Health inspection·July 9, 2025

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some this time. Clothing intact and resident continues up to wheelchair in dining area. RP made aware, DON, and MD notified. No injuries noted. No pain noted. Record review of Resident #4's change of condition for resident-to-resident incident completed by LVN G on 05/02/25 revealed Resident #4 was seen being kissed by Resident #23 and was reported to LVN G. Kiss was described as being fast and no saliva was seen on Resident #4. Resident #4's mouth area was dry and intact. Resident #4's clothes were on properly and intact. When incident occurred, residents were immediately separated from each other. After being separated, Resident #4 was back to participating in activity and watching tv in the dining room. Resident #4 showed no signs or symptoms of pain or discomfort. No other injuries noted. No pain noted. Transferred out of the unit to the regular hall after this incident. 2. Record review of Resident #9's face sheet, dated 07/08/25, revealed the resident was an [AGE] year-old male who was initially admitted to the facility on [DATE] with diagnoses that included: unspecified dementia (a group of thinking and social symptoms that interferes with daily functioning), major depressive disorder, delusional disorders (mental health condition that causes beliefs in something that is untrue), anxiety disorder, and cognitive communication deficit. Record review of Resident #9's quarterly MDS assessment, dated 04/08/25, revealed Resident #9 had a BIMS score of 2, indicating his cognition was severely impaired. Record review of Resident #9's care plan dated 07/08/25 revealed [Resident #9] had a behavior problem (history of inappropriate sexual behaviors towards staff and residents) related to diagnosis of unspecified dementia. Interventions: administer medications as ordered, behavior monitoring, intervene as necessary to protect the rights and safety, divert attention, remove from situation, approach in a calm manner, obtain labs if ordered and report results to MD, one to one for 72 hours, and praise indication of resident's progress. Date initiated: 10/19/24. Record review of Resident #9's change of condition for resident-to-resident incident completed by the DON on 10/19/24 revealed Resident #9 noted with increase behaviors. New orders received one to one for 72 hours, urine analysis, and labs. Spoke with RP in regard to possibly transferring Resident #9 to sister facility with an all-male memory care unit, but family refusing transfer. Psych to evaluate and treat due to recent behaviors. RP agreed. No injuries noted. No pain noted. Record review of Resident #9's progress notes-dated 10/19/24 revealed HK D was passing by room when she noted Resident #9 standing on the right side of Resident #4's wheelchair and noted his hand near Resident #4's front private area. LVN F made aware and immediately removed Resident #9 away from Resident #4. Resident #9's clothes noted to be intact. At the time of attempting to remove him away, Resident #9 got verbally and physically aggressive towards staff. Resident #9 stated they all want to lay with me. Head to toe assessment done, no pain noted. Resident #9 alert and oriented x1, able to make needs known and answer simple questions. Resident #9 is ambulatory with walker assist, wanderer, requires frequent redirection. MD was made aware, resident on one to one, attempted to call RP, no answer, and pending call back. Pending call back from psych. Documented by the DON. -dated 10/22/24 revealed Resident #9 is post day 3 for sexually inappropriate behavior. Resident #9 no longer needing one to one. 72 hours of monitoring with no sexual behaviors noted. Documented by LVN C. 3. Record review of Resident #12's face sheet, dated 07/08/25, revealed the resident was a [AGE] year-old male who was initially admitted to the facility on [DATE] with diagnoses that included: legal blindness (visual impairment), bipolar disorder (disorder associated with episodes of mood swings ranging from depressive lows to manic highs), schizophrenia (disorder that affects a person's ability to think, feel and behave clearly), Alzheimer's disease (decline in memory, thinking, and behavior) with early onset, cognitive communication deficit, depression, and anxiety disorder. Resident #12 was discharged to another facility on 04/05/25. Record review of Resident #12's quarterly MDS assessment, dated 04/01/25, revealed (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455662 If continuation sheet Page 2 of 11 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 455662 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of McAll 900 S 12th St McAllen, TX 78501 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 - Some Resident #12 had a BIMS score of 14, indicating his cognition was intact. Record review of Resident #12's care plan dated 07/08/25 revealed [Resident #12] had a behavior problem (hallucination, aggressive behavior) related to schizophrenia. On 04/03/25, Resident #12 noted kissing Resident #20 (placed on one to one monitoring). On 04/05/25, Resident #12 noted kissing Resident #4 (transferred to an all-male unit). Interventions: administer medications