Inspection·February 27, 2026

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few review of Resident #3's Care Plan, revised 02/26/26, reflected the resident had an acute care plan for COVID-19 infection with interventions that included: allowing the resident to get rest, encouraging fluids, encouraging covering mouth when sneezing and coughing, ensuring infection control measures and PPE is used during care, staying in room and away from people as much as possible, having oxygen available as ordered, listening to lung sounds, and monitoring vital signs. In an observation on 02/27/26 at 8:45 AM, the facility had a sign on the front door that alerted all visitors that the facility had experienced a case of COVID-19 in the last 14 days and masks were required. In an observation on 02/27/26 from 10:42 AM-10:45 AM, the LPC visited with Resident #1 and Resident #2 in their room, which had been designated an isolation room. He then visited Resident #3, who was also in an isolation room. The LPC only wore a cloth face mask when visiting with the residents. He did not put on any of the PPE that was available outside of each isolation room. Each resident's room was also observed to have a sign on the door that informed staff and visitors of the appropriate PPE and precautions to take when entering the room. In an interview on 02/27/26 at 10:45 AM, the LPC stated he noticed the signs at the front door and on resident doors, but he did not read them thoroughly. He stated when he entered the facility, he was not informed by staff that there was a COVID outbreak or informed to wear PPE. The LPC stated he was there to provide counseling services to a few of the residents who happened to be on the isolation hall, and that was how he realized there was an outbreak. The LPC stated he was looking for someone to advise how to proceed. In an interview on 02/27/26 at 10:52 AM, the Administrator stated the facility followed their policy and the CDC guidelines regarding isolation precautions and infection control for COVID. She stated there was currently a COVID outbreak at the facility and they were unsure of the root cause. The Administrator stated it was the facility's policy for contracted workers or vendors to read the posted signs and abide by the policy and procedures. The Administrator stated family members were the only visitors who were encouraged to follow the policy but could not be forced to do so, according to state guidelines. The DON stated the LPC was immediately educated on the facility's infection control policy and told to wear PPE when entering isolation room. The DON also stated she began in-servicing staff on correcting vendors who were not following protocol and reporting to the DON and Administrator. In an interview on 02/27/26 at 3:12 PM with the ED and DON, the DON stated the expectation was for all vendors to follow the facility's infection control policy the same as staff. The DON stated vendors not following the infection prevention policy and isolation precautions could place residents at risk of infection. The Administrator stated the facility followed stated regulations by posting signs at the front door of the facility and on each of the isolation rooms to alert everyone of the COVID outbreak and appropriate protocols. The Administrator revealed it was expected that everyone would read the signs and follow appropriate protocols. Record review of an in-service titled Vendors, dated 02/27/26, reflected staff were educated on informing vendors in the facility to follow policies related to isolation precautions and infection prevention and reporting to the DON or Administrator. Record review of the facility's Infection Control Plan: Overview policy, dated March 2024, reflected the following: Infection ControlThe facility will establish and maintain an Infection Control Program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of disease and infection. Infection Control ProgramThe facility will establish an Infection Control Program under which it - Investigates, controls, and prevents infections in the facility. Decides what procedures, such as isolation, should be applied to an individual resident; and maintains a record of incidents and corrective actions related to infections.Preventing Spread of InfectionWhen the Infection Control Program determines that a resident needs isolation to prevent the spread of infection, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675513 If continuation sheet Page 2 of 3 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 675513 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/27/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Heritage Place of Decatur 605 W Mulberry Decatur, TX 76234 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete the facility will isolate the resident.The facility will require staff to [NAME] and Doff PPE before and after contact with resident who needs isolation to prevent the spread of infection to others in the facility. Review of the Center for Disease Control and Prevention website, <https://www.cdc.gov/covid/hcp/infection-control/index.html>, updated 06/24/24, reflected in part the following.Personal Protective EquipmentHCP who enter the room of a patient with suspected or confirmed SARS-CoV-2 infection should adhere to Standard Precautions and use a NIOSH Approved particulate respirator with N95 filters or higher, gown, gloves, and eye protection (i.e., goggles or a face shield that covers the front and sides of the face) VisitationFor the safety of the visitor, in general, patients should be encouraged to limit in-person visitation while they are infectious. However, facilities should adhere to local, territorial, tribal, state, and federal regulations related to visitation. Additional information about visitation from the Centers for Medicare & Medicaid Services (CMS) is available at Policy & Memos to States and Regions | CMS.Counsel patients and their visitor(s) about the risks of an in-person visit.Encourage use of alternative mechanisms for patient and visitor interactions such as video-call applications on cell phones or tablets, when appropriate.Facilities should provide instruction, before visitors enter the patient's room, on hand hygiene, limiting surfaces touched, and use of PPE according to current facility policy.Visitors should be instructed to only visit the patient room. They should minimize their time spent in other locations in the facility. Event ID: Facility ID: 675513 If continuation sheet Page 3 of 3