Health inspection·November 20, 2025

F 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few EMS, Resident #1 wandered into the wrong room and was struck in the head by an object and fell. Review of the police report dated 11/08/2025 reflected Resident #1 went into another room and Resident #2 got mad and pushed Resident #1 to the ground. Resident #1 with heavy bleeding from the head. Resident #2 wanted to press charges against Resident #1; however, Resident #1 lacked the culpable mental state to commit a crime. Resident #2 possibly committed assault with serious bodily injury against elderly. Review of the NP visit note dated 11/10/2025 reflected Resident #1 was seen for acute visit for agitation, ER visit and medication adjustments. On 11/08/2025, Resident #1 was punched and fell backwards, hit his head and sustained laceration. Resident #2: Review of Resident #2's admission record, dated 11/20/2025, reflected a [AGE] year-old male admitted to the facility on [DATE] and readmitted on [DATE]. Resident #2 had a primary diagnosis of hypertensive emergency (a severe increase in blood pressure that can lead to life-threatening organ damage), along with diagnoses of end stage renal disease, chronic kidney disease, hypertensive encephalopathy (a form of brain dysfunction caused by extremely high blood pressure), depression, cardiomegaly (enlarged heart), and most recently unspecified dementia as of 11/19/2025. Review of Resident #2's admission MDS assessment, dated 10/28/2025, reflected a BIMS score of 11 which indicated moderate cognitive impairment. Under Section E - Behavior: verbal behavioral symptoms directed towards others (e.g., threatening others, screaming at others, cursing at others) and other behavioral symptoms not directed towards others (e.g., physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing or smearing food or bodily wastes, or verbal/vocal symptoms like screaming, disruptive sounds) occurred 1 to 3 days out of a week. Review of Resident #2's care plan, date initiated 11/07/2025, reflected at risk for delirium or acute confusion related to change of condition, change in environment; impaired communication related to hard of hearing; risk of behaviors related to demonstrative physically abusive behaviors, demonstrates verbally abusive behavior.and resident to resident on 11/08/2025; impaired cognition function/thought processes related to memory loss, short term memory loss and at risk behaviors associated with anxiety. Review of Resident #2's doctor orders dated 11/20/2025 reflected an order for Lorazepam 0.5 MG every 6 hours as needed for anxiety. Review of Resident #2's progress notes reflected a history of verbal aggression with staff on 10/28/2025, 11/05/2025, and 11/06/2025. Record review of a progress note date 11/08/2025 at 10:41 AM, written by indicated Resident #2 threatened to hit LVN A member and another resident (Resident #1) that had gone into his room. Staff explained that the other resident has dementia and gets confused - the other resident was redirected away from the resident's room. On 11/08/2025 at 2:51 PM, nurse heard Resident #2 with verbal outburst and cussing and Resident #2 stated, I told them to keep him out of my room. When the nurse looked into Resident #2's room, Resident #1 was observed laying on the floor. Resident #2 was asked if he pushed Resident #1 and Resident #2 stated, Fuck yes I did. Resident #2was escorted out of room, moved to another room, and monitored 1:1 in place. Review of TULIP (an online system used by the Texas Health and Human Services Commission for long-term care licensing, applications, and reporting) facility self-report dated 11/14/2025 reflected Resident #1 wandered into Resident #2's room with his walker. Resident #2 stated that, He (Resident #1) would not leave my room. Staff immediately responded to commotion in Resident #2's room and noted Resident #1 on the floor. Resident #1 stated, He (Resident #2) hit me. Staff immediately separated residents. EMS, police, families, and physicians were all notified. Resident #2 was placed on 1:1 monitoring and moved to a different room. Resident #1's assessment revealed discoloration to the left cheek area, and an open area on right side of scalp and back of head. Resident #1 was sent to the hospital. The facility re-educated staff on facility abuse and neglect policies, resident to resident incidences, and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 2 of 9 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 11/20/2025 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 - Immediate