Inspection·August 7, 2025

F 0553 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete [DATE]. Resident was admitted for skilled services on 07/25/2023 before discharging home. His diagnoses included: Traumatic subarachnoid hemorrhage with loss of consciousness of 30 minutes or less, subsequent encounter (a global ischemia, resulting from a lack of perfusion of pressure during aneurysmal rupture: a brain aneurysm that bursts); Epilepsy, unspecified, not intractable, without status epilepticus (a group of disorders marked by problems in normal functioning of the brain); Chronic Atrial Fibrillation, Unspecified (an irregular and often very rapid heart rhythm). Record review of Resident #69's file revealed no documentation for initial care plan meeting with resident or resident representation. It was noted on Resident #69's face sheet that he was his own responsible party and has two sons and two daughters. On 08/06/2025 at 12:47 PM, an interview with Resident #69's family member revealed he believed that there has been a meeting in the past when Resident #69 was at facility last year. Family member stated the facility keeps the family well informed. On 08/07/2025 at 10:20 AM, an interview with the SW revealed that she had been employed at the facility as of 11/01/2024. The SW revealed that she tries to keep up with the documentation when care plan meetings are held. The SW does not use the Family/Resident Conference Form located in the facility's assessment task. SW stated she was not trained to use that form. The SW revealed she documented in the SW progress notes. The process the SW used to invite the residents and family members to the care plan meetings was by calling them or by emails. She personally invited the residents. The goals were to ensure that the residents or their representatives was invited to participate in the care plan meetings and documentation is completed during the meetings. Record review of the facility's Comprehensive Care Plans (revised November 2010) revealed in part, Our facility's Care Planning/Interdisciplinary Team in coordination with the resident, his/her family or representative (sponsor), develops and maintains a comprehensive care plan for each resident that identifies the highest level of functioning the resident may be expected to attain. Event ID: Facility ID: 455523 If continuation sheet Page 2 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0583 Keep residents' personal and medical records private and confidential. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure each resident had a right to secure and confidential personal and medical records for 6 (Residents #7, #9, #45, #61, #69, & #74) of 7 residents reviewed for privacy and confidentiality The facility failed to ensure the privacy and confidentiality of resident's clinical records that were not left on top of a treatment cart face up in the hallway unattended from 11:30 AM to 11:57 AM, for Resident #7, #9, #45, #61, #69, & #74 on 08/7/25. This deficient practice could place residents at-risk of loss of dignity due to lack of privacy and confidentiality. Findings included: Record review of Resident #7's face sheet, dated 8/7/25, revealed a [AGE] year-old male with an initial admission of 09/14/23 and readmitted to the facility on [DATE]. His primary diagnosis was Altered mental Status, other diagnosis included Methicillin Resistant Staphylococcus Aureus infection as the cause of diseases classified elsewhere (MRSA is a type of bacteria that many antibiotics don't work on) and encounter for surgical aftercare following surgery on the genitourinary system (surgery on the urinary system). Record review of Resident #9's face sheet, dated 8/7/25, revealed a [AGE] year-old male admitted to the facility on [DATE] with diagnosis of Chronic obstructive pulmonary disease (a lung disease that blocks airflow and makes it difficult to breathe) and Chronic Peripheral Venous Insufficiency (a condition that occurs when veins in the legs or arms have difficulty returning blood to the heart). Record review of Resident #45's face sheet, dated 8/7/25, revealed an [AGE] year-old male admitted on [DATE] with a diagnoses of primary osteoarthritis right shoulder (this is a type of arthritis that occurs when flexible tissue at the ends of bones wear down) and non-pressure chronic ulcer of right heal and midfoot with other specified severity, pressure ulcer of right heal unstageable, and benign neoplasm of the parotid gland (cancer of the parathyroid gland located in the neck). Record review of Resident #61's face sheet, dated 8/7/25, revealed a [AGE] year-old male admitted to the facility on [DATE] with diagnosis of Vascular dementia (this is brain damage that is caused by multiple strokes that causes memory loss) and Type 2 Diabetes (a disease that occurs when the body does not respond properly to insulin leading to high blood sugar levels). Record review of Resident #69's face sheet, dated 8/7/25, revealed an [AGE] year-old male with an initial admission of 7/25/23 and readmitted [DATE] with a primary diagnosis of traumatic subarachnoid hemorrhage with loss of consciousness of 30 minutes or less, subsequent encounter (head injury resulting in consciousness of 30 minutes or less). Record review of Resident #74's face sheet, dated 8/7/25, revealed the resident was a [AGE] year-old female admitted on [DATE] with diagnoses of congestive heart failure and type 2 diabetes. Continuous observation on from 11:30 AM to 11:57 AM on 08/07/25 revealed 7 pages of residents' medical records spread on top of the treatment cart in the unit 5 hallway. The medical records were titled [facility name] dated 08/7/25. The documents had 6 columns, with handwritten notes in red ink as follows; first column had names of residents, second column had location of wound, third column had the stage of wound, the fourth was blank, the fifth had the treatments, and the sixth had the frequency. The documents were visible, face up, near resident's rooms and unattended on top of the treatment cart by the wall in unit 5 hallway with Residents # 7, #9, #45, #61, #69, & #74's medical records displayed. In an interview with the Treatment PA Assistant on 08/07/25 at 11:54 AM, it was revealed herself and a team of other NPs were in the facility doing wound treatments. She stated, oops we have been dinged for HIPPA, as she gathered the papers with the resident's medical records from the top of the treatment cart. When asked by Surveyor about the risk of leaving residents information out, Treatment PA did not state the risk of leaving residents information unattended and accessible to unauthorized persons. In an interview with the DON on 08/07/25 at 1:16 PM, Residents Affected - Some (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 3 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0583 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete she stated all medical persons are trained on HIPAA to protect resident information and privacy. She said