Health inspection·August 15, 2025

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few LVN EE documented that Resident #1 appeared to be in no pain and monitoring was conducted. 7/15/25 at 8:37 AM LVN EE documented that Resident #1 had no signs or symptoms of distress noted, resident in good spirits.7/15/25 at 10:13 PM LVN BB documented that Resident #1 had no signs or symptoms of distress and did not complain of any pain.During an interview on 8/14/25 at 12:31 PM, Resident #1 could not recall the incident that occurred between she and Resident #2. She could not identify her last roommate by name. She stated she could not remember if she was afraid on 7/11/25. She could not remember how long she had been in the room that she was and why she had moved. She reported that she felt safe at the facility.Resident #2 Record review of Resident #2's face sheet, dated 8/14/25, revealed a [AGE] year-old-female was admitted to the facility on [DATE] with diagnoses to include intermittent explosive disorder (mental disorder characterized by outburst of anger or violence), anxiety (increased worry) and dementia (memory loss). Record review of Resident #2's Comprehensive Minimum Data Set, dated [DATE], revealed: Section C Brief Interview for Mental Status score revealed a score of 08, which indicated the resident's cognition was moderately impaired. Section E did not reveal any coded behaviors.Record review of Resident #2's Quarterly Minimum Data Set, dated [DATE], revealed: Section E Behavior Resident #2 had other behavioral symptoms not directed towards others.Resident #2's care plan, dated 7/14/25 revealed the following:Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had potential to demonstrate physical behaviors. (initiated 7/4/25) The goal was for Resident #2 to demonstrate effective coping skills. Interventions included staff analyzing key times, places, circumstances, triggers, and what de-escalates behavior and document. Staff should assess and address sensory deficits and notify the charge nurse of any physically abusive behaviors. When Resident #2 becomes agitated staff should intervene before agitation escalates. Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had a behavior problem related to being verbally aggressive to staff and other residents. (initiated 7/14/25) The goal was for Resident #2 to not have episodes of being verbally aggressive. Interventions included anticipate the needs of Resident #2. Staff should provide opportunity for positive interaction. Consultation with psychiatry will be made if needed. Staff should also intervene as necessary to protect the rights and safety of others. Staff will also monitor behavior episode of Resident #2. Record review of Resident #2's progress notes, dated 5/13/25-8/14/25, revealed: No incidents documented involving Resident #2 and any other residents on 7/11/25.7/13/25 at 9:11 PM the DON documented Resident #2 had a behavior (verbal, resident to resident alleged behavior). Resident #2 scolded her roommate (Resident #1) with curse words to clean up her mess in the bathroom. 1:1 mentoring supervision implemented. Consulted FNP for new orders of hydroxyzine 50 mg PO Q4 hours prn. Recommended to conduct room swap. Resident #2 stated we get along good. Resident #2 stated she worried about her roommate because she sleeps all day and does not sleep much. Attempted to contact Resident #2's family. 7/14/25 at 8:20 AM the DON documented late entry: Informed by administrator the resident's (unspecified in this progress note) roommate's family informed her the CNA (unspecified in this progress note) told them Resident #2 was cursing at her roommate and telling her to clean up after herself in the bathroom. Resident #2 was immediately place on one-on-one observation. Consulted psych provider for any new orders/recommendations. New order to start hydroxyzine 50 mg prn Q4 hours for anxiety/agitation. Performed a roommate swap and may d/c one-on-one monitoring but ensure frequent monitoring as the resident was not physically aggressive. Attempted to notify Family Member FF multiple times. D/c one-on-one supervision. Resident #2 currently does not have a roommate currently.07/15/25 at 10:18 AM the SW documented that she received notification from the administration that a referral to the behavioral center was needed. The SW notified Family Member FF, and he agreed to the referral and the referral was (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 2 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few completed. 07/15/25 at 10:24 AM LVN EE documented no verbal behaviors noted, and Resident #2 was in good spirits. 07/15/25 at 10:29 PM LVN BB documented Resident #2 was quiet without negative behaviors, toward resident or staff. 07/16/25 at 8:57 AM LVN EE documented Resident #2 had no behaviors. 07/16/25 at 8:57 PM LVN B documented no behaviors reported during her shift. 07/17/25 at 2:57 PM The SW documented that the referral for Resident #2 was denied due to Resident #2's insurance being out of network. During an interview on 8/14/25 at 12:33 PM, Resident #2 stated she does not remember why her last roommate moved. She stated she got along well with her last roommate. She could not identify her last roommate by name. She could not report if she had an incident with Resident #1 on 7/11/25. During an interview on 8/14/25 at 9:31 AM, CNA A stated she did not have a calendar in front of her but believed the incident occurred on 7/11/25. She stated she worked the night shift (6:00 PM- 6:00 AM). She stated on that day (7/11/25) her partner that she worked with that day called in late. She stated she and LVN B were the only ones on the locked female unit. She stated around 7:00 PM or 7:30 PM while LVN B was attending to another resident next door to Resident #1 and Resident #2 they (CNA A and LVN B) heard Resident #2 yell a loud and clear Get your mother fucking ass in that God Damn bathroom and clean that shit up! CNA A stated she and LVN B looked at each other. CNA A stated LVN B asked her Who is she (Resident #2) hollering at? CNA A stated LVN B instructed her (CNA A) to go and look. CNA A stated when she stepped into Resident #1 and Resident #2's room she observed Resident #1 standing in front of Resident #2 and the look on Resident #1's face gave her (CNA A) the impression that she was scared. CNA A stated she motioned for Resident #1 to come with her. CNA A stated she took Resident #1 to where LVN B was and during this time LVN B then goes to Resident #2. CNA A stated she and Resident #1 stood outside the room where Resident #2 and LVN B were. CNA A stated LVN B asked Resident #2 what was going on and Resident #2 voiced her complaint about Resident #1 pissing on the bathroom floor. She stated LVN B instructed Resident #2 that if it happened again, she needed to call staff for help. CNA A stated she went to get a towel to clean up the urine in the bathroom and while she was doing this Resident #1 followed LVN B. CNA A stated Resident #2 yelled at her Don't clean up that shit! This is why she (Resident #1) don't learn because y'all baby her (Resident #1)! CNA A stated Resident #1 was afraid and did not go back to the room with Resident #2 for majority of the night. CNA A stated Resident #1 did not go to bed until Resident #2 was asleep. CNA A stated she was under the impression that since LVN B witnessed the incident along with her that she would report it to the abuse coordinator, document and notify the family. CNA A stated a couple of days later (unsure of the exact date), Resident #1's family came to the facility and in passing the family asked why is it that when they have come in Resident #1 is not in her bed and sometimes is found in other resident's bed. CNA A stated she told them that it was most likely because she (Resident #1) was afraid of her roommate (Resident #2). She stated that immediately once she mentioned the incident to Family Member CC, he became upset and exclaimed no one told him about the incident. She stated that LVN B was upset with her and told her at that time to complete a report. She stated unsure of the date the following Monday she was suspended because she failed to report the incident. CNA A stated she did not feel it was right that she was suspended for failure to report when LVN B also heard the incident and was present. CNA A stated that the ADM told her that LVN B may have misheard what happened. CNA A stated this was not the case because Resident #2 said what she said very loud, and they were next door to their room. CNA A stated Resident #1 slept in the same room with Resident #2 the night of the incident. CNA A stated she was told that Resident #1 was moved out of the room only after Resident #1's family complained. CNA A stated Resident #2 had a history of aggression and that she had expressed concern in the past. CNA A stated Resident #2 had broken the facility door before (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 3 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few and was an exceptionally large lady in comparison to Resident #1. She stated although she did not believe Resident #2 physically hit Resident #1, she believed that Resident #1 was afraid because she would not go back in her room the night of the incident. She stated she and other staff reported to LVN B that even they (staff) were afraid of Resident #2. CNA A stated no other incidents had occurred between Resident #1 and Resident #2 since 7/11/25 but she could not attest for any time after she was suspended. She stated she was trained that if she suspects or witness abuse, she was to report abuse to her chain of command, and this would have been LVN B. She stated that being a CNA for over 25 years this was the way it has always been. She stated that the ADM stated at the time of her suspension that she was supposed to report the incident to her (the ADM). CNA A stated the nurses were responsible for reporting incidents to the family. CNA A stated the night of the incident Resident #1 did not have any injuries that she could visibly see. During an interview on 8/14/25 at 2:33 PM, the ADM stated that she was unsure of the date and time but while at home one-night LVN B called her and explained that Resident #1's family was upset. She stated LVN B told her about the initial complaint from the family involved cleaning supplies and them (Family Member CC) having to clean the restroom. The ADM stated that she received a call from Family Member DD 30 minutes later who stated that the real reason that they (family) were upset was because Resident #1 had been abused and her roommate (Resident #2) was screaming at her (Resident #1). The ADM stated at the time Family Member DD notified her of Resident #2 screaming at Resident #1 she was unaware of the incident. She stated once Family Member DD notified her, she notified the DON. She stated she interviewed CNA A and CNA stated she did tell Family Member CC about the incident between Resident #1 and Resident #2. The ADM stated she asked CNA A why she did not report the incident directly to her as the abuse coordinator as she had been trained and CNA A response was my bad. During an interview on 8/15/25 at 12:15 PM, the ADM stated that she was unsure of the exact date of the incident between Resident #1 and Resident #2, but voiced that she was notified of the incident on 7/13/25 by Family Member DD. The ADM stated she reported the incident to HHSC on 7/13/25 at 11:05 PM. The ADM stated she suspended CNA A on 7/14/25 and the last date CNA A had been in the facility was on the morning of her shift ended on 7/14/25. She stated after consulting with the corporate office and gaining approval she terminated CNA A for failure to report ANE. She stated they started re-education on the facility's abuse policy and by 7/14/25 100 percent of her staff had been trained on the facility's abuse policy. The ADM stated she was sure all staff had been trained because the day they started re-education it was the facility's pay day and each staff that came in had to pick up their check. During an interview on 8/15/25 at 6:18 PM, Family Member CC stated they were not notified of the incident that occurred with Resident #1 and Resident #2 at the time of the incident. Family Member CC stated CNA A notified them that Resident #1 was afraid of her roommate (Resident #2). Family Member CC stated he had not observed any incidents between Resident #1 and Resident #2. He stated that they (he and his family) were incredibly pleased with how the facility responded to them reporting their concerns about Resident #1. Family Member CC stated as soon as they reported the incident the facility staff moved Resident #1. Family Member CC stated there had been no incidents since the incident. Family member CC stated that he was unsure if Resident #1 was afraid, but they (he and the family) had concerns that Resident #1 was sleeping in other resident's beds because she had a UTI. He stated when he asked CNA A about what she thought regarding Resident #1 sleeping in other's beds CNA disclosed the incident. He stated he honestly believed CNA was trying to console them because they had other concerns within the same night. He stated since the incident between Resident #1 and Resident #2 the facility staff have done so well notifying them (he and family). During an interview on 8/15/25 at 5:15 PM, the ADM stated the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 4 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few facility's system to ensure that the facility ANE policy (specifically family was notified) was being followed was through staff education, re-education, routine rounds and talking to staff. The ADM stated she and all her staff had been trained on the facility's ANE policy (specifically family was notified) and their specific roles as it related to the policy. The ADM stated she expected all staff to follow the abuse policy. Specifically, the ADM stated she expected family to be notified of incidents of ANE. The ADM stated more specifically the nursing staff, DON or the ADM was responsible for family notifications. The ADM stated the potential negative outcome for not notifying family was the family would not be aware of issues and they are supposed to be aware of issues concerning their resident. The ADM stated if CNA A would have notified the LVN B then LVN B could have notified Resident #1's family. The ADM stated the reason Resident #1's family was not notified was because CNA A did not report the details of the incident to LVN B. During an interview on 8/15/25 at 5:42 PM, the DON stated that she had been trained on the facility's abuse policy (specifically family was notified) as well as all her staff. The DON stated she expected that all staff follow the abuse policy (specifically was notified). The DON stated specifically for family notifications she expected family to be notified of all things that had to do with the residents. The DON stated that she expected for family to be notified of all incidents and any changes. The DON stated the nurse involved in the incident was responsible for notifying the family, but this could only be done after the person reported the incident to the nurse. The DON stated that the reason the family was not notified of the incident between Resident #1 and Resident #2 was because CNA A did not report the incident between Resident #1 and Resident #2 to LVN B and the abuse coordinator. The DON stated that the potential negative outcome for not notifying family was the family would not be aware of what was going on with the resident. The DON stated it was improper for notifications not to be done. The DON stated the reason the family was not notified was because CNA A did not notify LVN B or the abuse coordinator. During an interview on 8/15/25 at 8:45 PM, LVN B stated she was unsure of the exact date of the incident that occurred between Resident #1 and Resident #2. LVN B stated that she was in the last room at the end of the hallway assisting another resident. She stated CNA A heard one of the residents raise their voice. She stated she asked CNA A which resident raised their voice and was told by CNA A that it was Resident #2 and Resident #1. LVN B stated CNA A told her that Resident #2 was raising her voice at Resident #1. LVN B stated she voiced to Resident #2 that she does not need to raise her voice. LVN B stated that was it and she left Resident #2 in her room. LVN B stated 5 minutes later both residents could not remember the incident. LVN B stated she does not know what specifically Resident #2 said to Resident #1. She stated CNA A did not specify what was said but only stated Resident #2 was yelling at Resident #1 because there was piss on the floor. LVN B stated she did not suspect abuse because normally Resident #2 was loud resident and that was the way she talked. She stated working on the locked unit residents have behaviors and she considered Resident #2 yelling as one of her behaviors and she needed redirection. LVN B stated Resident #1 did not appear afraid to her. LVN B stated Resident #1 went back to her room within an hour of the incident. LVN B stated that CNA A did not report to her or indicate that Resident #1 was afraid. LVN B stated after the incident between Resident #1 and Resident #2 she never had a discussion with Resident #1's family nor did she discuss the incident any further with CNA A. LVN B stated that there had not been any other incidents since the verbal incident between Resident #1 and Resident #2 nor had there been any incidents before. LVN B stated CNA A reported to the Resident #1's family that Resident #1 felt threatened by Resident #2 and that is what caused them to call the ADM. LVN B stated she did not notify the family of the incident but could not give a reason as to why because she could not remember what was going on that day to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 5 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete be able to give the investigator accurate information. LVN B stated an incident of the same nature involving Resident #1 and Resident #2 would have been an incident that she would notify family of. LVN B stated she had been trained on the facility's abuse policy recently (within the past 30-60 days) by the ADM, DON and ADON. LVN B stated it was her responsibility to notify family and or responsible party of any significant events involving the residents that resided at the facility.The facility staff (The ADM and Regional Nurse Consultant) did not provide a policy regarding notification to responsible