Inspection·December 29, 2023

F 0684 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few find her. He stated he looked in her room, looked in her husband's room and asked staff but he could not locate resident. He stated he did not think to call the doctor and let them know he had not been able to find the resident or check her BP or blood sugar. He stated Resident #1 returned to the unit for dinner and he checker her BP and blood sugar then. He stated her sugar was a little low, but she was getting ready to eat dinner, so he waited and checked it again after she ate. He stated he continued to check her sugar as ordered and provide interventions as needed until his shift ended and then he gave report to LVN E who came on shift at 10pm. He stated he informed LVN E of the medication error and that Resident #1's blood sugar needed to be checked every hour. During an interview on [DATE] at 11:06 am, FM stated the facility did not check Resident #1's blood pressure and blood sugar like they were supposed to and then after midnight on[DATE], the facility checked her sugar, and it was in the 30's so Resident #1 was sent to the ER due to low blood sugar. FM stated Resident was in the hospital on IV medications for several days to try and stabilize her blood sugar. FM stated Resident #1's room was on the 2nd floor, and they went up to the activity room on the 3rd floor to make ornaments. She stated no staff came looking for Resident #1 and no staff called her or her another FM to see where Resident #1 was located. During an interview on [DATE] at 4:47 pm, the facility NP stated she was in the building on [DATE] and was notified of a medication error for Resident #1. She went and saw/assessed Resident #1 who was alert and in bed with family in the room. She stated she was concerned about hypotension (low blood pressure) and hypoglycemia (low blood sugar) with Resident #1 due to the medication errors. She stated her expectation when she gives orders to staff is that they will be followed. She stated she was not aware that some of the blood sugar checks, and blood pressure checks that she had ordered had been missed by the nursing staff. She stated she found out the resident had been sent to the hospital, so she found out on her own by reviewing the records that some of the blood sugar checks and blood pressure checks had been missed by the nursing staff. She stated she was concerned about the missed checks because I had not been notified that this happened and there was no documentation as to why it was not done. She further stated her concerns with the missed blood sugar checks would be exactly what happened. She became hypoglycemic. We should have been keeping a real close eye on her. It was not ideal that she ended up in the hospital. During an interview on [DATE] at 8:58 am, LVN E stated she was the nurse for Resident #1 on [DATE] on the 10 pm to 6 am shift. She stated she received report from LVN D and was made aware of Resident #1's medication error and the need to monitor Resident #1's blood sugar. She stated she saw the order in the system when she opened her computer a few minutes after 11. She stated she did not check Resident #1's blood sugar as ordered at 11pm because she got busy passing pain medications and I didn't think there was anything wrong with checking it later. She stated she saw the resident on rounds before 11 and she had crackers in her hand, so she didn't think she needed to check it. She stated she could not remember when she checked on the resident again, but she found her unresponsive and checked her sugar and it was in the 30's. She tried to give her orange juice and it was just running out of her mouth. She stated she called the DON to let her know and then called 911. She stated nurses are supposed to follow doctors orders and if they can't, they need to notify the DON or Doctor. She stated by not following orders and missing a blood sugar check a resident could potentially go into a coma - they need to check it to make sure it is stable - if it goes too low a resident could go into a state of shock or coma. During an interview on [DATE] at 9:36 am, LVN D stated when he got report at shift hand off, Resident #1 was sitting at the end of the hall with her family and then family took her off the unit and he didn't know where she was. He stated he looked around and asked some staff but did not attempt to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455866 If continuation sheet Page 2 of 9 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 455866 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/29/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brookdale Westlake Hills 1034 Liberty Park Dr Austin, TX 78746 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 0684 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few call the family. I didn't think of calling the family to see where she was. He stated by not checking her blood sugar She could have tanked - her blood sugar could have gone so low that she could have lost consciousness and injured herself or could have even died. During an interview on [DATE] at 12:57 pm, the DON stated she had called LVN E at 11pm on [DATE] to make sure she knew Resident #1 needed to be monitored and to check her sugar. She stated LVN E told her she had just gotten report and was aware that Resident #1's blood sugar had been dropping and needed to be monitored. The DON stated Resident #1's blood sugar should have been checked at 11 pm on [DATE] and said, why should she wait if she knew there had been a problem? She stated she received a call on [DATE] at 12:37 am from LVN E and was informed that Resident #1 was found unresponsive, and her blood sugar was thirty something. She stated LVN E told her she had just taken her sugar and tried to give the resident some orange juice, but she was