Health inspection·April 16, 2024

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few that Resident #1 had fallen so she began to walk from the dining room to the hallway to make a PRN visit since Resident #1 had fallen. The Hospice RN stated the DON had Resident #1 in her wheelchair and said, if you don't do something about this fucking patient, I'm going to stab her in the neck. The Hospice RN stated the DON made a motion with her hand as if she were holding a knife and put her hand up to her own (the DON's) neck. The Hospice RN stated the reason Resident #1 left the facility was because she needed a memory care unit and at the time of the incident on 4/03/2024, they were already looking at alternate placement because Resident #1 had fallen 12-15 times since she was admitted . The Hospice RN stated Resident #1 could not recall what the DON had said because she had advanced Alzheimer's disease. The Hospice RN said when she assessed Resident #1, Resident #1 stated, that's all I wanted, sweetheart. The Hospice RN stated she thought the DON was very frustrated with Resident #1 and that Resident #1 could be a difficult patient, but it was her disease. The Hospice RN stated Resident #1 had the mind of an 18-month-old child, she was regressing and you could tell the DON was irritated or annoyed. The Hospice RN stated she left the facility that day (4/03/2024) in tears because she trusts these people to take care of her residents. The Hospice RN stated if something were to happen to Resident #1, she would never forgive herself for not reporting the incident. The Hospice RN stated the Administrator pulled her in his office and she knew the DON was suspended for 2 days after the incident. The Hospice RN stated she was told there was nothing the facility could do because it was a he said, she said thing. During an interview on 4/16/2024 at 11:09 a.m., the DON stated she started working at the facility in November of 2023. The DON stated Resident #1 was admitted due to having increased falls at home, her dementia was pretty severe upon arrival, she was admitted on hospice and she required extensive to total care when she arrived. The DON stated Resident #1 required lots of care and none of it was affective. The DON stated, this place probably wasn't the best for her and she wasn't a bad patient, she wasn't screaming out all night, but she definitely needed one-on-one care. The DON stated it was a frustrating situation for staff because they did not know how to handle one-on-one care when they had a whole hall. The DON stated, there was nothing wrong with her except for her falling and needing one-on-one care with extra assistance. The DON stated the hospice birthday party was on a Wednesday or Thursday and they had a huge gathering in the dining room. The DON stated Resident #1 was roaming all over the place so we asked hospice for help. The DON stated Resident #1 had fallen on the 200 hall so she picked her up, told the Hospice RN she had a fall and handed off Resident #1 to the Hospice RN so she could do a PRN visit. The DON stated she had a pretty frustrating workload that week because she was on the floor working as a med aide and CNA, and she did not have any help. The DON stated, I do get a little frustrated, don't get me wrong but said it was not anything she could not handle. The DON stated, we're always understaffed and said she was the only nurse manager. The DON stated, when people call in, it's frustrating because no one can help me do my job. The DON stated, I honestly couldn't tell you if she said something out of frustration or by accident that she did not mean to say and stated, I tried to go back and figure it out. The DON stated, I'm not gonna say nothing came out of my mouth. The DON stated sometimes she should say she would stab herself in the neck and maybe staff heard it and it may have been misinterpreted. The DON stated she would never hurt a resident or take any aggression out on a resident. The DON stated, I'm not going to say I didn't because I don't know what I said at the time in question. The DON stated yeah that threatening to stab a resident in the neck would be considered verbal abuse. The DON stated right that she did not recall what she said. The DON stated she never got that rapport with the Hospice RN, it was nothing against her, and the hospice agency had not been very communicative. The DON stated she was not a firm believer in hospice companies, and she did not (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 2 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few feel like hospice companies needed to be in nursing facilities but there were already here. The DON stated if she said she stabbed herself, she was usually joking, and it was not taken seriously. The DON stated she was suspended until Tuesday 4/09/2024 and they did an all staff abuse education. The DON stated she was taking some courses with the Administrator but I haven't started it yet. The DON stated the Administrator told her they would get with corporate on which courses to take. The DON stated she had been trained on abuse, neglect, and exploitation during orientation. The DON stated if residents were verbally threatened, it could be harsh on them, they could fear their lives, and I could see where it could be hurtful for them. During an interview on 4/26/2024 at 1:23 p.m., Resident #1's family member stated the facility never contacted family in regard to the incident, but she did hear about it. Resident #1's family member stated she had not questioned Resident #1's safety and her reason for discharging from the facility was unrelated to the incident on 4/03/2024. During an interview on 4/16/2024 at 2:14 p.m., the SW stated she was unaware of the incident on 4/03/2024 and had not spoken to Resident #1 regarding it. During an interview on 4/16/2024 at 3:11 p.m., the Administrator stated he did safe surveys with residents on Resident #1's hall and there was nothing in that area. The Administrator stated the SW met with Resident #1 and corporate wanted a level of discretion to not prove the DON guilty before completing the investigation. The Administrator stated upon learning of the allegation, he joined a group call with hospice while hospice notified Resident #1's family and physician. The Administrator stated the facility left messages for the medical director but did not hear back. The Administrator stated corporate made the decision to not discuss it since there was not proof of abuse. The Administrator stated he discussed the incident with Resident #1's RP the next day. The Administrator stated the policy on preventing abuse was education on what it was and how to recognize it. The Administrator stated staff, including the DON, were in-serviced on abuse through in-services and computer-based trainings. The Administrator stated he did not know corporate wanted to do specific in-services with the DON. The Administrator stated the incident on 4/03/2024 was he said she said and ultimately, [the DON] said she didn't do it. The Administrator stated he went over professionalism and what was verbal abuse with the DON. The Administrator stated he felt like the Hospice RN feared retaliation. The administrator stated residents were protected from abuse while allegations were being investigated by removing the staff member and said the DON was suspended for 3 or 4 days. When asked why the DON returned a day prior to his PIR being submitted, the Administrator stated, I completed it on that Monday (4/08/2024) we did the education . The Administrator stated a potential negative outcome for residents if they were to be verbally abused included depression, fear and anxiety. When asked about the incident, the Administrator stated the DON told him she had not said anything out of the ordinary. A record review of the facility's in-service training dated 4/05/2024 reflected staff were trained on abuse, language in the hallways, verbal abuse and reporting abuse. The sign-in sheet did not reflect the DON's name. A record review of the DON's training record reflected she was trained on resident rights, dementia and abuse, neglect and exploitation on 11/01/2023. A record review of the facility's training document dated 4/08/2024 reflected the DON was given counseling from the Administrator and provided education on language around staff and residents and professional behavior. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 3 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0600 Level of Harm - Minimal harm or potential for actual harm A record review of the facility's PIR dated 4/10/2024 reflected yes a statement from the DON was attached, however, no statement was attached. A record review of safe surveys reflected the Administrator interviewed 4 residents on 4/05/2024 with no safety concerns reported Residents Affected - Few A record review of the facility's policy titled Resident Rights dated February 2021 reflected the following: Policy Statement Employees shall treat all residents with kindness, respect, and dignity. Policy Interpretation and Implementation 1. Federal and state laws guarantee certain basic rights to all residents of this facility. These rights include the resident's right to: a. a dignified existence; b. be treated with respect, kindness, and dignity; c. be free from abuse, neglect, misappropriation of property. and exploitation; A record review of the facility's policy titled Abuse, Neglect, Exploitation and Misappropriation Prevention Program dated April 2021 reflected the following: Policy Statement Residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. This includes but is not limited to freedom from corporal punishment, involuntary seclusion, verbal, mental. sexual or physical abuse, and physical or chemical restraint not required to treat the resident's symptoms. Policy Interpretation and Implementation The resident abuse, neglect and exploitation prevention program consists of a facility-wide commitment and resource allocation to support the following objectives: 1. Protect residents from abuse, neglect, exploitation or misappropriation of property by anyone including, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 4 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0600 but not necessarily limited to: Level of Harm - Minimal harm or potential for actual harm a. facility staff; 3. Ensure adequate staffing and oversight/support to prevent burnout, stressful working situations and high Residents Affected - Few turnover rates. 5. Establish and maintain a culture of compassion and caring for all residents and particularly those with behavioral, cognitive or emotional problems. 