as ordered, anticipate and meet needs, educate the resident, explain all procedures, assist in developing more appropriate methods of interacting, intervene as necessary to protect the rights and safety, divert attention, remove from situation, and provide a program of activities. Date initiated: 10/17/24. Record review of Resident #12's change of condition for resident-to-resident incident completed by LVN C on 04/03/25 revealed CNA B came to notify LVN C that Resident #12 had approached Resident #20, said something to her, and then gave her a kiss on the forehead followed by another to the lips. CNA B called out Resident #12's name and he left to his room. Resident #20 wiped her mouth. LVN C attempted to redirect Resident #12, but resident would look away and just say ok. Resident #12 will be on one to one supervision. RP aware, DON and MD notified. No injuries noted. No pain noted. Record review of Resident #12's psych NP consult dated 04/04/25 revealed Resident #12 was on a one to one due to behaviors. Changed medications. Record review of Resident #12's change of condition for resident-to-resident incident completed by LVN C on 04/05/25 revealed CNA A came to notify LVN C that Resident #12 was seen kissing Resident #4 in the mouth. CNA A called Resident #12's name out and he stood straight up and walked away to hall. LVN C attempted to redirect Resident #12, but he became aggressive and stated go f**k your mother. Resident #12 will be on a one to one supervision, and possible transfer to all-male unit. RP aware. DON and MD notified. No injuries noted. No pain noted. Record review of Resident #12's progress notes-dated 04/03/25 revealed RP made aware of incident of Resident #12 a female resident, clothes intact and no other physical contact noted at the time of incident. Resident #12 receiving medication for inappropriate behaviors. Psych NP contacted and pending response. Resident #12 will be on a one to one supervision as per MD. Police department made aware and waiting for them to arrive. Resident #12 is alert and oriented to self and place, able to answer simple questions, history of hallucinations and exit seeking. Made RP aware of possible transfer to an all-male memory care unit due to behaviors. RP stated understanding and will be here tomorrow to see resident. Pending psych eval. Documented by the DON. -dated 04/04/25 revealed Resident #12 was evaluated by psych and had his medications adjusted. -dated 04/05/25 revealed Resident-to-resident incident. RP was notified of possible transfer to another facility. Resident #12 started on a one to one supervision. Documented by LVN C. -dated 04/05/25 revealed Resident #12 was transferred to another facility with an all-male memory care unit after the incident with Resident #20 on 04/05/25. Documented by LVN C. 4. Record review of Resident #20's face sheet, dated 07/08/25, revealed the resident was an [AGE] year-old female who was initially admitted to the facility on [DATE] with diagnoses that included: Alzheimer's disease (decline in memory, thinking, and behavior), major depressive disorder, mood disorder, and schizoaffective disorder (mental health condition with hallucinations and delusions). Record review of Resident #20's quarterly MDS assessment, dated 05/01/25, revealed Resident #20 had a BIMS score of 1, indicating her cognition was severely impaired. Record review of Resident #20's care plan dated 07/08/25 revealed [Resident #20] had impaired cognitive function or impaired thought processes related to Alzheimer's, schizoaffective disorder. Interventions: administer medications as ordered, cue, reorient and supervise as needed, and present one thought, idea, question, or command at a time. Date initiated: 06/13/24. Record review of Resident #20's change of condition for resident-to-resident incident completed by LVN C on 04/03/25 revealed CNA B came to notify LVN C that Resident #12 had approached (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455662 If continuation sheet Page 3 of 11 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 455662 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of McAll 900 S 12th St McAllen, TX 78501 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 - Some Resident #20, said something to her, and then gave her a kiss on the forehead followed by another to the lips. CNA B called out Resident #12's name and resident left to his room. Resident #20 wiped her mouth. LVN C asked Resident #20 about incident but resident unable to recall situation. Head to toe assessment on resident, no visual injury noted resident showing no signs or symptoms of pain or discomfort, and no distress at this time. Clothing intact, Resident #20 continued to be in hallway up to wheelchair. RP made aware, DON, and MD notified. 