every staff member is trained on HIPAA. She said she expected the contracted treatment team members to flip over the papers with residents' information, or best practice was to take document with them. She said she expected everyone to protect resident's records. She said the risk was access of resident's information to unauthorized persons. Interview with the ADM on 08/07/25 at 3:49 PM, she stated she expected all staff to handle clinical records with confidentiality. She said she expected staff to close, turn off, or lock computer screen when not in use. She said all staff were taught to protect resident information when they were hired. She said if documents were on paper, she expected staff to take it with them and to secure it. She said it was the staff's responsibility to make sure documents were secure. The ADM said that she had reached out to corporate office to request that the contracted treatment company not return to the facility. The ADM said risk of leaving residents information exposed was a breach of resident's privacy. Record review of the facility's policy titled Confidentiality of Information and Personal Privacy revised 12/15/ 2017 revealed: .the facility will safeguard the personal privacy and confidentiality of all resident personal and medical records Event ID: Facility ID: 455523 If continuation sheet Page 4 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure the assessment accurately reflected the resident's status for 1 (Resident #8) of 5 residents reviewed for quality of care. 1. The facility failed to accurately assess Resident #8's bowel and bladder status. 2. The facility failed to accurately access Resident #8's ability to voice her bowel and bladder needs. These failures could place resident with having inaccurate care plans and inappropriate identification of care needs. Findings included: Review of Resident #8's annual MDS assessment dated [DATE] reflected she was a [AGE] year-old female admitted to the facility on [DATE]. Her diagnoses included: Unspecified Injury of Head, Subsequent Encounter (a healthcare visit that occurs after the initial active treatment of a condition or injury; Type 2 diabetes mellitus without complications (a chronic condition that affects the way the body processes blood sugar - glucose); Essential (Primary) Hypertension (high blood pressure that is multi-factorial and doesn't have one distinct cause). She had adequate hearing, clear speech, was always understood and had adequate vision with glasses. Her BIMS score was 15, which indicated memory fully intact. She did not have any issues with inattention, disorganized thinking or altered levels of consciousness. Her mood assessment reflected no issues. She had no delusions, hallucinations or psychosis. She was noted to have verbal behaviors towards others and wandering during the assessment period, but no physical behaviors directed towards others. She required limited assistance for bed mobility, locomotion, dressing, eating, toilet use and personal hygiene. She had no range of motion impairments and used a walker and wheelchair for mobility. She needed partial/moderate assistance with tub/shower transfers. It was noted in the MDS she was frequently incontinent with bladder and occasionally incontinent of bowel. No toileting program had not been used. The DON signed as the RN assessment coordinator verifying assessment as complete on 06/08/2025. Review of Resident #8's Bowel and Bladder assessment dated [DATE] revealed Resident #8 was continent of both bowel and bladder. Does not require a toileting plan. Review of Bowel and Bladder assessment dated [DATE] revealed Resident #8 was incontinent of bladder and continent of bowel. Does not require a toileting plan. Review of Resident #8's Plan of Care Tasks History dated 07/15/2025 through 08/07/2025 revealed Resident #8 was continent of bowel and bladder with no episodes of incontinence. On 08/06/2025 at 1:10 PM, interview with DON revealed that Resident #8 is not incontinent of bowel and bladder. Informed DON that Resident#8's MDS noted that resident is frequently incontinent of bladder and had occasional episodes of bowel incontinence. DON stated she will inform the MDS Coordinator to correct the mistake. On 08/07/2025 at 2:47 PM, interview with MDS Coordinator revealed he had worked at the facility since 2014. He works at both buildings. Responsible for all the MDS for building. Completes MDS almost daily. Monday through Friday. The process is to interview residents on paper in person and document information in the MDS program. He evaluated the resident in their room. Completed the MDS within the 14-day window. Every 90 days and if there had been a change in condition and end up in the hospital or a fall. Completed an annual MDS as well. Evaluating vision and hearing the SW completes, looks at progress notes such as shortness of breath when their bed is lowered, assess their skin for any breakdown. When a resident discharged home and return a new MDS is completed. A discharge MDS is completed when they discharged home. If a resident is discharged more than 72 hours from the facility and must return to facility a new MDS will have to be completed. Resident #8 has been labeled as having issues with bowel and bladder incontinence according to the POC. If these questions are answered yes, it will automatically trigger the MDS that resident has a bowel and bladder incontinence problem. The DON revealed resident does not have incontinence. The daily task notes resident is continent. He will go speak with the nurses if he has a question Residents Affected - Some (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 5 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0641 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete concerning discrepancies with the answer's r/t incontinence. On 08/07/2025 at 4:30 PM, interview with the ADM revealed that the MDS Coordinator completed all the MDS Assessments. The ADM's expectation is that the MDS are correct according to the assessment completed and that he is communicating with nursing staff to ensure accuracy of the assessments. No policy for MDS Accuracy was provided. Facility follows the RAI manual. Review of Long-Term Care Facility Resident Assessment Instrument 3.0 User's Manual version 1.17.1 dated October 2019 reflected, The RAI process has multiple regulatory requirements. Federal regulations at 42 CFR 483.20 (b)(1)(xviii), (g), and (h) require that (1) the assessment accurately reflects the resident's status (2) a registered nurse conducts or coordinates each assessment with the appropriate participation of health professionals (3) the assessment process includes direct observation, as well as communication with the resident and direct care staff on all shifts . In addition, an accurate assessment requires collecting information from multiple sources, some of which are mandated by regulations. Those sources must include the resident and direct care staff on all shifts, and should also include