Health inspection·September 16, 2025

F 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few still attempting to hit CNA B and CNA C. CNA B said that she went to get assistance from LVN A. LVN A was outside of the room and Resident #1 said you want to fight, N word?. She said that LVN A came in the room and said, you got one now and grabbed Resident #1 by the shirt up by his neck and Resident #1 was making a choking noise and crying. CNA B said that when LVN A let him go, Resident #1 sat crying in his wheelchair. Record review of the voice recording provided by CNA B on 9/11/25 at 4:30 p.m. that was recorded on 9/10/25 sometime after 6:00 p.m. and included the voice of LVA A, CNA B and CNA C as identified by CNA B. A summary of the recording was that LVN A approached CNA B and CNA C letting them know that he had to complete an incident report after being accused of abusing Resident #1. LVN A asked them what occurred in the bedroom and said that he was not confirming nor denying what occurred, but he did not remember. Both CNA B and CNA C told him that he had grabbed Resident #1 by the shirt around his neck and got into Resident #1's face when Resident #1 used a racial slur toward his roommate. LVN A then excused himself to go fill out the incident report. During an interview on 9/11/25 at 3:18 p.m. Resident #1 said that LVN A had choked him and that he was scared of LVN A. Resident #1 cried and left the interview. During an interview on 9/11/25 at 3:57 p.m. LVN A said that on 9/9/2025 he worked at the facility. He went into Resident #1's bedroom when he was fighting with his roommate. LVN A said that he was trying to calm Resident #1 down by rubbing his back and trying to talk to him. LVN A said that Resident #1 was on the floor and he was assisting him back to his chair and his hand got caught in Resident #1's t-shirt and when he pulled it out his hand went up toward Resident# 1's neck. LVN A said that Resident #1 was one of his favorite residents and that he would never abuse him. He said that residents have called him the N word before and he was not one so it does not bother him. LVN A said that he did not choke Resident #1. LVN A said that there were two CNAs in the room with him when his hand got caught in Resident #1's t-shirt. LVN A confirmed that the CNA's in the room were CNA B and CNA C. During an interview on 9/12/25 at 1:18 p.m. CNA C said that she worked on the night shift on 9/9/2025 alongside CNA B. She said around 7:30 p.m. she and CNA B were having issues with Resident #1 as he was being combative and fighting with them and his roommate. CNA C said that CNA B went to ask LVN A to come and assist them with Resident #1 and his roommate who were fighting. CNA B and CNA C got the two residents separated and they moved Resident #1 out into the day room area for a while and he was able to calm down. CNA C said that at around 10:30 p.m. she and CNA B asked Resident #1 if they could change him and get him ready for bed. She said that Resident #1 agreed and they took him to his room. She said that when they got Resident #1's brief off he became combative again and said, N word, do you want to fight? to his roommate. CNA C said that at that time LVN A came into the room and said, if you want an N, now you got one and he grabbed Resident #1 by his shirt up by his neck and got into his face. CNA C said that she was shocked and did not remember what all LVN A said to Resident #1. CNA C said that it sounded like Resident #1 was making a choking noise but he may also have been crying because when LVN A released him, Resident #1 started crying. CNA C said that LVN A said, I did not hurt you, I hurt your feelings and left the room. She said that there were no further incidents that evening. During an interview on 9/11/25 at 11:55 a.m. the Administrator said she expected staff to act professional and not choke the residents or react to anything the residents might say. The Administrator said all residents had the right to be safe from abuse. Record review of facility's Abuse and Neglect Clinical Protocol policy last revised March 2018 indicated, .This policy defines abuse as the willful infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain, or mental anguish . Record review of facility's Abuse-Reportable Events policy last revised May 2017 indicated, .it is the policy of this home to prohibit resident abuse or neglect in any form . Record review of (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 2 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 - Immediate jeopardy to resident health or safety Residents Affected - Few facility's termination document for LVN A indicated that he was terminated on 9/11/2025 for abuse. Record review of Resident # 1's assessment dated [DATE] at 11:44 a.m. that showed no injuries on his head to toe assessment related to the incident. The Administrator was notified on 9/12/25 at 3:30 p.m. that an Immediate Jeopardy situation was identified due to the above failure. The Administrator was provided the Immediate Jeopardy template on 9/12/25 at 3:34 p.m. The facility's plan of removal was accepted on 9/13/2025 at 7:46 p.m. and included: Interventions: LVN A suspended on 9/10/25 at 7:50 a.m. Resident # 1 assessed for injury on 9/10/25 at 11:44 a.m. Roommate of Resident #1 assessed. Residents on secured unit were not showing signs of distress or pain on 9/10/25. LVN A terminated on 9/12/25 at 2:00 p.m. In-service of all staff regarding abuse and neglect started. Monitoring: Staff in-serviced on abuse and neglect included types of abuse, who to report to and when to report Resident counsel held on 9/13/2025 at 10:00am was held to discuss the incident, what was considered