7. Implement measures to address factors that may lead to abusive situations, for example: a. adequately prepare staff for caregiving responsibilities; b. provide staff with opportunities to express challenges related to their job and work environment without reprimand or retaliation; c. instruct staff regarding appropriate ways to address interpersonal conflicts; A record review of the facility's policy titled Identifying Types of Abuse dated September 2022 reflected the following: Policy Statement As part of the abuse prevention strategy, volunteers, employees and contractors hired by this facility are expected to be able to identify the different types of abuse that may occur against residents. Policy Interpretation and Implementation 1. Abuse of any kind against residents is strictly prohibited. . 4. Abuse'' is defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. a. Abuse also includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 5 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0600 b. Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical Level of Harm - Minimal harm or potential for actual harm harm, pain or mental anguish. c. Abuse includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse facilitated Residents Affected - Few or enabled through the use of technology. 5. Abuse toward a resident can occur as: . b. staff-to-resident abuse; or Mental and Verbal Abuse . 2. Verbal abuse may be considered to be a type of mental abuse. Verbal abuse includes the use of verbal, written or gestured communication, or sounds, to residents within hearing distance, regardless of age, ability to comprehend, or disability. 3. Examples of mental and verbal abuse include. but are not limited to: . d. threatening residents, including but not limited to, depriving a resident of care or withholding a resident from contact with family and friends Psychosocial Outcomes I. Some situations of abuse do not result in an observable physical injury or the psychosocial effects of abuse may not be immediately apparent. In addition, the alleged victim may not report abuse due to shame, fear. or retaliation. Other residents may not be able to speak due to a medical condition and/or cognitive impairment (e.g., stroke, coma, Alzheimer's disease), cannot recall what has occurred, or may not express outward signs of physical harm, pain, or mental anguish. Neither physical marks on the body nor the ability to respond and/or verbalize is needed to conclude that abuse [NAME] occurred. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 6 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0610 Respond appropriately to all alleged violations. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to have evidence that all alleged violations of abuse were thoroughly investigated for 1 (Resident #1) of 8 residents reviewed for abuse allegations. Residents Affected - Few The facility failed to obtain written statements from staff and the alleged perpetrator of verbal abuse of Resident #1. The facility failed to contact the ombudsman in regard to an allegation of abuse for Resident #1. The facility failed to have the SW assess Resident #1 for emotional trauma after an allegation of abuse. The facility failed to keep Resident #1's family informed of the progress of the investigation. The facility failed to document the investigation completely and thoroughly for Resident #1. The facility failed to assess Resident #1 after an allegation of verbal abuse. These failures placed resident at risk for uninvestigated and continued abuse. Findings included: A record review of Resident #1's face sheet dated 4/16/2024 reflected an [AGE] year-old female admitted on [DATE] with diagnoses of unspecified dementia, depression, hypertension (high blood pressure), delusional disorder, Alzheimer's disease (type of dementia), lymphedema (localized swelling), anxiety disorder and gastro-esophageal reflux disease (acid reflux). A record review of Resident #1's admission MDS assessment dated [DATE] reflected a BIMS score of 00, which indicated severely impaired cognition. Resident #1's MDS assessment reflected she had fallen in the last month, and required substantial assistance to partial assistance with toileting, hygiene and dressing. Resident #1's MDS assessment reflected no behavioral symptoms were present. A record review of Resident #1's care plan last revised on 4/15/2024 reflected Staff will treat me with dignity and respect. Resident #1's care plan reflected she had been discharged from the facility and had falls on 3/22/2024, 3/23/2024, 3/24/2024, 3/25/2024, 3/26/2024, 4/01/2024, 4/02/2024 and 4/06/2024. A record review of Resident #1's assessments reflected no skin assessments were completed for Resident #1 on 4/03/2024. A record review of Resident #1's document titled Visit Note Report dated 4/03/2024 reflected the Hospice RN assessed Resident #1's skin, and found no injuries. During an interview on 4/16/2024 at 9:33 a.m., the Hospice RN stated she did not want any retaliation from the DON. During an interview on 4/16/2024 at 9:58 a.m., the Hospice RN stated she was at the facility on (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 7 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 4/03/2024 for another resident's birthday party. The Hospice RN stated the Dietary Manager told her that Resident #1 had fallen so she began to walk from the dining room to the hallway to make a PRN visit since Resident #1 had fallen. The Hospice RN stated the DON had Resident #1 in her wheelchair and said, if you don't do something about this fucking patient, I'm going to stab her in the neck. The Hospice RN stated the DON made a motion with her hand as if she were holding a knife and put her hand up to her own (the DON's) neck. The Hospice RN stated the reason Resident #1 left the facility was because she needed a memory care unit and at the time of the incident on 4/03/2024, they were already looking at alternate placement because Resident #1 had fallen 12-15 times since she was admitted . The Hospice RN stated Resident #1 could not recall what the DON had said because she had advanced Alzheimer's disease. The Hospice RN said when she assessed Resident #1, Resident #1 stated, that's all I wanted, sweetheart. The Hospice RN stated she thought the DON was very frustrated with Resident #1 and that Resident #1 could be a difficult patient, but it was her disease. The Hospice RN stated Resident #1 had the mind of an 18-month-old child, she was regressing and you could tell the [NAME] was irritated or annoyed. The Hospice RN stated she left the facility that day (4/03/2024) in tears because she trusts these people to take care of her residents. The Hospice RN stated if something were to happen to Resident #1, she would never forgive herself for not reporting the incident. The Hospice RN stated the Administrator pulled her in his office and she knew the DON was suspended for 2 days after the incident. The Hospice RN stated she was told there was nothing the facility could do because it was a he said, she said thing. During an interview on 4/16/2024 at 11:09 a.m., the DON stated she started working at the facility in November of 2023. The DON stated Resident #1 was admitted due to having increased falls at home, her dementia was pretty severe upon arrival, she was admitted on hospice and she required extensive to total care when she arrived. The DON stated Resident #1 required lots of care and none of it was affective. The DON stated, this place probably wasn't the best for her and she wasn't a bad patient, she wasn't screaming out all night, but she definitely needed one-on-one care. The DON stated it was a frustrating situation for staff because they did not know how to handle one-on-one care when they had a whole hall. The DON stated, there was nothing wrong with her except for her falling and needing one-on-one care with extra assistance. The DON stated the hospice birthday party was on a Wednesday or Thursday and they had a huge gathering in the dining room. The DON stated Resident #1 was roaming all over the place so we asked hospice for help. The DON stated Resident #1 had fallen on the 200 hall so she picked her up, told the Hospice RN she had a fall and handed off Resident #1 to the Hospice RN so she could do a PRN visit. When asked about her workload that week, the DON stated it was pretty frustrating because she was on the floor working as a med aide and CNA, and she did not have any help. The DON stated, I do get a little frustrated, don't get me wrong but said it was not anything she could not handle. The DON stated, we're always understaffed and said she was the only nurse manager. The DON stated, when people call in, it's frustrating because no one can help me do my job. When asked if in her frustration that day, if she said something by accident that she did not mean, the DON stated, I honestly couldn't tell you and I tried to go back and figure it out. The DON stated, I'm not gonna say nothing came out of my mouth. The DON stated sometimes she should say she would stab herself in the neck and maybe staff heard it and it may have been misinterpreted. The DON stated she would never hurt a resident or take any aggression out on a resident. The DON stated, I'm not going to say I didn't because I don't know what I said at the time in question. The DON stated yeah that threatening to stab a resident in the neck would be considered verbal abuse. The DON stated right that she did not recall what she said. The DON stated she never got that rapport with the Hospice RN, it was nothing against her, and the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 8 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few hospice agency had not been very communicative. The DON stated she was not a firm believer in hospice companies, and she did not feel like hospice companies needed to be in nursing facilities but there were already here. The DON stated if she said she stabbed herself, she was usually joking, and it was not taken seriously. The DON stated she was suspended until Tuesday 4/09/2024 and they did an all staff abuse education. The DON stated she was taking some courses with the Administrator but I haven't started it yet. The DON stated the Administrator told her they would get with corporate on which courses to take. The DON stated she had been trained on abuse, neglect, and exploitation during orientation. The DON stated if residents were verbally threatened, it could be harsh on them, they could fear their lives, and I could see where it could be hurtful for them. An attempt was made on 4/16/2024 at 1:09 p.m. to interview Resident #1's RP, however he was non-interviewable . During an interview on 4/26/2024 at 1:23 p.m., Resident #1's family member stated the facility never contacted family regarding the incident, but she did hear about it. Resident #1's family member stated she had not questioned Resident #1's safety and her reason for discharging from the facility was unrelated to the incident on 4/03/2024. During an interview on 4/16/2024 at 2:14 p.m., the SW stated she was unaware of the incident on 4/03/2024 and had not spoken to Resident #1 regarding it. The SW stated the last time she did safe surveys was at the end of March 2024. During an interview on 4/16/2024 at 3:11 