the resident's medical record, physician, and family, guardian, or significant other as appropriate or acceptable. It is important to note here that information obtained should cover the same observation period as specified by the MDS items on the assessment and should be validated for accuracy (what the resident's actual status was during that observation period) by the IDT completing the assessment. As such, nursing homes are responsible for ensuring that all participants in the assessment process have the requisite knowledge to complete an accurate assessment . Event ID: Facility ID: 455523 If continuation sheet Page 6 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights, that included measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment for 1 of 16 residents (Resident #1) reviewed for care plans. The facility failed to develop a person-centered care plan with interventions to address Resident #1's use of anti-coagulant medication, bed rails, and walker. This failure could have placed residents at risk of not having their needs identified and met. The findings included: Record review of Resident #1's admission Record/Face Sheet, dated 08/06/2025, revealed an [AGE] year-old female who originally admitted to the facility on [DATE] with most recent admission on [DATE]. Resident #1 was noted to have diagnoses of Alzheimer's Disease (a progressive brain condition that slowly damages your memory, thinking, learning, and organizing skills), Vascular Dementia (problems with reasoning, planning, judgement, memory, and other thought processes caused by brain damage from impaired blood flow to the brain), Anxiety (intense, excessive, and persistent worry and fear about everyday situations), Unspecified Asthma (condition that causes airways to swell, narrow, and fill with mucous; can make it hard to breathe or cause chest tightness, cough and wheezing), Chronic Obstructive Pulmonary Disease (term for lung airway diseases that restrict breathing; airway inflammation and scarring, damage to the air sacs in the lungs, or both), Atherosclerotic Heart Disease Of Native Coronary Artery Without Angina Pectoris (hardening of arteries from plaque building up gradually inside them; plaque consists of fat, cholesterol, and other substances), Chronic Diastolic (Congestive) Heart Failure (a stiff left heart ventricle; when the left heart ventricle is stiff, it doesn't relax properly between heartbeats), Chronic Constrictive Pericarditis (condition where the pericardium, the thin membrane that holds the heart in place, becomes stiffer and thicker than normal, keeps the heart from beating properly and can cause severe complications over time), Atrial Flutter (type of heart rhythm disorder, called an arrhythmia, in which the heart's upper chambers beat too quickly), and Chronic Atrial Fibrillation (occurs when abnormal heart rhythms last more than a week; common persisting symptoms include palpitations, shortness of breath, fatigue, chest pain, dizziness, and stroke). Record review of Resident #1's Baseline Care Plan, dated 07/04/2025, revealed the resident was able to communicate with and understand staff, had adequate hearing and vision, and was a full code status (in the event of cardiac or respiratory arrest, a patient's medical team will employ all available life-saving measures). Resident #1's admission and discharge goals were Assisted Living, with initial discharge goals of remain in the facility selected and no discharge plans initiated. Resident #1's functional status was noted to be Independent in all categories. The category of Mobility Devices indicated a walker was normally used by Resident #1. Resident #1 was noted to use Anticoagulants in the Medications category and was indicated to not self-administer medications. The Baseline Care Plan for Resident #1 had no Social Services notes. Baseline Care Plan for Resident #1 was signed by LVN D. Record review of Resident #1's Orders, dated 08/06/2025, revealed orders for TRANSFER ASSISTIVE DEVICE: X2, 1/4 bed rails up as per Dr.s orders while in bed, to assist with bed mobility. Observe for injury or entrapment related to side rail use. Reposition PRN (as needed) to avoid Injury. Pharmacy orders included Apixaban for A-FIB (atrial fibrillation), Klor-Con for Afib, Carvedilol for HTN (hypertension; high blood pressure), Hydralazine for HTN, Isosorbide Mononitrate for HTN, Losartan Potassium for HTN, Nifedipine ER Osmotic Release for HTN, Memantine HCL for Alzheimer's disease, and Donepezil HCL for dementia. Record review of Resident #1's Comprehensive MDS, dated (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 7 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few [DATE] for reentry admission on [DATE], revealed Hearing, Speech, and Vision were all in the adequate and understood ranges. Resident #1 had a BIMS (structured evaluation aimed at evaluating aspects of cognition in elderly patients) summary score of 04, indicating severely impaired cognition. Functional Abilities for Resident #1 were indicated to be no impairment for upper or lower extremities, resident utilized a walker to assist with mobility and was independent with mobility except for bathing in which Resident #1 needed partial/moderate assistance. It is noted that Resident #1 was at risk for pressure ulcers. Resident #1 was noted to take the following High-Risk Drug Classes of Anticoagulant, Antibiotic, and Diuretic. Care Ares triggered for Resident #1 included Cognitive Loss/Dementia resulting in BIMS assessment, Nutritional Status resulting in Nutritional Therapy admission Assessment, Dehydration/Fluid Maintenance resulting in dehydration risk screen, and Pressure Ulcer resulting in a Braden Scale (risk assessment tool for predicting pressure ulcers). The MDS was signed by DON as both RN Coordinator for CAA (Care Area Assessment) on 07/17/2025 and Person Completing Care Plan Decision on 07/24/2025. Record review of Resident #1's ongoing Care Plan, initiated on 07/08/2025, revealed that focus areas of Potential nutritional problem r/t weight loss/gains, dehydration, pain/discomfort; DNR-DO NOT RESUSCITATE; Independent for meeting emotional, intellectual, physical, and social needs; and Discharge Goals, have Goals and Interventions/Tasks, however no other Focus Areas are included in the Care Plan. Interview on 8/7/25 at 12:10 PM, LVN A revealed an experienced nurse with over 10 years longevity at the facility and good knowledge of residents. LVN A informed that when a new resident admitted to the facility, the nurse on shift for the unit admitting to would welcome the individual, make sure immediate needs were met, took vitals and weight, obtained information from resident/family or hospital on abilities, needs, preferences, ensured orders were entered into the electronic healthcare record, confirmed the orders with facility medical director, ensured a diet slip was completed and taken to the kitchen so resident would get next meal served, then work on medication reconciliation