parties. The facility did provide a policy regarding notification to the physician on 08/22/25 at 12:16 PM. A request for notification to the family was requested on 08/22/25 at 2:16 PM. As of 8/29/25 the policy for notification to the family was not provided. Event ID: Facility ID: 675527 If continuation sheet Page 6 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, and record review, the facility failed to ensure the residents had the right to be free from verbal abuse and neglect for 2 (Resident #1 and #2) of 7 residents reviewed for abuse. The facility staff failed to protect Resident #1 from verbal abuse from Resident #2 on 7/11/25 between 7:00 PM and 7:30 PM.The noncompliance was identified as PNC. The IJ began on 07/11/25 and ended on 7/25/25. The facility had corrected the noncompliance before the survey began.This failure could place residents at risk of abuse, neglect, trauma, injury and psychosocial harm. Findings included: Resident #1 Record review of Resident #1's face sheet, 8/14/25, revealed an [AGE] year-old-female was admitted to the facility on [DATE] with diagnoses to include dementia (memory loss), schizoaffective disorder (mental disorder), anxiety (increased worry), insomnia (difficulty sleeping), major depressive disorder (increase sadness) and UTI (infection in the urinary system). Record review of Resident #1's Comprehensive Minimum Data Set, dated [DATE], revealed: Section C Brief Interview for Mental Status score revealed a score of 00, which indicated the resident's cognition was severely impaired. Record review of Resident #1's care plan, dated 7/14/25, revealed the following:Resident #1 had a focus for elopement and wandering specifically that she wandered aimlessly (date initiated 8/14/25). The goal was for Resident #1 to remain safe within the facility unless accompanied by a staff or authorized person. Interventions included distracting resident from wandering by offering pleasant diversions and supervising closely and make regular compliance rounds. Resident #1 had a focus for coping, specifically Resident #1 had a tough time coping with a roommate as roommate might have been verbally aggressive towards Resident #1 (date initiated 7/14/25). The goal was for Resident #1 to feel comfortable in a safe living environment. Interventions included staff would listen to Resident #1's concerns. Staff would monitor if Resident #1 were unable to cope with roommate and the social worker would find a new roommate if applicable. Record review of Resident #1's progress notes, dated 5/13/25-8/14/25, revealed: No incidents documented involving Resident #1 and any other residents on 7/11/25.07/13/25 at 9:11 PM LVN B documented: family report a CNA reported to them Resident #1's roommate was cursing at her and telling her to clean up after herself in the bathroom. Initial treatment included skin assessment; roommate placed on 1:1 monitoring supervision. Medical doctor and nurse practitioner notified. Responsible party was notified. 07/13/25 at 10:37 PM LVN B documented skin assessment conducted with no negative findings. 07/14/25 at 2:58 AM LVN B documented trauma assessment conducted. There were no negative findings or experiences documented or found. Resident #1 did not express fear or anger. 7/14/25 at 9:36 PM the DON documented a late entry indicating Resident #1's family reported to administration that the CNA (unidentified in the progress note) told them Resident #1's roommate was cursing at Resident #1 and telling her to clean up after herself in the bathroom. Resident #1's roommate was placed on one-to-one monitoring. Skin Assessment performed on Resident #1. A room swap was made. Family was aware and notified. FNP was notified. 7/15/25 at 8:36 AM LVN EE documented that Resident #1 appeared to be in no pain and monitoring was conducted. 7/15/25 at 8:37 AM LVN EE documented that Resident #1 had no signs or symptoms of distress noted, resident in good spirits.7/15/25 at 10:13 PM LVN BB documented that Resident #1 had no signs or symptoms of distress and did not complain of any pain.During an interview on 8/14/25 at 12:31 PM, Resident #1 could not recall the incident that occurred between she and Resident #2. She could not identify her last roommate by name. She stated she could not remember if she was afraid on 7/11/25. She could not remember how long she had been in the room that she was and why she had moved. She reported that she felt safe at the facility. Resident #2 Record review of Resident #2's face sheet, dated 8/14/25, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 7 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 revealed a [AGE] year-old-female was admitted to the facility on [DATE] with diagnoses to include intermittent explosive disorder (mental disorder characterized by outburst of anger or violence), anxiety (increased worry) and dementia (memory loss). Record review of Resident #2's Comprehensive Minimum Data Set, dated [DATE], revealed: Section C Brief Interview for Mental Status score revealed a score of 08, which indicated the resident's cognition was moderately impaired. Section E did not reveal any coded behaviors.Record review of Resident #2's Quarterly Minimum Data Set, dated [DATE], revealed: Section E Behavior Resident #2 had other behavioral symptoms not directed towards others.Resident #2's care plan, dated 7/14/25 revealed the following:Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had potential to demonstrate physical behaviors. (initiated 7/4/25) The goal was for Resident #2 to demonstrate effective coping skills. Interventions included staff analyzing key times, places, circumstances, triggers, and what de-escalates behavior and document. Staff should assess and address sensory deficits and notify the charge nurse of any physically abusive behaviors. When Resident #2 becomes agitated staff should intervene before agitation escalates. Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had a behavior problem related to being verbally aggressive to staff and other residents. (initiated 7/14/25) The goal was for Resident #2 to not have episodes of being verbally aggressive. Interventions included anticipate the needs of Resident #2. Staff should provide opportunity for positive interaction. Consultation with psychiatry will be made if needed. Staff should also intervene as necessary to protect the rights and safety of others. Staff will also monitor behavior episode of Resident #2. Record review of Resident #2's progress notes, dated 5/13/25-8/14/25, revealed: No incidents documented involving Resident #2 and any other residents on 7/11/25.7/13/25 at 9:11 PM the DON documented Resident #2 had a behavior (verbal, resident to resident alleged behavior). Resident #2 scolded her roommate (Resident #1) with curse words to clean up her mess in the bathroom. 1:1 mentoring supervision implemented. Consulted FNP for new orders of hydroxyzine 50 mg PO Q4 hours prn. Recommended to conduct room swap. Resident #2 stated we get along good. Resident #2 stated she worried about her roommate because she sleeps all day and does not sleep much. Attempted to contact Resident #2's family. 7/14/25 at 8:20 AM the DON documented late entry: Informed by administrator the resident's (unspecified in this progress note) roommate's family informed her the CNA (unspecified in this progress note) told them Resident #2 was cursing at her roommate and telling her to clean up after herself in the bathroom. Resident #2 was immediately place on one-on-one observation. Consulted psych provider for any new orders/recommendations. New order to start hydroxyzine 50 mg prn Q4 hours for anxiety/agitation. Performed a roommate swap and may d/c one-on-one monitoring but ensure frequent monitoring as the resident was not physically aggressive. Attempted to notify Family Member FF multiple times. D/c one-on-one supervision. Resident #2 currently does not have a roommate currently.07/15/25 at 10:18 AM the SW documented that she received notification from the administration that a referral to the behavioral center was needed. The SW notified Family Member FF, and he agreed to the referral and the referral was completed. 07/15/25 at 10:24 AM LVN EE documented no verbal behaviors noted, and Resident #2 was in good spirits. 07/15/25 at 10:29 PM LVN BB documented Resident #2 was quiet without negative behaviors, toward resident or staff. 07/16/25 at 8:57 AM LVN EE documented Resident #2 had no behaviors. 07/16/25 at 8:57 PM LVN B documented no behaviors reported during her shift. 07/17/25 at 2:57 PM The SW documented that the referral for Resident #2 was denied due to Resident #2's insurance being out of network. During an interview on 8/14/25 at 12:33 PM, Resident #2 stated she does not remember why her last roommate moved. She stated she got along well with her last roommate. She could not identify her last roommate by name. She could not report if she had an incident with Resident #1 on 7/11/25. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 8 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 During an interview on 8/14/25 at 9:31 AM, CNA A stated she did not have a calendar in front of her but believed the incident occurred on 7/11/25. She stated she worked the night shift (6:00 PM- 6:00 AM). She stated on that day (7/11/25) her partner that she worked with that day called in late. She stated she and LVN B were the only ones on the locked female unit. She stated around 7:00 PM or 7:30 PM while LVN B was attending to another resident next door to Resident #1 and Resident #2 they (CNA A and LVN B) heard Resident #2 yell a loud and clear Get your mother fucking ass in that God Damn bathroom and clean that shit up! CNA A stated she and LVN B looked at each other. CNA A stated LVN B asked her Who is she (Resident #2) hollering at? CNA A stated LVN B instructed her (CNA A) to go and look. CNA A stated when she stepped into Resident #1 and Resident #2's room she observed Resident #1 standing in front of Resident #2 and the look on Resident #1's face gave her (CNA A) the impression that she was scared. CNA A stated she motioned for Resident #1 to come with her. CNA A stated she took Resident #1 to where LVN B was and during this time LVN B then goes to Resident #2. CNA A stated she and Resident #1 stood outside the room where Resident #2 and LVN B were. CNA A stated LVN B asked Resident #2 what was going on and Resident #2 voiced her complaint about Resident #1 pissing on the bathroom floor. She stated LVN B instructed Resident #2 that if it happened again, she needed to call staff for help. CNA A stated she went to get a towel to clean up the urine in the bathroom and while she was doing this Resident #1 followed LVN B. CNA A stated Resident #2 yelled at her Don't clean up that shit! This is why she (Resident #1) don't learn because y'all baby her (Resident #1)! CNA A stated Resident #1 was afraid and did not go back to the room with Resident #2 for majority of the night. CNA A stated Resident #1 did not go to bed until Resident #2 was asleep. CNA A stated she was under the impression that since LVN B witnessed the incident along with her that she would report it to the abuse coordinator, document and notify the family. CNA A stated a couple of days later (unsure of the exact date), Resident #1's family came to the facility and in passing the family asked why is it that when they have come in Resident #1 is not in her bed and sometimes is found in other resident's bed. CNA A stated she told them that it was most likely because she (Resident #1) was afraid of her roommate (Resident #2). She stated that immediately once she mentioned the incident to Family Member CC, he became upset and exclaimed no one told him about the incident. She stated that LVN B was upset with her and told her at that time to complete a report. She stated unsure of the date the following Monday she was suspended because she failed to report the incident. CNA A stated she did not feel it was right that she was suspended for failure to report when LVN B also heard the incident and was present. CNA A stated that the ADM told her that LVN B may have misheard what happened. CNA A stated this was not the case because Resident #2 said what she said very loud, and they were next door to their room. CNA A stated Resident #1 slept in the same room with Resident #2 the night of the incident. CNA A stated she was told that Resident #1 was moved out of the room only after Resident #1's family complained. CNA A stated Resident #2 had a history of aggression and that she had expressed concern in the past. CNA A stated Resident #2 had broken the facility door before and was an exceptionally large lady in comparison to Resident #1. She stated although she did not believe Resident #2 physically hit Resident #1, she believed that Resident #1 was afraid because she would not go back in her room the night of the incident. She stated she and other staff reported to LVN B that even they (staff) were afraid of Resident #2. CNA A stated no other incidents had occurred between Resident #1 and Resident #2 since 7/11/25 but she could not attest for any time after she was suspended. She stated she was trained that if she suspects or witness abuse, she was to report abuse to her chain of command, and this would have been LVN B. She stated that being a CNA for over 25 years this was the way it has always been. She stated that the ADM stated at the time of her (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 9 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 suspension that she was supposed to report the incident to her (the ADM). CNA A stated the nurses were responsible for reporting incidents to the family. CNA A stated the night of the incident Resident #1 did not have any injuries that she could visibly see. During an interview on 8/14/25 at 10:32 AM, CNA C stated she had never worked the female locked unit. She stated she had guarded the door once when the doors were not working. She stated she had not worked directly with Resident #1 and Resident #2. During an interview on 8/14/25 at 10:43 AM, CNA D stated she did not have any information regarding the verbal incident between Resident #1 and Resident #2 that occurred on 07/11/25. She stated she is unaware if any incidents had occurred since 7/11/25. During an interview on 8/14/25 at 11:09 AM, CNA E stated she did not have any firsthand information about the verbal incident that occurred on 7/11/25 between Resident #1 and Resident #2. She stated Resident #1 and Resident #2 had never had issues before 7/11/25 or since 7/11/25. She stated Resident #2 rarely has behaviors. She stated Resident #1 has no behaviors but will ask questions over and over. During an interview on 8/14/25 at 11:24 AM, CNA F stated she did not have any firsthand information about Resident #1's and Resident #2's verbal altercation that occurred on 7/11/25. She stated there had been no additional altercations between Resident #1 and Resident #2. She stated Resident #1 had an issue where she wanted to leave the unit but never had any altercations with residents in the unit. During an interview on 8/14/25 at 11:35 AM, CNA G stated she does not work the female unit and did not have any information regarding the incident that occurred on 7/11/25 between Resident #1 and Resident #2. During an interview on 8/14/25 at 11:45 AM, CNA H stated although she works the female locked unit at times, she did not have any information regarding the verbal altercation that occurred between Resident #1 and Resident #2. She stated she did not have any information about Resident #1 and Resident #2's behaviors as she had not worked the female locked unit in a while. During an interview on 8/14/25 at 11:55 AM, LVN I stated he did not have any firsthand information about the verbal altercation that occurred on 7/11/25 between Resident #1 and Resident #2. He stated Resident #1 and Resident #2 did not have a history of verbal altercations and there had been no incidents since 7/11/25. He stated Resident #1 was pleasantly confused. He stated she would wander but no other behaviors. He stated in the past Resident #2 had behaviors that included hoarding briefs. He stated in the past on an unknown date she (Resident #2) broke the female locked unit door but was sent to a behavior unit because of that behavior. He stated the facility manages Resident #2's behavior well through close monitoring. During an interview on 8/14/25 at 12:11 PM, LVN J stated she did not have any firsthand information about Resident #1 and Resident #2's verbal altercation that occurred on 7/11/25 as she did not work the female locked unit on that date. She stated she did not have any additional information regarding Resident #2 or Resident #1 behaviors. During an interview on 8/14/25 at 1:04 PM, CNA K stated she did not have firsthand information regarding Resident #1 and Resident #2 verbal altercation that occurred on 7/11/25. She stated she had worked with both residents before and after 7/11/25. She stated the two had never had any issues before or after. She stated Resident #2 never comes out of her room. She stated Resident #1 can be active at times. She stated neither resident has ever had significant behaviors in her presence. Interviews conducted on 8/14/25 between 10:32 AM-1:04 PM, revealed that daytime staff (CNA C, CNA D, CNA E, CNA F, CNA G, CNA H, LVN I, LVN J and CNA K) had been trained on the facility's abuse policy. The staff were able to identify the abuse coordinator, and stated if they suspected or witnessed abuse, they would report directly to the abuse coordinator. During their interviews, staff was able to report that apart of the suspicion or witnessing abuse they would protect the resident. During an interview on 8/14/25 at 2:33 PM, the ADM stated that she was unsure of the date and time but while at home one-night LVN B called her and explained that Resident #1's family was (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 10 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 upset. She stated LVN B told her about the initial complaint from the family involved cleaning supplies and them (Family Member CC) having to clean the restroom. The ADM stated that she received a call from Family Member DD 30 minutes later who stated that the real reason that they (family) were upset was because Resident #1 had been abused and her roommate (Resident #2) was screaming at her (Resident #1). The ADM stated at the time Family Member DD notified her of Resident #2 screaming at Resident #1 she was unaware of the incident. She stated once Family