abuse and who must be called immediately when abuse was suspected. Residents were informed that abuse coordinator signs are posted at the end of each hall and throughout facility. All residents were given a safety survey asking if they felt safe in the facility, whether they had seen anyone in the facility being abused or neglected and who they are to report abuse to if they have a concern of abuse or neglect. On 9/13/25 at 8:30 p.m. the investigator confirmed the plan of removal had been implemented sufficiently to remove the IJ by the following: During an interview with LVN F who worked the 2-10 shift on 9/13/25 at 4:38 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with LVN D who worked the 2-10 shift on 9/13/25 at 4:40 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with LVN E who worked the 2-10 shift on 9/13/25 at 4:54 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA J who worked the 6 p.m. to 6 a.m. shift on 9/13/25 at 4:52 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA K who worked the 6 p.m.-6 a.m. shift on 9/13/25 at 4:54 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA L who worked the 2-10 shift on 9/13/25 at 5:00 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA B who worked the 6 p.m.-6 a.m. shift on 9/13/25 at 5:40 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA C who worked the 6 p.m.-6 a.m. shift on 9/13/25 at 5:52 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with LVN G who worked the 6 p.m. to 6 a.m. shift on 9/13/25 at 6:50 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with RN H who worked the 8 a.m.-5 p.m. shift on 9/13/25 at 6:53 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with DON who worked the 8 a.m.-5 p.m. shift on 9/13/25 at 6:58 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with Resident # 2 on 9/13/25 at 6:15 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 3 on (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 3 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 - Immediate jeopardy to resident health or safety Residents Affected - Few 9/13/25 at 6:20 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 4 on 9/13/25 at 6:23 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 5 on 9/13/25 at 6:27 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 6 on 9/13/25 at 6:33 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 7 on 9/13/25 at 6:37 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 8 on 9/13/25 at 6:42 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 1 on 9/13/25 at 6:46 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 9 on 9/13/25 at 7:52 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 10 on 9/13/25 at 7:55 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 11 on 9/13/25 at 7:57 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 12 on 9/13/25 at 8:00 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 13 on 9/13/25 at 8:05 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 14 on 9/13/25 at 8:08 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 15 on 9/13/25 at 8:12 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 16 on 9/13/25 at 8:15 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 17 on 9/13/25 at 8:18 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 18 on 9/13/25 at 8:20 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 19 on 9/13/25 at 8:23 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 20 on 9/13/25 at 8:25 p.m. he was able to confirm that they had completed the safe (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 4 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. Record review of safety surveys conducted on 9/13/25 indicated that they had conducted a safety survey with all residents at the facility and all who were able to participate were able to identify who to report abuse to and how to report and all indicated that they had not observed any abuse or neglect. Record review of in-service documentation dated 9/12/2025 showed that all but six staff on all shifts had been in-serviced on abuse and neglect and all staff had been notified that they would be taken off the schedule until they had been in-serviced on abuse and neglect. Record review of in-service documentation dated 9/12/2025 indicated that CNA B and CNA C were in-serviced on abuse, neglect and reporting requirements. This in-service shows that it included specific reporting requirements that abuse must be reported immediately to the abuse coordinator and that it must be reported by voice phone call, not text message. Observation conducted on 9/13/25 at 8:15 p.m. showed a notice over all facility time clocks notifying staff not to clock in until they had completed required in-services on abuse and neglect. Notification to the Administrator on 9/13/2025 at 8:30 p.m. that the IJ had been lifted. An IJ was identified on 9/12/25. The IJ template was provided to the facility on 9/12/25 at 3:34 p.m. While the IJ was removed on 9/13/25 the facility remained out of compliance at a scope of Isolated and severity level of no actual harm with potential for more than minimal harm that was not IJ due to ongoing need for in-services on abuse and neglect, abuse coordinator and notification of abuse process. Event ID: Facility ID: 455855 If continuation sheet Page 5 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 - Immediate jeopardy to resident health or safety 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 observation, interview and record review the facility failed to ensure that all alleged violations involving abuse, neglect, exploitation or mistreatment are reported immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse to the administrator