5. Record review of Resident #23's face sheet, dated 07/08/25, revealed the resident was an [AGE] year-old male who was initially admitted to the facility on [DATE] with diagnoses that included: unspecified dementia (a group of thinking and social symptoms that interferes with daily functioning), age-related physical debility, insomnia (trouble sleeping), muscle weakness, and depression. Record review of Resident #23's quarterly MDS assessment, dated 06/11/25, revealed Resident #23 had a BIMS score of 9, indicating his cognition was moderately impaired. Record review of Resident #23's care plan dated 07/08/25 revealed [Resident #23] had a behavior problem related to sexual inappropriateness. On 05/02/25, Resident #23 noted kissing Resident #4. Interventions: administer medications as ordered, assist resident to develop more appropriate methods of interacting, educate the resident, explain all procedures, intervene as necessary to protect the rights and safety, divert attention, remove from situation, monitor behaviors, praise any progress, provide a program of activities, and placed on a one to one observation for 24 hours. Date initiated: 05/02/25. Record review of Resident #23's change of condition for resident-to-resident incident completed by LVN G on 05/02/25 revealed Resident #23 was seen giving Resident #4 a kiss. LVN G was told. Kiss was described as being fast and no saliva was seen on Resident #23. Resident #23's mouth area was dry and intact. Resident #23's clothes were on properly and intact. When incident occurred, residents were immediately separated from each other. LVN G educated Resident #23 on not being allowed to touch any of the residents in any inappropriate manner. Resident #23 stayed separate from Resident #4 throughout shift. Resident #23 showed no signs or symptoms of pain or discomfort. No injuries noted. No pain noted. Record review of Resident #23's change of condition for resident-to-resident incident completed by LVN E on 06/25/25 revealed AA H let LVN E know that Resident #23 was kissed on the lips by Resident #27. Both residents were already separated when LVN E checked on them. AA H let LVN E know that Resident #27 pulled Resident #23 to her and gave one kiss on lips. RP aware, MD, and DON aware. No new orders. No injuries noted. No pain noted. 6. Record review of Resident #15's face sheet, dated 07/08/25, revealed the resident was an [AGE] year-old female who was initially admitted to the facility on [DATE] with diagnoses that included: Alzheimer's disease (decline in memory, thinking, and behavior), unspecified dementia (a group of thinking and social symptoms that interferes with daily functioning), cognitive communication deficit, delusional disorders (mental health condition that causes beliefs in something that is untrue), major depressive disorder, and emotional lability (neurological condition that causes uncontrollable laughing or crying). Record review of Resident #15's quarterly MDS assessment, dated 06/11/25, revealed Resident #15 had a BIMS score of 00, indicating her cognition was severely impaired. Record review of Resident #15's care plan dated 07/08/25 revealed [Resident #15] has a behavior problem of physical aggression (hitting, pulling hair, towards staff and residents) related to anger, dementia, and poor impulse control. Interventions: the resident's triggers for physical aggression are looking at her. The resident's behaviors is de-escalated by giving her space or leaving her alone. Interventions also included: administer medications as ordered, analyze triggers, assess resident's needs, monitor behaviors, psych consult, and one to one monitoring. Date initiated: 04/24/25. [Resident #15] had a resident-to-resident incident on 06/21/25. Interventions: labs as ordered and one to one monitoring. Date initiated: 06/21/25. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455662 If continuation sheet Page 4 of 11 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 455662 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of McAll 900 S 12th St McAllen, TX 78501 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 - Some Record review of Resident #15's psych NP consult dated 04/22/25 revealed Resident #15 was evaluated due to refusing meals at times, mood is labile (easily changed) and yelling at staff. Medications adjusted. Record review of Resident #15's change of condition for resident-to-resident incident completed by LVN E on 06/21/25 revealed Resident #15 is being monitored for any aggressive behaviors and/or verbal aggressiveness for resident-to-resident incident. Resident #15 is being closely monitored for any other behavioral changes. Lab work was ordered for Resident #15, pending results. No injuries noted. No pain noted. Record review of Resident #15's psych NP consult dated 06/24/25 revealed Resident #15 was on a one to one for recent physical altercation with another resident. Medication orders adjusted. 