Member DD notified her, she notified the DON, and the DON instructed for 1:1 to be started for Resident #2 to LVN B. The ADM stated that LVN B stated she was unaware of any incidents of abuse that involved Resident #1 and Resident #2. She (the ADM) stated that she started her abuse process. The ADM stated LVN B reported to her that she (LVN B) heard yelling one night (date was not specified) and LVN B instructed CNA A to see what happened. The ADM stated LVN B reported to her that CNA A never reported to her that Resident #2 was yelling at Resident #1. The ADM stated Resident #2 had a history of yelling at staff. The ADM stated she immediately suspended CNA A for not reporting directly to her. She stated she interviewed CNA A and CNA stated she did tell Family Member CC about the incident between Resident #1 and Resident #2. The ADM stated she asked CNA A why she did not report the incident directly to her as the abuse coordinator as she had been trained and CNA A response was my bad. During an interview on 8/15/25 at 12:15 PM, the ADM stated that she was unsure of the exact date of the incident between Resident #1 and Resident #2, but voiced that she was notified of the incident on 7/13/25 by Family Member DD. The ADM stated she reported the incident to HHSC on 7/13/25 at 11:05 PM. She stated Resident #2 was placed on 1:1 supervision as soon as she was notified of the incident on 7/13/25. She stated Resident #1 was not moved out of the room with Resident #2 because of bed availability. She stated room moves had to be made before she could move Resident #1 out of the room with Resident #2. The ADM stated Resident #1 shared the same bedroom with Resident #2 after the incident up until she was notified on 7/13/25. The ADM said no additional incidents had occurred between Resident #1 and Resident #2. She stated she suspended CNA A on 7/14/25 and the last date CNA A had been in the facility was on the morning of her shift ended on 7/14/25. She started safe surveys were conducted on the female locked unit and there were no findings. She stated after consulting with the corporate office and gaining approval she terminated CNA A for failure to report ANE. She stated they started re-education on the facility's abuse policy and by 7/14/25 100 percent of her staff had been trained on the facility's abuse policy. The ADM stated she was sure all staff had been trained because the day they started re-education it was the facility's pay day and each staff that came in had to pick up their check. They re-educated and quizzed the staff verbally on the expectations. She stated staff had always been trained to report to her as the abuse coordinator. She stated Resident #2 was referred to psychiatric services for the incident.During an interview on 8/15/25 at 12:20 PM, the DON stated that on 07/09/25 Resident #2 had a recent change in medication where she had started Depakote. She stated because of the incident between Resident #1 and Resident #2 it was decided to continue to monitor the newly change medication and they added a PRN medication (Hydroxyzine). The ADM, DON, regional Nurse Consultant and Director of Operations were notified on 8/15/25 at 4:08 PM that a PNC IJ situation was identified due to the above failures and the IJ template and 3-strike letter was provided.Interviews conducted on 8/15/25 between 4:31 PM-6:16 PM, revealed that administration, daytime and nighttime staff (the DM, MDS Coordinator, ADON, HR, the Maintenance Supervisor, DS L, [NAME] M, LVN N, LVN O, CNA P, MA Q, CNA R, CNA S, RN T, CNA U, MA V, CNA W, CNA X, CNA Y, CNA Z, CNA AA, and LVN BB) had been trained on the facility's abuse policy recently (within the past 30-60 days). The staff voiced they had been trained by the ADM, DON and or the ADON. They stated that they were given the opportunity to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 11 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 ask questions if they needed to. They were all able to identify the abuse coordinator as the ADM and that they needed to report all suspected or witnessed abuse to the ADM. They all were able to voice that they would not assume that an incident had been reported but would report the incident as it was their responsibility. They all were able to report that protection of the resident(s) involved was a part of following the abuse protocol for the facility. They all were able to report that if they did not see any protection interventions put in place that they would follow up with management and or the abuse coordinator. All nurses interviewed were able to report that it was their responsibility to notify family and or responsible party of any significant events involving the residents that resided at the facility. All staff interviewed voiced that they were comfortable, confident in their role carrying out the facility's expectation regarding the facility's abuse policy and requirements. During an interview on 8/15/25 at 6:18 PM, Family Member CC stated they were not notified of the incident that occurred with Resident #1 and Resident #2 at the time of the incident. Family Member CC stated CNA A notified them that Resident #1 was afraid of her roommate (Resident #2). Family Member CC stated he had not observed any incidents between Resident #1 and Resident #2. He stated that they (he and his family) were incredibly pleased with how the facility responded to them reporting their concerns about Resident #1. Family Member CC stated as soon as they reported the incident the facility staff moved Resident #1. Family Member CC stated there had been no incidents since the incident. Family member CC stated that he was unsure if Resident #1 was afraid, but they (he and the family) had concerns that Resident #1 was sleeping in other resident's beds because she had a UTI. He stated when he asked CNA A about what she thought regarding Resident #1 sleeping in other's beds CNA disclosed the incident. He stated he honestly believed CNA was trying to console them because they had other concerns within the same night. He stated since the incident between Resident #1 and Resident #2 the facility staff have done so well notifying them (he and family). During an interview on 8/15/25 at 5:15 PM, the ADM stated regarding the failure to prevent abuse she had been trained on the facility's policy. She stated they review the abuse policy routinely. She stated the purpose of the policy was to protect the residents and ensure they investigate all allegations of abuse. The ADM stated when the allegation was reported to her on 7/13/25 she did investigate and found that CNA A failed to report timely. The ADM stated when she interviewed CNA A, she stated CNA A stated she thought LVN B had reported it. The ADM stated she reminded CNA A at that time it was her responsibility and CNA A's response was my bad. The ADM stated the potential negative outcome for not preventing abuse was residents could endure harm. The ADM stated she could not confirm if Resident #1 was abused. The ADM stated she had no indication that Resident #1 was harmed or was withdrawn. She stated after the incident no staff reported any changes. The ADM stated she was unaware that Resident #2 had yelled at Resident #1. She stated she became aware of the incident on 7/13/25 when the family called her. The ADM stated the system to monitor residents and ensuring they are not abused was re-educating staff, making rounds, and talking to residents and family about abuse. She stated staff are trained upon hire, annually and when there is an incident. The ADM stated she had never observed Resident #2 be aggressive to Resident #1 or any other residents. The ADM stated she expected facility staff to prevent abuse for all residents. The ADM stated all staff are responsible for preventing abuse. The ADM stated the reason abuse was not prevented in the incident involving Resident #1 and Resident #2 was because she was unaware of the incident as it was not reported to her by CNA A. The ADM stated she was unaware that Resident #2 was treating Resident #1 in any way that was negative. During an interview on 8/15/25 at 5:42 PM, the DON stated regarding the failure to prevent abuse that she was familiar with the facility's ANE policy. The DON stated the purpose of preventing abuse was to prevent (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 12 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 harm to the residents. The DON stated they did not want to harm the residents. The DON stated Resident #1 has always had the behavior of wandering as she (Resident #1) was pleasantly confused. The DON stated Resident #1 may have been in other resident's room during the time the family noticed not because she was afraid of Resident #2 but because of her dementia diagnoses. The DON stated residents with dementia do not remember. The DON stated she did not feel that Resident #2 abused Resident #1. The DON stated she interviewed Resident #2 and Resident #2 expressed that she and Resident #1 were good. She stated Resident #2 expressed that she (Resident #2) had concern regarding Resident #1's eating and sleeping habits. The DON stated she was unaware of the incident and was made aware of the incident on 7/13/25 when the ADM notified her. The DON stated their system to monitor and ensure residents do not experience abuse was through education to staff. The DON stated the staff were repeatedly trained on the policy and should have known what to do. She stated they also investigate all allegations, speak to staff and residents. The DON stated CNA A failed to report to the abuse coordinator, the ADM, and if CNA A had reported the incident, then the facility could protect the residents. The DON stated she had been trained on the abuse policy and all staff had all been trained. The DON stated she had never observed Resident #2 be verbally abusive to Resident #1. The DON stated she expected staff to prevent abuse from happening. The DON stated all staff are responsible for preventing abuse. The DON stated she does not feel abuse occurred but that regarding the incident between Resident #1 and Resident #2 CNA A did fail to report the incident to the abuse coordinator. During an interview on 8/15/25 at 8:45 PM, LVN B stated she was unsure of the exact date of the incident that occurred between Resident #1 and Resident #2. LVN B stated that she was in the last room at the end of the hallway assisting another resident. She stated CNA A heard one of the residents raise their voice. She stated she asked CNA A which resident raised their voice and was told by CNA A that it was Resident #2 and Resident #1. LVN B stated CNA A told her that Resident #2 was raising her voice at Resident #1. LVN B stated she voiced to Resident #2 that she does not need to raise her voice. LVN B stated that was it and she left Resident #2 in her room. LVN B stated 5 minutes later both residents could not remember the incident. LVN B stated she does not know what specifically Resident #2 said to Resident #1. She stated CNA A did not specify what was said but only stated Resident #2 was yelling at Resident #1 because there was piss on the floor. LVN B stated she did not suspect abuse because normally Resident #2 was loud resident and that was the way she talked. She stated working on the locked unit residents have behaviors and she considered Resident #2 yelling as one of her behaviors and she needed redirection. LVN B stated Resident #1 did not appear afraid to her. LVN B stated Resident #1 went back to her room within an hour of the incident. LVN B stated that CNA A did not report to her or indicate that Resident #1 was afraid. LVN B stated after the incident between Resident #1 and Resident #2 she never had a discussion with Resident #1's family nor did she discuss the incident any further with CNA A. LVN B stated that had not been any other incidents since the verbal incident between Resident #1 and Resident #2 nor had there been any incidents before. LVN B stated CNA A reported to the Resident #1's family that Resident #1 felt threatened by Resident #2 and that is what caused them to call the ADM. She stated when they called the ADM, she was instructed to place Resident #2 on 1:1 supervision. LVN B stated she did not report the incident to the abuse coordinator because she felt it was a nursing judgement call to redirect Resident #2. LVN B stated she had been trained on the facility's abuse policy recently (within the past 30-60 days) by the ADM, DON and ADON. She stated that protection of the resident(s) involved was a part of following the abuse protocol for the facility. She stated if she did not see any protection interventions put in place that she would follow up with management and or the abuse coordinator. LVN B stated Resident #1 and Resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 13 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 #2 shared the same room after the incident up until she was instructed to place Resident #2 on 1:1 supervision. LVN B stated no other incidents occurred with Resident #1 and Resident #2 after the verbal incident on the unknown date that she was aware of. She stated before the incident that occurred with Resident #1 and Resident #2, she had received training on the facility's ANE policy.During the investigation held on 8/14/25-8/15/25 there were no observation of any interactions between Resident #1 and Resident #2. Resident #1 and Resident #2 were observed in their separate rooms during the visit. Record review of the facility's Form 3614 (Provider Investigation Report), dated 7/17/25, revealed:Incident Date: 7/11/25Person(s) or Resident(s) involved:Resident #1 Alleged Perpetrator: None listed.Witnesses:CNA ADescription of the Allegation: Resident #1's roommate cusses at her and tries to make her clean up the bathroom. Assessment:7/13/25: Resident has no injuries. Provider Response: Resident #2 was placed on one-to-one monitoring immediately upon receiving report from Resident #1's family. Resident #1 was assessed for any injuries-none noted. Physician notified. Family, physician and psychiatry notified for Resident #2.Investigation Summary: Resident #1's family reported to LVN B, that they had been finding Resident #1 bathroom with bowel and urine on the floor and they had been bringing toilet paper because she had not had toilet paper and sometimes paper towels. LVN B notified the ADM via phone of the concern. The ADM later received a call from Family Member B stating what family had reported and added that Resident #2 had been yelling and cussing at Resident #1. LVN B was aware that one evening she heard raised voices and sent CNA A to see what was going on but nothing was ever reported to LVN B about cussing or demanding residents to het on her knees and clean up the bathroom. CNA A was suspended pending investigation and will be terminated for failure to report. Both residents lack capacity to m[TRUNCATED] Event ID: Facility ID: 675527 If continuation sheet Page 14 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. Level of Harm - Immediate jeopardy to resident health or safety **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review, the facility failed to implement written policies and procedures that prohibit and prevent abuse and neglect for 2 of 7 residents (Resident #1, and #2) reviewed for abuse. CNA A failed to follow the facility's abuse policy by not reporting the incident (verbal abuse) to the facility's Abuse Coordinator involving Resident #1and Resident #2 that occurred on 7/11/25 between 7:00 PM and 7:30 PM.LVN B failed to follow the facility's abuse policy by not reporting the incident (verbal abuse) to the facility's Abuse Coordinator involving Resident #1and Resident #2 that occurred on 7/11/25 between 7:00 PM and 7:30 PM.The ADM failed to follow the facility's abuse policy by not reporting the incident (verbal abuse) to HHSC involving Resident #1 and Resident #2 that occurred on 7/11/25 between 7:00 PM and 7:30 PM.The facility failed to notify Resident #1's family of the verbal abuse incident that occurred on 7/11/25 between 7:00 PM and 7:30 PM.The facility failed to put protective measures to protect Resident #1 from Resident #2 after a verbal abuse incident occurred on 7/11/25.The noncompliance was identified as PNC. The IJ began on 07/11/25 and ended on 7/14/25. The facility had corrected the noncompliance before the survey began.These failures could place residents as risk for abuse and injury. Findings included: Record review of the facility's abuse policy, dated 3/29/18, revealed the following: The resident has the right to be free from abuse,.Residents should not be subjected to abuse by anyone, including, but notlimited to, facility staff, other residents,.PreventionThe facility will provide the residents, families, and staff an environment free from abuse and neglect.The facility will be responsible to identify, correct, and intervene in situations of possible abuse/neglect.The facility has in place a method to identify events such as suspicious bruising of residents, occurrences, patterns, and trends that may constitute abuse.ReportingAny person having reasonable cause to believe an elderly or incapacitated adult is suffering from abuse,neglect or exploitation must report this to the DON, administrator, state and/or adult protective services.State law mandates that citizens report all suspected cases of abuse, neglect or financial exploitation ofthe elderly and incapacitated persons.When a suspected abused, neglected, exploited, mistreated or potential victim of misappropriation ofproperty comes to the attention of any employee, that employee will make an immediate verbal report tothe Abuse Preventionist or designee. If the discovery occurs outside of normal business hours, theAbuse Preventionist and/or designee will be called.Facility employees must report all allegations of: abuse, neglect, exploitation, mistreatment of residents, misappropriation of resident property or injury of unknown source to the facility administrator. The facility administrator or designee will report to HHSC.If the allegations involve abuse or result in serious bodily injury, the report is to be made within 2 hours of the allegationIf the allegation does not involve abuse or serious bodily injury, the report must be made within 24 hours of the allegation.Protection (Resident to Resident)The above policy will apply to potential resident-to-resident abuse. Provider letter 19-17 will be reviewed to determine if resident-to-resident abuse occurred.Resident #1 Record review of Resident #1's face sheet, 8/14/25, revealed an [AGE] year-old-female was admitted to the facility on [DATE] with diagnoses to include dementia (memory loss), schizoaffective disorder (mental disorder), anxiety (increased worry), insomnia (difficulty sleeping), major depressive disorder (increase sadness) and UTI (infection in the urinary system). Record review of Resident #1's Comprehensive Minimum Data Set, dated [DATE], revealed: Section C Brief Interview for Mental Status score revealed a score of 00, which indicated the resident's cognition was severely impaired. Record review of Resident #1's care plan, dated 7/14/25, revealed the following:Resident #1 had a focus for elopement and wandering specifically that she wandered aimlessly (date initiated 8/14/25). The goal was Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 15 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few for Resident #1 to remain safe within the facility unless accompanied by a staff or authorized person. Interventions included distracting resident from wandering by offering pleasant diversions and supervising closely and make regular compliance rounds. Resident #1 had a focus for coping, specifically Resident #1 had a tough time coping with a roommate as roommate might have been verbally aggressive towards Resident #1 (date initiated 7/14/25). The goal was for Resident #1 to feel comfortable in a safe living environment. Interventions included staff would listen to Resident #1's concerns. Staff would monitor if Resident #1 were unable to cope with roommate and the social worker would find a new roommate if applicable. Record review of Resident #1's progress notes, dated 5/13/25-8/14/25, revealed: No incidents documented involving Resident #1 and any other residents on 7/11/25.07/13/25 at 9:11 PM LVN B documented: family report a CNA reported to them Resident #1's roommate was cursing at her and telling her to clean up after herself in the bathroom. Initial treatment included skin assessment; roommate placed on 1:1 monitoring supervision. Medical doctor and nurse practitioner notified. Responsible party was notified. 