of the facility and to other officials including to the State Survey Agency in accordance with State law through established procedures for 1 of 6 (Resident #1) residents reviewed for abuse. The facility failed to ensure an allegation of abuse was immediately reported to the abuse coordinator. The facility failed to report the allegation of abuse within 2 hours. An IJ was identified on 9/12/25 The IJ template was provided to the facility on 9/12/25 at 3:34 p.m While the IJ was removed on 9/13/25 the facility remained out of compliance at a scope of Isolated and severity level of no actual harm with potential for more than minimal harm that is not IJ due to ongoing need for in-services on abuse and neglect, abuse coordinator and notification of abuse process. This failure could place residents at risk for physical and verbal abuse, psychosocial harm, and decreased quality of life. Findings included: Record review of the face sheet dated 9/11/2025 indicated that Resident #1 was a [AGE] year-old male admitted to the facility on [DATE] with diagnoses including severe intellectual disability which was below average intelligence, anxiety disorder which was intense, excessive, and persistent worry and fear about everyday situations, schizoaffective disorder which was a lifelong pattern of social withdrawal and limited emotional expression, ADHD which was a chronic condition including attention difficulty, hyperactivity and impulsiveness, cerebral palsy which was a congenital disorder of movement, muscle tone or posture, and cognitive communication deficit which was a group of disorders that affect a person's ability to communicate effectively due to underlying cognitive impairments. Record review of the MDS dated [DATE] indicated that Resident #1 had a BIMS score of 03 which was indicative of severe cognitive impairment. Record review of the care plan dated 9/7/25 which shows that Resident#1 was last admitted to the facility on [DATE] and was receiving services at the facility. Record review of progress note dated 9/10/2025 indicated that Resident #1 was on the floor of his bedroom fighting with his roommate and LVN A documented attempting to sooth Resident#1 by rubbing his back and his chest and his hand getting caught in the shirt of Resident #1. It indicated that LVN A instructed CNA B and CNA C to take Resident # 1 into the hallway. LVNA indicated that he assessed Resident # 1 and noted no injury. During an interview on 9/11/25 at 4:11 p.m. CNA B said that on 9/9/25 she worked with CNA C on the evening shift. She said that at around 10:30 p.m. she observed LVN A grab Resident #1 by the shirt near his neck and that she heard Resident #1 make a choking noise and cry once released. She said that she would consider the actions she witnessed LVN A carry out to be abuse. She said she sent a text to the DON at 10:39 p.m. and 10:46 p.m. letting the DON know about the incident and that she did not know what to do. She said she did not contact anyone else and did not try to call the DON. CNA B said she did not know who the abuse coordinator was at the time of the incident and did not recall being trained on abuse and neglect. She said she got a text the next morning at 6:38 a.m. from the DON asking her to call her. She said that the risk of not reporting abuse immediately was that LVN A could have gone back and carried out more abuse or abused other residents before his shift ended. Record review of the voice recording provided by CNA B on 9/11/25 at 4:30 p.m. that was recorded on 9/10/25 sometime after 6:00 p.m. and included the voice of LVA A, CNA B, and CNA C as identified by CNA B. A summary of the recording was that CNA B and CNA C acknowledged that they observed LVN A grab Resident #1 by the shirt and around his neck on 9/9/25. Both CNA B and CNA C told him that they had observed him grab Resident #1 by the shirt (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 6 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 - Immediate jeopardy to resident health or safety Residents Affected - Few around his neck and got into Resident #1's face when Resident #1 used a racial slur toward his roommate. During an interview on 9/11/25 at 3:18 p.m. Resident #1 said that LVN A had choked him and that he was scared of LVN A. Resident #1 cried and left the interview. During an interview on 9/11/25 at 3:57 p.m. LVN A said that on 9/9/2025 he worked at the facility. He went into Resident #1's bedroom when he was fighting with his roommate. LVN A said that he was trying to calm Resident #1 down by rubbing his back and trying to talk to him. LVN A said that Resident #1 was on the floor and he was assisting him back to his chair and his hand got caught in Resident #1's t-shirt and when he pulled his hand out of Resident #1's shirt and it went up toward Resident #1's neck. LVN A said that Resident #1 was one of his favorite residents and that he would never abuse him. He said that residents have called him the N word before and he was not one so it does not bother him. LVN A said that he did not choke Resident #1. LVN A said that there were two CNAs in the room with him when his hand got caught in Resident #1's t-shirt. LVN A confirmed that the CNA's in the room were CNA B and CNA C. During an interview on 9/12/25 at 1:18 p.m. CNA C said that she worked on the night shift on 9/9/2025 alongside CNA B. She said around 10:30 p.m. she witnessed LVN A enter the bedroom and grab Resident #1 by the shirt causing him to make a choking noise and cry when he was released. She said that what she witnessed was abuse and she had 24 hours to report it and intended to after the shift was over, but never got the chance to report it because she was contacted