Inspection·July 30, 2025

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete the residents told her not to. The SW stated she was aware of what verbal abuse was and that all suspected abuse should be reported to the abuse coordinator. The SW stated in-service on ANE was held every month and the SW was the one who conducted the monthly in-service. The SW stated all suspected abuse should be reported and could not give a reason why she did not report the allegations of the night nurses being mean to the residents other than the resident did not want me to. In an interview on 07/30/25, the DON stated the SW should have reported any and all suspected mistreatment or possible abuse. The DON stated resident safety was important to the facility and any allegations of abuse were taken seriously and needed to be investigated. The DON stated if suspected abuse was not reported, it could cause the residents to become fearful or allow the alleged perpetrator/s to continue or escalate the abuse. In an interview on 7/30/25 at 11:10 am, ADON B if a resident went to her and stated that a nurse was being mean or mistreating them, she would ask the resident for details, remove the nurse from the area and go tell the DON and ADM. ADON B stated a staff member yelling at a resident or cursing at a resident was verbal abuse and should be reported to the DON and ADM immediately. In an interview on 07/30/25 at 11:54pm, the ADM stated the SW should have reported any suspected abuse and the facility takes all allegations of abuse or neglect seriously. The ADM stated he was going to in-service the SW on ANE as well as all staff. The ADM stated the facility staff, including administration, conduct Angel Rounds every morning and residents have not expressed they were being mistreated by any staff. Record review of the facility's Abuse Investigation and Reporting policy not dated reflected: ‘Policy Statement All reports of resident abuse, neglect, exploitation, misappropriation of resident property, mistreatment and/or injuries of unknown source (‘abuse) shall be promptly reported to local, state, and federal agencies (as defined by current regulations) and thoroughly investigated by facility management. Findings of abuse investigations will also be reported. Record review of the facility's policy on Abuse Prevention not dated reflected: POLICY: The facility is committed to protecting the residents from abuse by anyone including, but not necessarily limited to: facility staff, other residents, consultants, volunteers, staff from other agencies providing services to our residents, family members, legal guardians, surrogates, sponsors, friends, visitors, or any other individual. b) Verbal Abuse: The use of oral, written, or gestured language that willfully includes disparaging and derogatory terms to residents or their families, or within their hearing distance, regardless of their age, ability to comprehend, or disability. 3. It is the responsibility of all staff to provide a safe environment for the residents. Resident care and treatment shall be monitored by all staff, on an ongoing basis, so that residents are free from abuse, neglect, or mistreatment. Care will be monitored so that the resident's care plan is followed. CORRECTIVE ACTION: Any instances of employee disregard for the policies and procedures of this facility are cause for corrective action up to and including suspension, termination, and reporting to licensing agencies. Event ID: Facility ID: 455557 If continuation sheet Page 2 of 5 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 455557 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Palms Nursing & Rehabilitation 5607 Everhart Rd Corpus Christi, TX 78411 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record reviews and interviews, the facility failed to ensure residents were free from accident hazards and received adequate supervision and assistance devices to prevent accidents for one (Resident #2) of three residents reviewed for accidents. 1. The facility failed to ensure Resident #2 did not fall out of his bed on 07/08/25 due to CNA C performing incontinent care alone instead of with a second person. This failure could place residents at risk for physical, mental, and psychosocial harm.The findings included: Record review of Resident #2's face sheet reflected a [AGE] year-old male admitted to the facility on [DATE] and discharged on 07/18/25. His diagnoses included cerebral infarction (stroke), hemiplegia and hemiparesis affecting right dominant side (paralysis and weakness on one side of the body), aphasia (an impairment in the ability to read, write, and speak), lack of coordination, seizures (abnormal brain activity which affects muscle control, behavior, and awareness), and history of falling. Record review of Resident #2's admission MDS dated [DATE] reflected a BIMS score of 4 which indicated severe mental impairment. Resident #2's admission MDS also reflected he required the assistance of two or more helpers with eating, oral hygiene, toileting hygiene, showering/bathing himself, dressing, and personal hygiene. Resident #2 required substantial/maximal assistance (helper did more than half the effort) to roll left and right in bed. Resident #2's admission MDS reflected he was always incontinent of bowel and bladder, and he weighed 178 pounds. Record review of Resident #2's care plan dated 07/09/25 reflected a potential for falls due to history of falls, CVA with residual right dominant hemiplegia, reduced range of motion to left leg, impaired cognitive functioning/ safety awareness/ problem solving, and seizure disorder. Interventions included provide adequate staff assistance and support for tasks. Record review of the facility's investigation report dated 07/11/25 reflected CNA C stated she rolled Resident #2 from his left side to his right side while providing incontinent care and the resident made a jerking move, slipped off the bed, and landed on his stomach/side on the floor. CNA C then contacted other staff to assist to get resident back to bed after he was assessed for injuries by the nurse. Resident #2 did not have any complaints or visible injuries; however, his RP wanted him sent to the emergency room to be evaluated. While in the emergency room, multiple radiological exams were completed, and it was determined Resident #2 sustained no injuries from the fall. CNA C was suspended pending the outcome of the investigation and was subsequently terminated after the investigation findings determined the allegation of resident neglect was confirmed. Record review of CNA C's employee file reflected a General Employee Orientation dated 01/08/25 which included the following: Nursing Department (ADON)Incidents and accidents Fall precautionsWelcome (Administrator)ExpectationsCompliance and communicationAll the above were dated 01/08/25 and were checked off by the respective instructor for that area.There were no previous disciplinary actions documented in CNA C's employee file. An attempt was made to contact CNA C on 07/29/25, however the phone number listed in her employee file was