jeopardy to resident health or safety Residents Affected - Few identification/de-escalation of behaviors procedures. The facility investigation findings reported as unfounded. During an interview with the ADM on 11/19/2025 at 9:20 A.M., the ADM stated he did not witness the altercation between Resident #1 and Resident #2. The ADM stated that the incident was unfounded because he did not feel like there was a system failure. Furthermore, Resident #2 stated, He responded in self-defense when he hit Resident #1. The ADM stated that Resident #1 was on the floor and could have fallen, and his injuries could have been sustained by a fall. There were no witnesses. The discoloration of the face would likely be from Resident #2 hitting Resident #1, but the head injury could have come from Resident #1 hitting the edge of the door when he fell. The ADM stated that Resident #2 could be aggressive with staff, but not with residents. The ADM stated that he felt the facility was equipped to handle the behaviors of the residents and did not think there was a risk of having aggressive residents. During an interview and observation with Resident #1 on 11/19/2025 at 11:26 A.M., he was in a wheelchair monitored by staff. Resident #1 was not oriented and was unable to answer questions about the incident. He stated he was a farmer and hurt his head while working. During an interview and observation with Resident #2 on 11/19/2025 at 12:03 PM, Resident #2 was lying in bed. He had his shirt off and a port access in his chest. He recalled the incident with Resident #1 and stated that before the incident occurred, Resident #1 came into his room telling him he needed to put on shoes and come outside. Resident #2 thought Resident #1 was nice at first, but then Resident #1 kept talking, not making sense, and would not leave the room. Resident #2 told Resident #1, If you are looking for trouble, you're in the wrong place. He didn't understand why Resident #1 would not leave his room and felt like he was being threatened. Resident #2 stated, what kind of game is he (Resident #1) playing? I didn't know what was going on. Is he testing me? Resident #1 left the room. Later, Resident #1 came into Resident #2's room with his walker and started getting in his (Resident #2) space. Resident #2 stated he felt threatened by Resident #1 and was scared. Resident #2 thought Resident #1 was posturing and he told Resident #1 to back up. Resident #1 backed up a little and then suddenly lunged towards Resident #2. Resident #2 stated, I hit him in the face. Resident #1 collapsed to the floor. Resident #2 stated he was protecting himself and said he was not sure why Resident #1 would not leave his room after he had warned Resident #1.During an interview on 11/19/2025 at 2:20 PM, a family member for Resident #1 stated that he was aware of the incident with Resident #1. The family member had accompanied Resident #1 to the hospital when it occurred. The family member stated Resident #1 had some change in behaviors within the last 30-60 days. Resident #1 was urinating in the dining room and wandering into another resident's room, which caused the incident. During an interview on 11/19/2025 at 2:28 PM, the NP stated she was familiar with Resident #1. Resident #1 had dementia, which had been worsening, and the NP had several conversations with the RP about having to potentially move Resident #1 to another facility if they could not get his behavior under control. The NP stated on 11/5/2025, the NP saw Resident #1 for worsening behaviors and NP increased Resident #1's medications (Buspar to 10 mg, Lorazepam to 1 m and added Trazadone). The NP had been trying to make a psychiatric referral, but PR had been refusing but finally agreed. The NP talked to the psychiatric NP on 11/19/2025 and Resident #1 will be seen by the psychiatric NP on 11/25/2025 because the NP stated she needed more help in managing Resident #1's behavior and had already done everything within her scope of practice. Resident #1 also had UTIs, which could cause agitation, aggression, and impulsive behaviors. The NP stated there was always a risk of having aggressive residents, but stated Resident #1's aggression was more towards staff than to other residents.During an interview on 11/19/2025 at 3:34 PM, LVN A stated before the incident on 11/08/2025, a CNA told her Resident #1 had wandered into Resident #2's room and Resident #2 got very upset and threatened to hit (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 3 of 9 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 11/20/2025 