7. Record review of Resident #31's face sheet, dated 07/08/25, revealed the resident was a [AGE] year-old male who was initially admitted to the facility on [DATE] with diagnoses that included: Parkinsonism (clinical syndrome characterized by tremor, slowed movement, and postural instability), vascular dementia (reduced blood flow to the brain leading to cognitive decline), depression, anxiety disorder, mood disorder, and muscle weakness. Record review of Resident #31's quarterly MDS assessment, dated 06/11/25, revealed Resident #31 had a BIMS score of 7, indicating his cognition was severely impaired. Record review of Resident #31's care plan dated 07/08/25 revealed [Resident #31] has a behavior problem of physical aggression related to dementia and poor impulse control. [Resident #31] had a resident-to-resident incident on 06/21/25. Interventions: administer medications as ordered, analyze triggers, assess resident's needs, monitor behaviors, psych consult, and one to one monitoring. Date initiated: 06/21/25. Record review of Resident #31's change of condition for resident-to-resident incident completed by LVN E on 06/21/25 revealed Resident #31 hit another resident without being provoked. Resident #31 is continued to be monitored and lab results (from 06/20/25) still pending. No injuries noted. No pain noted. Record review of Resident #31's psych MD consult dated 06/23/25 revealed Resident #31 was evaluated due to behavioral decline and increased behaviors of aggression, crying, irritability, and hallucinations. Medications adjusted. 8. Record review of Resident #27's face sheet, dated 07/08/25, revealed the resident was a [AGE] year-old female who was initially admitted to the facility on [DATE] with diagnoses that included: Alzheimer's disease (decline in memory, thinking, and behavior), vascular dementia (reduced blood flow to the brain leading to cognitive decline), Parkinson's disease (brain disorder that affects movement and causes tremors, stiffness, and slowness), mood disorder, and major depressive disorder. Record review of Resident #27's quarterly MDS assessment, dated 04/15/25, revealed Resident #27 had a BIMS score of 3, indicating her cognition was severely impaired. Record review of Resident #27's care plan dated 07/08/25 revealed [Resident #27] has a behavior problem of physical aggression (hitting, pulling hair, towards staff and residents) related to anger, dementia, and poor impulse control. Interventions: the resident's triggers for physical aggression are looking at her. The resident's behaviors is de-escalated by giving her space or leaving her alone. Interventions also included: administer medications as ordered, analyze triggers, assess resident's needs, monitor behaviors, psych consult, and one to one monitoring. Date initiated: 04/24/25. [Resident #27] had a resident-to-resident incident on 06/21/25. Interventions: labs as ordered and one to one monitoring. Date initiated: 06/21/25. Record review of Resident #27's psych NP consult dated 06/24/25 revealed Resident #27 was evaluated due to refusing meals at times, mood is labile (easily changed) and yelling at staff. Medications adjusted. Record review of Resident #27's change of condition for resident-to-resident incident completed by LVN E on 06/25/25 revealed LVN E was made aware by AA H that Resident #27 kissed Resident #23 on the lips. Both residents were already separated when LVN E checked on them. AA H let LVN E know that Resident #27 pulled Resident #23 to her and gave one kiss on lips. RP aware, and MD aware. MD let LVN E know to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455662 If continuation sheet Page 5 of 11 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 455662 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of McAll 900 S 12th St McAllen, TX 78501 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 - Some let MD know if behavior persists. No new orders. No injuries noted. No pain noted. On 07/08/25 at 10:45 AM, in an attempted interview and observation with Resident #4, she was not interviewable. Resident #4 did not answer baseline questions or questions related to the incidents. Resident #4 sat in her wheelchair, in the hallway. Resident #4 appeared with good personal hygiene, no injury, and not in distress. On 07/08/25 at 11:00 AM, in an attempted interview and observation with Resident #9, he was not interviewable. Resident #9 did not answer baseline questions or questions related to the incidents. Resident #9 sat in his wheelchair, in the dining room of the unit. Resident #9 appeared with good personal hygiene, no injury, and not in distress. On 07/08/25 at 11:15 AM, in an attempted interview with Resident #12, it was verified with the DON that he was no longer at the facility. Resident #12 was discharged to another facility on 04/05/25. On 07/08/25 at 11:30 AM, in an attempted interview and observation with Resident #20, she was not interviewable. Resident #20 did not answer baseline questions or questions related to the incidents. Resident #20 smiled. Resident #20 sat in her wheelchair, in the dining room of the unit. Resident #20 appeared with good personal hygiene, no injury, and not in distress. On 07/08/25 at 11:45 AM, in an attempted interview and observation with Resident #15, she was not interviewable. Resident #15 did not answer baseline questions or questions related to the incidents. Resident #15 smiled and nodded, then looked away. Resident #15 sat in a chair in the dining room of the unit. Resident #15 appeared with good personal hygiene, no injury, and not in distress. On 07/08/25 at 1:10 PM, in an interview and observation with Resident #27, she provided her name, but did not know other information. Resident #27 did not know what was being asked and spoke about other topics. Resident #27 was in the unit. Resident #27 was lying in bed with the call light within reach. Resident #27 appeared with good personal hygiene, no