by the DON at around 7:00 a.m. the next morning. She said the Administrator was the abuse coordinator. She said that the risk of not reporting abuse immediately was that further abuse can occur. During and interview with the DON on 9/12/2025 at 9:11 a.m. DON said that she was notified by text of the abuse at 10:45 p.m. on 9/9/2025 but did not see the text until the following morning and immediately asked CNA B to call her. She said that once she spoke to CNA B and CNA C she reported the incident to the abuse coordinator who was the administrator and started the investigation process. During an interview on 9/11/25 at 11:55 a.m. the Administrator said she expected staff to report abuse within two hours so that appropriate protections can be put in place to protect the residents. The Administrator said she reported the incident of alleged abuse on 9/10/25 as soon as she found out about the incident on 9/9/25. The Administrator said she expected staff to immediately report any incidents of alleged or suspected abuse to her immediately. The Administrator said the importance of reporting abuse to the state agency in a timely manner was to aid in preventing further abuse and to protect the residents from abuse. Record review in TULIP on 9/11/25 indicated that the incident of abuse occurred on 9/9/25 at 10:45 p.m. and was reported to the State on 9/10/25 at 8:30 a.m. TULIP is a web based online platform developed and maintained by the Texas Health and Human Services Commission. It served as a centralized electronic system for handling licensure, credentialing, renewals, and related regulatory processes for long-term care providers in Texas, with a particular focus on nursing facilities. Record review of a screenshot obtained on 9/11/25 at 4:25 p.m. showed a text message from CNA B to DON at 10:39 p.m. asking if DON was awake. Another message sent at 10:44 p.m. indicated that CNA B did not know what to do in a situation that she described by saying that Resident #1 had been combative and that LVN A had put his hands around Resident #1's neck causing him to make a choking noise. LVN A was raising his voice and Resident #1 was crying. A return text from DON at 6:38 a.m. asked CNA B to call her. Record review of facility's Abuse and Neglect Clinical Protocol policy last revised March 2018 indicated, .This policy defines abuse as the willful infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain, or mental anguish . Record review of facility's Abuse-Reportable Events policy last revised May 2017 indicated, .it was the policy of this home to prohibit resident abuse or neglect in any form, and to report in accordance with the law and any (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 7 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 - Immediate jeopardy to resident health or safety Residents Affected - Few incident/event in which there was cause to believe a resident's physical or mental health or welfare has been or may be adversely affected by abuse or neglect caused by another person.Nursing facility must report the above immediately but not later than 2 hours after the allegation was made, if the events that caused the allegation involved abuse or result in serious bodily injury . The Administrator was notified on 9/12/25 at 3:30 p.m. that an Immediate Jeopardy situation was identified due to the above failure. The Administrator was provided the Immediate Jeopardy template on 9/12/25 at 3:34 p.m. The facility's plan of removal was accepted on 9/13/2025 at 7:46 p.m. and included: Interventions: LVN A suspended on 9/10/25 at 7:50 a.m. Resident # 1 assessed for injury on 9/10/25 at 11:44 a.m. Roommate of Resident #1 assessed. Residents on secured unit were not showing signs of distress or pain on 9/10/25. LVN A terminated on 9/12/25 at 2:00 p.m. In-service of all staff regarding abuse and neglect to include reporting abuse immediately to the administrator who was the abuse coordinator. Administrator completed one on one in-service with both witness CNA B on 9/12/2025 at 10:00pm. Witness CNA C was in serviced on 9/13/2025 at 1:30pm. Resident counsel held on 9/13/2025 at 10:00am was held to discuss the incident, what was considered abuse and who must be called immediately when abuse was suspected. Residents were informed that abuse coordinator signs are posted at the end of each hall and throughout facility. Monitoring: Staff in-serviced on abuse and neglect included types of abuse, reporting timely, who to report to and when to report In-service on facility abuse coordinator and back up coordinator and that a phone call must be made, text was not acceptable when it was regarding abuse. All residents were given a safety survey asking if they felt safe in the facility, whether they had seen anyone in the facility being abused or neglected and who they are to report abuse to if they have a concern of abuse or neglect. Abuse coordinator signs are throughout the facility and there will continue to be ongoing training to ensure the staff was knowledgeable of who to report to and what to report. Staff was in serviced by Administrator, DON, Dietary supervisor, and housekeeping supervisor. All staff in facility must be in serviced. As of 9/13/2025 at 11:54am 66 employees in all departments have signed in services. Twelve employees that need to be still in-services, all employees must be in-serviced by 9/13/2025 by 3:30pm any staff that has not been in-serviced was not to clock into the facility until they have been in serviced by DON or administrator anyone who fails to complete in-service will be removed from schedule and not allowed to work until they have been in serviced. On 9/13/25 at 8:30 p.m. the investigator confirmed the plan of removal had been implemented sufficiently to remove the IJ by the following: During an interview with LVN F who worked the 2-10 shift on 9/13/25 at 4:38 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with LVN D who worked the 2-10 shift on 9/13/25 at 4:40 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with LVN E who worked the 2-10 shift on 9/13/25 at 4:54 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA J who worked the 6 p.m. to 6 a.m. shift on 9/13/25 at 4:52 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA K who worked the 6 p.m.