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 - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Resident #1 if he came back into the room. LVN A stated she did not know the name of the CNA but stated they worked on the 400 hallway. LVN A explained to Resident #2 that Resident #1 had dementia and did not know any better. LVN A stated she notified the ADM and DON. LVN A stated that staff tried to keep an eye on Resident #1, but after she went to lunch, she heard yelling, cursing, and Resident #2 was standing out in the hallway. Resident #2 stated he pushed/hit Resident #1 and she observed Resident #1 lying on the floor by the door in Resident #2's room. LVN A stated she did an assessment and Resident #1 had pooled blood underneath him, redness on his face, wound on the head and she put a bandage on it because it was bleeding. LVN A called the DON, the ADM, 9-1-1 and EMS. LVN A had not known or seen Resident #1 to be aggressive with any other residents prior to the incident; only staff. LVN A had been trained in abuse policy, identification and de-escalation of behaviors, and preventing resident-to-resident altercations.During an interview with the DON on 11/19/2025 at 4:55 PM the DON stated she did know who the C.N.A was who had reported to LVN A before the incident when Resident #1 had wandered into Resident #2's room and Resident #2 had threatened to harm Resident #1 if he returned, she said she would need to investigate that. During an interview with the ADM on 11/20/2025 at 9:23 AM, the State Surveyor asked for all documentation related to the incident on 11/08/2025 as there were no statements or interviews in the provider investigation. Review of the police report reflected Resident #3 was listed as a witness. Review of the facility provider investigation reflected an undated witness statement by Resident #3. Resident #3 had reported Resident #1 came in and Resident #2 punched him.hit him. During an interview with Resident #3 on 11/20/2025 at 2:02 PM, Resident #3 stated he used to be Resident #2's roommate and was lying in bed when the incident occurred on 11/08/2025. Resident #1 came into their room and Resident #2 punched him (Resident #1) in the face as hard as he could. Resident #1 fell backwards and might have hit something. Staff immediately responded and took Resident #2 out of the room and a nurse helped Resident #1. The DON was presented with the IJ template at 11/20/2025 at 6:19 PM and it was explained that the IJ was PNC and there was no current immediacy. During an interview with the DON on 11/20/2025 at 6:45 PM, she stated she did not find out the identity of the CNA that talked to LVN A and warned LVN A that Resident #2 had threatened to hit Resident #1. The DON stated she was not aware of the progress note until the State Surveyor pointed it out in Resident #2's chart. The ADM was unable to interview prior to exit as he had left the facility. Review of in-service dated 11/08/2025 reflected abuse policy, identification and de-escalation of behaviors, and preventing resident-to-resident altercations were reviewed with most staff. Review of facility policy titled Abuse, Neglect, Exploitation, and Misappropriation Prevention Program dated April 2021 reflected, Residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation.1. Protect residents from abuse, neglect, exploitation or misappropriation of property by anyone including, but not necessarily limited to: b. other residents. Review of facility policy titled Identifying Types of Abuse dated September 2022 reflected, 1. Abuse of any kind against residents is strictly prohibited. 4. Abuse is defined as the willful infliction of injury.with resulting physical harm, pain or mental anguish. Physical Abuse: 1. Physical abuse includes, but is not limited to hitting, slapping, biting, punching, or kicking. Review of facility policy titled Resident Rights dated February 2021 reflected:1. Federal and state laws guarantee certain basic rights to all residents of this facility. These rights include the resident's right to: c. be free from abuse, neglect, misappropriation of property, and exploitation. Event ID: Facility ID: 675458 If continuation sheet Page 4 of 9 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 11/20/2025 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure the residents' environment remained as free of accident hazards as was possible and ensure each resident received adequate supervision and assistance devices to prevent accidents for one (Resident #1) of three residents reviewed for accidents and hazards.The facility failed to ensure