injury, and not in distress. On 07/08/25 at 1:25 PM, in an interview and observation with Resident #23, he provided his name, but did not know other information. Resident #23 stated nothing had happened, everything was fine, and he had no problems. Resident #23 did not provide information regarding the incidents. Resident #23 was in the unit. Resident #23 was lying in bed with the call light within reach. Resident #23 appeared with good personal hygiene, no injury, and not in distress. On 07/08/25 at 1:55 PM, in an attempted interview with AA H, she had gone home due to a personal matter. AA H would return to work tomorrow. On 07/08/25 at 2:00 PM, in an interview with LVN E, she stated she worked on 06/25/25, when AA H informed her that when Resident #23 walked into the activities area, Resident #27 grabbed Resident #23 and kissed him on the lips. LVN E stated AA H intervened, redirected the residents, and informed her right away. LVN E stated the residents were not injured or in distress. LVN E stated Resident #27 was placed on a 1:1, labs were ordered, and she had a psych consult. LVN E stated she was in-serviced on abuse and neglect and the protocol was followed. LVN E stated the incident on 06/25/25 was reported to the ADM immediately. LVN E stated a resident kissing another resident was considered abuse as the residents cannot consent to any sexual contact . On 07/08/25 at 2:25 PM, in an attempted interview with CNA A, she stated she was no longer employed at the facility and did not wish to speak to the surveyor regarding any incidents. On 07/09/25 at 8:45 AM, in an interview and observation with Resident #31, he provided his name and stated he had been at the facility for months. Resident #31 stated things were fine and he had no problems. Resident #31 was difficult to understand as he mumbled and spoke softly. Resident #31 did not provide information regarding the incidents. Resident #31 sat in his wheelchair, in the dining room of the unit. Resident #31 appeared with good personal hygiene, no injury, and not in distress. On 07/09/25 at 9:00 AM, in an interview with AA H, she stated she worked on 05/02/25 when Resident #23 kissed Resident #4. AA H stated she did not recall if it was on the lips or more details as it had been some time ago. AA H stated she recalled it (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455662 If continuation sheet Page 6 of 11 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 455662 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of McAll 900 S 12th St McAllen, TX 78501 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 - Some happened in the dining room during activities. AA H stated sometimes the residents stay in the dining room the entire duration of the activity and other times the residents leave to their rooms, so it was not uncommon for residents to move around. AA H stated Resident #23 showed no indication that he was going to kiss Resident #4 and it was all of a sudden. AA H stated she intervened right away by redirecting Resident #23 and he moved away from Resident #4. AA H stated she informed the nurse right away, but did not remember which nurse. AA H stated the nurse checked on Resident #23 and Resident #4 and notified the ADM. AA H stated she worked on 06/25/25 when Resident #27 kissed Resident #23. AA H stated they were in the dining room doing activities. AA H stated Resident #27 all of a sudden grabbed Resident #23 and kissed him on the lips one time. AA H stated she was providing an activity but when she saw it happen, she separated Resident #27 and Resident #23 immediately and told LVN E. AA H stated LVN E assessed Resident #27 and Resident #23 and notified the ADM. AA H stated when the residents were in the dining room for activities, the nurse was in the hallway facing the dining room, and the CNAs were doing rounds or checked on other residents that were not in the dining room. AA H stated she was in-serviced on abuse and neglect and the protocol was followed for both incidents. AA H stated the nurse was informed and the nurse notified the ADM right away. AA H stated she did her part in reporting and it was not up to her to say if an incident was or was not abuse. AA H stated it was difficult because the residents could not decide if they consented or not based on the way their minds worked and the residents did not remember what happened. On 07/09/25 at 9:25 AM, in an interview with LVN E, she stated she worked on 06/21/25 when Resident #31 hit Resident #15. LVN E stated Resident #31 was in the hallway and Resident #15 did not provoke or upset him, but when Resident #15 walked by Resident #31, Resident #31 used a fist to punch Resident #15 in the lower back/buttocks area. LVN E stated Resident #15 turned around and hit Resident #31 on the shoulder blade. LVN E stated she was standing in the hallway, not too far from the residents, but she could not prevent them hitting each other as it all happened very fast. LVN E stated she intervened and redirected the residents away from each other. LVN E stated Resident #31 had been agitated but it was towards staff, not residents. LVN E stated the MD had been notified of the increased agitation on 06/20/25 and the MD had