-6 a.m. shift on 9/13/25 at 4:54 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA L who worked the 2-10 shift on 9/13/25 at 5:00 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA B who worked the 6 p.m.-6 a.m. shift on 9/13/25 at 5:40 p.m. she was able to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 8 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 - Immediate jeopardy to resident health or safety Residents Affected - Few articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA C who worked the 6 p.m.-6 a.m. shift on 9/13/25 at 5:52 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with LVN G who worked the 6 p.m. to 6 a.m. shift on 9/13/25 at 6:50 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with RN H who worked the 8 a.m.-5 p.m. shift on 9/13/25 at 6:53 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with DON who worked the 8 a.m.-5 p.m. shift on 9/13/25 at 6:58 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with Resident # 2 on 9/13/25 at 6:15 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 3 on 9/13/25 at 6:20 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 4 on 9/13/25 at 6:23 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 5 on 9/13/25 at 6:27 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 6 on 9/13/25 at 6:33 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 7 on 9/13/25 at 6:37 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 8 on 9/13/25 at 6:42 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 1 on 9/13/25 at 6:46 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 9 on 9/13/25 at 7:52 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 10 on 9/13/25 at 7:55 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 11 on 9/13/25 at 7:57 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 12 on 9/13/25 at 8:00 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 13 on 9/13/25 at 8:05 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 14 on 9/13/25 at 8:08 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 9 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete interview with Resident # 15 on 9/13/25 at 8:12 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 16 on 9/13/25 at 8:15 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 17 on 9/13/25 at 8:18 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 18 on 9/13/25 at 8:20 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 19 on 9/13/25 at 8:23 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 20 on 9/13/25 at 8:25 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. Record review of facility's in-service documentation reviewed on 9/11/25 for Reporting Abuse and Neglect dated 9/10/2025 indicated that 13 employees had been in-serviced. CNA B and CNA C were not listed on this document. Record review of safety surveys conducted on 9/13/25 indicated that they had conducted a safety survey with all residents at the facility and all who were able to participate were able to identify who to report abuse to and how to report and all indicated that they had not observed any abuse or neglect. Record review on 9/13/25 at 8:10 p.m. of in-service documentation showed that all but six staff had been in-serviced on abuse and neglect and all staff had been notified that they would be taken off the schedule until they had been in-serviced on abuse and neglect and reporting requirements. Record review of in-service documentation dated 9/12/2025 indicated that CNA B and CNA C were in-serviced on abuse, neglect and reporting requirements. This in-service shows that it included specific reporting requirements that abuse must be reported immediately to the abuse coordinator and that it must be reported by voice phone call, not text message. Observation conducted on 9/13/25 at 8:15 p.m. showed a notice over all facility time clocks notifying staff not to clock in until they had completed required in-services on abuse and neglect. Observation conducted on 9/13/25 at 8:00 p.m. of abuse coordinator signs located on each hallway, at each nurses station and in the dining room. It included the name of the Administrator as well as the number to the abuse hotline. Record review of Resident #1's skin assessment dated [DATE] at 11:44 a.m. showed no signs of injury. Notification to Administrator on 9/13/2025 at 8:30 p.m. that the IJ had been lifted. An IJ was identified on 9/12/25. The IJ template was provided to the facility on 9/12/25 at 3:34 p.m. While the IJ was removed on 9/13/25 the facility remained out of compliance at a scope of Isolated and severity level of no actual harm with potential for more than minimal harm that is not IJ due to ongoing need for in-services on abuse and neglect, abuse coordinator and notification of abuse process. Event ID: Facility ID: 455855 If continuation sheet Page 10 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 0610 Respond appropriately to all alleged violations. Level of Harm - Immediate jeopardy to resident health or safety **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to in response to allegations of abuse, neglect, exploitation, or