Health inspection·November 18, 2025

F 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some that causes extreme mood swings), type 2 diabetes, and hypertension.Record review of a Quarterly MDS Assessment for Resident #12 dated 8/15/2025 indicated he had moderate impairment in thinking with a BIMS score of 8. He was independent in eating and required supervision or touching assistance with oral hygiene.Record review of a care plan for Resident #12 dated 6/3/2024 indicated he had impaired cognitive function or impaired thought processes. Interventions included to keep the resident's routine consistent and try to provide consistent caregivers as much as possible.5. Record review of an admission record for Resident #5 dated 10/8/2025 indicated he admitted to the facility on [DATE] and was [AGE] years old with diagnoses of Alzheimer's Disease (a progressive and irreversible decline in memory and cognitive abilities), major depressive disorder (persistent sadness and loss of interest), anemia (decreased production of red blood cells in the body), and BPH (the prostate glands grows larger than normal).Record review of a Quarterly MDS Assessment for Resident #5 dated 9/3/2025 indicated he had severe impairment in thinking with a BIMS score of 3. He was independent with eating and supervision or touching assistance with oral hygiene and toileting.Record review of a care plan for Resident #5 dated 4/21/2025 indicated he had impaired cognitive function or impaired thought processes. Interventions included to present just one thought, idea, questions, or command at a time.Record review of the personnel file for BOM/[NAME] indicated she was hired at the facility on 10/13/2022. She had an initial criminal history check on 10/12/2022. An annual EMR was checked on 1/1/2025 and she was not listed as being unemployable. She had annual training on abuse on 4/1/2025.Record review of a [store name] receipt dated 8/31/2025 at 2:33 p.m., revealed a total purchase was made to buy food items using the food debit card that belonged to Resident #1. The total purchase was $89.00 that was charged. Some food items purchased included: energy drinks, spaghetti noodles, alfredo noodles, etc.Record review of a [store name] receipt dated 8/26/2025 at 2:38 p.m., revealed a total purchase was made to buy food items using the food debit card that belonged to Resident #6. The total purchase was $98.17 that was charged. Some food items purchased included: Starbucks coffee, guacamole, French mustard, and mayonnaise.Record review of a [store name] receipt dated 8/26/2025 at 11:26 a.m., revealed a total purchase was made to buy food items using the food debit card that belonged to Resident #6. The total purchase was $1.68 that was charged.Record review of a [store name] receipt dated 7/26/2025 at 10:55 a.m., revealed a total purchase was made to buy food items using food debit cards that belonged to Resident #1 and Resident #5. The total purchase was $102.33 that was charged to both cards used. Resident #1's card was charged $100.00 and Resident #5's card was charged $2.33. Some food items purchased included: pizza rolls, tater tots, broccoli rice, flour tortillas, etc.Record review of a [store name] receipt dated 7/26/2025 at 10:51 a.m., revealed a total purchase was made to buy food items using the food debit cards that belonged to Resident #8 and Resident #12. The total purchase was $179.04 that was charged to both cards used. Resident #8's card was charged $86.16 and Resident #12's card was charged 92.88. Some food items purchased included: Brussel sprouts, fettuccini, energy drinks, etc.Record review of a [store name] receipt dated 6/28/2025 at 1:47 a.m., revealed a total purchase was made to buy food items using the food debit cards that belonged to Resident #1 and Resident #6. The total purchase was $200.00 that was charged to both cards used. Resident #1 and Resident #6 cards were both charged $100.00 each. Some food items purchased included: New York strip steak, cubed steak, tater tots, instant potatoes, country gravy mixes, baked beans, etc.The total of the receipts reviewed was $670.22.During a confidential interview on 10/6/2025 at an undisclosed time, a complainant reported that the facility had a program where many residents in the facility received a food card that they could use to buy food at [store name]. The complainant reported they had overheard facility staff talk about the person who was over the money in the facility had (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675398 If continuation sheet Page 2 of 5 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 675398 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/18/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care of Center 501 Timpson Center, TX 75935 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 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some spent some of the money from the resident's food cards and wanted it investigated.During an interview on 10/6/2025 at 11:44 a.m., the [NAME] said the food cards provided by [insurance company name] allowed the residents who was signed up on the program to buy anything that was edible that included snacks, drinks, etc. She said that each resident that received the benefit received $100 at the beginning of the month. She said some residents kept their cards in their possession and some were in the possession of family members. She said for everyone else their cards were locked in her office for the staff to use to buy items for the residents. She said the Activities Director would shop for most of the residents in the facility along with some of the resident care partners. She said the residents received $100 monthly and the benefits did not roll over, so whatever was not spent each month, they would lose. She said the residents would provide the staff members with a list and the staff would shop for them at [store name] which was the designated store to use the cards. She said the staff was to give her the receipt for purchases