not able to. The DON stated she told LVN E to call the on-call doctor and see if she could get an order for glucagon. The DON stated, I got the impression that this all had just happened, not that she had checked her sugar an hour ago. The DON stated she called LVN E back at 12:45 and I asked her if she had gotten ahold of the doctor yet and she said no, so I told her to call 911 and send the resident out. The DON stated nurses are supposed to follow doctors orders and if they are not able to they need to call the doctor and notify the DON. Review of Facility policy Change of Condition for Skilled Nursing Communities, revised 8/23 reflected. When a resident is evaluated or assessed as having a change in condition, the licensed nurse should document notification to the family/resident representative, the Healthcare Provider (HCP) and other licensed nurses in order to facilitate the appropriate plan of care. 2. Upon receiving a Stop and Watch documentation or observing a difference in the resident's usual physical, emotional or cognitive patterns the licensed nurse should:2g) Implement treatment interventions, received orders and document HCP recommendations as indicated. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455866 If continuation sheet Page 3 of 9 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 455866 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/29/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brookdale Westlake Hills 1034 Liberty Park Dr Austin, TX 78746 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 0760 Ensure that residents are free from significant medication errors. 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 ensure residents were free of significant medications errors for one of five residents (Resident #1) reviewed for any significant medication errors, Residents Affected - Few in that: The facility gave Resident #1 medications belonging to another patient on 12/3/2023 and 12/4/2023 resulting in Resident #1 blood sugar dropping and being transferred to the emergency department. An Immediate Jeopardy (IJ) existed from 12/03/23 - 12/05/23. The IJ was determined to be at past noncompliance as the facility had implemented actions that corrected the noncompliance prior to the beginning of the investigation. This failure placed residents at risk of experiencing non-therapeutic side effects from medications which could cause injury and/or death. Findings included : Review of Resident #1's face sheet dated 12/8/2023 reflected an [AGE] year-old female admitted to the facility with diagnoses that included: scalp laceration (cut on the head), Parkinson's Disease (central nervous system disorder that affects movement), muscle weakness, abnormality of gait and mobility, Hyperlipidemia (high cholesterol) and history of falling. Review of Resident #1's MDS reflected a BIMS of 9 indicating moderate impairment of cognitive ability. Review of Resident #1's MAR reflected the resident received the following medications at 9:00 am on 12/4/2023: glipizide XL10 MG (medication to treat Diabetes) and Carvedilol 25 MG (blood pressure medication). Review of Resident #1's orders reflected a physician order dated 12/4/2023 at 11:00 am to Monitor BP and HR every hour for the next 6 hours r/t medication error and Monitor blood sugar every hour for the next 12 hours r/t medication error . During an interview with LVN A on 12/8/2023 at 1:32 pm she stated she was working on 12/3/2023 in the evening when Resident #1 arrived as a new admission with a packet from the hospital. She stated she took the packet and handed it to her supervisor, RN B. LVN A stated RN B put all the medication orders in the system and then LVN A verified them to make sure they were correct. She stated she looked at the medication list but somehow I missed looking at the name of the resident on the medication list, but I checked the face sheet and history, and they all had the right name. I missed that there was a different name on the paper with the meds. She stated, I am supposed to look at all the names on everything; all the paperwork in the packet including the medication list. I did not do this. I made an assumption that everything in the packet was for that resident. (resident #1) She stated the facility practice was to have two nurses check medications to make sure they were correct, and she was the second witness for Resident #1's medication orders after RN B put them in the system. She stated not checking names on medication lists could lead to med errors and residents could get very sick . (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455866 If continuation sheet Page 4 of 9 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 455866 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/29/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brookdale Westlake Hills 1034 Liberty Park Dr Austin, TX 78746 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 0760 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few During an interview on 12/8/2023 at 2:13 pm, RN C stated she was working on 12/4/2023 when a FM for Resident #1 came to her and asked her to print out Resident #1's med list. She printed it out and a short while later, the FM came back and notified RN C that Resident #1 was not on any of the medications on the list. RN C stated she opened Resident #1 chart binder and reviewed the discharge med list from the hospital and the name on the med list was for another patient from the hospital, not Resident #1. She stated the med list was signed by two nurses on Sunday night 12/3/2023. RN C stated she alerted the DON who alerted the facility NP who was in the building and the NP assessed Resident #1. RN C stated the NP gave new orders to stop all current medications and to monitor the resident's BP, HR, and blood sugar for any changes in