ordered a urine analysis. LVN E stated Resident #31 had been started on antibiotics as well. LVN E stated for this incident, she reported to the DON, called the RP, notified the MD, and reported to the ADM. LVN E stated Resident #31 was placed on a 1:1. LVN E stated the MD ordered labs or a urine analysis for Resident #15. LVN E stated there were no injuries or distress noted for Resident #31 and Resident #15. LVN E stated residents hitting each other was abuse or something that would need to be reported to the ADM. LVN E stated the protocol was followed. On 07/09/25 at 9:40 AM, in an interview with HK D, she stated she worked on 10/19/24 and recalled the incident of Resident #9 touching Resident #4. HK D stated lunch was about to start so she pushed her cart down the hall, to exit the unit and go on her lunch break. HK D stated she passed by a room, did not remember which room, and when she turned her head, she saw Resident #9 and Resident #4 in the room. HK D stated she knew that was neither of their rooms. HK D stated Resident #4 was trying to move but Resident #9 was not letting her. HK D stated Resident #4 was in her wheelchair and Resident #9 had his walker right next to Resident #4. HK D stated Resident #9 was touching Resident #4 by rubbing his hand into her private area (vagina/crotch area). HK D stated as soon as she saw, she told Resident #9 to stop but Resident #9 did not listen so she called out for the staff for help. HK D stated LVN F worked that day and went to the room right away. HK D stated LVN F redirected Resident #9 away from Resident #4. HK D stated she left the unit because the meal trays could not be in the area with the housekeeping cart. HK D stated the CNAs were getting the residents ready for lunch or maybe changing a resident. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455662 If continuation sheet Page 7 of 11 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 455662 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of McAll 900 S 12th St McAllen, TX 78501 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 - Some FORM CMS-2567 (02/99) Previous Versions Obsolete HK D stated she believed a CNA went to the room to help LVN F, but did not remember who. HK D stated she was instructed that if she saw an incident happen, to tell the resident to stop and redirect, but if the resident does not stop then tell the nurse or ask for help. HK D stated she was in-serviced on abuse and neglect and knew to report to the nurse right away and make the ADM aware of any situation. HK D stated there was different types of abuse. LVN F notified the DON and the ADM of the incident. HK D stated what she witnessed when she saw Resident #9 touching Resident #4 was sexual abuse and it was an incident to report right away, which they did report. HK D stated she did not believe the residents could consent. HK D stated Resident #4 said to Resident #9, no, no let me go, but Resident #9 did not want to let her move away. HK D stated it was definitely abuse. On 07/09/25 at 10:10 AM, in an attempted interview with LVN F, she did not answer. A message was left requesting a callback. No callback was received. On 07/09/25 at 10:15 AM, in an interview with CNA B, he stated he assisted residents in the unit on 04/03/25 and monitored the dining room. CNA B stated there were two entrances to the dining room. CNA B stated he stood closer to one entrance, when Resident #12 entered the dining room through the other entrance and when Resident #20 moved in her wheelchair, Resident #12 gave Resident #20 a kiss on the mouth, and then on the forehead, or vice versa, on the forehead then on the lips. CNA B stated he called out Resident #12's name to redirect him and Resident #12 left the dining room right away. CNA B stated he moved Resident #20 next to him and reported to the nurse immediately. CNA B stated he did not remember the nurse that worked that day. CNA B stated the nurse went to look for Resident #12 and he went with the nurse as a precaution. CNA B stated the nurse asked Resident #12 what happened and why did he kiss Resident #20. CNA B stated Resident #12's answer was because he wanted to as if Resident #12 knew what he was doing. CNA B stated he did not recall if the nurse asked other questions, but he believed Resident #12 was placed on a 1:1 after that. CNA B stated he continued with the residents in the dining room along with another CNA. CNA B stated he did not recall which CNAs were working or where the CNAs were when the incident happened. CNA B stated he was monitoring and supervising the residents in the dining room but the incident happened fast and Resident #12 did not show indications that he was going to kiss Resident #20. CNA B stated the nurse checked Resident #20 and she was okay, she did not remember what happened. CNA B stated he was in-serviced on abuse and neglect and knew that abuse could be physical, verbal, financial, or sexual. CNA B stated Resident #12 kissing Resident #20 was sexual abuse. CNA B sta Event ID: Facility ID: 455662 If continuation sheet Page 8 of 11 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 455662 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of McAll 900 S 12th St McAllen, TX 78501 