Health inspection·December 11, 2025

F 0808 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few MD if Resident #1 could have a diabetic order diet. Resident #1's MD responded to the request and said yes, she could have an order for Resident #1 to have a diabetic diet. During an interview on 12/11/2025 at 9:45 AM, Resident #1's family member said Resident #1 had diabetes mellitus and GERD and was told she was supposed to have frequent small meals and a diabetic diet. Resident #1's family member said Resident #1 was supposed to have a diabetic diet and the facility could not accommodate her. She said she called the facility on 11/21/2025 and inquired about Resident #1's blood sugars and was told her HGBA1C level was a 9.6 (normal levels 4.7-5.7). She said when she asked about Resident #1 getting a diabetic diet, the ADON told her the facility did not offer a diabetic diet, and everybody received the same diet. During an interview on 12/11/2025 at 10:00 AM, Resident #1's family member #2 was at the facility and said when Resident #1 was at home they had always eaten healthy. He said they were able to control Resident #1's diabetes at home with her diet. He said since Resident #1 had been in the facility her blood sugars have been out of control. He said they feed Resident #1 hamburgers, hot dogs and all kinds of things a diabetic should not be eating. He said he addressed it with the facility, and nothing had changed. Resident #1's family member #2 said he had not been invited to attend any care plan meeting since Resident #1's family member had addressed concerns regarding her HGBA1C level. During an interview and record review on 12/11/2025 at 11:50 AM, the Dietary Manager said if a resident required a special diet the nursing staff notified dietary, and they tried to accommodate the diet. The Dietary Manager said a diet order should be completed and given to the kitchen. The Dietary Manager said she was not aware Resident #1 requested a diabetic diet and required small, frequent meals, and she was not provided with a diet order. During the interview with the Dietary Manager Resident #1's physician orders were reviewed and indicated Resident #1's diet order had been changed on 12/11/2025 at 11:10 am after State Surveyor intervention, to a diabetic diet (CCHO). During an interview and record review on 12/11/2025 at 11:55 AM, the RD said she had not assessed Resident #1, because she had taken over the facility in October of 2025 and Resident #1 had not triggered for her to be assessed. She said triggers for residents to be assessed consisted of weight gain, weight loss, and wounds which Resident #1 did not have. She said she would assess Resident #1 while she was at the facility that day. During an interview on 12/11/2025 at 12:50 PM, the DON said she changed Resident #1's diet order to a diabetic diet on 12/11/2025 at 11:10 AM after state surveyor intervention based on the RD's recommendation of a diabetic diet. She said she had a verbal discussion with the RD regarding Resident #1's HGBA1C level and the RD's recommendation was to change Resident #1's diet order to a diabetic diet (CCHO). When asked if it was normal to have a discussion with the RD regarding resident's lab values, she said yes, she called the RD at times to notify her of resident's lab values. When asked why Resident #1's lab values were discussed with the RD on 12/11/2025 instead of when Resident #1's lab values were received on 11/21/2025, she stated this was the first time the RD had been to the facility since Resident #1's lab values were received. During an interview on 12/11/2025 at 1:45 PM, the MD said he visited Resident #1 while at the facility on 12/11/2025. He said he changed Resident #1's medication on 11/21/2025 when he was notified of Resident #1's HGBA1C level of 9.6. He said had he known Resident #1 or her family wanted Resident #1 to have a diabetic diet he would have ordered it, but he was not told. He said he did not think a diabetic diet was sufficient in managing Resident #1's diabetes. He said he had previously spoken with Resident #1's family regarding insulin but they did not want her to take insulin but said he was going to speak with the family again about putting Resident #1 on insulin. During an interview on 12/11/2025 at 2:35 PM, the ADON said on 11/21/2025 Resident #1's family member found out Resident #1 had a hypoglycemic (low blood sugar) episode and requested Resident #1 have a HGBA1C level done. He said (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675379 If continuation sheet Page 2 of 3 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 675379 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/11/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Oaks at Longview 111 Ruthlynn Dr Longview, TX 75601 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 0808 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Resident #1's family member called the facility and requested a diabetic diet, and he told her the facility did not offer a diabetic diet. He said he was not aware the facility offered a diabetic diet and would go and find out what that was. During an interview on 12/11/2025 at 3:00 PM, LVN B said on 11/21/2025 she received a call from Resident #1's family member asked about Resident #1 having a diabetic diet. She said she explained to Resident #1's family member that the facility did not offer a diabetic diet. She said Resident #1's family member got upset that they did not offer a diabetic diet, so she transferred the call to the ADON. She said she did not know the facility had a diabetic diet, and she had never heard of a CCHO diet. Record review of the facility's policy titled, Therapeutic Diets: dated 1/1/2025, indicated: Purpose: To ensure that the facility provides therapeutic diets to residents that meet nutritional guidelines and physician orders. Policy: Therapeutic diets are diets that deviate from the regular diet and require a physician's order. Per the physician's order, therapeutic diets are planned prepared and served in consultation with the registered dietician. The attending physician may delegate to a registered or licensed dietitian the task of prescribing a resident's diet, including a therapeutic diet, to the extent allowed by state law. Record review of the facility's, undated, Resident admission Guide indicated: Food and Nutrition Services: Our food and Nutrition Services Department offers therapeutically planned meals that are specially designed to meet each resident's nutritional needs. A registered dietitian will evaluate and review your diet and nutritional status on a regular basis and will coordinate your nutritional needs with you, your physician, and the facility staff. Event ID: Facility ID: 675379 If continuation sheet Page 3 of 3