when they returned to the facility. She said they had a binder she kept in her office. They started in July 2025 in which the staff was to sign out the cards and sign them back in along with placing the receipts for the purchase in the binder under the resident's name. She said she shopped for some of the residents in the facility as well.During an interview on 10/6/2025 at 11:57 a.m., the LED said some of the residents in the facility received a food card as part of their insurance benefits for $100 monthly and the money did not roll over each month on what they did not spend. She said the program started sometime between December 2024 to January 2025 when she was out for maternity leave. She said she shopped for most of the residents and only a few had cards that was checked out by family to use. She said on the first of every month the cards reloaded with $100. She said every other week she went to the store and shopped for the residents in the facility and would go about 2-3 times a month. She said the residents would give her a list and she would shop for them. She said she had to get their cards if they were not in their possession from the [NAME] and would have to sign the cards out and back in once back in the facility. She said they wrote the resident's names on the receipts so they could keep track of what was spent for each resident and the receipt was placed in the binder. She said there were a few people in the facility that was authorized to shop for the residents, including the [NAME] and RCP B.During an interview on 10/6/2025 at 3:17 p.m., the DRSS said she did not shop for any of the residents in the facility. She said it was done by the LED. She said PTA A called her on the day she was in [store name] when she tried to purchase food for Resident #6 when the card declined. She said she told PTA A to call and speak to the Administrator or the [NAME].During a phone interview on 10/6/2025 at 3:30 p.m., the Transport Driver said she shopped for some of the residents in the facility. She said the last time she shopped for them was Sunday a week ago (9/28/2025). She said a couple of months ago she shopped for Resident #6 but did not remember what date it was. She said Resident #6 was not a snacker and had a twelve pack of sodas that had been in her room for a while. She said when she shopped for the residents, she used their food card that was provided to them by their insurance company. She said the [NAME] would give them the cards and when they returned to the facility, they would print the resident name on the receipt and turn it into the [NAME]. She said she never had a problem with the cards for the residents she shopped for, and all had enough money to buy what they wanted. She said the facility had used the cards for some months. She said she did not remember the facility providing any training or in-service to the staff on the use of the cards.During an interview on 10/6/2025 at 2:50 p.m., PTA A said Resident #6 was a resident at the facility who was like a grandmother to her and the POA had asked her about a month ago (August 2025) to go to the store and purchase some things for her. She said she received the card from the LED and went to [store name] to buy the resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675398 If continuation sheet Page 3 of 5 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 675398 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/18/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care of Center 501 Timpson Center, TX 75935 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 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some some food items and when she tried to check out, the card declined. She said she called the number on the back of the card and listened to the most recent transactions, and it revealed multiple purchases in June 2025, July 2025 and August 2025 that was close to $100 that was made and the POA had not made any purchases for Resident #6. She said she contacted the POA and discussed what she had discovered and talked to [store name] about video surveillance but was told they could not give her video footage without a police report. She said she reported the information to the facility and was told they would conduct an investigation to see if there were any discrepancies with the food cards.During an interview on 10/6/2025 at 3:09 p.m., the Administrator said the [NAME] was responsible for overseeing the food card program and had the cards locked up until they were needed. She said the LED/Activities Director, DRSS/SW, [NAME]/BOM and some of the resident care partners could use the cards to purchase food items for the residents. She said she was aware of an issue with the use of the cards and had planned to audit last week (9/29/2025-10/3/2025) but did not get a chance to and then planned to the week of 10/6/2025-10/10/2025. She said the LED had used the cards of some of the residents and the cards declined. She said charges were made and thought someone had gone to shop for the residents and did not turn in the receipts. She said she had no idea someone had used the resident food cards for their personal use and just thought someone did not turn in receipts for purchases made.During a phone interview on 10/6/2025 at 3:52 p.m., the POA for Resident #6 said the resident was at the hospital. She said she was made aware by PTA A whom she had asked to buy some food for Resident #6 using her food card that was provided by her insurance company. She said she was informed that when PTA A went to [store name], there was not anything on the card as the card declined. She said she had not talked to the Administrator about the incident and PTA A was going to let her know what to do. She said Resident #6 did not snack a lot and had sodas in her room and had them for a while. She said she was picky with her foods. She said she would wait and see what was discovered about the food cards.During an interview on 10/7/2025 at 12:24 p.m., the Administrator said