so medications could be ordered. LVN A stated that the nurses would complete assessments of new residents including baseline assessment, transfer assessment, skin assessment, pain assessment, etc. LVN A stated that the care plan meetings were attended by the DON and ADON's to represent nursing and update associated care plan areas, care plan meetings were held quarterly, and any major or significant changes that were discussed were relayed to other nursing staff verbally; nursing staff were not really informed about minor changes from care plan meetings. Interview on 8/7/25 at 12:20 PM, CNA E, who also works as a Medication Technician, revealed an experienced staff member with over 10 years of longevity with the facility. CNA E stated that when a new resident admitted to the facility, staff were to introduce themself, make sure vitals and weight had been taken, orient the resident to the call light and make sure it was within reach, and ask about preferences from a family member or resident directly. CNA E stated that conversation with the nurse about other information, like for pain management, would take place once resident settled in. CNA E stated that charting in the electronic health record was completed by nurses; CNA's and Medication Techs could document completion of tasks such as incontinent care, feeding or meal completion amounts, showers, etc. was documented as they only had access to that one screen on their tablets with the specific tasks they do. CNA E stated that CNAs were able to see resident assessments however did not look at them very often; a resident care plan was sometimes looked at as specific interventions could be seen. CNA E stated that it would have been a concern if a care plan had little to no information on it and would tell the DON right away. Interview on 8/7/25 at 12:51 PM, the DON revealed that care plans should include information on anything the facility or staff were providing for resident. The care plan was to be checked and updated on a resident's change of condition, significant change, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 8 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete quarterly, when a new assessment was required, annually, and during any care plan meetings with the interdisciplinary team and resident/family. The DON stated that a baseline care plan was to be completed within 48 hours of admission of a resident, a comprehensive care plan was to be completed within the first 7 days of admission. The DON stated that a comprehensive care plan should be completed by the RNs and were based off of the assessments competed by the LVNs at admission that trigger the care plan areas; certain medications when entered into a resident's electronic health record would also trigger care plan areas as well as some diagnosis. The DON stated that medications used as an anticoagulant should have triggered the care plan area as having needed to be completed. The DON stated that the comprehensive resident-centered care plan was important so that all staff knew how to care for the resident, what interventions to use or avoid, what the focus and goals were and what was needed to be done for resident. The DON was asked about Resident #1 in specific and when the resident's care plan was accessed, the DON agreed the care plan was lacking for anticoagulant, hospital discharge, and other care area information. The DON agreed that the comprehensive person-centered care plan for Resident #1 was incomplete. The DON stated that resident needs could go unmet with the lack of a completed comprehensive care plan. Record review of the facility's policy titled Care Plans - Comprehensive, from the Nursing Services Policy Manual Morningside Ministries (Revised November 2010), revealed: Developing the Comprehensive Care Plan- 1. Our facility's Care Planning/Interdisciplinary Team, in coordination with the resident, his/her family or representative (sponsor), develops and maintains a comprehensive care plan for each resident that identifies the highest level of functioning the resident may be expected to attain.Purpose of Care Plan- 3. Each resident's Comprehensive Care Plan has been designed to: a, Incorporate identified problem areas; b. Incorporate risk factors associated with identified problems; c. Build on the resident's strengths; d. Reflect treatment goals and objectives in measurable outcomes; e. Identify the professional services that are responsible for each element of care; f. Aid in preventing or reducing declines in the resident's functional status and/or functional levels; and g. To attain or maintain the highest practical functioning of the resident.Time Frame for Completing the Care Plan- 4. The resident's Comprehensive Care Plan is developed within seven (7) days of the completion of the resident's comprehensive assessment (MDS). Event ID: Facility ID: 455523 If continuation sheet Page 9 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure enteral feeding physician orders were followed for 1 (Resident #12) of 7 resident reviewed for enteral tube feeding, in that: The facility failed to assess, obtain physician order, care plan, and obtain consent for Resident #12 to self-administer her bolus feedings via the g-tube two times a day. This failure could place residents with G-tubes at risk of needs not met and a decline in resident's health. Findings included: Record review of Resident #12's face sheet dated 8/14/25 revealed a [AGE] year-old female admitted to the facility on [DATE]. Her diagnoses were cirrhosis of the liver (chronic liver damage from a variety of causes leading to scarring and liver failure), type 2 diabetes, breast cancer, neoplasm of uncertain behavior of pharynx (throat cancer), and difficulty swallowing. Review of Resident #12's quarterly MDS dated [DATE] reflected Resident #12 had a BIMS of 15, indicating cognitive intact. She makes self-understood, and she understands others. The document reflected Resident #12 had a feeding tube and received 26-50% of her nutrition and 500 cc/day or less fluid through the feeding tube. Record review of Resident #12's physician orders for August 2025 reflected: MIC-KEY G-TUBE 20FR 3.5CM, 5CC BALLOON LAST CHANGE 9/25/24- active 09/25/24. - Enteral Feed Protocol: Hydration Flush every shift Flush enteral tube with 90____ mL of water before and after feeding for hydration. Total volume of water flush _180____ mL/24hr- Active 11/18/22. - Enteral Feed Protocol: Placement every shift Check tube for proper placement by auscultation and inspect stomach contents prior to: - Each Feeding - Flush - Medication administration May obtain x-ray for placement of feeding tube if indicated- Active 11/18/22. - Enteral Feed Protocol: Residual every shift Check for residual by aspirating stomach contents Q shift, if more than 100mL of stomach contents is aspirated, return the contents to the stomach, hold feeding and notify the physician for further instruction- Active 11/17/22. - Residents with PO diets may use house