p.m., the Administrator stated he did safe surveys with residents on Resident #1's hall and there was nothing in that area . The Administrator stated the SW met with Resident #1 and corporate wanted a level of discretion to not prove the DON guilty before completing the investigation. The Administrator stated upon learning of the allegation, he joined a group call with hospice while hospice notified Resident #1's family and physician. The Administrator stated corporate made the decision to not discuss it since there was not proof of abuse. The Administrator stated there was no one to interview as a potential witness to the incident on 4/03/2024. The Administrator stated the SW met with Resident #1. The Administrator stated staff, including the DON, were in-serviced on abuse through in-services and computer-based trainings. The Administrator stated he did not know corporate wanted to do specific in-services with the DON. The Administrator stated the incident on 4/03/2024 was he said she said and ultimately, [the DON] said she didn't do it. The Administrator stated he went over professionalism and what was verbal abuse with the DON. The Administrator stated he felt like the Hospice RN feared retaliation. The administrator stated residents were protected from abuse while allegations were being investigated by removing the staff member and said the DON was suspended for 3 or 4 days. The Administrator stated 4/10/2024 was when he finished his investigation of the incident. When asked why the DON returned a day prior to his PIR being submitted, the Administrator stated, I completed it on that Monday (4/08/2024) we did the education. The Administrator stated he did not contact the ombudsman regarding the incident and he did not provide updates to Resident #1's family because she had already moved out of the facility at that point. The Administrator stated himself and his regional VP were responsible for ensuring investigations were through. The Administrator stated a nursing incident report was not completed for the incident on 4/03/2024 because we didn't know who made the allegation for 2-3 days. The Administrator stated, we had them put in the skin assessment. The Administrator stated a potential negative outcome for residents if they were to be verbally abused included depression, fear and anxiety. When asked about the incident, the Administrator stated the DON told him she had not said anything out of the ordinary. A record review of the facility's in-service training dated 4/05/2024 reflected staff were trained (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 9 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few on abuse, language in the hallways, verbal abuse and reporting abuse. The sign-in sheet did not reflect the DON's name. A record review of a hospice communication note dated 4/03/2024 reflected the Hospice RN wrote a note for Resident #1 which reflected that when she went to get Resident #1 from the DON, the DON stated, if you don't do something with this fucking patient, I am going to stab her in [the] neck. A record review of the DON's training record reflected she was trained on resident rights, dementia and abuse, neglect and exploitation on 11/01/2023. A record review of the facility's document dated 4/08/2024 reflected the DON was given counseling from the Administrator and provided education on language around staff and residents and professional behavior. A record review of the facility's PIR dated 4/10/2024 reflected yes a statement from the DON was attached, however, no statement was attached. The PIR reflected the following: Agency Immediate Response Staff member [suspended] Nurse assessed resident social worker, admin check in with ms [Resident #1] Family, physician, and admin notified education on abuse, resident to resident encounters working with family and resident to ensure resident feels safe and welcome in facility . Investigation Summary (attach additional sheets as necessary) Form 3613 Page 4 I 03-2023 Following investigation unable to verify accusation. Facility nurse denied making statement and no witnesses present. Education done with staff member on [language] and professionalism in facility. . Investigation Findings Inconclusive Agency Action Post-Investigation continue screening and education for abuse and education with staff on abuse. Staff member able to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 10 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0610 return to work with education. Level of Harm - Minimal harm or potential for actual harm A record review of safe surveys reflected the Administrator interviewed 4 residents on 4/05/2024 with no reported safety concerns. Residents Affected - Few A record review of the facility's policy titled Resident Rights dated February 2021 reflected the following: Policy Statement Employees shall treat all residents with kindness. respect. and dignity. Policy Interpretation and Implementation 1. Federal and state laws guarantee certain basic rights to all residents of this facility. These rights include the resident's right to: a. a dignified existence; b. be treated with respect, kindness, and dignity; c. be free from abuse, neglect, misappropriation of property. and exploitation; A record review of the facility's policy titled Abuse, Neglect, Exploitation or Misappropriation - Reporting and Investigating dated September 2022 reflected the following: All reports of resident abuse (including injuries of unknown