Health inspection·November 25, 2025

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some female who was admitted to the facility on [DATE]. The resident was diagnosed with dementia and assistance of personal care. The resident did not have any diagnosis for dry eyes, hemorrhoids, or any skin condition. Record review of Resident #2's Comprehensive MDS Assessment, dated 11/05/2025, reflected the resident had moderate impairment (resident may need additional support and monitoring) with a BIMS score of 09. The Comprehensive MDS Assessment indicated the resident had dementia (a condition characterized by loss of memory and ability to reason). Record review of Resident #2's Comprehensive Care Plan, dated 11/13/2025, reflected the resident had impaired cognitive function/dementia one of the interventions was to give step by step instructions. Record review of Resident #2' Physician Order, on 11/25/2025, reflected no order for eye drops, hemorrhoid ointment, hydrocortisone ointment. Ther resident did not have an order for wound care that would require a triple antibiotics. Record review of Resident #2's Assessment Notes, on 11/25/2025, reflected no assessment for self-administration of medications, no clear instructions for self-administrations, and no assessment the resident was competent to manage their own medications. An observation on 11/25/2025 at 8:21 AM revealed Resident #2 was not inside her room. A plastic rectangular basket was observed on top of her overbed table with a container of eye drops on it. The container of eye drops was in plain view. During an observation and interview on 11/25/2025 at 1:12 PM revealed Resident #2 was in her bed, awake. When asked about the medications found inside her room, the resident did not reply. 3. Record review of Resident #4's Face Sheet, dated 11/25/2025, reflected a [AGE] year-old female who was admitted to the facility on [DATE]. The resident was diagnosed with multiple sclerosis and major depressive disorder (persistent feeling of sadness or loss of interest). Record review of Resident #4's Comprehensive MDS Assessment, dated 09/22/2025, reflected the resident was cognitively intact with a BIMS score of 15. The Comprehensive MDS Assessment did not indicate any skin issue. Record review of Resident #4's Physician Order, on 11/25/2025, reflected no order for wound care. During an observation and interview on 11/25/2025 at 8:40 AM revealed two containers of wound cleanser inside Resident #4's room. The containers of wound cleansers were on top of the dresser and was in plain sight. The resident said it had been on top of her dresser for some time. The resident said she did not have any wound recently that needed cleaning. She said she did not know who left the wound cleansers. During an observation and interview on 11/25/2025 starting at 9:59 AM, RN B stated there should be no medications inside the rooms of the residents unless they had an assessment that they could self-administer their medications. She said residents #1, #2, and #4 did not have any assessment that they could administer their medication, do their wound care, or apply the barrier cream. She said it might result in overmedication or misuse of medications. She said there were some confused residents in the facility that might enter the room and might get hold of the medication. She went inside Resident #1's room and saw a wound cleanser, an antiseptic skin cleanser, tubes of barrier creams, a bottle of nystatin powder, and sachets of povidone-iodine. She said those should be inside the wound care cart. She said if the resident wanted them inside her room, then it should be placed where it would not be accessed by other residents. She said she did not know exactly why those were inside Resident #1's room. She took the wound cleanser, an antiseptic skin cleanser, tubes of barrier creams, a bottle of nystatin powder, and sachets of povidone-iodine and said she would put them in the treatment cart. She then went to Resident #2's room and saw the eye drops in the plastic basket. She said she did not notice it when she did her morning round. She took the eye drops and said Resident #2 did not have an order for the eye drops. RN B saw a tube of hemorrhoid ointment, a tube of hydrocortisone ointment, and a tube of triple antibiotics in the plastic basket. She said she did not notice the said medications when she would go inside Resident #2's room. She said those medications should not be inside the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675004 If continuation sheet Page 2 of 4 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 675004 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McKinney Healthcare and Rehabilitation Center 253 Enterprise Dr McKinney, TX 75069 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some room because the resident might use them aside from what was recommended. She said Resident #2 might mistakenly use the ointments as toothpaste. She said ingesting them might cause stomach upset or even poisoning. She said Resident #2 did not have any wound that would require triple antibiotics. She said she would check if Resident #2 needed the medications so she could request orders for those medications. She then went inside Resident #4's room and saw the wound cleanser on the dresser. She took the wound cleansers and said she would put a name on them and would put them inside the treatment cart. She said Resident #4 did not have any wound that needed to be cleaned. She said she would also contact the resident's family member to know if they brought the medication and educate them about letting them know if they were bringing any medication. She said a confused resident might get hold of it and spray it in their eyes. In an interview on 11/25/2025 at 10:48 AM, CNA D stated the tube and sachets of barrier creams should not be inside the room because the resident might mistakenly consume it. She said it should be somewhere secured so the resident did not have any access to it. She said the skin protectant was applied on the skin and might have adverse effects if consumed by the resident. She said they already checked the rooms of the residents, took the skin barriers left inside the residents' rooms. She said if staff were done using the sachet of skin barrier, the staff should have thrown it in the trash can. She said another option would be putting the barrier ointment along with the briefs and wipes, inside the drawers. 