07/13/25 at 10:37 PM LVN B documented skin assessment conducted with no negative findings. 07/14/25 at 2:58 AM LVN B documented trauma assessment conducted. There were no negative findings or experiences documented or found. Resident #1 did not express fear or anger. 7/14/25 at 9:36 PM the DON documented a late entry indicating Resident #1's family reported to administration that the CNA (unidentified in the progress note) told them Resident #1's roommate was cursing at Resident #1 and telling her to clean up after herself in the bathroom. Resident #1's roommate was placed on one-to-one monitoring. Skin Assessment performed on Resident #1. A room swap was made. Family was aware and notified. FNP was notified. 7/15/25 at 8:36 AM LVN EE documented that Resident #1 appeared to be in no pain and monitoring was conducted. 7/15/25 at 8:37 AM LVN EE documented that Resident #1 had no signs or symptoms of distress noted, resident in good spirits.7/15/25 at 10:13 PM LVN BB documented that Resident #1 had no signs or symptoms of distress and did not complain of any pain.During an interview on 8/14/25 at 12:31 PM, Resident #1 could not recall the incident that occurred between she and Resident #2. She could not identify her last roommate by name. She stated she could not remember if she was afraid on 7/11/25. She could not remember how long she had been in the room that she was and why she had moved. She reported that she felt safe at the facility. Resident #2 Record review of Resident #2's face sheet, dated 8/14/25, revealed a [AGE] year-old-female was admitted to the facility on [DATE] with diagnoses to include intermittent explosive disorder (mental disorder characterized by outburst of anger or violence), anxiety (increased worry) and dementia (memory loss). Record review of Resident #2's Comprehensive Minimum Data Set, dated [DATE], revealed: Section C Brief Interview for Mental Status score revealed a score of 08, which indicated the resident's cognition was moderately impaired. Section E did not reveal any coded behaviors.Record review of Resident #2's Quarterly Minimum Data Set, dated [DATE], revealed: Section E Behavior Resident #2 had other behavioral symptoms not directed towards others.Resident #2's care plan, dated 7/14/25 revealed the following:Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had potential to demonstrate physical behaviors. (initiated 7/4/25) The goal was for Resident #2 to demonstrate effective coping skills. Interventions included staff analyzing key times, places, circumstances, triggers, and what de-escalates behavior and document. Staff should assess and address sensory deficits and notify the charge nurse of any physically abusive behaviors. When Resident #2 becomes agitated staff should intervene before agitation escalates. Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had a behavior problem related to being verbally aggressive to staff and other residents. (initiated 7/14/25) The goal was for Resident #2 to not have episodes of being verbally aggressive. Interventions included anticipate the needs of Resident #2. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 16 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Staff should provide opportunity for positive interaction. Consultation with psychiatry will be made if needed. Staff should also intervene as necessary to protect the rights and safety of others. Staff will also monitor behavior episode of Resident #2. Record review of Resident #2's progress notes, dated 5/13/25-8/14/25, revealed: No incidents documented involving Resident #2 and any other residents on 7/11/25.7/13/25 at 9:11 PM the DON documented Resident #2 had a behavior (verbal, resident to resident alleged behavior). Resident #2 scolded her roommate (Resident #1) with curse words to clean up her mess in the bathroom. 1:1 mentoring supervision implemented. Consulted FNP for new orders of hydroxyzine 50 mg PO Q4 hours prn. Recommended to conduct room swap. Resident #2 stated we get along good. Resident #2 stated she worried about her roommate because she sleeps all day and does not sleep much. Attempted to contact Resident #2's family. 7/14/25 at 8:20 AM the DON documented late entry: Informed by administrator the resident's (unspecified in this progress note) roommate's family informed her the CNA (unspecified in this progress note) told them Resident #2 was cursing at her roommate and telling her to clean up after herself in the bathroom. Resident #2 was immediately place on one-on-one observation. Consulted psych provider for any new orders/recommendations. New order to start hydroxyzine 50 mg prn Q4 hours for anxiety/agitation. Performed a roommate swap and may d/c one-on-one monitoring but ensure frequent monitoring as the resident was not physically aggressive. Attempted to notify Family Member FF multiple times. D/c one-on-one supervision. Resident #2 currently does not have a roommate currently.07/15/25 at 10:18 AM the SW documented that she received notification from the administration that a referral to the behavioral center was needed. The SW notified Family Member FF, and he agreed to the referral and the referral was completed. 07/15/25 at 10:24 AM LVN EE documented no verbal behaviors noted, and Resident #2 was in good spirits. 07/15/25 at 10:29 PM LVN BB documented Resident #2 was quiet without negative behaviors, toward resident or staff. 07/16/25 at 8:57 AM LVN EE documented Resident #2 had no behaviors. 07/16/25 at 8:57 PM LVN B documented no behaviors reported during her shift. 07/17/25 at 2:57 PM The SW documented that the referral for Resident #2 was denied due to Resident #2's insurance being out of network. During an interview on 8/14/25 at 12:33 PM, Resident #2 stated she does not remember why her last roommate moved. She stated she got along well with her last roommate. She could not identify her last roommate by name. She could not report if she had an incident with Resident #1 on 7/11/25. During an interview on 8/14/25 at 9:31 AM, CNA A stated she did not have a calendar in front of her but believed the incident occurred on 7/11/25. She stated she worked the night shift (6:00 PM- 6:00 AM). She stated on that day (7/11/25) her partner that she worked with that day called in late. She stated she and LVN B were the only ones on the locked female unit. She stated around 7:00 PM or 7:30 PM while LVN B was attending to another resident next door to Resident #1 and Resident #2 they (CNA A and LVN B) heard Resident #2 yell a loud and clear Get your mother fucking ass in that God Damn bathroom and clean that shit up! CNA A stated she and LVN B looked at each other. CNA A stated LVN B asked her Who is she (Resident #2) hollering at? CNA A stated LVN B instructed her (CNA A) to go and look. CNA A stated when she stepped into Resident #1 and Resident #2's room she observed Resident #1 standing in front of Resident #2 and the look on Resident #1's face gave her (CNA A) the impression that she was scared. CNA A stated she motioned for Resident #1 to come with her. CNA A stated she took Resident #1 to where LVN B was and during this time LVN B then goes to Resident #2. CNA A stated she and Resident #1 stood outside the room where Resident #2 and LVN B were. CNA A stated LVN B asked Resident #2 what was going on and Resident #2 voiced her complaint about Resident #1 pissing on the bathroom floor. She stated LVN B instructed Resident #2 that if it happened again, she needed to call staff for help. CNA A stated she went to get a towel to clean up the urine in the bathroom and while she was doing this (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 17 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Resident #1 followed LVN B. CNA A stated Resident #2 yelled at her Don't clean up that shit! This is why she (Resident #1) don't learn because y'all baby her (Resident #1)! CNA A stated Resident #1 was afraid and did not go back to the room with Resident #2 for majority of the night. CNA A stated Resident #1 did not go to bed until Resident #2 was asleep. CNA A stated she was under the impression that since LVN B witnessed the incident along with her that she would report it to the abuse coordinator, document and notify the family. CNA A stated a couple of days later (unsure of the exact date), Resident #1's family came to the facility and in passing the family asked why is it that when they have come in Resident #1 is not in her bed and sometimes is found in other resident's bed. CNA A stated she told them that it was most likely because she (Resident #1) was afraid of her roommate (Resident #2). She stated that immediately once she mentioned the incident to Family Member CC, he became upset and exclaimed no one told him about the incident. She stated that LVN B was upset with her and told her at that time to complete a report. She stated unsure of the date the following Monday she was suspended because she failed to report the incident. CNA A stated she did not feel it was right that she was suspended for failure to report when LVN B also heard the incident and was present. CNA A stated that the ADM told her that LVN B may have misheard what happened. CNA A stated this was not the case because Resident #2 said what she said very loud, and they were next door to their room. CNA A stated Resident #1 slept in the same room with Resident #2 the night of the incident. CNA A stated she was told that Resident #1 was moved out of the room only after Resident #1's family complained. CNA A stated Resident #2 had a history of aggression and that she had expressed concern in the past. CNA A stated Resident #2 had broken the facility door before and was an exceptionally large lady in comparison to Resident #1. She stated although she did not believe Resident #2 physically hit Resident #1, she believed that Resident #1 was afraid because she would not go back in her room the night of the incident. She stated she and other staff reported to LVN B that even they (staff) were afraid of Resident #2. CNA A stated no other incidents had occurred between Resident #1 and Resident #2 since 7/11/25 but she could not attest for any time after she was suspended. She stated she was trained that if she suspects or witness abuse, she was to report abuse to her chain of command, and this would have been LVN B. She stated that being a CNA for over 25 years this was the way it has always been. She stated that the ADM stated at the time of her suspension that she was supposed to report the incident to her (the ADM). CNA A stated the nurses were responsible for reporting incidents to the family. CNA A stated the night of the incident Resident #1 did not have any injuries that she could visibly see. During an interview on 8/14/25 at 10:32 AM, CNA C stated she had never worked the female locked unit. She stated she had guarded the door once when the doors were not working. She stated she had not worked directly with Resident #1 and Resident #2. During an interview on 8/14/25 at 10:43 AM, CNA D stated she did not have any information regarding the verbal incident between Resident #1 and Resident #2 that occurred on 07/11/25. She stated she is unaware if any incidents had occurred since 7/11/25. During an interview on 8/14/25 at 11:09 AM, CNA E stated she did not have any firsthand information about the verbal incident that occurred on 7/11/25 between Resident #1 and Resident #2. She stated Resident #1 and Resident #2 had never had issues before 7/11/25 or since 7/11/25. She stated Resident #2 rarely has behaviors. She stated Resident #1 has no behaviors but will ask questions over and over. During an interview on 8/14/25 at 11:24 AM, CNA F stated she did not have any firsthand information about Resident #1's and Resident #2's verbal altercation that occurred on 7/11/25. She stated there had been no additional altercations between Resident #1 and Resident #2. She stated Resident #1 had an issue where she wanted to leave the unit but never had any altercations with residents in the unit. During an interview on 8/14/25 at 11:35 AM, CNA G stated she (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 18 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few does not work the female unit and did not have any information regarding the incident that occurred on 7/11/25 between Resident #1 and Resident #2. During an interview on 8/14/25 at 11:45 AM, CNA H stated although she works the female locked unit at times, she did not have any information regarding the verbal altercation that occurred between Resident #1 and Resident #2. She stated she did not have any information about Resident #1 and Resident #2's behaviors as she had not worked the female locked unit in a while. During an interview on 8/14/25 at 11:55 AM, LVN I stated he did not have any firsthand information about the verbal altercation that occurred on 7/11/25 between Resident #1 and Resident #2. He stated Resident #1 and Resident #2 did not have a history of verbal altercations and there had been no incidents since 7/11/25. He stated Resident #1 was pleasantly confused. He stated she would wander but no other behaviors. He stated in the past Resident #2 had behaviors that included hoarding briefs. He stated in the past on an unknown date she (Resident #2) broke the female locked unit door but was sent to a behavior unit because of that behavior. He stated the facility manages Resident #2's behavior well through close monitoring. During an interview on 8/14/25 at 12:11 PM, LVN J stated she did not have any firsthand information about Resident #1 and Resident #2's verbal altercation that occurred on 7/11/25 as she did not work the female locked unit on that date. She stated she did not have any additional information regarding Resident #2 or Resident #1 behaviors. During an interview on 8/14/25 at 1:04 PM, CNA K stated she did not have firsthand information regarding Resident #1 and Resident #2 verbal altercation that occurred on 7/11/25. She stated she had worked with both residents before and after 7/11/25. She stated the two had never had any issues before or after. She stated Resident #2 never comes out of her room. She stated Resident #1 can be active at times. She stated neither resident has ever had significant behaviors in her presence. Interviews conducted on 8/14/25 between 10:32 AM-1:04 PM, revealed that daytime staff (CNA C, CNA D, CNA E, CNA F, CNA G, CNA H, LVN I, LVN J and CNA K) had been trained on the facility's abuse policy. The staff were able to identify the abuse coordinator, and stated if they suspected or witnessed abuse, they would report directly to the abuse coordinator. During their interview staff was able to report that apart of the suspicion or witnessing abuse they would protect the resident. During an interview on 8/14/25 at 2:33 PM, the ADM stated that she was unsure of the date and time but while at home one-night LVN B called her and explained that Resident #1's family was upset. She stated LVN B told her about the initial complaint from the family involved cleaning supplies and them (Family Member CC) having to clean the restroom. The ADM stated that she received a call from Family Member DD 30 minutes later who stated that the real reason that they (family) were upset was because Resident #1 had been abused and her roommate (Resident #2) was screaming at her (Resident #1). The ADM stated at the time Family Member DD notified her of Resident #2 screaming at Resident #1 she was unaware of the incident. She stated once Family Member DD notified her, she notified the DON, and the DON instructed for 1:1 to be started for Resident #2 to LVN B. The ADM stated that LVN B stated she was unaware of any incidents of abuse that involved Resident #1 and Resident #2. She (the ADM) stated that she started her abuse process. The ADM stated LVN B reported that she (LVN B) heard yelling one night (date was not specified) and LVN B instructed CNA A to see what happened. The ADM stated LVN B reported to her that CNA A never reported to her that Resident #2 was yelling at Resident #1. The ADM stated Resident #2 had a history of yelling at staff. The ADM stated she immediately suspended CNA A for not reporting directly to her. She stated she interviewed CNA A and CNA stated she did tell Family Member CC about the incident between Resident #1 and Resident #2. The ADM stated she asked CNA A why she did not report the incident directly to her as the abuse coordinator as she had been trained and CNA A response was my bad. During an