mistreatment, prevent further potential abuse, neglect, exploitation, or mistreatment while the investigation is in progress for 1 of 6 (Resident #1) residents reviewed for abuse. LVN A physically abused Resident #1 on 9/9/25 and the facility failed to protect residents from further potential abuse when LVN A returned to the facility on the night shift of 9/10/2025 after being suspended at 7:50 a.m. on 9/10/25. An IJ was identified on 9/12/25. The IJ template was provided to the facility on 9/12/25 at 3:34 pm. While the IJ was removed on 9/13/25 the facility remained out of compliance at a scope of Isolated and severity level of no actual harm with potential for more than minimal harm that is not IJ due to ongoing need for in-services on abuse and neglect, abuse coordinator and notification of abuse process. This failure could place residents at risk for physical and verbal abuse, psychosocial harm, and decreased quality of life.Findings included: Record review of the face sheet dated 9/11/2025 indicated that Resident #1 was a [AGE] year-old male admitted to the facility on [DATE] with diagnoses including severe intellectual disability which was below average intelligence, anxiety disorder which was intense, excessive, and persistent worry and fear about everyday situations, schizoaffective disorder which was a lifelong pattern of social withdrawal and limited emotional expression, ADHD which was a chronic condition including attention difficulty, hyperactivity and impulsiveness, cerebral palsy which was a congenital disorder of movement, muscle tone or posture, and cognitive communication deficit which was a group of disorders that affect a person's ability to communicate effectively due to underlying cognitive impairments. Record review of the MDS dated [DATE] indicated that Resident #1 had a BIMS score of 03 which was indicative of severe cognitive impairment. Record review of the care plan dated 9/7/25 which showed that Resident#1 was last admitted to the facility on [DATE] and was receiving services at the facility. During an interview on 9/11/25 at 4:11 p.m. CNA B said that on 9/10/25 she worked with CNA C on the evening shift. She said that they were outside smoking around 9:40 p.m. when LVN A approached them and asked them about the incident the night before between LVN A and Resident #1 and that he did not remember but was at the facility to document an incident report about it. She said that she did not know that LVN A was under investigation and that if she had she would have reported it. She said that the risk of not knowing that he was under investigation was that he could have come to the facility for retaliation which placed the staff and residents at risk of abuse. She said that LVN A got onto the computer and went onto the secured unit but she did not see him interact with any residents. CNA A said that the incident the night before that she was referring to was LVN A grabbing Resident # 1 by the shirt and making him choke. Record review of the voice recording provided by CNA B on 9/11/25 at 4:30 p.m. that was recorded on 9/10/25 sometime after 6:00 p.m. and included the voice of LVA A, CNA B, and CNA C as identified by CNA B. A summary of the recording was that CNA B and CNA C acknowledged that they observed LVN A grab Resident #1 by the shirt and around his neck on 9/9/25. LVN A admitted that he had returned to the facility to document the incident from last night with Resident #1. LVN A said that he got allegations for beating up on [unintelligible]. During an interview on 9/11/25 at 3:18 p.m. Resident #1 said that LVN A had choked him and that he was scared of LVN A. Resident #1 cried and left the interview. During an interview on 9/11/25 at 3:57 p.m. LVN A said that on 9/9/2025 he worked at the facility. He went into Resident #1's bedroom when he was fighting with his roommate. LVN A said that he was trying to calm Resident #1 down by rubbing his back and trying to talk to him. LVN A said that Resident #1 was on the floor and he was assisting him back to his chair and his hand got caught in Resident #1's t-shirt and when he pulled his Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 11 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few hand out of Resident #1's shirt and his hand went up toward Resident #1's neck . LVN A said that Resident #1 was one of his favorite residents and that he would never abuse him. He said that residents have called him the N word before and he was not one so it does not bother him. LVN A said that he did not choke Resident #1. LVN A said that there were two CNAs in the room with him when his hand got caught in Resident #1's t-shirt. LVN A confirmed that the CNA's in the room were CNA B and CNA C. LVN A said that he was informed by DON that he was suspended pending an investigation on the morning of 9/10/25 and was told that he could likely return to work on Saturday if everything looked good. During an interview on 9/12/25 at 1:18 p.m. CNA C said that she worked on the night shift on 9/10/2025 alongside CNA B. She said around 9:30 p.m. LVN A came up to her and CNA B and started talking to them about the incident that had occurred the night before with LVN A grabbing Resident #1 by the shirt and throat and making him make a choking sound. She said that he told them that he comes back to work on Saturday 9/13/25, but he had come up to the facility on the night of 9/10/25 to document an incident report about the night before. She said that she did not know he was suspended and if she had she would have reported it and not allowed him to have access to the residents. She said that she saw LVN A get on the computer but did not see him go onto the secured unit or