condition . During an interview on 12/11/2023 at 11:06 am, Resident #1s FM stated she was reviewing the hospital paperwork with RN C and found the error in the paperwork from the hospital and pointed it out to RN C who then alerted the DON, AD and NP. She stated the facility did not check Resident #1's blood pressure and blood sugar like they were supposed to and then after midnight on 12/5/2023, the facility checked her blood sugar, and it was in the 30's so Resident #1 was sent to the ER due to low blood sugar. The FM stated Resident #1 was in the hospital on IV medications for several days to try and stabilize her blood sugar. During an interview on 12/11/2023 at 3:13 pm RN B stated he was the nursing supervisor working on the evening on 12/3/2023 and he put in the medication orders for Resident #1 and then LVN A verified them. He stated Resident #1 arrived from the hospital with a packet with records and medication orders. He stated he verified the name on the history and physical and face sheet, then found the med orders and put them in. He stated he never noticed the name on the discharge medication list was not Resident #1. He stated they were supposed to verify names on all documents from the hospital. He stated he put the medication orders in the system and then LVN A verified them. He stated the facility policy was to have two nurses check the orders and they did that, but neither one of them saw the name on the medication list was not Resident #1. He stated by not checking the name it resulted in a med error for Resident #1 and she ended up going to the emergency department with low blood sugar. During an interview via a text message exchange on 12/11/2023 from 3:41 pm to 4:07 pm, the CCO for the on-call NP group stated their group had provided NP on call services to the facility. She stated when the facility called for admission orders for new residents, the on-call NP would review the orders verbally with a nurse from the facility. She stated, The nurse reads the orders out load verbally and we just approve/deny them. We do not get visibility for the discharge orders from the hospital. She said they were just provided verbally by the facility nurses and the on-call NPs did not actually put any medication orders in the system, the facility nurses do. During an interview on 12/11/2023 at 4:47 pm, the facility NP stated she had been in the building on 12/4/2023 and had been notified of a medication error for Resident #1. She stated she went and saw/assessed Resident #1 who was alert and in bed with family in the room. She stated she had been concerned about hypotension (low blood pressure) and hypoglycemia (low blood sugar) with Resident #1 due to the medication errors. She stated her expectation when she gave orders to staff was that they will be followed. She stated she was not aware that some of the blood sugar checks, and blood pressure checks that she had ordered had been missed by the nursing staff. She stated she had heard the resident had been sent to the hospital, so she found out on her own by reviewing the records that some of the blood sugar checks and blood pressure checks had been missed by the nursing staff. She stated she was concerned about the missed checks because I had not been notified that this happened and there was no documentation as to why it was not done. She further stated her concerns with the missed blood sugar checks would be exactly what happened. She became hypoglycemic. We should have been (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455866 If continuation sheet Page 5 of 9 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 455866 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/29/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brookdale Westlake Hills 1034 Liberty Park Dr Austin, TX 78746 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 0760 keeping a real close eye on her. It was not ideal that she ended up in the hospital. Level of Harm - Immediate jeopardy to resident health or safety During an interview on 12/8/2023 at 12:13 pm, the AD stated as part of the order verification process upon admission the name on the orders should be verified that they are for the resident being admitted . He further stated that if that verification was not done, then there could be a medication error just like with Resident #1 and a resident could get very sick. Residents Affected - Few During an interview on 12/8/2023 at 12:27 pm, the MD stated the facility had notified her of the medication error and they held an emergency QAPI meeting. She stated the hospital sent the discharge packet and had another patient's medication orders in it. She stated it was a HIPAA violation and error on the hospital's part. She stated the two nurses failed to recognize the medication orders had a different name on it than Resident #1's name and the root cause was human error. She further stated it was not a systemic error, it was an error from outside the organization and it was reported back to the hospital. She stated most med errors had little to no consequences and an individual's reaction to a med error was dependent on the individual. She stated she felt it was managed appropriately; even at the change of condition. She also stated There is always a risk of significant effect, hospitalization, and a rare complication, death. During an interview on 12/28/23 at 2:30 p.m., the ADM stated the hospital sent the wrong medication orders during Resident #1's discharge to the facility. The ADM stated the orders were primarily for Resident #1, but the last few pages were for another resident. The ADM stated the facility conducted an investigation and implemented interventions and preventions to ensure a similar incident would not occur in the future. The ADM stated Resident #1 was still residing at the facility. During an interview