interview on 8/15/25 at 12:15 PM, the ADM stated that she was unsure (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 19 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few of the exact date of the incident between Resident #1 and Resident #2, but voiced that she was notified of the incident on 7/13/25 by Family Member DD. The ADM stated she reported the incident to HHSC on 7/13/25 at 11:05 PM. She stated Resident #2 was placed on 1:1 supervision as soon as she was notified of the incident on 7/13/25. She stated Resident #1 was not moved out of the room with Resident #2 because of bed availability. She stated room moves had to be made before she could move Resident #1 out of the room with Resident #2. The ADM stated Resident #1 shared the same bedroom with Resident #2 after the incident up until she was notified on 7/13/25. The ADM no additional incidents had occurred between Resident #1 and Resident #2. She stated she suspended CNA A on 7/14/25 and the last date CNA A had been in the facility was on the morning of her shift ended on 7/14/25. She started safe surveys were conducted on the female locked unit and there were no findings. She stated after consulting with the corporate office and gaining approval she terminated CNA A for failure to report ANE. She stated they started re-education on the facility's abuse policy and by 7/14/25 100 percent of her staff had been trained on the facility's abuse policy. The ADM stated she was sure all staff had been trained because the day they started re-education it was the facility's pay day and each staff that came in had to pick up their check. They re-educated and quizzed the staff verbally on the expectations. She stated staff had always been trained to report to her as the abuse coordinator. She stated Resident #2 was referred to psychiatric services for the incident.During an interview on 8/15/25 at 12:20 PM, the DON stated that on 07/09/25 Resident #2 had a recent change in medication where she had started Depakote. She stated because of the incident between Resident #1 and Resident #2 it was decided to continue to monitor the newly change medication and they added a PRN medication (Hydroxyzine). The ADM, DON, regional Nurse Consultant and Director of Operations were notified on 7/15/25 at 4:08 PM and a PNC IJ situation was identified due to the above failures and the IJ template and 3-strike letter was provided.Interviews conducted on 8/15/25 between 4:31 PM-6:16 PM, revealed that administration, daytime and nighttime staff (the DM, MDS Coordinator, ADON, HR, the Maintenance Supervisor, DS L, [NAME] M, LVN N, LVN O, CNA P, MA Q, CNA R, CNA S, RN T, CNA U, MA V, CNA W, CNA X, CNA Y, CNA Z, CNA AA, and LVN BB) had been trained on the facility's abuse policy recently (within the past 30-60 days). The staff voiced they had been trained by the ADM, DON and or the ADON. They stated that they were given the opportunity to ask questions if they needed to. They were all able to identify the abuse coordinator as the ADM and that they needed to report all suspected or witnessed abuse to the ADM. They all were able to voice that they would not assume that an incident had been reported but would report the incident as it was their responsibility. They all were able to report that protection of the resident(s) involved was a part of following the abuse protocol for the facility. They all were able to report that if they did not see any protection interventions put in place that they would follow up with management and or the abuse coordinator. All nurses interviewed were able to report that it was their responsibility to notify family and or responsible party of any significant events involving the residents that resided at the facility. During an interview on 8/15/25 at 6:18 PM, Family Member CC stated they were not notified of the incident that occurred with Resident #1 and Resident #2 at the time of the incident. Family Member CC stated CNA A notified them that Resident #1 was afraid of her roommate (Resident #2). Family Member CC stated he had not observed any incidents between Resident #1 and Resident #2. He stated that they (he and his family) were incredibly pleased with how the facility responded to them reporting their concerns about Resident #1. Family Member CC stated as soon as they reported the incident the facility staff moved Resident #1. Family Member CC stated there had been no incidents since the incident. Family member CC stated that he was unsure if Resident #1 was afraid, but they (he and the family) had concerns that Resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 20 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few #1 was sleeping in other resident's beds because she had a UTI. He stated when he asked CNA A about what she thought regarding Resident #1 sleeping in other's beds CNA disclosed the incident. He stated he honestly believed CNA was trying to console them because they had other concerns within the same night. He stated since the incident between Resident #1 and Resident #2 the facility staff have done so well notifying them (he and family). During an interview on 8/15/25 at 5:15 PM, the ADM stated regarding the failure to prevent abuse she had been trained on the facility's policy. She stated they review the abuse policy routinely. She stated the purpose of the policy was to protect the residents and ensure they investigate all allegations of abuse. The ADM stated when the allegation was reported to her on 7/13/25 she did investigate and found that CNA A failed to report timely. The ADM stated when she interviewed CNA A, she stated CNA A stated she thought LVN B had reported it. The ADM stated she reminded CNA A at that time it was her responsibility and CNA A's response was my bad. The ADM stated the potential negative outcome for not preventing abuse was residents could endure harm. The ADM stated she could not confirm if Resident #1 was abused. The ADM stated she had no indication that Resident #1 was harmed or was withdrawn. She stated after the incident no staff reported any changes. The ADM stated she was unaware that Resident #2 had yelled at Resident #1. She stated she became aware of the incident on 7/13/25 when the family called her. The ADM stated the system to monitor residents and ensuring they are not abused was re-educating staff, making rounds, and talking to residents and family about abuse. She stated staff are trained upon hire, annually and when there is an incident. The ADM stated she had never observed Resident #2 be aggressive to Resident #1 or any other residents. The ADM stated she expected facility staff to prevent abuse for all residents. The ADM stated all staff are responsible for preventing abuse. The ADM stated the reason abuse was not prevented in the incident involving Resident #1 and Resident #2 was because she was unaware of the incident as it was not reported to her by CNA A. The ADM stated she was unaware that Resident #2 was treating Resident #1 in any way that was negative. The ADM stated regarding the failure to follow the facility's abuse policy that she had been trained on the facility policy and it is routine that they go over the abuse policy. She stated the overall potential negative outcome for not following the facility's abuse policy was the residents would not be free from abuse in their own home. The ADM stated she was unaware that the facility's ANE policy was not being followed. She stated she became aware on 7/13/25 when Resident #1's family called her. The ADM stated the facility's system to ensure that the facility ANE policy (specifically ANE was reported to the appropriate parties (HHSC and abuse coordinator), protection measures were put in place and family was notified) was being followed was through staff education, re-education, routine rounds and talking to staff. The ADM stated she and all her staff had been trained on the facility's ANE policy (specifically ANE was reported to the appropriate parties (HHSC and abuse coordinator), protection measures were put in place and family was notified) and their specific roles as it related to the policy. The ADM stated she expected all staff to follow the abuse policy. Specifically, the ADM stated she expected family to be notified of incidents of ANE, the abuse coordinator to be notified immediately if they suspect or witness abuse, incidents of ANE to be reported to HHSC and protective measures to protect residents should be implemented. The ADM stated everyone was responsible for following the abuse policy. The ADM stated more specifically the nursing staff, DON or the ADM was responsible for family notifications. The ADM stated all staff was responsible for reporting to the abuse coordinator immediately. The ADM stated she and the DON was responsible for reporting incidents to HHSC. The ADM stated once they were notified, they were responsible for implementing protective measures, but all staff had been trained to ensure resident safety. The ADM stated the reason the facility ANE policy was not followed was (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 21 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete because CNA A did not report the details of the incident between Resident #1 and Resident #2 to LVN B. The ADM stated the potential negative outcome for not notifying family was the family would not be aware of issues and they are supposed to be aware of issues concerning their resident. The ADM stated if CNA A would have notified the LVN B then LVN B could have notified Resident #1's family. The ADM stated the reason Resident #1's family was not notified was because CNA A did not report the details of the incident to LVN B. The ADM stated the potential negative outcome for not reporting to the abuse coordinator was the abuse coordinator would not know. The ADM stated with the abuse coordinator not knowing of an incident then they would not be able to report to HHSC timely to HHSC. The ADM stated the reason the incident was not reported to HHSC timely was because CNA A did not report to the incident to LVN B or to her timely. The ADM stated the potential negative outcome for not reporting to HHSC would be a thorough investigation may not be conducted. The ADM stated the reason that the incident was not reported to HHSC timely was because CNA A did not report the details to LVN B or to her as the abuse coordinator. The ADM stated the potential negative outcome for not implementing protective measures for a resident after an incident would be resident safety could be affected. The ADM stated protective measures are put in place to ensure that the resident is safe. The ADM additionally stated that she also ensures that protective measures were put in place by initiating 1:1 supervision until other protective measures can be put in place. The ADM stated protective measures were not put in place for Resident #1 because CNA A did not report the incident details to LVN B. During an interview on 8/15/25 at 5:42 PM, the DON stated regarding the failure to prevent abuse that she was familiar with the facility's ANE policy. The DON stated the purpose of pr[TRUN Event ID: Facility ID: 675527 If continuation sheet Page 22 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0609 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review, the facility failed to ensure that all alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property, were reported immediately, but not later than 2 hours if the alleged violation involved abuse or neglect and resulted in bodily injury, to other officials (including the State Agency) and the Abuse Coordinator for 2 of 7 residents (Resident #1, and #2) reviewed for abuse. CNA A failed to report the allegation of abuse involving Resident #1 and Resident #2, to the abuse Coordinator (ADM) on 7/11/25 when she heard Resident #2 verbally assault Resident #1 between 7:00 PM and 7:30 PM.LVN B failed to report the allegation of abuse involving Resident #1 and Resident #2, to the abuse Coordinator (ADM) on 7/11/25 when she heard Resident #2 verbally assault Resident #1 between 7:00 PM and 7:30 PM.The Abuse Coordinator (ADM) failed to follow the facility's abuse policy by not reporting to HHSC verbal abuse involving Resident #1 and Resident #2 that occurred on 7/11/25 between 7:00 PM and 7:30 PM.The noncompliance was identified as PNC. The IJ began on 07/11/25 and ended on 7/14/25. The facility had corrected the noncompliance before the survey began.These failures could place residents as risk for abuse and neglect. Findings included: Resident #1 Record review of Resident #1's face sheet, 8/14/25, revealed an [AGE] year-old-female was admitted to the facility on [DATE] with diagnoses to include dementia (memory loss), schizoaffective disorder (mental disorder), anxiety (increased worry), insomnia (difficulty sleeping), major depressive disorder (increase sadness) and UTI (infection in the urinary system). Record review of Resident #1's Comprehensive Minimum Data Set, dated [DATE], revealed: Section C Brief Interview for Mental Status score revealed a score of 00, which indicated the resident's cognition was severely impaired. Record review of Resident #1's care plan, dated 7/14/25, revealed the following:Resident #1 had a focus for elopement and wandering specifically that she wandered aimlessly (date initiated 8/14/25). The goal was for Resident #1 to remain safe within the facility unless accompanied by a staff or authorized person. Interventions included distracting resident from wandering by offering pleasant diversions and supervising closely and make regular compliance rounds. Resident #1 had a focus for coping, specifically Resident #1 had a tough time coping with a roommate as roommate might have been verbally aggressive towards Resident #1 (date initiated 7/14/25). The goal was for Resident #1 to feel comfortable in a safe living environment. Interventions included staff would listen to Resident #1's concerns. Staff would monitor if Resident #1 were unable to cope with roommate and the social worker would find a new roommate if applicable. Record review of Resident #1's progress notes, dated 5/13/25-8/14/25, revealed: No incidents documented involving Resident #1 and any other residents on 7/11/25.07/13/25 at 9:11 PM LVN B documented: family report a CNA reported to them Resident #1's roommate was cursing at her and telling her to clean up after herself in the bathroom. Initial treatment included skin assessment; roommate placed on 1:1 monitoring supervision. Medical doctor and nurse practitioner notified. Responsible party was notified. 07/13/25 at 10:37 PM LVN B documented skin assessment conducted with no negative findings. 07/14/25 at 2:58 AM LVN B documented trauma assessment conducted. There were no negative findings or experiences documented or found. Resident #1 did not express fear or anger. 7/14/25 at 9:36 PM the DON documented a late entry indicating Resident #1's family reported to administration that the CNA (unidentified in the progress note) told them Resident #1's roommate was cursing at Resident #1 and telling her to clean up after herself in the bathroom. Resident #1's roommate was placed on one-to-one monitoring. Skin Assessment performed on Resident #1. A room swap was made. Family was aware and notified. FNP was notified. 7/15/25 at 8:36 AM LVN EE documented that Resident #1 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 23 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0609 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few appeared to be in no pain and monitoring was conducted. 7/15/25 at 8:37 AM LVN EE documented that Resident #1 had no signs or symptoms of distress noted, resident in good spirits.7/15/25 at 10:13 PM LVN BB documented that Resident #1 had no signs or symptoms of distress and did not complain of any pain.During an interview on 8/14/25 at 12:31 PM, Resident #1 could not recall the incident that occurred between she and Resident #2. She could not identify her last roommate by name. She stated she could not remember if she was afraid on 7/11/25. She could not remember how long she had been in the room that she was and why she had moved. She reported that she felt safe at the facility. Resident #2 Record review of Resident #2's face sheet, dated 8/14/25, revealed a [AGE] year-old-female was admitted to the facility on [DATE] with diagnoses to include intermittent explosive disorder (mental disorder characterized by outburst of anger or violence), anxiety (increased worry) and dementia (memory loss). Record review of Resident #2's Comprehensive Minimum Data Set, dated [DATE], revealed: Section C Brief Interview for Mental Status score revealed a score of 08, which indicated the resident's cognition was moderately impaired. Section E did not reveal any coded behaviors.Record review of Resident #2's Quarterly Minimum Data Set, dated [DATE], revealed: Section E Behavior Resident #2 had other behavioral symptoms not directed towards others.Resident #2's care plan, dated 7/14/25 revealed the following:Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had potential to demonstrate physical behaviors. (initiated 7/4/25) The goal was for Resident #2 to demonstrate effective coping skills. Interventions included staff analyzing key times, places, circumstances, triggers, and what de-escalates behavior and document. Staff should assess and address sensory deficits and notify the charge nurse of any physically abusive behaviors. When Resident #2 becomes agitated staff should intervene before agitation escalates. Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had a behavior problem related to being verbally aggressive to staff and other residents. (initiated 7/14/25) The goal was for Resident #2 to not have episodes of being verbally aggressive. Interventions included anticipate the needs of Resident #2. Staff should provide opportunity for positive interaction. Consultation with psychiatry will be made if needed. Staff should also intervene as necessary to protect the rights and safety of others. Staff will also monitor behavior episode of Resident #2. Record review of Resident #2's progress notes, dated 5/13/25-8/14/25, revealed: No incidents documented involving Resident #2 and any other residents on 7/11/25.7/13/25 at 9:11 PM the DON documented Resident #2 had a behavior (verbal, resident to resident alleged behavior). Resident #2 scolded her roommate (Resident #1) with curse words to clean up her mess in the bathroom. 