disconnected. There were no other phone numbers or means of contact available. In an interview on 07/29/25 at 11:12 am, CNA D stated Resident #2 was paralyzed on his right side, but he would scoot in the bed, roll over and throw his left leg off the bed. It was in the ADL book that he was a two person assist all the time because he was paralyzed on one side, and he was heavy. CNA D stated Resident #2 had fallen several times that she was aware of. CNA D stated she was not working on that hall the day he fell off the bed with CNA C. CNA D further stated, If they were a two person assist, I would not do it on my own, I would wait until I had help. CNA D stated if she did not wait until she had help, the resident could fall of the bed and get hurt. CNA D stated she had assisted with incontinent care for Resident #2 before and he (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455557 If continuation sheet Page 3 of 5 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 455557 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Palms Nursing & Rehabilitation 5607 Everhart Rd Corpus Christi, TX 78411 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few would move around while being cleaned and rolled from side to side. CNA D stated, I always tell the new CNAs that everyone is a two person assist because it was standard practice in places where I worked in the past and it was just better and safer for residents. In an interview on 07 /29/25 at 4:18 pm ADON A stated the CNA care plan was how the CNAs knew if a resident was a one or two person assist with things like incontinent care and repositioning. The CNA care plans for each resident were in the front of the ADL book at the nurse's station. ADON A stated if a resident was supposed to be a two person assist with incontinent care and the CNA did not follow that, they could get disciplined which included teachable moments and/or a verbal warning. ADON A stated if a resident fell it could cause serious injuries such as fractures, bleeds, hospitalization, and even death if they were on blood thinners and hit their head. ADON A stated they called the administrator first if someone fell, then the DON, the RP and the physician. ADON A stated, In-services on fall prevention and transfers were done every 3 months, I think. Sometimes we did them in our monthly meetings which consisted of Abuse/Neglect and whatever happened that month. In an interview 0n 07/29/25 at 5:25 pm, CNA H stated they went to the ADL book to see if a resident was a one or two person assist. If they were a two person assist and she did not have another CNA to help, she would call the charge nurse to help or another CNA on another floor. CNA H stated if she did not wait for help, she would not have followed the rules, and the resident could fall or be hurt. CNA H stated they usually did once a week in-service on fall prevention and the last in-service on fall prevention was yesterday. In an interview on 07/29/25 at 5:35 pm CNA I stated neglect was when a resident needed help, or you saw them in a bad situation, and you did not help them. CNA I stated the ADL book at the nurse's station had care plans in the front and it was on there if a resident was a one or two person assist. CNA I stated, If a resident was a two person assist and only one person provided care and the resident fell, it was neglect. If there was no other CNA to help, I got a nurse to help. CNA I stated if a resident fell during care, she reported it to the charge nurse then to the administrator immediately. CNA I stated in-services on fall prevention and abuse/ neglect were done all the time, most were done by the DON or ADON A and the last in-service was yesterday. In an interview on 7/30/25 at 10:23 am, the DON stated Resident #2 was admitted after a stroke and he had shaking/ jerking movements and was always moving. The DON stated they put floor mats on each side of Resident #2's bed after he fell the first time which was about a week after he got to the facility. The DON stated CNA C was changing Resident #2 and he fell off the bed because he threw his leg over the edge of the bed, and it pulled him down. The DON stated the CNAs knew if a resident was a one or two person assist with incontinent care because it was in the ADL book at the nurse's station. The DON stated they did in-services twice a week on fall prevention and the CNAs had skills check offs frequently that covered safe resident care. The DON stated if a CNA did not have a second CNA to assist, they could ask a nurse, the DON, or even physical therapy to help them. The DON stated CNA C had not previously done resident care alone when it should have been two people that she knew of. The DON stated, If a CNA did care alone when there was supposed to be two people, the resident could fall, get a head injury or broken bone, which would lead to hospitalization or even death if they had a brain bleed and were on blood thinners. If I found out that a CNA did care alone when there was supposed to be two people, I would have taken them into my office, talked to them about it, and done retraining with them. Then I would follow up with an in-service for everyone about two person assist. In an interview on 7/30/25 at 11:10 am, ADON B stated the CNAs knew if a resident was supposed to be a one or two person assist with incontinent care by looking at the ADL book that was at the nurse's station. The ADL book listed each task that a resident may have needed assistance with and if that task required one or two people to assist the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455557 If continuation sheet Page 4 of 5 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 455557 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Palms Nursing & Rehabilitation 5607 Everhart Rd Corpus Christi, TX 78411 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete resident. ADON B stated Resident #2 was a two person assist with incontinent care because he was wiggling or throwing his legs across or off the bed. ADON B stated Resident #2's right side was weaker than the left, but he could move both sides. ADON B stated when CNA C was turning Resident #2 to provide incontinent care, he rolled off the bed. ADON B stated Resident #2 was a big guy and CNA C had a small stature. ADON B stated there were in-services done almost once a week on fall prevention and safe resident care. ADON B also stated if a CNA did incontinent care alone on a resident that was supposed to be a two person assist, the charge nurse would have done a disciplinary form and talked with the CNA about expectations and job duties. When asked what could happen if a CNA provided care alone and a resident fell off the bed, ADON B replied, The resident could have a skin tear, head injury or fracture and been hospitalized . If there was not another CNA to help, they were supposed to ask the charge nurse, a medication aide, or any other qualified staff member for assistance. ADON B stated to her knowledge, there had not been any previous issues with CNA C. Event ID: Facility ID: 455557 If continuation sheet Page 5 of 5