Health inspection·December 3, 2025

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few with the nervous system). In an interview on 12/02/2025 at 10:35 AM, Resident #4 stated she did not feel like it was an appropriate thing for CNA-C make the statement we know what you like. She found it offensive, and she did not feel like it was meant like she knew what type of care she wanted or liked, but they felt like she wanted them to keep wiping or touching her private area. She stated she told CNA-C that it was inappropriate and uncalled for to talk to her like that, and she would provide the video of CNA-C during the incident on 10/25/2025. Observation of a video footage, dated 10/25/2025 9:43 PM, provided by Resident #4, CNA-C was cleaning Resident #4 while the MA assisted with handing her supplies, and CNA-C stated, Is it clean now? Resident #4 responded with yes, thank you. CNA-C stated Good. Yeah, we know what you like. Resident #4 responded Excuse me, that's not called for. CNA-C proceeded to raise her voice and stated No. No. No, it's not. You got us scrubbing down here when I already told you that I had already cleaned you, and I did. I had already cleaned you like 3 or 4 times already. That don't make any sense. In an interview on 12/02/2025 at 11:02 AM, the SW stated she thought she had spoken to the resident after the verbal abuse incident, but she could not recall for sure, and she did not think she had written a note regarding the incident. She stated the incident had occurred over the weekend, so she did not find out about it until the following Monday, and she usually went and spoke with residents after incidents or allegations, but she could not remember if she had spoken to Resident #4 in regard this incident. The SW also stated she was not sure if what CNA-C stated was considered verbal abuse because she had not known the context in which it was used or the surrounding conversation in which it happened. She stated she saw the video of the incident, but it was only a small section which did not show what led up to the incident or after the incident, so she was not sure if CNA-C saying oh, that's the way you like it, or we know how you like it was considered verbal abuse because it was all about interpretation. The SW stated she felt like CNA-C meant she knew how Resident #4 liked to be cleaned. In an interview on 12/02/2025 at 1:30 PM, CNA-C stated she knew she should not have said what she said, and she felt bad about it. CNA-C stated she gave Resident #4 good care, and she thought they had a good relationship where they joked, but it was not okay for Resident #4 to moan and groan or tell her to get in there deeper every time she wiped her vaginal area. CNA-C stated she had not even known what a labia was until Resident #4 told her to clean her labia good. CNA-C stated Resident #4 even referred to it as her bull's eye, and to clean her bull's eye good. She stated she was made to write her statement again because the Administrator did not feel her first statement was appropriate because she wrote what actually happened, and she was made to re-write her statement so it looked like she was referring to having known what type of care the resident liked instead of the fact Resident #4 liked the CNAs to keep wiping her vagina. CNA-C reiterated she knew what she said was wrong, but she should not have to keep wiping or cleaning Resident #4 just because she wanted her to, especially when she had already told Resident #4 she was already clean. CNA-C stated sometimes her mouth got her in trouble, but she was a good CNA, and she should not be forced to clean residents in a way which seemed or felt inappropriate. It was not okay. In an interview on 12/02/2025 at 2:06 PM, the MA stated CNA-C asked her to go with her to clean up Resident #4 because the staff preferred to have two people in Resident #4's room for peri-care. The MA stated CNA-C had cleaned front and back with soap, and had gotten Resident #4 clean, but Resident #4 told CNA-C to open her up and go deeper to clean her, and CNA-C then made the comment we know how you like it, meaning we knew how you liked for us to clean you. The MA stated Resident #4 made grunting sounds when she was wiped, but the MA never realized Resident #4 was meaning it in a sexual way, until Resident #4 told CNA-C to open her up and go harder and clean her labia and clean her deeper. The MA stated since the incident, she refused to go into the room to assist with (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455557 If continuation sheet Page 2 of 7 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 12/03/2025 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 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Resident #4. In an interview on 12/02/2025 at 2:19 PM, ADON-A stated the MA called her and reported the incident and notified her Resident #4's family was at the facility and upset about the incident which had just happened. ADON-A stated she came to the facility and sent CNA-C home on