Resident #1 was free from accidents and hazards, when the facility did not have adequate supervision in place for Resident #1's aggressive and wandering behaviors. On 11/08/2025 at 10:41 AM, Resident #2 threatened to hit Resident #1 because Resident #1 was entering his room. Resident #1 wandered into Resident #2's room on 11/08/2025 at 2:51 PM, and Resident #2 hit Resident #1. Resident #1 was sent to the hospital on [DATE], treated for head injury and scalp laceration, and received staples to the posterior scalp. The noncompliance was identified as PNC. The IJ began on 11/08/2025 and ended on 11/08/2025. The facility had corrected the noncompliance before the survey began. This deficient practice placed residents at risk of injury and hospitalization.Findings included: Review of Resident #1's admission record, dated 11/19/2025, reflected an [AGE] year-old male admitted to the facility on [DATE]. Resident #1 had diagnoses that included: Alzheimer's disease (a form of dementia that worsens over time), unspecified dementia, unsteadiness of feet, depression, and COVID-19. Review of Resident #1's Quarterly MDS assessment, dated 08/09/2025, reflected a BIMS score of 3 which indicated significant cognitive impairment. Under section E- Behavior, there were no behaviors listed, except for wandering occurring daily. Review of Resident #1's care plan, last revised on 11/13/2025, reflected at risk for falls related to Use of Psychoactive Medication, Wandering behavior and Unsteady Gait/Balance with interventions listed as Monitor for restlessness and implement interventions. Also, impaired cognitive function/dementia/thought processes related to Alzheimer's disease; at risk for injury related to wandering behavior, impaired safety awareness with interventions Encourage to stay in common areas of building for observation if needed and redirect back to area of familiarity if disoriented/irritable such as room or activity room; and potential for complication related to diagnosis of depression. Review of NP visit dated 11/05/2025 reflected Resident #1 was seen for acute visit for agitation and behaviors of urinating in the dining room, making statements he will kill employees; running down the hallways, and increased restlessness. Medications were adjusted at that time. The family agreed to psychiatric to follow up next week if behaviors continue to increase or remain unchanged. Review of Resident #1's progress notes reflected a history of aggression with staff, increased wandering, and agitation from 10/25/2025 to 11/07/2025. Further review reflected on 11/08/2025, at 2:51 pm, Resident #1 wandered into Resident #2's room. Resident #2 admitted pushing Resident #1 to the ground and Resident #1 was observed lying on the floor, with blood on floor. Review of Resident #1's physician orders on 11/19/2025 reflected sertraline for depression (order date 10/29/2025), trazadone for insomnia (order date 11/05/2025), and buspirone (order date 11/05/2025), Depakote tablet (order date 11/13/2025), and Ativan (Lorazepam) for anxiety (order date 11/20/2025). Record review of Resident #1's incident report dated 00/00/00, reflected on 11/08/2025, at 2:51 P.M., Resident #1 wandered into Resident #2's room. Resident #2 admitted pushing Resident #1 to the ground and Resident #1 was observed lying on the floor, with blood on floor. Resident #1 had a head laceration to side and back of head and discoloration to left cheek.Review of Resident #1's hospital Discharge summary dated [DATE] reflected the resident was seen for assault, hit head, head injury, scalp laceration, and received stitches. Per EMS, Resident #1 wandered into the wrong room and was struck in the head by an object and fell.Resident #2: Review of Resident #2's admission record, dated 11/20/2025, reflected a [AGE] year-old male admitted to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 5 of 9 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 11/20/2025 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few the facility on [DATE] and readmitted on [DATE]. Resident #2 had a primary diagnosis of hypertensive emergency (a severe increase in blood pressure that can lead to life-threatening organ damage), along with diagnoses of end stage renal disease, chronic kidney disease, hypertensive encephalopathy (a form of brain dysfunction caused by extremely high blood pressure), depression, cardiomegaly (enlarged heart), and most recently unspecified dementia as of 11/19/2025. Review of Resident #2's admission MDS assessment, dated 10/28/2025, reflected a BIMS score of 11 which indicated