Health inspection·October 23, 2024

F 0880 The facility failed to implement and maintain contact precautions and prevent cross contamination for resident (Resident #31) by cohorting him with a positive resident (Resident #13) with COVID-19. Level of Harm - Minimal harm or potential for actual harm These failures could place residents at risk for spread of infection and cross contamination. Residents Affected - Many Findings included: Resident #1 Record Review of Resident #1's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: dementia (memory loss), pneumonia (lung infection) and muscle weakness. Record Review of Resident #1's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 14, indicating the resident was not cognitively impaired. Record review of Resident #1's care plan, dated 10/22/24, did not the residents positive status for COVID-19. Record review of Resident #1's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident #1's nursing progress notes entered by LVN D dated 10/21/24 at 5:10 PM indicated Resident #1 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #1 tested positive on 10/21/24 with the following symptoms: lethargy and weakness. Resident #2 Record Review of Resident #2's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: diabetes (blood sugar condition), reduced mobility, morbid obesity and major depressive disorder. Record Review of Resident #2's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 15, indicating the resident was not cognitively impaired. Record review of Resident #2's care plan, dated 10/14/24, reflected the following: A focused area, initiated on 11/09/20, Resident #2 was at risk for exposure to respiratory virus (COVID-19) due to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #2 was to minimize risk of potential exposure over through next review date. Record review of Resident #2's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 2 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 Level of Harm - Minimal harm or potential for actual harm Record Review of Resident #2's nursing progress notes entered by LVN E dated 10/18/24 at 4:09 AM indicated Resident #2 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #2 tested positive on 10/16/24 with the following symptoms: congestion, chills and runny nose. Residents Affected - Many Resident #3 Record Review of Resident #3's face sheet revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: cognitive communication deficit (difficulty communicating), pneumonia (lung infection), anxiety disorder (increased worry) and muscle wasting atrophy (loss of muscle tissue). Record Review of Resident #3's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 14, indicating the resident was not cognitively impaired. Record review of Resident #3's care plan, dated 10/14/24, reflected the following: A focused area, initiated on 11/09/20, Resident #3 was at risk for exposure to respiratory virus (COVID-19) due to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #3 was to minimize risk of potential exposure over through next review date. Record review of Resident #3's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #3's nursing progress notes entered by the DON dated 10/16/24 at 7:58 PM indicated Resident #3 tested positive for COVID-19 on 10/16/24. Record review of the email sent by the DON on 10/29/24 at 10:00 AM revealed Resident #3 tested positive on 10/16/24 with the following symptoms: asymptomatic. Resident #4 Record Review of Resident #4's face sheet revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: schizophrenia (chronic mental illness), dementia (memory loss) and cognitive communication deficit (difficulty communicating). Record Review of Resident #4's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 10, indicating the resident was moderately cognitively impaired. Record review of Resident #4's care plan, dated 10/14/24, reflected the following: A focused area, initiated on 10/14/24, Resident #4 was COVID positive and had clinical concerns. The goal initiated on 10/15/24, was that Resident #4 would be monitored for secondary infections/virus. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 3 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Record review of Resident #4's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #4's nursing progress notes entered by LVN E dated 10/18/24 at 4:12 AM indicated Resident #4 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #4 tested positive on 10/14/24 with the following symptoms: lethargy and dizziness. Resident #5 Record Review of Resident #5's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: traumatic brain injury, anxiety (increased worry) and bipolar disorder (mental illness that causes mood swings). Record Review of Resident #5's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 09, indicating the resident was moderately cognitively impaired. Record review of Resident #5's care plan, dated 8/14/24, reflected the following: A focused area, initiated on 1/2/23, Resident #5 was COVID positive and had clinical concerns. The goal initiated on 10/15/24, was that Resident #5 would be monitored for secondary infections/virus. Record review of Resident #5's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Record Review of Resident #5's nursing progress notes entered by the DON dated 10/14/24 at 6:33 PM indicated Resident #1 tested positive for COVID-19 on 10/14/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #5 tested positive on 10/14/24 with the following symptoms: congestion cough and SOB. Resident #6 Record Review of Resident #6's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted [DATE], with the following diagnoses: need for assistance with personal care, muscle wasting atrophy (loss of muscle tissue), and lack of coordination. Record Review of Resident #6's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 15, indicating the resident was not cognitively impaired. Record review of Resident #6's care plan, dated 08/24/24, reflected the following: A focused area, initiated on 10/21/24, Resident #6 was COVID positive and had clinical concerns. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 4 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 The goal initiated on 10/15/24, was that Resident #6 would be monitored for secondary infections/virus. Level of Harm - Minimal harm or potential for actual harm Record review of Resident #6's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Residents Affected - Many Record Review of Resident #6's nursing progress notes entered by the DON dated 10/14/24 at 5:36 PM indicated Resident #6 tested positive for COVID-19 on 10/14/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #6 tested positive on 10/14/24 with the following symptoms: congestion, sneezing and runny nose. Resident #7 Record Review of Resident #7's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: dementia (memory loss), major depressive disorder, and schizophrenia (chronic mental illness). Record Review of Resident #7's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 14, indicating the resident was not cognitively impaired. Record review of Resident #7's care plan, dated 9/05/24, reflected the following: A focused area, initiated on 12/14/21, Resident #7 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #7 was to increase knowledge deficit related to infection control practices and/ or minimizing risks related to virus through next review date. Record review of Resident #7's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #7's nursing progress notes entered by the DON dated 10/16/24 at 10:16 AM indicated Resident #7 tested positive for COVID-19 on 10/16/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #7 tested positive on 10/16/24 with the following symptoms: fatigue. Resident #8 Record Review of Resident #8's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was admitted to the facility on [DATE], with the following diagnoses: malignant neoplasm of the brain (cancer growth in the brain), diabetes (blood sugar condition) and dementia (memory loss). Record Review of Resident #8's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 00, indicating the resident was severely cognitively impaired. Record review of Resident #8's care plan, dated 10/2/24, did not address the residents positive (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 5 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 status of COVID-19. Level of Harm - Minimal harm or potential for actual harm Record review of Resident #8's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/20/2024. Residents Affected - Many Record Review of Resident #8's nursing progress notes entered by the DON dated 10/20/24 at 12:24 PM indicated Resident #8 tested positive for COVID-19 on 10/20/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #8 tested positive on 10/20/24 with the following symptoms: asymptomatic. Resident #9 Record Review of Resident #9's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: dementia (memory loss), muscle weakness. And cognitive communication deficit (difficulty communicating). Record Review of Resident #9's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 13, indicating the resident was not cognitively impaired. Record review of Resident #9's care plan, dated 9/18/24, reflected the following: A focused area, initiated on 11/09/20, Resident #9 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #9 was to minimize risk of potential exposure over through next review date. Record review of Resident #9's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #9's nursing progress notes entered by the DON dated 10/16/24 at 11:21 AM indicated Resident #1 tested positive for COVID-19 on 10/16/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #9 tested positive on 10/16/24 with the following symptoms: congestion and runny nose. Resident #10 Record Review of Resident #10's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was admitted to the facility on [DATE], with the following diagnoses: heart failure, muscle weakness, anxiety (increased worry) and lack of coordination. Record Review of Resident #10's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 15, indicating the resident was not cognitively impaired. Record review of Resident #10's care plan, dated 9/11/24, reflected the following: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 6 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many A focused area, initiated on 5/24/22, Resident #10 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 5/24/22, was that Resident #10 would remain free from virus through next review date. Record review of Resident #10's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident #10's nursing progress notes entered by LVN D dated 10/21/24 at 3:09 PM indicated Resident #10 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #10 tested positive on 10/21/24 with the following symptoms: congestion and runny nose. Resident #11 Record Review of Resident #11's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE] with the following diagnoses: epilepsy (seizure disorder), morbid obesity and lack of coordination. Record Review of Resident #11's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 15, indicating the resident was slightly, cognitively impaired. Record review of Resident #11's care plan, dated 0/7/24 reflected the following: A focused area, initiated on 5/03/23, Resident #11 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 5/03/23, was that Resident #11 would increase knowledge deficit related to infection control practices and/or minimize risk to virus through next review date. Record review of Resident #11's Order Summary Report, dated 10/29/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/18/2024. Record Review of Resident #11's nursing progress notes entered by the DON dated 10/18/24 at 4:16 PM indicated Resident #11 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #11 tested positive on 10/18/24 with the following symptoms: weakness. Resident #12 Record Review of Resident #12's face sheet, dated 10/23/24 revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: muscle weakness, COVID-19 and schizophrenia (chronic mental disorder). Record Review of Resident #12's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 00, indicating the resident was severely cognitively impaired. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 7 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 Record review of Resident #12's care plan, dated 9/5/24, reflected the following: Level of Harm - Minimal harm or potential for actual harm A focused area, initiated on 10/29/20, Resident #12 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 10/29/20, was that Resident #12 was to minimize risk of potential exposure over through next review date. Residents Affected - Many Record review of Resident #12's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/18/2024. Record Review of Resident #12's nursing progress notes entered by the DON dated 10/18/24 at 5:10 PM indicated Resident #12 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #12 tested positive on 10/18/24 with the following symptoms: asymptomatic. Resident #13 Record Review of Resident #13's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: anxiety (increased worry), pneumonia (lung infection), and schizophrenia (chronic mental illness). Record Review of Resident #13's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 13, indicating the resident was not cognitively impaired. Record review of Resident #13's care plan, dated 10/2/24, reflected the following: A focused area, initiated on 10/12/22, Resident #13 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 10/12/22, was that Resident #13 would remain free from virus through next review date. Record review of Resident #13's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident #13's nursing progress notes entered by LVN D dated 10/21/24 at 3:08 PM indicated Resident #13 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #13 tested positive on 10/21/24 with the following symptoms: runny nose and weakness. Resident #14 Record Review of Resident #1's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was admitted to the facility on [DATE], with the following diagnoses: dementia (memory loss), muscle weakness and muscle wasting atrophy (loss of muscle tissue). Record Review of Resident #14's Comprehensive MDS assessment dated [DATE], revealed under Section (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 8 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 C, Cognitive Patterns, a BIMS score of 11, indicating the resident was moderately cognitively impaired. Level of Harm - Minimal harm or potential for actual harm Record review of Resident #14's care plan, dated 10/23/24, reflected the following: Residents Affected - Many A focused area, initiated on 10/16/24, Resident #14 was COVID positive and had clinical concerns. The goal initiated on 10/16/24, was that Resident #4 would be monitored for secondary infections/virus. Record review of Resident #14's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #14's nursing progress notes entered by the DON dated 10/16/24 at 5:10 PM indicated Resident #14 tested positive for COVID-19 on 10/16/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #14 tested positive on 10/16/24 with the following symptoms: congestion, chills and runny nose. Resident #15 Record Review of Resident #15's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was admitted to the facility on [DATE], with the following diagnoses: dementia (memory loss), anxiety (increased worry), and cognitive communication deficit (difficulty communicating). Record Review of Resident #15's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 14, indicating the resident was not cognitively impaired. Record review of Resident #15's care plan, dated 8/7/24, reflected the following: A focused area, initiated on 6/7/23, Resident #15 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 6/07/23, was that Resident #15 would increase knowledge deficit related to infection control practices and/or minimize risk related to virus through next review date. Record review of Resident #15's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Record Review of Resident #15's nursing progress notes entered by the DON dated 10/14/24 at 6:35 PM indicated Resident #15 tested positive for COVID-19 on 10/14/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #15 tested positive on 10/14/24 with the following symptoms: congestion and Runny nose. Resident #16 Record Review of Resident #16's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted [DATE], with the following diagnoses: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 9 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 muscle weakness, COVID-19 and dementia (memory loss). Level of Harm - Minimal harm or potential for actual harm Record Review of Resident #16's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 09, indicating the resident was moderately cognitively impaired. Residents Affected - Many Record review of Resident #16's care plan, dated 10/22/24, reflected the following: A focused area, initiated on 2/15/23, Resident #16 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 2/15/23, was that Resident #16 was to minimize risk of potential exposure over through next review date. Record review of Resident #16's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/18/2024. Record Review of Resident #16's nursing progress notes entered by LVN E dated 10/18/24 at 4:21 AM indicated Resident #16 tested positive for COVID-19 on 10/18/24. Record review of the email sent by the DON on 10/29/24 at 10:00 AM revealed