suspension pending investigation, which ultimately ended in termination. ADON-A stated she spoke with Resident #4's family and watched the video, and determined it was inappropriate for CNA-C to say these things to Resident #4. She stated they followed protocol and reported everything like they were supposed to. In an interview on 12/03/2025 at 11:15 AM, the Administrator stated he knew staff were being interviewed about being made to re-write their statements during incidents or investigations, and he stated he would never do this, and the only time had staff re-write a statement was if something was misspelled, or if the statement written was not in regard to the incident the facility was investigating. The Administrator stated CNA-C was removed from Resident #4's hall during the investigation, then ultimately terminated. In an interview on 12/03/2025 at 4:23 PM, the DON stated CNA-C was a good CNA, but she should not have said what she said. The DON stated she did not feel CNA-C meant it the way Resident #4 took it because they joked around a lot together, and CNA-C was just joking with her, but still, it was not an appropriate thing to say to a resident. She stated CNA-C was terminated, and an Abuse and Neglect in-service was done with the staff. Record review of CNA-C's personnel file, dated 11/05/2025, revealed CNA-C was terminated, and her last day of work was on 10/29/2025. Record review of the facility's Abuse Prevention Policy, no date indicated, revealed Residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. This includes, but is not limited to freedom from corporal punishment, involuntary seclusion, verbal, mental, sexual or physical abuse, and physical or chemical restraint not required to treat the resident's symptoms. Event ID: Facility ID: 455557 If continuation sheet Page 3 of 7 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 12/03/2025 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 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 interview and record review the facility failed to ensure the comprehensive care plan was developed and implemented within a timely manner for each resident, consistent with resident rights, to include measurable objectives and timeframes to meet resident's medical, nursing, mental, and psychosocial needs identified in the comprehensive assessment for 1 of 5 residents (Resident #3) reviewed for care plans. The facility failed to develop or implement Resident #3's comprehensive care plan when, after searching for over 3 hours, they were unable to find Resident #3's comprehensive care plan in her chart, on the electronic medical system, or in medical records. This failure could place residents at risk of receiving inadequate care and services.The findings included: Record review of Resident #3's face sheet dated 09/17/2025 revealed an [AGE] year-old female with an admission date of 12/18/2024. Pertinent diagnoses included Unspecified Dementia (a condition which affects memory, thinking, and the ability to perform daily activities), Cerebral Infarction (a type of stroke which occurs when a blood clot blocks a brain artery, leading to a loss of blood flow to a specific area of the brain), Aphasia (a communication disorder which affects a person's ability to process and formulate language, and it could impact various aspects of communication, including speaking, understanding, reading, and writing), and Atrioventricular (AV) block (a condition characterized by the partial or complete block of electrical impulses from the atria (upper chambers) to the ventricles (lower chambers) of the heart. Record review of Resident #3's quarterly MDS assessment dated [DATE] revealed no BIMS as the BIMS interview was not conducted due to Resident #3 was rarely or never understood. C0700 and C0800 revealed Resident #3 had short-term and long-term memory problems. C1000 revealed severely impaired decision-making skills. C1310 revealed Resident #3 continuously had difficulty with focusing attention. GG0130 revealed Resident #3 was dependent with oral hygiene, toileting, showering, and personal hygiene. There was no care plan to be reviewed in the electronic chart or the paper chart. In an interview on 12/02/2025 at 4:45 PM, the SW stated she kept a list of quarterly care plan meetings due, and she was the one who sent out the notifications for the care plan meetings. The SW stated she was not sure whose responsibility it was to update the care plan information since they no longer had an MDS nurse, and she was not sure if Resident #3's care plan was ever completed. In an interview on 12/02/2025 at 4:55 PM, ADON-A stated the MDS nurse was the one who updated the care plans, but since they did not currently have an MDS nurse, the regional MDS nurses had been coming to help with care plans. ADON-A stated she was not sure how may care plans had been updated so far, but she knew they had been working on them. In an interview on 12/03/2025 at 4:14 PM, the DON stated care plan meeting should be held quarterly and with