interact with any residents. She said the risk of not knowing who was suspended was that the suspended person could come to the facility to do harm to staff or residents. Record review of facility Incident Audit Report indicated that LVN A entered an incident audit report into PCC on 9/10/25 at 10:53 p.m. PCC was the electronic medical record used by the facility. The note indicated that LVN A entered the bedroom of Resident #1 and Resident #1 was on the floor trying to fight with his roommate. LVN A documented that he directed the CNA to put Resident #1 in his wheelchair and get him out of the room. LVN A documented that Resident #1 was agitated and that LVN A was rubbing his back to calm him down and then was rubbing his chest as a calming procedure. LVN A documented that his hand slipped inside the shirt of Resident #1 as he was bending down to fight with his roommate and LVN A stated that he removed his hand immediately and asked the CNAs to removed Resident #1 from the room. LVN A noted that Resident #1 was assessed for injury and none were found. During an interview on 9/11/25 at 11:55 a.m. the Administrator said she expected suspended staff to not enter the facility during their suspension and there was a policy entitled Disciplinary Action and Suspension Pending Investigation Policy that told them. She said that they did not tell other staff when a staff member was suspended as they did not want to spread their business and that she was not aware of any policy that directed the Administrator or DON to notify anyone of a suspended staff member. She said she assumed that a suspended staff member's common sense would tell them that they should not be at the facility during suspension in addition to that policy. She said that she understands the need for a process for others to know about the suspension as a suspended person coming to the facility places everyone at the facility at risk of abuse or assault. She said that she was not aware that LVN A was at the facility after he was notified on 9/10/25 at 7:50 a.m. that he was suspended. She said that they started the investigation upon being notified of the incident by interviewing CNA B and CNA C, assessing Resident # 1 and in-servicing staff on abuse and neglect. Record review of facility's Disciplinary Action and Suspension Pending Investigation Policy undated indicated, .In cases involving serious allegations, employees may be placed on suspension pending investigation and are not permitted to return to the facility until the investigation was concluded.the employee was not permitted on facility premises or to engage with residents or staff during the suspension . Record review of the document titled {Facility} New Hire/Status Change Form which indicated that LVN A was terminated on 9/11/25 for abuse. This document did not show a suspension date or time. Record review of facility's Employee Discipline (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 12 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Policies and Professional and Personal Responsibility policy indicated that the suspended employee was not to enter premises until suspension was complete or until results are determined from suspension. Record review of facility's Abuse-Reportable Events policy last revised May 2017 indicated, .it is the policy of this home to prohibit resident abuse or neglect in any form . The Administrator was notified on 9/12/25 at 3:30 p.m. that an Immediate Jeopardy situation was identified due to the above failure. The Administrator was provided the Immediate Jeopardy template on 9/12/25 at 3:34 p.m. The facility's plan of removal was accepted on 9/13/2025 at 7:46 p.m. and included: Interventions: LVN A suspended on 9/10/25 at 7:50 a.m. Resident # 1 assessed for injury on 9/10/25 at 11:44 a.m. Roommate of Resident #1 assessed on 9/10/25. Residents on secured unit were not showing signs of distress or pain on 9/10/25. LVN A terminated on 9/12/25 at 2:00 p.m. In-services related to abuse/neglect started 9/10/2025 at 8:00am. Updated policy on suspension pending investigation with Be informed when an employee is suspended-suspended employee is not allowed to be in facility and all staff must ask the suspended staff to leave and call the administrator/DON if they enter the facility. Monitoring: Policy on suspension pending investigation updated. All staff will be informed each time an employee was suspended and will be responsible for asking staff to leave if they come to the premises and contact Administrator and DON. Any employee suspected of abuse will be removed from the facility immediately. Abuse coordinator signs are throughout the facility and there will continue to be ongoing training to ensure the staff was knowledgeable of who to report to and what to report. Staff was in serviced by Administrator, DON, Dietary supervisor, and housekeeping supervisor. All staff in facility must be in serviced. As of 9/13/2025 at 11:54am 66 employees in all departments have signed in services. There are twelve employees that need to be still in-services. All employees must be in-serviced by 9/13/2025 by 3:30pm. Any staff that has not been in-serviced was not to clock into the facility until they have been in serviced by DON or administrator. Anyone who fails to complete in-service will be removed from schedule and not allowed to work until they have been in-serviced. On 9/13/25 at 8:30 p.m. the investigator confirmed the plan of removal had been implemented sufficiently to remove the IJ by the following: During an interview with LVN F who worked the 2-10 shift on 9/13/25 at 4:38 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with LVN D who worked the 2-10 shift on 9/13/25 at 4:40 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with LVN E who worked the 2-10 shift on 9/13/25 at 4:54 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA J who worked the 6 p.m. to 6 a.m. shift on 9/13/25 at 4:52 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA K who worked the 6 p.m.