moderate cognitive impairment. Under Section E - Behavior: verbal behavioral symptoms directed towards others (e.g., threatening others, screaming at others, cursing at others) and other behavioral symptoms not directed towards others (e.g., physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing or smearing food or bodily wastes, or verbal/vocal symptoms like screaming, disruptive sounds) occurred 1 to 3 days out of a week. Review of Resident #2's doctor orders dated 11/20/2025 reflected an order for Lorazepam 0.5 MG every 6 hours as needed for anxiety. Review of Resident #2's care plan, date initiated 11/07/2025, reflected at risk for delirium or acute confusion related to change of condition, change in environment; impaired communication related to hard of hearing; risk of behaviors related to demonstrative physically abusive behaviors, demonstrates verbally abusive behavior.and resident to resident on 11/08/2025; impaired cognition function/thought processes related to memory loss, short term memory loss and at risk behaviors associated with anxiety. Review of Resident #2's progress notes reflected a history of verbal aggression with staff 10/28/2025, 11/05/2025, and 11/06/2025. On 11/08/2025 at 10:41 AM, Resident #2 threatened to hit LVN A and another resident (Resident #1) that had gone in his room. Staff explained that the other resident has dementia and gets confused - the other resident was redirected away from the resident's room. On 11/08/2025 at 2:51 PM, nurse heard Resident #2 with verbal outburst and cussing and Resident #2 stated, I told them to keep him out of my room. When the nurse looked into Resident #2's room, Resident #1 was observed laying on the floor. Resident #2 was asked if he pushed Resident #1 and Resident #2 stated, Fuck yes I did. Resident #2 was escorted out of room, moved to another room, and monitored 1:1 in place. During an interview and observation with Resident #1 on 11/19/2025 at 11:26 A.M., he was in a wheelchair monitored by staff. Resident #1 was not oriented and was unable to answer questions about the incident. He stated he was a farmer and hurt his head while working. Several staff members were in the hallway redirecting him. During an interview with the HA on 11/19/2025 at 11:26 A.M. and 3:21 PM, she stated Resident #1 was being monitored because he wandered into another resident's room and she was told to redirect him. The HA did not witness the incident but did receive abuse in service training and named the ADM as the abuse coordinator. The HA had not received any training regarding monitoring Resident #1 and has not documented the monitoring anywhere. If she had any concerns, she would tell the nurse or DON. During an interview on 11/19/2025 at 2:20 PM, a family member stated that he was aware of the incident with Resident #1. A family member had accompanied Resident #1 to the hospital when it occurred. The family member stated Resident #1 had some change in behaviors within the last 30-60 days. Resident #1 was urinating in the dining room and wandering into another resident's room, which caused the incident. During an interview on 11/19/2025 at 2:28 PM, the NP stated she was familiar with Resident #1. The NP stated that staff were watching Resident #1 to monitor his behaviors. There were no official orders for 1:1 as that was done by the facility. The NP stated that the facility did not have to have a doctor's orders for 1:1 monitoring. The NP did not know when 1:1 started, but stated the DON told her the 1:1 was due to Resident #1 being unpredictable. The NP started residents with dementia that had COVID-19, it caused a change in behavior. Resident #1 also had UTIs, which could cause agitation, aggression, and impulsive (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 6 of 9 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 11/20/2025 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few behaviors. The NP stated there was always a risk of having aggressive residents, but stated Resident #1's aggression was more towards staff than to other residents. During an interview on 11/19/2025 at 3:14 PM, the DON stated Resident #1 had been on 1:1 since he returned from the hospital and the incident on 11/08/2025. The DON stated that the 1:1 was ordered for Resident #2 by the on-call provider, but they realized Resident #2 did not need it and put the 1:1 on Resident #1 to monitor for increased wandering behaviors after he had COVID-19. The DON stated Resident #1 was not a threat to anyone, but since he had COVID-19, his behaviors had changed. The DON stated