significant changes to update any changes or needs the resident may have had. She also stated the ADONs, and the Nurse Managers were the ones who should be updating the care plans since they did not currently have an MDS nurse. The DON stated she was not sure what happened to Resident #3's care plan. In an interview on 12/03/2025 at 4:35 PM, ADON-A stated care plan meetings were held quarterly and with significant changes, or at least they were supposed to be. The SW kept up with who needed the care plan meetings, and she sent out the notifications for the meetings. ADON-A stated after three hours searching for Resident #3's care plan, they were not able to find one. She was not sure if a care plan meeting was ever held or a comprehensive care plan was ever completed for Resident #3. She stated residents were supposed to have care plans to help staff identify the type of individualized care the residents needed. Record review of the facility's Care Plans, Comprehensive Person-Centered Policy, no date indicated, revealed a comprehensive, person-centered care plan that includes measurable objectives and timetables to meet (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455557 If continuation sheet Page 4 of 7 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 12/03/2025 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 0656 Level of Harm - Minimal harm or potential for actual harm the resident's physical, psychosocial and functional needs is developed and implemented for each resident. 2. The care plan interventions are derived from a thorough analysis of the information gathered as part of the comprehensive assessment. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455557 If continuation sheet Page 5 of 7 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 12/03/2025 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 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure the comprehensive care plan was reviewed and revised by the interdisciplinary team after each assessment including both the comprehensive and quarterly review assessments, and the change of condition assessments to reflect the current conditions for 2 of 5 residents (Resident #1 and Resident #2) whose care plans were reviewed for timing and revision. The facility failed to ensure Resident #1's care plan was revised after a significant change to accurately reflect current diagnoses and needs. The facility failed to ensure Resident #2's care plan had been reviewed or revised since 2024. These failures could place residents at risk of receiving inadequate, individualized care and services. The findings included: Record review of Resident #1's face sheet dated 12/02/2025 revealed a [AGE] year-old male admitted to the facility on [DATE]. Pertinent diagnoses included Unspecified Dementia (a group of thinking and social symptoms which interfere with daily functioning) and Chronic Obstructive Pulmonary Disease (COPD, an ongoing lung condition caused by damage to the lungs). Record review of Resident #1's significant change MDS assessment dated [DATE] revealed a BIMS score of 11, which indicated moderately impaired cognition. The MDS assessment section J1400 revealed Resident #1 did not have a condition or chronic disease which resulted in a life expectancy of less than 6 months. The MDS assessment section N0415 revealed Resident #1 was not on an Opioid. The MDS assessment section O0110 revealed Resident #1 was placed on hospice care. Section Z0500 of the MDS assessment revealed it was signed as complete on 11/07/2025. Record review of Resident #1's active physician orders started 10/15/2025 revealed multiple orders for Morphine (an opioid, narcotic medication used to treat pain) for mild, moderate, or severe pain. There was another order dated for 10/15/2025 to admit Resident #1 to nursing home care under hospice routine care. Record review of Resident #1's comprehensive care plan, initiated 05/01/2025 and revised 07/03/2025, revealed the care plan had not been reviewed or revised since 07/03/2025. There was no care plan regarding Resident #1's hospice transition, and no care plan regarding Resident #1's morphine. Record review of an email dated 12/02/2025 at 4:35 PM, revealed the Administrator stated we (the facility) did our best to have care plan meetings, and the SW contacts hospice to attend, but they did not always comply. Record review of Resident #2's face sheet dated 12/03/2025 revealed a [AGE] year-old male admitted to the facility on [DATE] and discharged [DATE]. Pertinent diagnoses included Unspecified Dementia (a group of thinking and social symptoms which interfere with daily functioning) and Type 2 Diabetes (a chronic condition which affects how your body metabolizes sugar (glucose), leading to high blood sugar levels and various health complications). Record review of Resident #2's Quarterly MDS assessment dated [DATE] revealed a BIMS score of 09, which indicated moderately impaired cognition. The MDS assessment also revealed Resident #2 had lower extremity