1:1 mentoring supervision implemented. Consulted FNP for new orders of hydroxyzine 50 mg PO Q4 hours prn. Recommended to conduct room swap. Resident #2 stated we get along good. Resident #2 stated she worried about her roommate because she sleeps all day and does not sleep much. Attempted to contact Resident #2's family. 7/14/25 at 8:20 AM the DON documented late entry: Informed by administrator the resident's (unspecified in this progress note) roommate's family informed her the CNA (unspecified in this progress note) told them Resident #2 was cursing at her roommate and telling her to clean up after herself in the bathroom. Resident #2 was immediately place on one-on-one observation. Consulted psych provider for any new orders/recommendations. New order to start hydroxyzine 50 mg prn Q4 hours for anxiety/agitation. Performed a roommate swap and may d/c one-on-one monitoring but ensure frequent monitoring as the resident was not physically aggressive. Attempted to notify Family Member FF multiple times. D/c one-on-one supervision. Resident #2 currently does not have a roommate currently.07/15/25 at 10:18 AM the SW documented that she received notification from the administration that a referral to the behavioral center was needed. The SW notified Family Member FF, and he agreed to the referral and the referral was completed. 07/15/25 at 10:24 AM LVN EE (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 24 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0609 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few documented no verbal behaviors noted, and Resident #2 was in good spirits. 07/15/25 at 10:29 PM LVN BB documented Resident #2 was quiet without negative behaviors, toward resident or staff. 07/16/25 at 8:57 AM LVN EE documented Resident #2 had no behaviors. 07/16/25 at 8:57 PM LVN B documented no behaviors reported during her shift. 07/17/25 at 2:57 PM The SW documented that the referral for Resident #2 was denied due to Resident #2's insurance being out of network. During an interview on 8/14/25 at 12:33 PM, Resident #2 stated she does not remember why her last roommate moved. She stated she got along well with her last roommate. She could not identify her last roommate by name. She could not report if she had an incident with Resident #1 on 7/11/25. During an interview on 8/14/25 at 9:31 AM, CNA A stated she did not have a calendar in front of her but believed the incident occurred on 7/11/25. She stated she worked the night shift (6:00 PM- 6:00 AM). She stated on that day (7/11/25) her partner that she worked with that day called in late. She stated she and LVN B were the only ones on the locked female unit. She stated around 7:00 PM or 7:30 PM while LVN B was attending to another resident next door to Resident #1 and Resident #2 they (CNA A and LVN B) heard Resident #2 yell a loud and clear Get your mother fucking ass in that God Damn bathroom and clean that shit up! CNA A stated she and LVN B looked at each other. CNA A stated LVN B asked her Who is she (Resident #2) hollering at? CNA A stated LVN B instructed her (CNA A) to go and look. CNA A stated when she stepped into Resident #1 and Resident #2's room she observed Resident #1 standing in front of Resident #2 and the look on Resident #1's face gave her (CNA A) the impression that she was scared. CNA A stated she motioned for Resident #1 to come with her. CNA A stated she took Resident #1 to where LVN B was and during this time LVN B then goes to Resident #2. CNA A stated she and Resident #1 stood outside the room where Resident #2 and LVN B were. CNA A stated LVN B asked Resident #2 what was going on and Resident #2 voiced her complaint about Resident #1 pissing on the bathroom floor. She stated LVN B instructed Resident #2 that if it happened again, she needed to call staff for help. CNA A stated she went to get a towel to clean up the urine in the bathroom and while she was doing this Resident #1 followed LVN B. CNA A stated Resident #2 yelled at her Don't clean up that shit! This is why she (Resident #1) don't learn because y'all baby her (Resident #1)! CNA A stated Resident #1 was afraid and did not go back to the room with Resident #2 for majority of the night. CNA A stated Resident #1 did not go to bed until Resident #2 was asleep. CNA A stated she was under the impression that since LVN B witnessed the incident along with her that she would report it to the abuse coordinator, document and notify the family. CNA A stated a couple of days later (unsure of the exact date), Resident #1's family came to the facility and in passing the family asked why is it that when they have come in Resident #1 is not in her bed and sometimes is found in other resident's bed. CNA A stated she told them that it was most likely because she (Resident #1) was afraid of her roommate (Resident #2). She stated that immediately once she mentioned the incident to Family Member CC, he became upset and exclaimed no one told him about the incident. She stated that LVN B was upset with her and told her at that time to complete a report. She stated unsure of the date the following Monday she was suspended because she failed to report the incident. CNA A stated she did not feel it was right that she was suspended for failure to report when LVN B also heard the incident and was present. CNA A stated that the ADM told her that LVN B may have misheard what happened. CNA A stated this was not the case because Resident #2 said what she said very loud, and they were next door to their room. CNA A stated Resident #1 slept in the same room with Resident #2 the night of the incident. CNA A stated she was told that Resident #1 was moved out of the room only after Resident #1's family complained. CNA A stated Resident #2 had a history of aggression and that she had expressed concern in the past. CNA A stated Resident #2 had broken the facility door before and was an exceptionally large lady in (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 25 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0609 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few comparison to Resident #1. She stated although she did not believe Resident #2 physically hit Resident #1, she believed that Resident #1 was afraid because she would not go back in her room the night of the incident. She stated she and other staff reported to LVN B that even they (staff) were afraid of Resident #2. CNA A stated no other incidents had occurred between Resident #1 and Resident #2 since 7/11/25 but she could not attest for any time after she was suspended. She stated she was trained that if she suspects or witness abuse, she was to report abuse to her chain of command, and this would have been LVN B. She stated that being a CNA for over 25 years this was the way it has always been. She stated that the ADM stated at the time of her suspension that she was supposed to report the incident to her (the ADM). CNA A stated the nurses were responsible for reporting incidents to the family. CNA A stated the night of the incident Resident #1 did not have any injuries that she could visibly see. Interviews conducted on 8/14/25 between 10:32 AM-1:04 PM, revealed that day time staff (CNA C, CNA D, CNA E, CNA F, CNA G, CNA H, LVN I, LVN J and CNA K) had been trained on the facility's abuse policy. The staff were able to identify the abuse coordinator, and stated if they suspected or witnessed abuse, they would report directly to the abuse coordinator. During their interview staff was able to report that apart of the suspicion or witnessing abuse they would protect the resident. During an interview on 8/14/25 at 2:33 PM, the ADM stated that she was unsure of the date and time but while at home one-night LVN B called her and explained that Resident #1's family was upset. She stated LVN B told her about the initial complaint from the family involved cleaning supplies and them (Family Member CC) having to clean the restroom. The ADM stated that she received a call from Family Member DD 30 minutes later who stated that the real reason that they (family) were upset was because Resident #1 had been abused and her roommate (Resident #2) was screaming at her (Resident #1). The ADM stated at the time Family Member DD notified her of Resident #2 screaming at Resident #1 she was unaware of the incident. She stated once Family Member DD notified her, she notified the DON, and the DON instructed for 1:1 to be started for Resident #2 to LVN B. The ADM stated that LVN B stated she was unaware of any incidents of abuse that involved Resident #1 and Resident #2. She stated that she started her abuse process and notified HHSC the same day the family notified her. The ADM, DON, regional Nurse Consultant and Director of Operations were notified on 7/15/25 at 4:08 PM and a PNC IJ situation was identified due to the above failures and the IJ template and 3-strike letter was provided.Interviews conducted on 8/15/25 between 4:31 PM-6:16 PM, revealed that administration, daytime and nighttime staff (the DM, MDS Coordinator, ADON, HR, the Maintenance Supervisor, DS L, [NAME] M, LVN N, LVN O, CNA P, MA Q, CNA R, CNA S, RN T, CNA U, MA V, CNA W, CNA X, CNA Y, CNA Z, CNA AA, and LVN BB) had been trained on the facility's abuse policy recently (within the past 30-60 days). The staff voiced they had been trained by the ADM, DON and or the ADON. They stated that they were given the opportunity to ask questions if they needed to. They were all able to identify the abuse coordinator as the ADM and that they needed to report all suspected or witnessed abuse to the ADM. They all were able to voice that they would not assume that an incident had been reported but would report the incident as it was their responsibility. All staff interviewed voiced that they were comfortable, confident in their role carrying out the facility's expectation regarding the facility's abuse policy and requirements. During an interview on 8/15/25 at 12:15 PM, the ADM stated that she was unsure of the exact date of the incident between Resident #1 and Resident #2, but voiced that she was notified of the incident on 7/13/25 by Family Member DD. The ADM stated she reported the incident to HHSC on 7/13/25 at 11:05 PM. The ADM stated she was sure all staff had been trained because the day they started re-education it was the facility's pay day and each staff that came in had to pick up their check. They re-educated and quizzed the staff verbally on the expectations. She stated (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 26 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0609 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few staff had always been trained to report to her as the abuse coordinator. She stated Resident #2 was referred to psychiatric services for the incident.During an interview on 8/15/25 at 6:18 PM, Family Member CC stated they were not notified of the incident that occurred with Resident #1 and Resident #2 at the time of the incident. Family Member CC stated CNA A notified them that Resident #1 was afraid of her roommate (Resident #2). Family Member CC stated he had not observed any incidents between Resident #1 and Resident #2. He stated that they (he and his family) were incredibly pleased with how the facility responded to them reporting their concerns about Resident #1. Family Member CC stated as soon as they reported the incident the facility staff moved Resident #1. Family Member CC stated there had been no incidents since the incident. Family member CC stated that he was unsure if Resident #1 was afraid, but they (he and the family) had concerns that Resident #1 was sleeping in other resident's beds because she had a UTI. He stated when he asked CNA A about what she thought regarding Resident #1 sleeping in other's beds CNA disclosed the incident. He stated he honestly believed CNA was trying to console them because they had other concerns within the same night. He stated since the incident between Resident #1 and Resident #2 the facility staff have done so well notifying them (he and family). During an interview on 8/15/25 at 5:15 PM, the ADM stated the facility's system to ensure that the facility ANE policy (specifically ANE was reported to the appropriate parties (HHSC and abuse coordinator) and family was notified) was being followed was through staff education, re-education, routine rounds and talking to staff. The ADM stated she and all her staff had been trained on the facility's ANE policy (specifically ANE was reported to the appropriate parties (HHSC and abuse coordinator), and family was notified) and their specific roles as it related to the policy. The ADM stated she expected all staff to follow the abuse policy. Specifically, the ADM stated she expected family to be notified of incidents of ANE, the abuse coordinator to be notified immediately if they suspect or witness abuse and incidents of ANE to be reported to HHSC. The ADM stated more specifically the nursing staff, DON or the ADM was responsible for family notifications. The ADM stated all staff was responsible for reporting to the abuse coordinator immediately. The ADM stated she and the DON was responsible for reporting incidents to HHSC. The ADM stated the potential negative outcome for not notifying family was the family would not be aware of issues and they are supposed to be aware of issues concerning their resident. The ADM stated if CNA A would have notified the LVN B then LVN B could have notified Resident #1's family. The ADM stated the reason Resident #1's family was not notified was because CNA A did not report the details of the incident to LVN B. The ADM stated the potential negative outcome for not reporting to the abuse coordinator was the abuse coordinator would not know. The ADM stated with the abuse coordinator not knowing of an incident then they would not be able to report to HHSC timely to HHSC. The ADM stated the reason the incident was not reported to HHSC timely was because CNA A did not report to the incident to LVN B or to her timely. The ADM stated the potential negative outcome for not reporting to HHSC would be a thorough investigation may not be conducted. The ADM stated the reason that the incident was not reported to HHSC timely was because CNA A did not report the details to LVN B or to her as the abuse coordinator. During an interview on 8/15/25 at 5:42 PM, the DON stated the system to monitor ANE was reported to the appropriate parties (HHSC and abuse coordinator), and family was notifications was inservicing and educating staff on the policy. The DON stated they teach the staff over and over to follow the abuse policy which included reporting and family notifications. The DON stated she reviews documentation to also ensure that the policy was being followed. The DON stated that she had been trained on the facility's expectation that ANE was reported to the appropriate parties (HHSC and abuse coordinator), and family notifications as well as all her staff. The DON stated she expected that all staff to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 27 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0609 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few follow the expectation that ANE was reported to the appropriate parties (HHSC and abuse coordinator), and family notifications were made. The DON stated specifically for family notifications she expected family to be notified of all things that had to do with the residents. The DON stated that she expected for family to be notified of all incidents and any changes. The DON stated expected that the abuse coordinator should be notified immediately of any suspicions of ANE so that the proper steps are taken and followed. The DON stated that she expected HHSC to notified timely according to their policy so the proper investigations can be initiated. The DON stated whichever staff witnessed the incident was responsible for reporting to the abuse coordinator. The DON stated the nurse involved in the incident was responsible for notifying the family, but this could only be done after the person reported the incident to the nurse. The DON stated the abuse coordinator was responsible for notifying HHSC. The DON stated that the reason ANE was not reported to the appropriate parties (HHSC and abuse coordinator) was because CNA A did not report the incident between Resident #1 and Resident #2 to LVN B and the abuse coordinator. The DON stated that the potential negative outcome for not notifying family was the family would not bee aware of what was going on with the resident. The DON stated it was improper for notifications not to be done. The DON stated the reason the family was not notified was because CNA A did not notify LVN B or the abuse coordinator. The DON stated the potential negative outcome of not reporting to the abuse coordinator immediately was the situation with the resident would not be addressed and the residents would be at risk for harm. The DON was unaware that Resident #1's family had not been notified. The DON stated the reason the abuse coordinator was not notified was because CNA A did not notify LVN B or her. The DON stated the potential negative outcome of not reporting to HHSC timely was the facility would not be following the proper procedures. The DON stated that potentially the incident would not be investigated, and safety could not be ensured. The DON stated she was unaware that HHSC had not been notified because she was unaware of the incident until it was reported on 7/13/25. The DON stated the reason HHSC was not notified was because CNA A did not notify LVN B or the abuse coordinator. During an interview on 8/15/25 at 8:45 PM, LVN B stated she was unsure of the exact date of the incident that occurred between Resident #1 and Resident #2. LVN B stated that she was in the last room at the end of the hallway assisting another resident. She stated CNA A heard one of the residents raise their voice. She stated she asked CNA A which resident raised their voice and was told by CNA A that it was Resident #2 and Resident #1. LVN B stated CNA A told her that Resident #2 was raising her voice at Resident #1. LVN B stated she voiced to Resident #2 that she does not need to raise her voice. LVN B stated that was it and she left Resident #2 in her room. LVN B stated 5 minutes later both residents could not remember the incident. LVN B stated she does not know what specifically Resident #2 said to Resident #1. She stated CNA A did not specify what was said but only stated Resident #2 was yelling at Resident #1 because there was piss on the floor. LVN B stated she did not suspect abuse because normally Resident #2 was loud resident and that was the way she talked. She stated working on the locked unit residents have behaviors and she considered Resident #2 yelling as one of her behaviors and she needed redirection. LVN B stated Resident #1 did not appear afraid to her. LVN B stated Resident #1 went back to her room within an hour of the incident. LVN B stated that CNA A did not report to her or indicate that Resident #1 was afraid. LVN B stated after the incident between Resident #1 and Resident #2 she never had a discussion with Resident #1's family nor did she discuss the incident any further with CNA A. LVN B stated that had not been any other incidents since the verbal incident between Resident #1 and Resident #2 nor had there been any incidents before. LVN B stated CNA A reported to the Resident #1's family that Resident #1 felt threatened by Resident #2 and that is what caused them to call the ADM. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 28 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0609 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few She stated when they called the ADM, she was instructed to place Resident #2 on 1:1 supervision. LVN B stated she did not report the incident to the abuse coordinator because she felt it was a nursing judgement call to redirect Resident #2. LVN B stated she did not notify the family of the incident but could not give a reason as to why because she could not remember what was going on that day to be able to give the investigator accurate information. LVN B stated an incident of the same nature involving Resident #1 and Resident #2 would have been an incident that she would notify family of. She stated she did not document the incident in either resident's progress notes. LVN B stated she could not give the investigator a reason because she could not recall specifically what went on that day that would potentially hinder her in documenting. LVN B stated she had been trained on the facility's abuse policy recently (within the past 30-60 days) by the ADM, DON and ADON. LVN B was able to identify the abuse coordinator as the ADM and that she needed to report all suspected or witnessed abuse to the ADM. She stated that she would not assume that an incident had been reported but would report the incident as it was her responsibility. She stated that protection of the resident(s) involved was a part of following the abuse protocol for the facility. She stated if she did not see any protection interventions put in place that she would follow up with management and or the abuse coordinator. LVN B stated Resident #1 and Resident #2 shared the same room after the incident up until she was instructed to place Resident #2 on 1:1 supervision. LVN B stated no other incidents occurred with Resident #1 and Resident #2 after the verbal incident on the unknown date that she was aware of. LVN B stated it was her responsibility to notify family and or responsible party of any significant events involving the residents that resided at the facility. She stated before the incident that occurred with Resident #1 and Resident #2, she had received training on the facility's ANE policy.During the investigation held on 8/14/25-8/15/25 there were no observation of any interactions between Resident #1 and Resident #2. Resident #1 and Resident #2 were observed in their separate rooms during the visit. Record review of the facility's Form 3614 (Provider Investigation Report), dated 7/17/25, revealed:Incident Date: 7/11/25Person(s) or Resident(s) involved:Resident #1 Alleged Perpetrator: None listed.Witnesses:CNA ADescription of the Allegation: Resident #1's roommate cusses at her and tries to make her clean up the bathroom. Assessment:7/13/25: Resident has no injuries. Provider Response: Resident #2 was placed on one-to-one monitoring immediately upon receiving report from Resident #1's family. Resident #1 was assessed for any injuries-none noted. Physician notified. Family, physician and psychiatry notified for Resident #2.Investigation Summary: Resident #1's family reported to LVN B, that they had been finding Resident #1 bathroom with bowel and urine on the floor and they had been bringing toilet paper because she had not had toilet paper and sometimes paper towels. LVN B notified the ADM via phone of the concern. The ADM later received a call from Family Member B stating what family had reported and added that Resident #2 had been yelling and cussing at Resident #1. LVN B was aware that one evening she heard raised voices and sent CNA A to see what was going on but nothing was ever reported to LVN B about cussing or demanding residents to het on her knees and clean up the bathroom. CNA A was suspended pending investigation and will be terminated for failure to report. Both residents lack capacity to make informed decisions. Room changes were done, and Resident #2 remained one to one until the room changes were done. Referral was made to the behavior center for Resident #2. No issues since Resident #2 does not have a roommate. Facility Investigation Findings: UnconfirmedProvider Action Taken Post-Investigation: Continue to monitor resident and re-education with staff on abuse, neglect and reporting procedures.Record review of CNA A's witness statement, dated 7/14/25, revealed: I was in the room talking to my nurse, LVN B, when I heard Resident #2 yelling and cussing, saying Get your fucking ass in that goddamn bathroom and clean up that mess (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 29 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 0609 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete right now. I'm sick of this shit. LVN B had asked me to go see who she was talking to. I walked to the door and saw Resident #1 standing in front of Resident #2. I motioned for Resident #1 to come out in the hall. I then told LVN B she was talking to Resident #1. LVN B then asked Resident #2 what was going on and Resident #2 stated Resident #1 had peed on the bathroom floor and had done it before, and she wanted her to clean it up. LVN B told Resident #2 that Resident #1 could not do that because she could fall. I had went to get a towel to clean up the urine and Resident #2 stated to me that Resident #1 needed to get on her hands and knees and clean that shit up because she was tired of her doing that. I had advised Resident #2 that Resident #1 was not able to do so. I told Resident #2 if it happened again for her to let me or any aide that is on the hall and we would clean it up. Resident #2 then told me as long as we keep babying her and not making her clean up her mess then she would never stop. I walked out of the room and nothing more was said. Record review of Resident #2's 1:1 monitoring supervision sheet, dated 7/13/25-, revealed:Resident #2 was on 1:1 monitoring from 7/13/25 at 9:49 PM until 7/14/25 at 4:45 AM.Record review of CNA Record review of staff (LVN BB), undated, witness statements that revealed they had never observed Resident #2 being mean or rude to Resident #1.Record review of staff (CNA Z) written statement, undated, revealed she was not sure of the date, but she heard Resident #2 tell Resident #1 tell Resident #1 to clean up the bathroom, or she would make her and then she would kick her butt. The statement stated Resident #2 told Resident #1 she knew what she was doing. Record review of staff (CNA HH), dated 7/14/25, witness statements that revealed they had never observed Resident #2 being mean or rude to Resident #1.Record review of LVN B's written statement, dated, 7/16/25, revealed she (LVN B) was in the room assisting another resident in the restroom Event ID: Facility ID: 675527 If continuation sheet Page 30 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 - Immediate jeopardy to resident health or safety **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews the facility failed to prevent further potential abuse, neglect, exploitation, or mistreatment for 2 of 7 residents (Resident #1, #2) reviewed for abuse.The facility failed to immediately implement protective measures to protect Resident #1 from Resident #2 after a verbal abuse incident occurred on 7/11/25 between 7:00 PM and 7:30 PM.The noncompliance was identified as PNC. The IJ began on 07/11/25 and ended on 7/14/25. The facility had corrected the noncompliance before the survey began.These failures could place residents as risk for further abuse to include emotional and physical.Findings Included: Resident #1 Record review of Resident #1's face sheet, 8/14/25, revealed an [AGE] year-old-female was admitted to the facility on [DATE] with diagnoses to include dementia (memory loss), schizoaffective disorder (mental disorder), anxiety (increased worry), insomnia (difficulty sleeping), major depressive disorder (increase sadness) and UTI (infection in the urinary system). Record review of Resident #1's Comprehensive Minimum Data Set, dated [DATE], revealed: Section C Brief Interview for Mental Status score revealed a score of 00, which indicated the resident's cognition was severely impaired. Record review of Resident #1's care plan, dated 7/14/25, revealed the following:Resident #1 had a focus for elopement and wandering specifically that she wandered aimlessly (date initiated 8/14/25). The goal was for Resident #1 to remain safe within the facility unless accompanied by a staff or authorized person. Interventions included distracting resident from wandering by offering pleasant diversions and supervising closely and make regular compliance rounds. Resident #1 had a focus for coping, specifically Resident #1 had a tough time coping with a roommate as roommate might have been verbally aggressive towards Resident #1 (date initiated 7/14/25). The goal was for Resident #1 to feel comfortable in a safe living environment. Interventions included staff would listen to Resident #1's concerns. Staff would monitor if Resident #1 were unable to cope with roommate and the social worker would find a new roommate if applicable. Record review of Resident #1's progress notes, dated 5/13/25-8/14/25, revealed: No incidents documented involving Resident #1 and any other residents on 7/11/25.07/13/25 at 9:11 PM LVN B documented: family report a CNA reported to them Resident #1's roommate was cursing at her and telling her to clean up after herself in the bathroom. Initial treatment included skin assessment; roommate placed on 1:1 monitoring supervision. Medical doctor and nurse practitioner notified. Responsible party was notified. 07/13/25 at 10:37 PM LVN B documented skin assessment conducted with no negative findings. 07/14/25 at 2:58 AM LVN B documented trauma assessment conducted. There were no negative findings or experiences documented or found. Resident #1 did not express fear or anger. 7/14/25 at 9:36 PM the DON documented a late entry indicating Resident #1's family reported to administration that the CNA (unidentified in the progress note) told them Resident #1's roommate was cursing at Resident #1 and telling her to clean up after herself in the bathroom. Resident #1's roommate was placed on one-to-one monitoring. Skin Assessment performed on Resident #1. A room swap was made. Family was aware and notified. FNP was notified. 7/15/25 at 8:36 AM LVN EE documented that Resident #1 appeared to be in no pain and monitoring was conducted. 7/15/25 at 8:37 AM LVN EE documented that Resident #1 had no signs or symptoms of distress noted, resident in good spirits.7/15/25 at 10:13 PM LVN BB documented that Resident #1 had no signs or symptoms of distress and did not complain of any pain.During an interview on 8/14/25 at 12:31 PM, Resident #1 could not recall the incident that occurred between she and Resident #2. She could not identify her last roommate by name. She stated she could not remember if she was afraid on 7/11/25. She could not remember how long she had been in the room that she was and why she had moved. She reported that she felt safe at the facility. Resident #2 Record review of Resident #2's face sheet, dated 8/14/25, revealed a [AGE] year-old-female was Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 31 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 - Immediate jeopardy to resident health or safety Residents Affected - Few admitted to the facility on [DATE] with diagnoses to include intermittent explosive disorder (mental disorder characterized by outburst of anger or violence), anxiety (increased worry) and dementia (memory loss). Record review of Resident #2's Comprehensive Minimum Data Set, dated [DATE], revealed: Section C Brief Interview for Mental Status score revealed a score of 08, which indicated the resident's cognition was moderately impaired. Section E did not reveal any coded behaviors.Record review of Resident #2's Quarterly Minimum Data Set, dated [DATE], revealed: Section E Behavior Resident #2 had other behavioral symptoms not directed towards others.Resident #2's care plan, dated 7/14/25 revealed the following:Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had potential to demonstrate physical behaviors. (initiated 7/4/25) The goal was for Resident #2 to demonstrate effective coping skills. Interventions included staff analyzing key times, places, circumstances, triggers, and what de-escalates behavior and document. Staff should assess and address sensory deficits and notify the charge nurse of any physically abusive behaviors. When Resident #2 becomes agitated staff should intervene before agitation escalates. Resident #2 had a focus for behavioral symptoms specifically that Resident #2 had a behavior problem related to being verbally aggressive to staff and other residents. (initiated 7/14/25) The goal was for Resident #2 to not have episodes of being verbally aggressive. Interventions included anticipate the needs of Resident #2. Staff should provide opportunity for positive interaction. Consultation with psychiatry will be made if needed. Staff should also intervene as necessary to protect the rights and safety of others. Staff will also monitor behavior episode of Resident #2. Record review of Resident #2's progress notes, dated 5/13/25-8/14/25, revealed: No incidents documented involving Resident #2 and any other residents on 7/11/25.7/13/25 at 9:11 PM the DON documented Resident #2 had a behavior (verbal, resident to resident alleged behavior). Resident #2 scolded her roommate (Resident #1) with curse words to clean up her mess in the bathroom. 1:1 mentoring supervision implemented. Consulted FNP for new orders of hydroxyzine 50 mg PO Q4 hours prn. Recommended to conduct room swap. Resident #2 stated we get along good. Resident #2 stated she worried about her roommate because she sleeps all day and does not sleep much. Attempted to contact Resident #2's family. 7/14/25 at 8:20 AM the DON documented late entry: Informed by administrator the resident's (unspecified in this progress note) roommate's family informed her the CNA (unspecified in this progress note) told them Resident #2 was cursing at her roommate and telling her to clean up after herself in the bathroom. Resident #2 was immediately place on one-on-one observation. Consulted psych provider for any new orders/recommendations. New order to start hydroxyzine 50 mg prn Q4 hours for anxiety/agitation. Performed a roommate swap and may d/c one-on-one monitoring but ensure frequent monitoring as the resident was not physically aggressive. Attempted to notify Family Member FF multiple times. D/c one-on-one supervision. Resident #2 currently does not have a roommate currently.07/15/25 at 10:18 AM the SW documented that she received notification from the administration that a referral to the behavioral center was needed. The SW notified Family Member FF, and he agreed to the referral and the referral was completed. 07/15/25 at 10:24 AM LVN EE documented no verbal behaviors noted, and Resident #2 was in good spirits. 07/15/25 at 10:29 PM LVN BB documented Resident #2 was quiet without negative behaviors, toward resident or staff. 07/16/25 at 8:57 AM LVN EE documented Resident #2 had no behaviors. 07/16/25 at 8:57 PM LVN B documented no behaviors reported during her shift. 