there was a hospitality aid that monitored Resident #1 during the day from 7 AM to 4 PM and then another aid that monitored Resident #1 from about 5:45 PM to 10:30 PM. The night nursing staff monitor Resident #1 at night if needed, but they don't have any problems with him after he went to bed at night. The DON stated that all staff were responsible for doing the 1:1 monitoring and she was doing the monitoring now with Resident #1 in her office. During an observation on 11/19/2025 at 3:21 PM, Resident #1 was observed sitting in a wheelchair in the DON's office. He was calm with no concerns observed. He was surrounded by the HA and two treatment nurses. During an interview on 11/19/2025 at 3:34 PM, LVN A stated Resident #1 had been wandering more and going in and out of residents' rooms and appeared more confused. The UA was negative for a UTI, but the NP put him on antibiotics for precaution for UTI. LVN A stated there were multiple acts of aggression towards staff. Resident #1 grabbed the LVN's arms the day prior to the incident. Resident #1 had grabbed the Medication aid's blood pressure cuff and would not give it back. Resident #1 tried to hit LVN A and pushed LVN A. LVN A stated that she called the NP and was given approval to give Resident #1 psychotropic medication. LVN A stated that Resident #1 was put on 1:1 after he returned from the hospital due to him wandering. LVN A stated that when leadership was in the building, they would monitor him, do activities with him, and stay with him in his room. LVN A stated they have a sheet where they document monitoring, but she was not aware of a monitoring sheet for Resident #1 because she had not done 1:1 with resident; she only did frequent rounding. LVN A stated she monitored Resident #1 for aggressive behaviors and wandering and would redirect if he tried to go into another resident's room. During an interview on 11/19/2025 at 4:12 PM, CNA B stated that since the incident on 11/08/2025, Resident #1 was always monitored by staff for behavior and wandering. She had not been asked to monitor Resident #1 and stated that the nurses were responsible for completing the monitoring log. She had not been trained in monitoring Resident #1. On 11/19/2025 at 4:16 PM, surveyor received and reviewed a copy of Resident #1's Frequent Monitoring Record dated 11/10/2025 - 11/19/2025, which reflected Resident #1 was monitored by staff every 30 minutes. During an interview on 11/19/2025 at 4:20 PM, LVN B stated was familiar with Resident #1. Resident #1 had increased agitation and aggression, and wandering in and out of other residents' rooms. LVN B stated that since the incident, Resident #1 had been on 1:1 monitoring and the nurses were responsible for monitoring and documenting in the progress notes. The surveyor showed LVN B the monitoring logs for Resident #1. LVN B stated she did not fill that out; did not know who did but stated that form was used for monitoring. During an interview on 11/19/2025 at 4:55 PM, the DON stated that the hospitality aids do not have access to PCC, so the DON had been filling out the Monitoring sheets for Resident #1. The 1:1 was not official, but it was for his safety. Staff were always with Resident #1 and staff took him into the activity room or other offices to monitor him for behavior and wandering. The DON stated they were trying to determine the root cause of these new wandering behaviors. Resident #1 had never been the aggressor before. The DON stated that she was going to in service all staff about documenting behaviors in PCC, monitoring Resident #1 and ensure the monitoring was document (on forms or in PCC). The DON stated she would get a doctor's order to make the monitoring (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 7 of 9 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 11/20/2025 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few official. The DON stated that the family was aware of the monitoring, and the facility might have to discharge Resident #1 to a locked facility if they could not determine the cause of his recent decline. The DON stated that Resident #1's care plan was updated about his wandering behavior. The State Surveyor asked about his behaviors of threatening to kill staff, trying to hit LVN A, grabbing hold of hospice aid's arm, grabbing hold of medication aid's cart, trying to stab staff with a fork, urinating on the dining room floor and other examples of behaviors listed in the progress notes. The DON stated those behaviors (aggressive) and the 1:1 monitoring had not been updated in his care plan