available supplement whenever Ensure or other name brand nutritional supplement is ordered- Active 11/17/22. -Residents with PO diet may have a Regular Diet according to texture modification for monthly activities and holidays- Active 11/17/22. - [Resident#12] may take medications PO or by PEG-tube depending on how she feels regarding her ability to swallow due to her history of throat cancer. every shift related to neoplasm of uncertain behavior of pharynx- Active 12/27/22. -Enteral Feed Protocol: Administration Set and Supplies every night shift Change administration set (spike, cap, and bag) daily on night shift. Date and label with each change. Change syringe/irrigation set daily on night shiftActive 11/18/22. - Enteral Feed Protocol: Cleanse Stoma Site everyday shift Cleanse stoma site with NS, pat dry and apply sterile split sponge if needed Q shift and PRN- Active 11/18/22. - Enteral Feed Order two times a day ([brand name] 1.2) Formula to be administered via bolus _2___ times per day for a total of 474___ cc's and __711_ calories in 24 hours- Active 11/19/25. - Special Diet: REGULAR diet Consistency: REGULAR texture, Liquid: THIN consistency. -The physician orders did not reflect self-administration of eternal feeding by Resident. Record review of Resident #12's care plan initiated 02/7/23 revealed a focus: I have bolus enteral feedings r/t Dysphagia and Chronic fatigue syndrome and have a Regular diet to eat by mouth as I tolerate, family signed wavier.Goal: will receive diet as ordered and will maintain weight over next 90 days Target Date: 05/30/2025Interventions: Provide bolus feeding and flushes as ordered. Observe for nausea/vomiting and report to MD. -The care plan did not reflect Resident #12 could self-administer her own g-tube bolus feeding two times a day via the g-tube. Record review of quarterly nutrition assessment completed on 05/28/25 by Dietitian did not reflect any weight loss concerns. It reflected that Resident #12 liked to do things herself, and her weight (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 10 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some was improving with a goal weight of 148 lbs. Record Review of Resident #12's monthly weights reflected no concerns.-8/5/25-120.8lbs-7/10/25- 120.2lbs-5/18/25- 119.5lbs Record review of assessments on 08/5/25, did not reflect a completed self- administration assessment for g-tube bolus feeding two times a day via the g-tube. Record review of consent and waiver did not reflect self- administration consent or waiver for g-tube bolus feeding two times a day via the g-tube. In an observation and interview with Resident #12 on 08/05/25 at 1:30 PM, revealed Resident #12 in her room. She stated she had not eaten lunch, because she did not like the food. She said she was going to do her bolus feeding via her g-tube. She stated she had been trained many years before coming to the facility. She stated she was very comfortable doing her own feeding. No concerns during self-administration of bolus feeding and a new gauze dressing was applied to the MIC-KEY stoma and attachment cleaned and stored after administration of bolus. In an interview with the dietician on 08/05/25 at 2:33 PM, revealed Resident #12 was monitored for weight loss monthly. She said nursing was responsible for assessing and care planning for Resident #12's g-tube self-administration. She said it was important to assess the resident so that you can know that they can safely do the feeding. The Dietitian said she had no input on the care plan and assessment, but she did note on the quarterly nutrition assessment that Resident #12 liked to do things by herself. She said she did not see any risk to the resident self-administering the feeds because she was maintaining and even gaining weight. In an interview at 08/06/25 at 3:21 PM, LVN C said she was assigned to care for Resident #12, and she used to try and do the feeding for Resident #12 when she first moved to the facility but Resident #12 would yell and scream at her. She said Resident #12 does not like anyone to touch her feeding tube. LVN C stated she has monitored Resident #12 as she did her own feeding, and she had no concerns with the procedure. LVN C stated she did not do an assessment for Resident #12 to self-feed, and she did not do the care plans for the residents because it was not in her scope of practice. She said Resident #12 should not be in the skilled facility because she did everything for herself and refused help from the staff. She said Resident #12 is very independent and very mobile. She said that the nurses made sure that all the supplies are changed daily such as the syringe and they made sure that she has the formula. LVN C stated that Resident #12 was up the whole night and slept during the day and she did not want to be woken up. LVN C said that they monitor for infection as well by discarding any open or left over formula and making sure she has cleaning solution for the MIC-KEY attachment. LVN C said there was no risk to Resident #12 self-administering because she's been doing it long before she came here. In an interview on 08/07/25 at 12:06 PM, the ADON B said Resident #12 should be in independent living because she does everything herself. ADON B stated Resident #12 did not like anyone doing her feedings. She said they were monitoring Resident #12's weight and that the G-tube was only used for supplemental when resident had poor oral intake. ADON B said the expectation was that a resident that self-administer got an assessment before they were allowed to self-administer. She said she thought it had already been done prior to her working at the facility. ADON B stated she believed Resident #12 was care planned to self-administer feedings. In an interview with the DON on 08/07/25 at 1:16 PM, she said she went and observed Resident #12 do her feeding today and she had no concerns. She said Resident #12 was very independent and before she came to the facility, she already had the g-tube and was feeding herself. The DON said that she would reach out to the physician and obtain a physician order to self-administer formular via g-tube. She said Resident #12 had a care plan to self-administer but it may have resolved. She said she did not know who had resolved that care plan. The DON said that the ADON had completed a self-administration assessment on of 08/6/25. She said she was responsible for making sure that all care areas were care planned but the nurse could do assessments and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 11 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete get physician orders. She said that if there were any concerns then they would discuss the issues in the morning meetings. She said the expectation was that the nurses would supervise the residents during feeding however for residents that could do it themselves they had the right to do it themselves. She said there was no risk to Resident #12 because she had a high BIMS and could safely self-administer the feeding. The DON said that she was not aware that they needed a consent to self-administer bolus feedings. Record review of a medication self-administration evaluation completed on 08/06/25 for Resident #12 reflected no concerns for self-administration evaluation. Record review of facility Policy Self-Administrating of Drugs, revision date April 2009 reflected: As part of their overall evaluation, the staff and the Attending/On Call Physician will assess each resident's mental and physical abilities, to determine whether a resident is capable of self-administering medications. 