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interview and record review, the facility failed to ensure that all alleged violations involving abuse, neglect, or mistreatment, were reported immediately to the State Survey Agency, within two hours if the events that cause the allegation involve abuse or result in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury, for 2 of 16 (Resident #15 and Resident #4) residents reviewed for abuse/neglect, in that: The facility failed to report allegations of resident abuse for Resident #15 and Resident #4 to the State Survey Agency within the allotted time frame of 2 hours on 04/24/25 when Resident #15 pulled Resident #4's hair. This failure could place all residents at increased risk for potential abuse due to unreported allegations of abuse and neglect.The findings included: 1. Record review of Resident #15's face sheet, dated 07/08/25, revealed the resident was an [AGE] year-old female who was initially admitted to the facility on [DATE] with diagnoses that included: Alzheimer's disease (decline in memory, thinking, and behavior), unspecified dementia (a group of thinking and social symptoms that interferes with daily functioning), cognitive communication deficit, delusional disorders (mental health condition that causes beliefs in something that is untrue), major depressive disorder, and emotional lability (neurological condition that causes uncontrollable laughing or crying). Record review of Resident #15's quarterly MDS assessment, dated 06/11/25, revealed Resident #15 had a BIMS score of 00, indicating her cognition was severely impaired. Record review of Resident #15's care plan dated 07/08/25 revealed [Resident #15] has a behavior problem of physical aggression (hitting, pulling hair, towards staff and residents) related to anger, dementia, and poor impulse control. Interventions: the resident's triggers for physical aggression are looking at her. The resident's behaviors is de-escalated by giving her space or leaving her alone. Interventions also included: administer medications as ordered, analyze triggers, assess resident's needs, monitor behaviors, psych consult, and one to one monitoring. Date initiated: 04/24/25. [Resident #15] had a resident-to-resident incident on 06/21/25. Interventions: labs as ordered and one to one monitoring. Date initiated: 06/21/25. Record review of Resident #15's psych NP consult dated 04/22/25 revealed Resident #15 was evaluated due to refusing meals at times, mood is labile (easily changed) and yelling at staff. Medications adjusted. Record review of Resident #15's change of condition for resident-to-resident incident completed by ADON J on 04/24/25 revealed CNA A stated that upon entering Resident #15's room, Resident #15 was standing behind her roommate, Resident #4, pulling her hair back and complaining that Resident #4 talks too much. MD notified of Resident #15's behavior. New orders for urine analysis. RP attempted to be notified of incident and new orders. No answer at this time. No injuries noted. No pain noted. 2. Record review of Resident #4's face sheet, dated 07/08/25, revealed the resident was a [AGE] year-old female who was initially admitted to the facility on [DATE] with diagnoses that included: unspecified dementia (a group of thinking and social symptoms that interferes with daily functioning), chronic atrial fibrillation (irregular heartbeats), chronic obstructive pulmonary disease (lung disease), acute kidney failure (kidney disease), major depressive disorder, bipolar disorder (disorder associated with episodes of mood swings ranging from depressive lows to manic highs), and anxiety disorder. Record review of Resident #4's quarterly MDS assessment, dated 05/09/25, revealed Resident #4 had a BIMS score of 00, indicating her cognition was severely impaired. Record review of Resident #4's care plan dated 07/08/25 revealed [Resident #4] has a behavior problem related to dementia, history of alcohol abuse and bipolar disorder. Interventions: administer medications as ordered, anticipate and meet needs, explain procedures to the resident, followed up by (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455662 If continuation sheet Page 9 of 11 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 455662 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of McAll 900 S 12th St McAllen, TX 78501 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few psych services, intervene as necessary to protect the rights and safety, divert attention, remove from the situation, monitor behavior episodes, and provide a program of activities. Date initiated: 12/30/22. Record review of Resident #4's change of condition for resident-to-resident incident completed by ADON J on 04/24/25 revealed as per CNA A, upon entering room, Resident #15 was noted to be standing behind Resident #4, pulling her hair back, and complaining that Resident #4 was too loud. DON made aware of incident. RP attempted to be notified, no answer. MD notified and pending response. No injuries noted. No pain noted. On 07/08/25 at 10:45 AM, in an attempted interview and observation with Resident #4, she was not interviewable. Resident #4 did not answer baseline questions or