reviewing the receipts that was requested, she saw some things that were troubling that included large purchases for items such as steaks and multiple resident cards was used for the purchases. She said she filed a police report and was going to start an internal investigation into the matter. She said the officer went to [store name] and reviewed video footage for the dates of the receipts that had large purchase amounts and described the BOM/[NAME] as the person who made the purchases. She said charges would be filed and she would be suspended until her investigation was complete and was going to take possession of the food cards. She was going to in-service staff on proper use of the cards according to their policy. She said they would conduct a complete audit of all residents in the facility who had the food cards on tomorrow 10/8/2025. She said she expected the staff to use the food cards for the people for whom they were designated.Record review of a disciplinary action record signed and dated 10/7/2025 for the [NAME]/BOM by the BOM indicated she was suspended for an allegation of misappropriation of resident funds. The date of occurrence was 6/28/2025.During a follow up interview on 10/7/2025 at 12:28 p.m., the [NAME]/BOM said she had been in the position as the Director of Resident Accounts for about a year. She said she was responsible for keeping up with the food cards for the residents in the facility. She said the program started around January 2025. She said she had made purchases on the weekends on her off time a few months ago. She said the staff were not supposed to be on the clock when they shopped for the residents. When asked about her using the food cards for her personal benefit, she admitted that she had. She said she bought food for herself and had used the cards of Resident #1 and Resident #6. She said she could not remember what other cards she had in her possession at the times she used the cards but there were multiple cards she had with her. She said (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675398 If continuation sheet Page 4 of 5 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 675398 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/18/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care of Center 501 Timpson Center, TX 75935 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 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete she knew what she did was wrong and did not have an explanation as to why she did it. She said she knew the residents received $100 each month and whatever they did not use, they would lose. She said she hated that the residents would lose the money when it could have been used. She said she knew it was theft as the cards were not hers and she did not have permission to use their cards for her personal benefit. She said initially when the food card program started at the facility, they were told repeatedly to use the cards and spend the money, if not they would lose the money at the end of the month. When questioned if the facility told her, it was ok for the staff to use the resident cards for their personal use, she said they did not specifically tell her that. She said she made purchases for herself at the end of the month with the resident food cards when she knew they had money left on the cards and they were about to get reloaded. She said she would not like it if someone took advantage of a family member if they were in a facility. She said it would be hurtful to think someone did that to a family member of hers. She said what she did was theft. She said she took an unethical route and accepted full responsibility for her actions. She said she could not remember how many purchases she made but thinks she only used cards for her personal benefit at the end of June and July 2025. She said she had annual training on abuse.During a phone interview on 10/9/2025 at 10:15 a.m., loss prevention manager at [store name] said all the receipts that were in question from June 2025, July 2025, and August 2025 was all purchased by the same person (BOM/[NAME]).During a phone interview on 10/9/2025 at 10:18 a.m., the detective assigned to the case said he was off yesterday 10/8/2025. He said the initial reporting officer indicated in his narrative that the Administrator of the facility had filed a report on 10/7/2025 to report a staff member had been using the debit cards of residents in the facility. He said the investigation was ongoing and the police report would not be available for a while.Record review of a facility policy titled And More Grocery Benefit Card by PPHP dated 1/10/2025 indicated, .The $100 grocery benefit card should be stored in the business office and made available to the responsible party or the resident themselves. The community LED will also be able to support the use of this card as an activity for the residents. This process will support the utilization for the residents' benefit and appropriate use of their funds as it is intended. 1. Storage a. The grocery benefit cards will need to be stored in a secure location in the business office as they are received via mail. Check in & check out process for the cards may only be exercised by the responsible party for the resident, the resident themselves or the community LED. All staff are expected to adhere to the policy provided for the use of this card to maximize and protect residents' supplemental benefits. 2. The EDO will oversee the proper use of these benefits. 3. [NAME] will: c. keep sign out log in binder-require proper ID. D. Keep all receipts received by the LED of the facility.Record review of a facility policy titled Abuse revised 1/27/2020 indicated, .the purpose of this policy is to ensure that each resident has the right to be free from any type of Abuse and or Misappropriation of property. The facility staff will adhere to the policies and procedures and will follow the guidelines in the written policy and procedure. Event ID: Facility ID: 675398 If continuation sheet Page 5 of 5