2. In addition to general evaluation of decision-making capacity, the staff and Attending/On Call Physician will perform a more specific skill assessment, including (but not limited to) the resident's: a. Ability to read and understand medication labels, b. Comprehension of the purpose and proper dosage and administration time for his or her medications, c. Ability to remove medications from a container and to ingest and swallow (or otherwise administer) them, and d. Ability to recognize risks and major adverse consequences of his or her medications. Record review of facility Policy Enteral Nutrition revised May 2009 reflected in part 1. The dietitian monitors residents who are receiving enteral nutrition and makes appropriate recommendations for interventions to enhance tolerance and nutritional adequacy of enteral feedings. 3. A Dietitian will conduct a full nutritional assessment within current initial assessment timeframes. Current Standards of Practice, facility formulary, and facility policies will be the basis for the assessment and recommendations. The Dietitian will confirm or modify initial orders based on the complete nutritional assessment. Event ID: Facility ID: 455523 If continuation sheet Page 12 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to provide pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals) to meet the needs of each resident for 3 of 9 reviewed for pharmaceutical services, in that: LVN A administered the expired insulin to Resident #4, Resident #22, and Resident #74. This failure could result in residents not receiving an accurate dose of medication as well as not being maintained at their best therapeutic level.Findings included: Review of Resident #4's face sheet, dated 8/6/2025, revealed the resident was a [AGE] year-old admitted on [DATE] with diagnoses of type 2 diabetes and stroke. Review of Resident #4's active order list, there was an order for Lantus Solostar Subcutaneous Solution Pen-injector 100unit/ml (insulin Glargine), start date 3/8/2025. Review of Resident #22's face sheet, dated 8/6/2025, revealed the resident was a [AGE] year-old female admitted on [DATE] with diagnoses of type 2 diabetes with hyperglycemia (high blood sugar). Review of Resident #22's active order list, there was an order for Novolog Flexpen Subcutaneous Solution Pen-injector 100unil/ml (insulin aspart), start date 3/30/2025. Review of Resident #74's face sheet, dated 8/6/2025, revealed the resident was a [AGE] year-old female admitted on [DATE] with diagnoses of congestive heart failure and type 2 diabetes. Review of Resident #74's active order list, there were 2 orders for insulin: Insulin Lispo Subcutaneous Solution Pen-injector 100unit/ml (insulin Lispo) with a start date of 6/30/2025; and Lantus Solostar 100unil/ml Solution pen-injector with a start date of 6/30/2025. Observation on 8/6/2025 at 9:04am revealed on LVN A's nurse cart, there were the following insulin pens:_Lantus Solostar (insulin glargine) for Resident#4 that did not have an open date._Novolog Flexpen (insulin aspart) for Resident#22 with an open date of 6.24_Insulin Lispo for Resident#74 with an open date of 5/23/2025._Lantus Solostar for Resident #74 that did not have an open date. In an interview with LVN A on 8/6/2025 at 9:07am, he stated that insulin pens should be labeled with an open date and once opened, the insulin pen should be discarded after 28 days. He admitted that he forgot to check his carts for expired insulin pens and label them accordingly. LVN A also stated that he had been administering the above insulin to Resident #4, Resident#22, and Resident #74. He stated that the risk of giving residents expired medication include adverse reaction, hyperglycemia or hypoglycemia. Review of Resident#4's medication administration log revealed on 8/6/2025 at 7am, LVN A administered insulin glargine. Review of Resident #22's medication administration log revealed on 8/6/2025 at 7am, LVN A administered Insulin aspart. Review of Resident #74's medication administration log revealed on 8/6/2025 at 7am, LVN A administered Insulin Lispo. In an interview with the DON on 8/7/2025 at 10:50am, she stated that all nurses were supposed to audit med carts weekly. The DON performed spot checks occasionally on the med carts. The following were to be done during med cart audit: checking for expired medications, discontinuing medications that are not in use, checking for any pens, vials that needed to be dated and labeled, making sure the cart is clean and organized. She stated that the risk of giving residents expired medication included decreased medication potency, adverse effects, and if the medications were insulin, the risks included hyperglycemia or hypoglycemia. The DON also stated that the physician had been notified, and Resident #4, Resident #22 and Resident #74 were assessed for adverse reactions. In a review of the facility's medication administration checklist, called Mock survey medication pass, dated unknown, revealed for injectable medications, nurses were to date vials when opened (i.e., insulin for 28 days). Review of facility's Labeling of medication containers, dated 4/2009, revealed that one of the requirements for individual medication container labeling included .the date that the medication was (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 13 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0755 dispensed. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 14 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, interview, and record review, the facility failed to label drugs and biologicals used in the facility in accordance with currently accepted professional principles, and include the appropriate accessory and cautionary instructions, and the expiration date when applicable for 1 of 5 medication carts in that: Two insulin pens were not labeled with an open date in Unit 5 nurse med cart.Two insulin pens were expired in Unit 5 nurse med cart. These failures could result in residents not receiving an accurate dose of medication as well as not being maintained at their best therapeutic level.Findings included: Observation of Unit 5 med cart on 8/6/2025 at 9:06am revealed there were 2 insulin pens for Resident #4 and Resident #74 that did not have an open date on them. There were also 1 insulin pen for Resident #74 that was opened on 5/23/2025 and 1 insulin pen for Resident #22 that was opened on 6.24 In an interview with LVN A on 8/6/2025 at 9:07am, he stated that insulin pens should be labeled with an open date and once opened, the insulin pen should be discarded after 28 days. He admitted that he forgot to check his carts for expired insulin pens and label them accordingly. In an interview with the DON on 8/7/2025 at 10:50am, she stated that all nurses were supposed to audit med carts weekly. DON performed spot checks occasionally on med carts. She stated the following were to be done during med cart audit: checking for expired medications, discontinuing medications that are not in use, checking for any pens, vials that needed to be dated and labeled, making sure the cart is clean and organized. She stated that the risk of giving residents expired medication included decreased medication potency, adverse effects, and if the medications were insulin, the risks included hyperglycemia or hypoglycemia. In a review of facility's undated medication administration checklist, called Mock survey medication pass,, revealed for injectable medications, nurses were to date vials when opened (i.e., insulin for 28 days). Review of the facility's Labeling of medication containers, dated April 2009, revealed that one of the requirements for individual medication container labeling included .the date that the medication was dispensed. In an observation on 08/07/25 at 11:30 AM and at 11:57 AM, a Treatment cart was unlocked and unattended with the lock mechanism out (indicating it was unlocked) in Unit 5 hallway, against the wall facing outwards to the hallway. Residents and staff were walking by the unlocked Treatment Cart. The facility staff attending to Treatment cart were inside a resident's room and could not see the cart. It was out of view. In an interview with the Treatment PA on 08/07/25 at 11:57 AM, it was revealed herself and a team of other NPs were in the facility doing wound treatments and some were in training, and they had left the Treatment cart unlocked. She did not state the risk of leaving the Treatment cart unlocked, unattended and out of view. Interview on 08/07/25 at 12:06 PM with ADON B revealed, the facility had a contract Treatment NP and her assistant that did treatments for the facility. She said the expectation was the Treatment cart should be locked when staff was not directly working with the cart. She stated the expectation was that even the contracted staff would follow policy and procedures and lock and secure the medication cart when not in use. She said all nursing staff were responsible for securing medications when not in use. She said the potential risk was a resident may get into the cart and grab something. She said it was a safety concern. In an interview with the DON on 08/07/25 at 1:16 PM, she revealed that it was disheartening that it was not her facility staff that left the Treatment cart unlocked. She said the expectation for all staff was that they would follow policy and procedures, and lock and secure the Treatment cart when not in use. She said the risk was unauthorized access to the cart. Interview on 08/07/25 at 3:49 PM with the Administrator revealed, the Treatment Cart should be locked if it was out of sight and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 15 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete staff were not actively working in the cart. She said the expectation was that all staff would follow company policies and procedures and the expectation for contract personnel was to follow facility policies and to always keep the resident safe. Record review of the facility's policy Administering Medication revised in April 2009 reflected 9.During administration of medications, the medication cart is kept closed and locked when out of sight of the medication nurse or aide. No medications are kept on top of the cart. Record review the facility's policy Security of Medication cart, revision date April 2009, reflected 1. The nurse must secure the medication cart during the medication pass to prevent unauthorized entry. 2. The cart must be locked before the nurse enters the resident's room. 3. Medication carts must be securely locked at all times when out of the nurse's view. 4. When the medication cart is not being used, it must be locked and parked. Event ID: Facility ID: 455523 If continuation sheet Page 16 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0814 Dispose of garbage and refuse properly. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview and record review, the facility must properly dispose of garbage and rubbish in accordance with current state laws for dumpster 1 of 2 reviewed for garbage disposal. The facility failed to ensure the doors on dumpster 1 were secured. This failure could place residents at risk of contracting disease by attracting pest and disease carrying rodents. Findings included: Observation on 08/05/25 at 8:36 AM, reflected the facility's dumpster area, which was outside of the dietary department to the right side of the parking lot were two commercial size dumpsters. Dumpster 1 had the left and right-side doors open which were 1/2 full of garbage. Interview on 08/05/25 at 8:40 AM, reflected the KD stated the dumpsters were for the entire facility and not just the kitchen. He stated the lids and doors on the dumpsters were supposed to be closed to keep all trash contained. He stated that the risk of the dumpster doors being opened could attract rodents. Interview on 08/05/25 at 3:31 PM, the FSS stated the kitchen and housekeeping were responsible for making sure the dumpsters were closed. He stated that the dumpsters were for the entire facility. He stated that the risk of dumpster 1 being left opened could cause critters to get into the trash. Interview on 08/07/25 at 1:15 PM, the HS revealed the housekeeping department were mainly responsible, but the dumpsters are universal to the entire facility. He stated it is not okay for the dumpster doors to be open. He stated he expected his staff to have a constant diligence on both dumpsters to be sure they were always closed. He stated that the risk of dumpster 1 doors being left open could cause a few different factors such as having unwanted rodents like racoons or skunks, infection control, or a potential of cross-contamination. Interview on 08/07/25 at 4:00 PM, the ADM revealed the dumpsters were community dumpsters, but the dietary department and housekeeping staff mainly used it. She stated she expected her department heads to manage dumpster 1 as a team and keep it closed. She stated the risk of dumpster 1 being left open exposes them to having unsanitary practices or could cause critters to wonder into the trash. Record review of the facility's policy Disposal of Garbage and Refuse, revised on 01/25 stated: Policy: The facility shall properly dispose of kitchen garbage and refuse. Policy Explanation and Compliance Guidelines: 7. Refuse containers and dumpsters kept outside the facility shall be designed and constructed to have tightly fitting lids, doors, or covers. Containers and dumpsters shall be kept covered when not being loaded. Surrounding area shall be kept clean so that accumulation of debris and insect/rodent attractions are minimized. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 17 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 1 (Resident #45) of 7 residents reviewed for infection control. The facility failed to follow EBP (Enhanced Barrier Precautions) procedures for Resident #45 when the wound treatment team failed to wear PPE while providing wound care to Resident #45 on 08/07/25. This failure affected residents by placing them at an increased and unnecessary risk of exposure to communicable diseases and infections. Findings included: Record review of Resident #45's face sheet, dated 8/7/25, revealed an [AGE] year-old male admitted on [DATE] with a diagnoses of primary osteoarthritis right shoulder (this is a type of arthritis that occurs when flexible tissue at the ends of bones wear down) and non-pressure chronic ulcer of right heal and midfoot with other specified severity, pressure ulcer of right heal unstageable, and benign neoplasm of the parotid gland (cancer of the parathyroid gland located in the neck) Record review of Resident #45's quarterly MDS dated [DATE] revealed a BIMS score of 14 indicating cognitively intact. Further review of MDS indicated Resident #45 had a diabetic foot ulcer and required application of dressings to feet. Record review of Resident #45's care plan, dated 07/01/25, revealed the Resident #45 was at risk for infection and was on enhanced barrier precautions r/t wound at risk for multidrug resistance organism. Wear gowns and gloves for high contact resident care activities with a goal of resident not showing any signs and symptoms of infection. Interventions included: Educate Resident / Representative on infection control practices, Educate Resident / Representative on techniques to prevent infection, such as handwashing, adequate rest, nutrition and avoidance of crowds and Evaluate wounds for signs / symptoms of infection. Record review of Resident #45's physician orders for August 2025 reflected:-Enhanced Barrier Precautions r/t wound care. at risk for multidrug-resistance organism. wear gowns and gloves for high-contact resident care activities. Every shift. Order active 07/01/25.Record Review of Resident #45's treatment note dated 08/05/25 by wound physician reflected: Wound #1 Location: Right heel 1.5cm x 0.9cm x 0.1cmPrimary Etiology: Diabetic ulcerArea cleansed with wound cleanser and [brand name] solution, patted dry. Applied collagen then calcium alginate with AG [refers to wound dressing that incorporates silver] to wound bed and covered with silicone dressing.20% slough 80% granulation. Moderate serosanguineous drainage [this is drainage that is mixed consisting of thin watery pale-yellow fluid and bloody red fluid]. Periwound callused edges. No odor. No pain Observation on 08/07/25 at 11:30 AM revealed Resident #45's door signage on the door read Gloves and gowns should be donned if any of the following activities were to occur: linen change, resident hygiene, transfer, dressing, toileting/incontinent care, bed mobility, wound care, enteral feeding care, catheter care, trach care, bathing, or other high-contact activity. Perform hand sanitation before entering the room and prior to leaving the room. Postings at the resident's room entrance indicating the resident was on enhanced barrier precautions. Resident #45's door was open with privacy curtain slightly halfway. Five staff were observed in the resident's room. Three stood at the foot of the bed and two were providing wound care. None of the five staff were wearing PPE for EBP and of the two providing wound care none wore gowns for EBP. The two staff wore blue gloves. In an interview on 08/07/25 at 11:54 AM, the PA stated they were a contracted wound treatment company, and she had some NP's training with her. She said there were no precaution necessary for Resident #45 for EBP. Pointing to the signage on Resident #45's door, she said Resident# 45 did not have drainage in his wound and did not require to be on EBP. She stated, No risk to resident, he does not have any fluids or infection. Interview on 08/07/25 at Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455523 If continuation sheet Page 18 of 19 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 455523 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Morningside Manor 602 Babcock Rd San Antonio, TX 78201 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete 12:06 PM with ADON B revealed she was one of the infection control preventionists. She stated all staff, including contract staff, were expected to follow infection control policy and procedure. She said all the nurse managers and DON were responsible for monitoring infection and implementing infection control training. She said all contract personnels were educated about facility policies and following infection control. ADON B said she was disappointed that the outside company did not follow the facility policies. She said she expected the treatment team that was providing wound care to wear gowns for EBP as per facility policy for EBP. She said the risk was spreading infection. In an interview with the DON on 08/07/25 at 1:16 PM, she stated all staff were expected to use standard infection control precautions including EBP wherever it was applicable. The DON stated she had in serviced on infection control, including EBP, and she was upset that the contract company did not follow the facility infection policy and procedures. The DON said she was responsible for monitoring that infection control precautions were being followed. She said the risk was spreading infection. Record review of the facility's Infection Prevention & Control Tracking Log and Antibiotic Stewardship on 08/06/25, did not reveal an infection pattern in last 90 days. Record Review of the facility's Enhanced Barrier Precautions policy, dated March 2024, reflected, .It is the policy of this facility to implement enhanced barrier precautions for the prevention of transmission of multidrug-resistant organisms .1. a. All staff receive training on enhanced barrier precautions upon hire and at least annually and are expected to comply with all designated precautions. 2. Initiation of Enhanced Barrier Precautions: a. An order for enhanced barrier precautions will be obtained for residents with any of the following: i. Infection or colonization with a CDC-targeted MDRO when Contact Precautions do not otherwise apply. ii. Chronic wounds (pressure ulcers stage III & IV, diabetic foot ulcers, and venous ulcers) > 6 weeks old, even if resident is not known to be infected or colonized with a MDRO. 3. Implementation of Enhanced Barrier Precautions: a. Residents placed on EBP will be identified using an orange star on their name tag outside the door of their room. Event ID: Facility ID: 455523 If continuation sheet Page 19 of 19