and needed to be so that staff knew about them. The DON stated she would update the care plan. During an interview with the ADM on 11/19/2025 at 5:06 PM, he stated he would have the DON provide in-service training to all staff about monitoring Resident #1 and filing out the monitoring form or documenting in PCC. The ADM stated he expected to be notified of increased aggression or if Resident #1 hit another resident or staff or any behavior consistent with abuse or neglect. Observations on 11/19/2025 and 11/20/2025 revealed Resident #1 was safe, not aggressive, calm, monitored by staff, and receptive to staff's redirection. During an interview on 11/20/2025 at 8:35 AM, LVN B stated Resident #1 now had a doctor's orders for 1:1 monitoring. LVN B stated she worked 6 AM to 6 PM and had not been in-serviced 11/19/2025 or 11/20/2025 but had received in-service training this month about monitoring Resident #1 and documenting in his progress notes. She had monitored Resident #1 and there had been no behavior. During an interview on 11/20/2025 at 8:38 AM, RN stated she was not sure if Resident #1 was on 1:1 monitoring, but staff were always with him. The RN sat with Resident #1 at breakfast and had him with her in her office on 11/19/2025. The RN had not been in-serviced 11/19/2025 or 11/20/2025 about monitoring Resident #1 or documenting behaviors but had received in-service training about Resident #1 last week on monitoring and documentation. During an interview on 11/20/2025 at 9:52 AM, the DM stated she knew Resident #1 and he had a change in behavior about two weeks ago. She had not been in-serviced about monitoring Resident #1 or documenting behaviors. The DM stated she knew Resident #1 was on 1:1 monitoring due to his behavior (confused, agitated, going in and out of residents' rooms). The DM stated staff were always sitting with Resident #1 at the dining room table, but she did not know how long the 1:1 had been going on. During an interview on 11/20/2025 at 10:05 AM, the SS stated she knew Resident #1 and he had a change in behavior about two weeks ago. Staff must redirect him a lot and staff were always with Resident #1. The SS stated that she had Resident #1 in her office a lot because he had been wandering into other residents' rooms, but she did not know if he had an order for 1:1 monitoring. The SS stated she had been in-serviced on 11/19/2025 regarding monitoring and documenting changes of behaviors in the resident's chart. During an interview on 11/20/2025 at 5:29 PM, CNA D stated he worked with Resident #1. Resident #1 tried to hit staff with his walker in the past. He provided 1:1 monitoring to Resident #1 to prevent wandering into other residents' rooms and would redirect Resident #1. He had received in-service training on monitoring on 11/19/2025, but was not in-service on abuse policy, resident to resident altercations or de-escalation on 11/08/2025 because he was out on leave. He had received that training before and named the ADM as the abuse coordinator. Review of Resident #1's orders as of 11/20/2025 reflected a new order dated 11/19/2025 to begin 11/20/2025: 1:1 monitoring with all activities, document any behaviors in progress noted, and notify provider, the DON, and the ADM every shift for routine monitoring. The DON was presented with the IJ template at 11/20/2025 at 6:19 PM and it was explained that the IJ was PNC and there was no current immediacy. The ADM was not available for interview prior to exit as he had left the facility. Review of facility policy titled Accidents and Supervision dated 05/16/2025, reflected: Policy: The resident environment will remain as free of accident hazards as is possible. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 8 of 9 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 11/20/2025 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Each resident will receive adequate supervision and assistive devices to prevent accidents. This includes: 1. Identifying hazard(s) and risk(s).2. Evaluating and analyzing hazard(s) and risk(s). 3. Implementing interventions to reduce hazard(s) or risk(s). 4. Monitoring for effectiveness and modifying interventions as necessary. Definitions: Risk refers to any external factor, facility characteristic (e.g. staffing or physical environment) or characteristic of an individual resident that influences the likelihood of an accident. Supervision/Adequate Supervision refers to intervention and means of mitigating risk of an accident. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675458 If continuation sheet Page 9 of 9