on 12/28/23 at 2:42 p.m., the NP stated when Resident #1 came to the facility from the hospital on [DATE], the discharge medication orders that were attached to the discharge paperwork were for someone else. The NP stated the nurse did not check Resident #1's discharge medication orders to ensure they were for Resident #1 and inputted the orders into Resident #1's EHR. The NP stated Resident #1 received blood pressure and blood sugar medications, which she normally did not take because she was not diabetic. The NP stated on 12/4/23, the nurse caught the error , but already administered the medications to Resident #1. The NP stated following the medication administration, nurses were assigned to check Resident #1's blood sugar and blood pressure levels. The NP stated there were some vital checks the nurses did not complete for whatever reason. The NP stated when Resident #1's blood sugar and blood pressure were checked during the night shift of 12/4/23, the nurse found Resident #1's blood sugar level was critically low . The NP stated staff sent Resident #1 to the hospital for the critically low blood sugar levels. The NP stated Resident #1 developed a secondary infection in the hospital. The NP stated Resident #1's blood sugar levels were stabilized, and she had no issues since returning from the hospital. The NP stated Resident #1's vital checks for blood sugar were conducted for a short-term because Resident #1 no longer received blood sugar and blood pressure medications. The NP stated staff no longer checked Resident #1's blood sugar levels when she returned from the hospital because she was not diabetic and did not take any medication that would affect her blood sugar levels. The NP stated staff routinely checked Resident #1's blood pressure levels. During an interview on 12/28/23 at 3:45 p.m., CNA F stated he worked for the facility for 7 years. CNA F stated he was in-serviced on BS and BP levels by the ADON and the ADON taught him s/s of hypoglycemia, how to check, how to respond in the event, and notifying the nurse on duty if a resident had a low BP. CNA F stated he checked residents' vitals immediately. CNA F stated residents' BP was checked every shift by a CNA. CNA F stated residents' BS was checked by the LVNs. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455866 If continuation sheet Page 6 of 9 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 455866 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/29/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brookdale Westlake Hills 1034 Liberty Park Dr Austin, TX 78746 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 0760 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few During an observation and interview on 12/28/23 at 3:50 p.m., revealed LVN G was checking and verifying a newly admitted resident's hospital discharge medication orders. LVN stated he worked at the facility for 8 months. LVN stated he was in-serviced on BP and BS by the DON. LVN stated he learned how to report irregular levels. LVN stated vitals were checked every shift. LVN stated the BS was checked according to orders. LVN stated the BP was checked every shift. LVN stated vitals were checked by a CNA and BP was checked by LVNs. LVN stated charge nurses verified hospital discharge medication orders with the resident's name. During an interview on 12/28/23 at 3:58 p.m., RN H stated he worked at the facility for a month. RN stated he was in-serviced on the BP and BS levels during orientation. RN stated he learned how to check BP and BS levels and what to do in the event of hypoglycemia. RN stated residents' vitals were checked by CNAs every shift unless on BP meds. RN stated BS checks were done by LVNs, who also administered BS meds. RN stated he was trained on verifying residents' hospital discharge medication orders with the correct resident and sign and date verification whenever newly admitted and during night shift as well. During an interview on 12/28/23 at 4:02 p.m., LVN I stated she was in-serviced on BP and BS by the ADON. LVN stated she learned how to check the BP according to orders. LVN stated she checked the BS of residents with diabetes. LVN stated if residents' had irregular levels, she was trained to notify the MD. LVN stated she verified residents' hospital discharge medication orders to make sure match with residents and second verified to make sure correct verification. LVN stated CNAs checked vitals every shift. LVN stated LVNs checked the BS according to orders. During an interview on 12/28/23 at 4:06 p.m., CNA J stated she worked for the facility for two months. CNA stated she was in-serviced on BP and BS. CNA stated she could not remember who in-serviced her on the training topics. CNA stated she learned the signs and symptoms of hypoglycemia and how to respond and notify a nurse when there were signs and symptoms. CNA stated CNAs checked residents' BP every shift and whenever residents were admitted . CNA stated LVNs checked residents' BS. During an interview on 12/28/23 at 4:17 p.m., MA K stated she worked at the facility for two years. MA stated she was in-serviced on checking BP and how to verify orders by the DON and ADM. MA stated residents' BP were checked twice a day. MA stated if a resident had low BP, she was trained to notify a charge nurse, hold the residents' medicine, and check the resident's BP again. During an interview on 12/28/23 at 4:11 p.m., the ADON stated she in-serviced all nurses and taught them how to verify hospital discharge orders and made sure the nurses correctly matched the residents to the residents' discharge orders. ADON stated CNAs, MAs , and LVNs were also taught how to recognize signs and symptoms of hypoglycemia. ADON stated CNAs were also taught on how to report the signs and symptoms of hypoglycemia. ADON stated IDT meetings were conducted daily