Resident #16 tested positive on 10/17/24 with the following symptoms: asymptomatic. Resident #17 Record Review of Resident #17's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was admitted to the facility on [DATE], with the following diagnoses: dementia (memory loss), anxiety (increased worry), diabetes (blood sugar deficit) and lack of coordination. Record Review of Resident #17's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 3, indicating the resident was severely cognitively impaired. Record review of Resident #17's care plan, dated 08/21/24, reflected the following: A focused area, initiated on 10/15/23, Resident #17 was at risk for exposure to respiratory virus (COVID-19). The goal initiated on 10/15/23, was that Resident #17 would remain free from virus through next review date. Record review of Resident #17's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/18/2024. Record Review of Resident #17's nursing progress notes entered by the DON dated 10/18/24 at 4:20 PM indicated Resident #1 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #17 tested positive on 10/18/24 with the following symptoms: asymptomatic. Resident #18 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 10 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Record Review of Resident #18's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was admitted to the facility on [DATE], with the following diagnoses: lack of coordination, schizophrenia (chronic mental disorder), and dementia (memory loss). Record Review of Resident #18's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 07, indicating the resident was severely cognitively impaired. Record review of Resident #18's care plan, dated 9/25/24, reflected the following: A focused area, initiated on 06/07/23, Resident #18 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 06/07/23, was that Resident #18 would remain free from virus through next review date. Record review of Resident #18's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Record Review of Resident #18's nursing progress notes entered by LVN D dated 10/15/24 at 5:57 PM indicated Resident #18 tested positive for COVID-19 on 10/15/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #18 tested positive on 10/14/24 with the following symptoms: congestion and runny nose. Resident #19 Record Review of Resident #19's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was admitted to the facility on [DATE], with the following diagnoses: dementia (memory loss), muscle wasting and atrophy (loss of muscle tissue), and muscle weakness. Record Review of Resident #19's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 08, indicating the resident was moderately cognitively impaired. Record review of Resident #19's care plan, dated 08/07/24, did not address the residents positive COVID-19 status. Record review of Resident #19's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident #19's nursing progress notes entered by LVN D dated 10/21/24 at 5:10 PM indicated Resident #19 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #19 tested positive on 10/21/24 with the following symptoms: runny nose, congestion and weakness. Resident #20 Record Review of Resident #20's face sheet, dated 10/23/24, revealed a [AGE] year-old female that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 11 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many was initially admitted to the facility on [DATE] and readmitted [DATE], with the following diagnoses: cerebral infarction (dying brain tissue that occurs due to blocked or reduced blood flow), muscle wasting atrophy (loss of muscle tissue), , abnormal weight loss and lack of coordination. Record Review of Resident #20's Comprehensive MDS assessment dated [DATE], revealed under Section C, no data was entered. Record review of Resident #20's care plan, dated 09/11/24, reflected the following: A focused area, initiated on 11/09/20, Resident #20 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #20 was to minimize risk of potential exposure over through next review date Record review of Resident #20's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident 20's nursing progress notes entered by LVN D dated 10/21/24 at 3:17 PM indicated Resident #20 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #20 tested positive on 10/21/24 with the following symptoms: asymptomatic. Resident #21 Record Review of Resident #21's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted [DATE], with the following diagnoses: diabetes (blood sugar deficit), dementia (memory loss) and lack of coordination. Record Review of Resident #21's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 11, indicating the resident was moderately cognitively impaired. Record review of Resident #21's care plan, dated 09/5/24, reflected the following: A focused area, initiated on 11/09/20, Resident #21 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #21 would increase knowledge deficit related to infection control practices and/or minimize risks related to virus through next review date. Record review of Resident #21's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Record Review of Resident #21's nursing progress notes entered by LVN D dated 10/14/24 at 5:46 PM indicated Resident #21 tested positive for COVID-19 on 10/14/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 12 of 13 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 455936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331 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 0880 #21 tested positive on 10/14/24 with the following symptoms: congestion and runny nose. Level of Harm - Minimal harm or potential for actual harm Resident #22 Record Review of Resident #22's face sheet, dated 10/23/24, revealed a 68-[NAME][TRUNCATED] Residents Affected - Many FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455936 If continuation sheet Page 13 of 13