-6 a.m. shift on 9/13/25 at 4:54 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA L who worked the 2-10 shift on 9/13/25 at 5:00 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA B who worked the 6 p.m.-6 a.m. shift on 9/13/25 at 5:40 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with CNA C who worked the 6 p.m.-6 a.m. shift on 9/13/25 at 5:52 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with LVN G who worked the 6 p.m. to 6 a.m. shift on 9/13/25 at (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 13 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few 6:50 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with RN H who worked the 8 a.m.-5 p.m. shift on 9/13/25 at 6:53 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with DON who worked the 8 a.m.-5 p.m. shift on 9/13/25 at 6:58 p.m. she was able to articulate who the abuse coordinator was, the types of abuse, reporting timeframes and appropriate methods of reporting. During an interview with Resident # 2 on 9/13/25 at 6:15 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 3 on 9/13/25 at 6:20 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 4 on 9/13/25 at 6:23 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 5 on 9/13/25 at 6:27 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 6 on 9/13/25 at 6:33 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 7 on 9/13/25 at 6:37 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 8 on 9/13/25 at 6:42 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 1 on 9/13/25 at 6:46 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 9 on 9/13/25 at 7:52 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 10 on 9/13/25 at 7:55 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 11 on 9/13/25 at 7:57 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 12 on 9/13/25 at 8:00 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 13 on 9/13/25 at 8:05 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 14 on 9/13/25 at 8:08 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 15 on 9/13/25 at 8:12 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 16 on 9/13/25 at 8:15 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455855 If continuation sheet Page 14 of 15 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 455855 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Kennedy Health & Rehab 504 N John Redditt Dr Lufkin, TX 75904 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete who they were to report abuse to. During an interview with Resident # 17 on 9/13/25 at 8:18 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 18 on 9/13/25 at 8:20 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 19 on 9/13/25 at 8:23 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. During an interview with Resident # 20 on 9/13/25 at 8:25 p.m. he was able to confirm that they had completed the safe survey on 9/13/2025 and been asked about abuse and neglect, whether they felt safe and who they were to report abuse to. Record review of facility's in-service documentation reviewed on 9/11/25 for Reporting Abuse and Neglect dated 9/10/2025 indicated that 13 employees had been in-serviced. CNA B and CNA C were not listed on this document. Record review on 9/13/25 at 8:10 p.m. of in-service documentation showed that all but six staff had been in-serviced on the changes to the suspension pending investigation policy and all staff had been notified that they would be taken off the schedule until they had been in-serviced. Record review of in-service documentation dated 9/12/2025 indicated that CNA B and CNA C were in-serviced on abuse, neglect and reporting requirements. This in-service shows that it included specific reporting requirements that abuse must be reported immediately to the abuse coordinator and that it must be reported by voice phone call, not text message. Record review on 9/13/25 at 8:12 p.m. of the facility suspension pending investigation policy update. There was no date on the policy but the change from the old policy to the new policy was the addition that was as follows: All staff must be informed when an employee is suspended- Suspended employee is not to be in the facility and staff must ask them to leave and call the administrator/DON if they enter the facility. Observation conducted on 9/13/25 at 8:00 p.m. of abuse coordinator signs located on each hallway, at each nurses station and in the dining room. It included the name of the Administrator as well as the number to the abuse hotline. Observation conducted on 9/13/25 at 8:15 p.m. showed a notice over all facility time clocks notifying staff not to clock in until they had completed the required in-services on recent policy changes. Record review of Resident #1's skin assessment dated [DATE] at 11:44 a.m. showed no signs of injury. Notification to Administrator on 9/13/2025 at 8:30 p.m. that the IJ had been lifted. An IJ was identified on 9/12/25 The IJ template was provided to the facility on 9/12/25 at 3:34 p.m. While the IJ was removed on 9/13/25 the facility remained out of compliance at a scope of Isolated and severity level of no actual harm with potential for more than minimal harm that is not IJ due to ongoing need for in-services on abuse and neglect, abuse coordinator and notification of abuse process. Event ID: Facility ID: 455855 If continuation sheet Page 15 of 15