at 2:51 pm, the MD stated his expectations regarding the management and receipt of narcotics in general that there would be zero errors, no diversion and no missing medications. He stated with diversion there was a potential of misuse, or an overdose, a danger of meds not being available and a lack of pain control for the residents. He stated he is pleased with the facility's implementation of a different process, and they recently changed pharmacies - the new pharmacy's system has more up to date technology, and it was a good move. During an interview on 2/6/2026 at 3:15 pm, the DON stated her expectations regarding the receipt of narcotics was that staff would adhere to the rules regarding getting meds from the pharmacy, storing of meds, passing keys and signing the narcotic sheets as required. She stated when narcotic medications are not available residents could have increased pain or anxiety. During an interview on 2/6/2026 at 3:40 pm, Resident #2 stated he was aware of the missing medications, but it did not affect him in any way. He stated he had no concerns with care at the facility, and his pain was being managed. Attempts to reach LVN A by phone calls and text for an interview were unsuccessful. Review of facility policy Abuse, Neglect and Exploitation dated 4/11/2025 reflected It is the policy of this facility to provide protections for the health, welfare and rights of each resident by developing and implementing written policies and procedures that prohibit and prevent abuse, neglect, exploitation and misappropriation of resident property. Definition:Misappropriation of Resident Property means the deliberate misplacement, exploitation, or wrongful, temporary or permanent, use of a resident's belongings or money without the resident's consent. Policy Explanation and Compliance Guidelines:1. The facility will develop and implement written policies and procedures that:a. Prohibit and prevent abuse, neglect, and exploitation of residents and misappropriation of resident property;b. Establish policies and procedures to investigate any such allegations; andc. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455478 If continuation sheet Page 2 of 3 Printed: 05/15/2026 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 455478 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/06/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ivy Creek Wellness & Rehabilitation 2501 Maple Ave Waco, TX 76707 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 0602 Level of Harm - Minimal harm or potential for actual harm Include training for new and existing staff on activities that constitute abuse, neglect, exploitation, and misappropriate of resident property, reporting procedures, and dementia management and resident abuse prevention Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455478 If continuation sheet Page 3 of 3