questions related to the incidents. Resident #4 sat in her wheelchair, in the hallway. Resident #4 appeared with good personal hygiene, no injury, and not in distress. On 07/08/25 at 11:45 AM, in an attempted interview and observation with Resident #15, she was not interviewable. Resident #15 did not answer baseline questions or questions related to the incidents. Resident #15 smiled and nodded, then looked away. Resident #15 sat in a chair in the dining room of the unit. Resident #15 appeared with good personal hygiene, no injury, and not in distress. On 07/08/25 at 2:25 PM, in an attempted interview with CNA A, she stated she was no longer employed at the facility and did not wish to speak to the surveyor regarding any incidents. On 07/08/25 at 4:30 PM, in an interview with LVN K, she stated she worked on 04/24/25 when Resident #15 pulled Resident #4's hair. LVN K stated CNA A informed her at around 6 AM, that she walked into the room and saw Resident #15 behind Resident #4, pulling on Resident #4's hair, telling her to be quiet. LVN K stated CNA A said that when she walked into the room, Resident #15 got startled and let go of Resident #4's hair. LVN K stated CNA A had brought Resident #4 out to the dining room to ensure the residents were separated and notified LVN K of the incident. LVN K stated she assessed both residents. LVN K stated Resident #15 refused to speak to her but she had no injuries and did not appear to be in distress. LVN K stated Resident #4 did not know what happened, was not injured, was not crying, and was not in distress. LVN K stated she immediately reported the incident to the DON. LVN K stated she was in-serviced on abuse and neglect and followed the protocol. LVN K stated she reported to the DON and initiated the risk management forms. LVN K stated Resident #15 pulling Resident #4's hair was considered abuse. On 07/09/25 at 11:20 AM, in an interview with ADON J, he stated if a resident hit another resident, that was reported. ADON J stated physical abuse was hitting, slapping, kicking, or hurting a resident in a physical way. ADON J stated if there was a physical injury then the incident was more than likely reported. ADON J stated on 04/24/25, Resident #15 pulled Resident #4's hair, but when Resident #4 was assessed, she was not injured, so it did not need to be reported. ADON J stated based on the documentation he reviewed, he could not gage if it was a hard or soft hair pull. ADON J stated it depended on the situation, but if there was no injury then that was likely why the incident was not reported to the state. On 07/09/25 at 2:10 PM, in an interview with the DON, she stated on 04/24/25, Resident #15 pulled Resident #4's hair. The DON stated she was informed by LVN K and she notified the ADM. The DON stated the ADM and the team consulted with their regional staff to determine if it was reportable to the State. The DON stated she was not sure of the details but recalled Resident #15 and Resident #4 were not injured or in distress. The DON stated the incident was witnessed by CNA A and that was possibly why they did not report. On 07/09/25 at 3:45 PM, in an interview with the ADM, he stated on 04/24/25, Resident #15 pulled Resident #4's hair. The ADM stated it would be reported, depending on if the incident was witnessed or not, or if the residents were able to say what happened. The ADM stated he usually consulted with regional staff to determine if something was reported or not. The ADM stated perhaps Resident #15 could say what happened but Resident #4 could not. The ADM stated he did not recall this (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455662 If continuation sheet Page 10 of 11 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 455662 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of McAll 900 S 12th St McAllen, TX 78501 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete incident or the specifics. The ADM stated more than likely they did not report it because they were able to rule things out. The ADM stated maybe there was a witness or maybe there was no physical contact, and that was why they did not report it. The ADM stated pulling of the hair was not physical contact. The ADM stated the incident was reviewed and investigated as part of risk management and he had no knowledge that the facility failed to follow protocols that led to abuse or neglect. The ADM stated he had no knowledge that the incident on 04/24/25 resulted in injuries, distress, or negative outcomes. The ADM stated it was important to report incidents of abuse or possible abuse to protect the residents and ensure their safety. Record review of the facility's policy titled Abuse, Neglect, and Exploitation, dated 08/15/22, revealed Reporting/Response:The facility will have written procedures that include: 1. Reporting of all alleged violations to the Administrator, state agency, adult protective services and to all other required agencies (law enforcement when applicable) within specified timeframes:a. Immediately, but no later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury, orb. Not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury. Event ID: Facility ID: 455662 If continuation sheet Page 11 of 11