with the nurses, her, and the DON who verify and check to make sure hospital discharge medication orders correctly matched residents and were documented on the IDT checklist. ADON stated she was in-serviced by the DON on the processes. ADON stated the CNAs checked residents' BP once every shift and according to the physician's orders. ADON stated LVNs checked residents' BS twice a day, before meals and according to the physician's orders. ADON stated Resident #1 was no longer being checked for BS after she returned to the hospital because she was not taking any diabetic medication. During an observation and interview on 12/18/23 at 4:40 p.m., revealed Resident #1 was sitting in her wheelchair. Resident #1 was clean, comfortable, and her call light was sitting on her bed. Resident #1 was interacting with her family. Resident #1 and her family stated staff checked Resident #1's (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455866 If continuation sheet Page 7 of 9 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 455866 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/29/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brookdale Westlake Hills 1034 Liberty Park Dr Austin, TX 78746 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 0760 BP twice a day. Level of Harm - Immediate jeopardy to resident health or safety Record review of Resident #1's December 2023 MAR/TAR revealed she received medications within required timeframes and that were active physician's orders. Residents Affected - Few During an interview on 12/28/23 at 5:25 p.m., the ADM stated LVN E was suspended pending the investigation and then terminated after he completed the investigation. During an interview on 12/29/23 at 10:52 a.m., the ADM stated the facility made own POC. ADM stated there was monitoring that had been taking place daily for two weeks and then three times weekly for 12 weeks since 12/5/23. ADM stated QAPI had been conducting audits of the monitoring for the next three months and based on the audit results. ADM stated the facility had no other incidents since Resident #1's admission on [DATE]. Record review of the facility's QAPI meeting attendance sheet, dated 12/5/23, reflected there was a QAPI meeting. The members who attended the meeting were the Executive Director/Healthcare Administrator, Director of Clinical Services, Infection Preventionist, RDCS, DDO, VP of Clinical Services, and MD. The meeting topic was regarding discharge orders entered from hospital did not match Resident #1. The incident was reported to ED/HCA, DCS, POA, and SSA. The incident investigation report was completed. The root cause analysis was completed and determined the admitting nurse and verifying nurse did not confirm name on Resident #1's orders. Resident #1 had 9 BIMS score. The clinical admission orders were reviewed and audited on 12/5/23. Record review of the facility's resident roster, dated 12/7/23, reflected residents' medication orders and names were verified and matched . An audit was completed by the ADM. Record review of the facility's in-services reflected staff were trained on the following: Medications and admissions on 12/4/23, 12/5/23 at 1:00pm, and 12/7/23: Medication errors, medication administration (including 6 rights of medication, medication reconciliation on admission including verifying name of resident, blood glucose management including documentation of ongoing monitoring, CNAs signs and symptoms of hypoglycemia, and initialing next to resident's name on discharge orders. Record review of 49 knowledge-based exams reflected staff were tested from 12/5/23 through 12/10/23 on the following: What is hypoglycemia Signs of low blood sugar What to do when they believe a resident had low blood sugar Values that were considered low blood sugar What is given to raise up a resident's blood sugar How often resident's physician order section of the medical record and electronic orders were to be reviewed (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455866 If continuation sheet Page 8 of 9 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 455866 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/29/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brookdale Westlake Hills 1034 Liberty Park Dr Austin, TX 78746 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 0760 Where the 24-hour physician order audit form was located and completed by a nurse Level of Harm - Immediate jeopardy to resident health or safety What a charge nurse verifies in reviewing each order Residents Affected - Few Medication reconciliation helps identify what factors Purpose of performing medication reconciliation How many nurses needed to complete medication reconciliation for a new admission Second charge nurse responsibilities Information to be gathered for an admission/readmission to reconcile the medication list Common signs and symptoms of hypoglycemia How to respond when symptomatic and unresponsive residents with hypoglycemia Record review of Resident #1's blood pressure log reflected staff assessed and documented levels daily since readmission on [DATE] (12/12/23 - 12/29/23). Review of the facility policy admission and Data Collection and Orders last revised 02/23 reflected #2 The charge nurse who admits the resident is responsible for completing the Nursing admission Data Collection, verifying orders are present for admission, additional corresponding data collections and reviewing the information sent by the discharging community, hospital and/or attending physician. and #5 The charge nurse should contact the attending physician after the resident has been admitted to the community and resident data is collected. a) Orders should be reviewed with the physician and verified. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455866 If continuation sheet Page 9 of 9