functional limitations. The quarterly MDS also revealed Resident #2 had active diagnoses of Coronary Artery Disease (CAD, a common type of heart disease which affects the main blood vessels which supply blood to the heart, called the coronary arteries), Hypertension (high blood pressure happens when the force of the blood pushing against the artery walls was consistently too high, and the heart had to work harder to pump blood), Unspecified Dementia (a group of thinking and social symptoms which interfere with daily functioning), Anxiety (intense, excessive and persistent worry and fear about everyday situations), and Depression (a mood disorder which causes a persistent feeling of sadness and loss of interest). The MDS was signed as completed by the DON on 09/11/2025. Record review of Resident #2's physician orders, started 03/02/2025, revealed an order for Amlodipine (a Hypertension medication). Record review of Resident #2's comprehensive care plan, revealed the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455557 If continuation sheet Page 6 of 7 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 12/03/2025 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 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete care plan had not been reviewed, revised, or edited since 10/04/2024. The most recent MDS revealed a diagnosis of Hypertension, and the most recent physician orders revealed a hypertension, or high blood pressure, medication, but there was no care plan noted for the Hypertension or the medication. In an interview on 12/02/2025 at 4:45 PM, the SW stated she kept a list of quarterly care plan meetings which were due, and she was the one who sent out the notifications for the care plan meetings. The SW also stated she showed Resident #1 had a quarterly care plan meeting in September 2025 and a change of condition care plan meeting in October 2025, but she could not find the care conference meeting forms, and she was not sure whose responsibility it was to update the care plan information since they no longer had an MDS nurse. After stating she had Resident #1 on the care plan meeting lists for September 2025 and October 2025, SW then stated she could only find Resident #1 on the lists for care plan meetings for April 2025 and September 2025. The SW stated she could not find the care conference meeting forms, utilized in care plan meetings, to show that care plans had actually been held. In an interview on 12/02/2025 at 4:55 PM, ADON-A stated the MDS nurse was the one who was supposed to be updating the care plans, but they did not currently have an MDS nurse, so the Regional MDS nurses were the ones who had been coming to help with the care plans. She stated she was not sure if they had performed a care plan meeting or updated Resident #1's or Resident #2's care plans, but she was going to reach out to them and see what she could find out. After reaching out to them, she concluded neither care plan had been reviewed, revised or updated appropriately. In an interview on 12/03/2025 at 9:21 AM, the Regional MDS Nurse stated when she looked at Resident #2's care plan last night and updated it, it looked like it had been looked at it, but when she reviewed it, it had not been reviewed, revised, or updated. The Regional MDS Nurse stated there should have been a meeting for the quarterly care plans, as well as the care plans with a change of condition, and the care plans should have been reviewed and revised. The Regional MDS Nurse admitted prior to last night (12/02/2025) she had not looked at or updated Resident #1's or Resident #2's care plan. In an interview on 12/03/2025 at 4:14 PM, the DON stated care plans were used to identify the type of care residents need, and the ADONs and the MDS Nurse were responsible for checking to make sure the care plans were getting completed, but there currently was no MDS nurse. She stated the care plan meetings were supposed to be held quarterly and for significant changes, and if an MDS was completed for a significant change, a care plan meeting should have been held. Record review of the facility's Care Plans, Comprehensive Person-Centered Policy, no date indicated, revealed a comprehensive, person-centered care plan that includes measurable objectives and timetables to meet the resident's physical, psychosocial and functional needs is developed and implemented for each resident. 2. The care plan interventions are derived from a thorough analysis of the information gathered as part of the comprehensive assessment. 8. Areas of concern that are identified during the resident assessment will be evaluated before interventions are added to the care plan. 11. The comprehensive, person-centered care plan is developed within seven days of the completion of the required comprehensive assessment (MDS). 12. Assessments of the Residents are ongoing, and care plans are revised as information about the residents and the residents' conditions change. Event ID: Facility ID: 455557 If continuation sheet Page 7 of 7