origin), neglect. exploitation, or theft/misappropriation of resident property are reported to local, state and federal agencies (as required by current regulations) and thoroughly investigated by facility management. Findings of all investigations are documented and reported. Policy Interpretation and Implementation Reporting Allegations to the Administrator and Authorities 2. The administrator or the individual making the allegation immediately reports his or her suspicion to the following persons or agencies: a. The state licensing/certification agency responsible for surveying/licensing the facility; b. The local/state ombudsman; c. The resident's representative; d. Adult protective services (where state law provides jurisdiction in long-term care); (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 11 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0610 e. Law enforcement officials; Level of Harm - Minimal harm or potential for actual harm f. The resident's attending physician; and g. The facility medical director. Residents Affected - Few 3. Immediately is defined as: a. within two hours of an allegation involving abuse or result in serious bodily injury; or b. within 24 hours of an allegation that does not involve abuse or result in serious bodily injury. 6. Upon receiving any allegations of abuse, neglect, exploitation, misappropriation of resident property or injury of unknown source the administrator is responsible for determining what actions (if any) arc needed for the protection of residents. investigating Allegations 1. All allegations are thoroughly investigated. The administrator initiates investigations. 3. The administrator provides supporting documents and evidence related to the alleged incident to the individual in charge of the investigation. 4. The administrator is responsible for keeping the resident and his/her representative (sponsor) informed of the progress of the investigation. 5. The administrator ensures that the resident and the person(s) reporting the suspected violation are protected from retaliation or reprisal by the alleged perpetrator, or by anyone associated with the facility. 6. Any employee who has been accused of resident abuse is placed on leave with no resident contact until the investigation is complete. 7. The individual conducting the investigation as a minimum: a. reviews the documentation and evidence; b. reviews the resident's medical record to determine the resident's physical and cognitive status at the time of the incident and since the incident; c. observes the alleged victim, including his or her interactions with staff and other residents; d. interviews the person(s) reporting the incident; e. interviews any witnesses to the incident; (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 12 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0610 f. interviews the resident (as medically appropriate) or the resident's representative; Level of Harm - Minimal harm or potential for actual harm g. interviews the resident's attending physician as needed to determine the resident's condition; h. interviews staff members (on all shifts) who have had contact with the resident during the period of the Residents Affected - Few alleged incident; i. interviews the resident's roommate, family members, and visitors; j. interviews other residents to whom the accused employee provides care or services; k. reviews all events leading up to the alleged incident; and l. documents the investigation completely and thoroughly. 8. The following guidelines arc used when conducting interviews: d. Witness statements are obtained in writing, signed and dated. The witness may write his/her statement, or the investigator may obtain a statement. 9. The investigator notifies the ombudsman that an abuse investigation is being conducted. The ombudsman is invited to participate in the review process. a. lf the ombudsman declines the invitation to participate in the investigation, that information is noted in the investigation record. b. The ombudsman is notified of the results of the investigation as well as any corrective measures taken. Follow-Up Report 3. The follow-up investigation report will provide as much information as possible at the time of submission of the report. 4. The resident and/or representative are notified of the outcome immediately upon conclusion of the investigation. Corrective Actions 3. Any allegations of abuse are filed in the accused employee's personnel record along with any statement by the employee disputing the allegation, if the employee chooses to make one. A record review of the facility's policy titled Protection of Residents During Abuse Investigations (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 13 of 14 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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 0610 dated April 2021 reflected the following: Level of Harm - Minimal harm or potential for actual harm Policy Statement Residents Affected - Few Residents are protected from harm, retaliation, reprisal, discrimination or coercion during investigations of abuse, neglect, exploitation and misappropriation of resident property. Policy Interpretation and Implementation 5. The victim is evaluated for his or her feelings of safety. If he or she communicates fear, insecurity, etc., measures are taken to alleviate this (e.g., changing the room assignment or providing more supervision). FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 14 of 14