4. Record review of Resident #3's Face Sheet, dated 11/25/2025, reflected a [AGE] year-old female who was admitted to the facility on [DATE]. The resident was diagnosed with dementia, overactive bladder (a bladder control problem which leads to a sudden urge to urinate), and need for assistance for personal care. Record review of Resident #3's Comprehensive MDS Assessment, dated 11/10/2025, reflected the resident was cognitively intact with a BIMS score of 14. The Comprehensive MDS Assessment indicated the resident had urinary and bowel incontinence. During an observation and interview on 11/25/2025 at 8:33 AM revealed Resident #3 was sitting in her wheelchair. Sachets of skin barrier ointments were observed on the resident's side table. One of the sachets was ripped open on one side with some remains of the ointment still visible from the open side. She said the CNAs used the ointment every time they cleaned and changed her. She said that would not be the first time the CNAs left sachets or tubes of skin barrier ointment on her side table. In an interview on 11/25/2025 at 12:34 PM, LVN C stated zinc oxide was a form of medication because it was applied topically to prevent any skin issues. She said it should not be inside the room because confused residents might consume it or put it in their eyes. She said the ointment should be stored in the cart or somewhere not accessible to any residents. She said once the CNAs were done with the skin barrier, they should throw the sachet because the resident might lick it. She said she would check the rooms assigned to her to see if they had any skin barrier ointments inside. In an interview on 11/25/2025 at 12:42 PM, the DON stated Resident #1 wanted her wound care supplies to be inside her room. She said she would talk to Resident #1 to let her know that the wound care supplies should be inside the treatment cart. She said if Resident #1 insisted, she said she would instruct the nurse to secure them and put them inside the drawer of the Resident #1's dresser where they would not be accessible to any of the residents. She said RN B also showed her the medications she found inside Resident #2's room and the wound cleanser from Resident #3's room. She said the staff would not know if the medications were inside the drawer but if they were in plain view, the staff should have seen them. She said those medications were not supposed to be inside the resident's room because the residents might use them inappropriately or consume them instead of applying topically. She said the wound cleanser should be stored in the treatment cart. She said she would check if Resident #2 needed the medications found inside her room so she could get an order for the said (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675004 If continuation sheet Page 3 of 4 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 675004 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McKinney Healthcare and Rehabilitation Center 253 Enterprise Dr McKinney, TX 75069 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete medications. She said the risk could be the resident using it without any assessment and might be using it more than as ordered and nobody would know. She said skin barrier creams should not be accessible to the residents for the same reason. She said she already started an in-service about medication storage. In an interview on 11/25/2025 at 12:52 PM, ADON A stated she was also the wound care nurse. She said she did not know why Resident #1's wound care supplies were inside her room. She said she would get the things needed for her wound care from her treatment cart. She said Resident #1 was bed-bound and would not be able to access the wound care supplies, but other residents might be able to use them aside from what they were intended to. She said the supplies could be secured by putting them inside a plastic bag and put them inside the drawer. She said Resident #4 did not have any wound and she did not know why she had wound cleansers inside the room. She said medications should not be inside the room because the residents might eat, drink, or use them improperly. She said other residents, who were suffering from psychological disorder, might enter the room and use the medication as well. She said the staff should be aware that medications should not be inside the rooms of the residents. She said she would collaborate with the DON with regards to the issue. In an interview on 11/25/2025 at 1:28 PM, the Administrator-in-Training stated what he knew was there should be no medications inside the rooms of the residents for safety reasons. He said the expectation was for the staff to scan the rooms of the residents when they did their rounds because medications inside the rooms of the residents could be harmful for the residents. He said the DON already started an in-service. Record review of the facility's policy entitled, Medication Access and Storage, E kit access Policy/Procedure - Nursing Clinical revised 07/2019 reflected POLICY: It is the policy of this facility to store all drugs and biological in locked compartments . The medication supply is accessible only to license nursing personnel, pharmacy personnel, or staff members lawfully authorized to administer medications. Event ID: Facility ID: 675004 If continuation sheet Page 4 of 4