07/17/25 at 2:57 PM The SW documented that the referral for Resident #2 was denied due to Resident #2's insurance being out of network. During an interview on 8/14/25 at 12:33 PM, Resident #2 stated she does not remember why her last roommate moved. She stated she got along well with her last roommate. She could not identify her last roommate by name. She could not report if she had an incident with Resident #1 on 7/11/25. During an interview on 8/14/25 at (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 32 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 - Immediate jeopardy to resident health or safety Residents Affected - Few 9:31 AM, CNA A stated she did not have a calendar in front of her but believed the incident occurred on 7/11/25. She stated she worked the night shift (6:00 PM- 6:00 AM). She stated on that day (7/11/25) her partner that she worked with that day called in late. She stated she and LVN B were the only ones on the locked female unit. She stated around 7:00 PM or 7:30 PM while LVN B was attending to another resident next door to Resident #1 and Resident #2 they (CNA A and LVN B) heard Resident #2 yell a loud and clear Get your mother fucking ass in that God Damn bathroom and clean that shit up! CNA A stated she and LVN B looked at each other. CNA A stated LVN B asked her Who is she (Resident #2) hollering at? CNA A stated LVN B instructed her (CNA A) to go and look. CNA A stated when she stepped into Resident #1 and Resident #2's room she observed Resident #1 standing in front of Resident #2 and the look on Resident #1's face gave her (CNA A) the impression that she was scared. CNA A stated she motioned for Resident #1 to come with her. CNA A stated she took Resident #1 to where LVN B was and during this time LVN B then goes to Resident #2. CNA A stated she and Resident #1 stood outside the room where Resident #2 and LVN B were. CNA A stated LVN B asked Resident #2 what was going on and Resident #2 voiced her complaint about Resident #1 pissing on the bathroom floor. She stated LVN B instructed Resident #2 that if it happened again, she needed to call staff for help. CNA A stated she went to get a towel to clean up the urine in the bathroom and while she was doing this Resident #1 followed LVN B. CNA A stated Resident #2 yelled at her Don't clean up that shit! This is why she (Resident #1) don't learn because y'all baby her (Resident #1)! CNA A stated Resident #1 was afraid and did not go back to the room with Resident #2 for majority of the night. CNA A stated Resident #1 did not go to bed until Resident #2 was asleep. CNA A stated she was under the impression that since LVN B witnessed the incident along with her that she would report it to the abuse coordinator, document and notify the family. CNA A stated a couple of days later (unsure of the exact date), Resident #1's family came to the facility and in passing the family asked why is it that when they have come in Resident #1 is not in her bed and sometimes is found in other resident's bed. CNA A stated she told them that it was most likely because she (Resident #1) was afraid of her roommate (Resident #2). She stated that immediately once she mentioned the incident to Family Member CC, he became upset and exclaimed no one told him about the incident. She stated that LVN B was upset with her and told her at that time to complete a report. She stated unsure of the date the following Monday she was suspended because she failed to report the incident. CNA A stated she did not feel it was right that she was suspended for failure to report when LVN B also heard the incident and was present. CNA A stated that the ADM told her that LVN B may have misheard what happened. CNA A stated this was not the case because Resident #2 said what she said very loud, and they were next door to their room. CNA A stated Resident #1 slept in the same room with Resident #2 the night of the incident. CNA A stated she was told that Resident #1 was moved out of the room only after Resident #1's family complained. CNA A stated Resident #2 had a history of aggression and that she had expressed concern in the past. CNA A stated Resident #2 had broken the facility door before and was an exceptionally large lady in comparison to Resident #1. She stated although she did not believe Resident #2 physically hit Resident #1, she believed that Resident #1 was afraid because she would not go back in her room the night of the incident. She stated she and other staff reported to LVN B that even they (staff) were afraid of Resident #2. CNA A stated no other incidents had occurred between Resident #1 and Resident #2 since 7/11/25 but she could not attest for any time after she was suspended. She stated she was trained that if she suspects or witness abuse, she was to report abuse to her chain of command, and this would have been LVN B. She stated that being a CNA for over 25 years this was the way it has always been. She stated that the ADM stated at the time of her suspension that she was supposed to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 33 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 - Immediate jeopardy to resident health or safety Residents Affected - Few report the incident to her (the ADM). CNA A stated the nurses were responsible for reporting incidents to the family. CNA A stated the night of the incident Resident #1 did not have any injuries that she could visibly see. During an interview on 8/14/25 at 10:32 AM, CNA C stated she had never worked the female locked unit. She stated she had guarded the door once when the doors were not working. She stated she had not worked directly with Resident #1 and Resident #2. During an interview on 8/14/25 at 10:43 AM, CNA D stated she did not have any information regarding the verbal incident between Resident #1 and Resident #2 that occurred on 07/11/25. She stated she is unaware if any incidents had occurred since 7/11/25. During an interview on 8/14/25 at 11:09 AM, CNA E stated she did not have any firsthand information about the verbal incident that occurred on 7/11/25 between Resident #1 and Resident #2. She stated Resident #1 and Resident #2 had never had issues before 7/11/25 or since 7/11/25. She stated Resident #2 rarely has behaviors. She stated Resident #1 has no behaviors but will ask questions over and over. During an interview on 8/14/25 at 11:24 AM, CNA F stated she did not have any firsthand information about Resident #1's and Resident #2's verbal altercation that occurred on 7/11/25. She stated there had been no additional altercations between Resident #1 and Resident #2. She stated Resident #1 had an issue where she wanted to leave the unit but never had any altercations with residents in the unit. During an interview on 8/14/25 at 11:35 AM, CNA G stated she does not work the female unit and did not have any information regarding the incident that occurred on 7/11/25 between Resident #1 and Resident #2. During an interview on 8/14/25 at 11:45 AM, CNA H stated although she works the female locked unit at times, she did not have any information regarding the verbal altercation that occurred between Resident #1 and Resident #2. She stated she did not have any information about Resident #1 and Resident #2's behaviors as she had not worked the female locked unit in a while. During an interview on 8/14/25 at 11:55 AM, LVN I stated he did not have any firsthand information about the verbal altercation that occurred on 7/11/25 between Resident #1 and Resident #2. He stated Resident #1 and Resident #2 did not have a history of verbal altercations and there had been no incidents since 7/11/25. He stated Resident #1 was pleasantly confused. He stated she would wander but no other behaviors. He stated in the past Resident #2 had behaviors that included hoarding briefs. He stated in the past on an unknown date she (Resident #2) broke the female locked unit door but was sent to a behavior unit because of that behavior. He stated the facility manages Resident #2's behavior well through close monitoring. During an interview on 8/14/25 at 12:11 PM, LVN J stated she did not have any firsthand information about Resident #1 and Resident #2's verbal altercation that occurred on 7/11/25 as she did not work the female locked unit on that date. She stated she did not have any additional information regarding Resident #2 or Resident #1 behaviors. During an interview on 8/14/25 at 1:04 PM, CNA K stated she did not have firsthand information regarding Resident #1 and Resident #2 verbal altercation that occurred on 7/11/25. She stated she had worked with both residents before and after 7/11/25. She stated the two had never had any issues before or after. She stated Resident #2 never comes out of her room. She stated Resident #1 can be active at times. She stated neither resident has ever had significant behaviors in her presence. Interviews conducted on 8/14/25 between 10:32 AM-1:04 PM, revealed that daytime staff (CNA C, CNA D, CNA E, CNA F, CNA G, CNA H, LVN I, LVN J and CNA K) had been trained on the facility's abuse policy. The staff were able to identify the abuse coordinator, and stated if they suspected or witnessed abuse, they would report directly to the abuse coordinator. During their interview staff was able to report that apart of the suspicion or witnessing abuse they would protect the resident. During an interview on 8/14/25 at 2:33 PM, the ADM stated that she was unsure of the date and time but while at home one-night LVN B called her and explained that Resident #1's family was upset. She stated LVN B told her about (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 34 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 - Immediate jeopardy to resident health or safety Residents Affected - Few the initial complaint from the family involved cleaning supplies and them (Family Member CC) having to clean the restroom. The ADM stated that she received a call from Family Member DD 30 minutes later who stated that the real reason that they (family) were upset was because Resident #1 had been abused and her roommate (Resident #2) was screaming at her (Resident #1). The ADM stated at the time Family Member DD notified her of Resident #2 screaming at Resident #1 she was unaware of the incident. She stated once Family Member DD notified her, she notified the DON, and the DON instructed for 1:1 to be started for Resident #2 to LVN B. The ADM stated that LVN B stated she was unaware of any incidents of abuse that involved Resident #1 and Resident #2. She (the ADM) stated that she started her abuse process. The ADM stated LVN B reported to her that she (LVN B) heard yelling one night (date was not specified) and LVN B instructed CNA A to see what happened. The ADM stated LVN B reported to her that CNA A never reported to her that Resident #2 was yelling at Resident #1. The ADM stated Resident #2 had a history of yelling at staff. The ADM stated she move Resident #1 away from Resident #2 on 7/14/25. The ADM could not specifically state when the incident between the two residents happened but that she became aware of the incident on 7/13/25. During an interview on 8/15/25 at 12:15 PM, the ADM stated that she was unsure of the exact date of the incident between Resident #1 and Resident #2, but voiced that she was notified of the incident on 7/13/25 by Family Member DD. She stated Resident #2 was placed on 1:1 supervision as soon as she was notified of the incident on 7/13/25. She stated Resident #1 was not moved out of the room with Resident #2 because of bed availability. She stated room moves had to be made before she could move Resident #1 out of the room with Resident #2. The ADM stated Resident #1 shared the same bedroom with Resident #2 after the incident up until she was notified on 7/13/25. The ADM no additional incidents had occurred between Resident #1 and Resident #2. She started safe surveys were conducted on the female locked unit and there were no findings. She stated they started re-education on the facility's abuse policy and by 7/14/25 100 percent of her staff had been trained on the facility's abuse policy. The ADM stated she was sure all staff had been trained because the day they started re-education it was the facility's pay day and each staff that came in had to pick up their check. They re-educated and quizzed the staff verbally on the expectations. She stated Resident #2 was referred to psychiatric services for the incident.During an interview on 8/15/25 at 12:20 PM, the DON stated that on 07/09/25 Resident #2 had a recent change in medication where she had started Depakote. She stated because of the incident between Resident #1 and Resident #2 it was decided to continue to monitor the newly change medication and they added a PRN medication (Hydroxyzine). The ADM, DON, regional Nurse Consultant and Director of Operations were notified on 7/15/25 at 4:08 PM and a PNC IJ situation was identified due to the above failures and the IJ template and 3-strike letter was provided.Interviews conducted on 8/15/25 between 4:31 PM-6:16 PM, revealed that administration, daytime and nighttime staff (the DM, MDS Coordinator, ADON, HR, the Maintenance Supervisor, DS L, [NAME] M, LVN N, LVN O, CNA P, MA Q, CNA R, CNA S, RN T, CNA U, MA V, CNA W, CNA X, CNA Y, CNA Z, CNA AA, and LVN BB) had been trained on the facility's abuse policy recently (within the past 30-60 days). The staff voiced they had been trained by the ADM, DON and or the ADON. They stated that they were given the opportunity to ask questions if they needed to. They all were able to report that protection of the resident(s) involved was a part of following the abuse protocol for the facility. They all were able to report that if they did not see any protection interventions put in place that they would follow up with management and or the abuse coordinator. All nurses interviewed were able to report that it was their responsibility to notify family and or responsible party of any significant events involving the residents that resided at the facility. During an interview on 8/15/25 at 6:18 PM, Family Member CC stated they were not notified of the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 35 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 - Immediate jeopardy to resident health or safety Residents Affected - Few incident that occurred with Resident #1 and Resident #2 at the time of the incident. Family Member CC stated CNA A notified them that Resident #1 was afraid of her roommate (Resident #2). Family Member CC stated he had not observed any incidents between Resident #1 and Resident #2. He stated that they (he and his family) were incredibly pleased with how the facility responded to them reporting their concerns about Resident #1. Family Member CC stated as soon as they reported the incident the facility staff moved Resident #1. Family Member CC stated there had been no incidents since the incident. Family member CC stated that he was unsure if Resident #1 was afraid, but they (he and the family) had concerns that Resident #1 was sleeping in other resident's beds because she had a UTI. He stated when he asked CNA A about what she thought regarding Resident #1 sleeping in other's beds CNA disclosed the incident. He stated he honestly believed CNA was trying to console them because they had other concerns within the same night. He stated since the incident between Resident #1 and Resident #2 the facility staff have done so well notifying them (he and family). During an interview on 8/15/25 at 5:15 PM, the ADM stated the facility's system to ensure that protection measures were put in place was through staff education, re-education, routine rounds and talking to staff. The ADM stated she and all her staff had been trained on implementing protection measures for residents and their specific roles as it related to the facility's abuse policy. Specifically, the ADM stated she expected the abuse coordinator to be notified immediately if they suspect or witness abuse, and protective measures to protect residents should be implemented. The ADM stated once they were notified, they were responsible for implementing protective measures, but all staff had been trained to ensure resident safety. The ADM stated the potential negative outcome for not implementing protective measures for a resident after an incident would be resident safety could be affected. The ADM stated protective measures are put in place to ensure that the resident is safe. The ADM additionally stated that she also ensures that protective measures were put in place by initiating 1:1 supervision until other protective measures can be put in place. The ADM stated protective measures were not put in place for Resident #1 because CNA A did not report the incident details to LVN B. During an interview on 8/15/25 at 5:42 PM, the DON stated the system to monitor implementation of protection measures were through inservicing and educating staff on the abuse policy. The DON stated they teach the staff over and over to follow the abuse policy which included protecting the residents from abuse. The DON stated she reviews documentation to also ensure that the policy was being followed and that protection measures were put in place. The DON stated that she had been trained to implement protection measures for residents when there is a suspicion or witnessed abuse as well as all her staff. The DON stated she expected that all staff to implement protection measures for all residents that experienced abuse or potentially could experience abuse. The DON stated expected that the abuse coordinator should be notified immediately of any suspicions of ANE so that the proper steps are taken and followed. The DON stated she expected for protective measures to be put in place to protect residents so that the residents are always safe, and the proper additional interventions can be put in place and implemented. The DON stated all staff were responsible for implementing protective measures, but this could only be done if the incident was reported correctly. The DON stated the potential negative outcome of not implementing protective measures for residents was harm to the residents involved could occur. The DON stated she was unaware that protective measures were not implemented immediately because she was unaware of the incident. The DON stated the reason protective measures were not implemented at the time of the incident was because CNA A did not notify LVN B or the abuse coordinator. During an interview on 8/15/25 at 8:45 PM, LVN B stated she was unsure of the exact date of the incident that occurred between Resident #1 and Resident #2. LVN B stated that she was in the last room at the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 36 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 - Immediate jeopardy to resident health or safety Residents Affected - Few end of the hallway assisting another resident. She stated CNA A heard one of the residents raise their voice. She stated she asked CNA A which resident raised their voice and was told by CNA A that it was Resident #2 and Resident #1. LVN B stated CNA A told her that Resident #2 was raising her voice at Resident #1. LVN B stated she voiced to Resident #2 that she does not need to raise her voice. LVN B stated that was it and she left Resident #2 in her room. LVN B stated 5 minutes later both residents could not remember the incident. LVN B stated she does not know what specifically Resident #2 said to Resident #1. She stated CNA A did not specify what was said but only stated Resident #2 was yelling at Resident #1 because there was piss on the floor. LVN B stated she did not suspect abuse because normally Resident #2 was loud resident and that was the way she talked. She stated working on the locked unit residents have behaviors and she considered Resident #2 yelling as one of her behaviors and she needed redirection. LVN B stated Resident #1 did not appear afraid to her. LVN B stated Resident #1 went back to her room within an hour of the incident. LVN B stated that CNA A did not report to her or indicate that Resident #1 was afraid. LVN B stated after the incident between Resident #1 and Resident #2 she never had a discussion with Resident #1's family nor did she discuss the incident any further with CNA A. LVN B stated that had not been any other incidents since the verbal incident between Resident #1 and Resident #2 nor had there been any incidents before. LVN B stated CNA A reported to the Resident #1's family that Resident #1 felt threatened by Resident #2 and that is what caused them to call the ADM. She stated when they called the ADM, she was instructed to place Resident #2 on 1:1 supervision. LVN B stated she did not report the incident to the abuse coordinator because she felt it was a nursing judgement call to redirect Resident #2. LVN B stated she had been trained on the facility's abuse policy recently (within the past 30-60 days) by the ADM, DON and ADON. LVN B was able to identify the abuse coordinator as the ADM and that she needed to report all suspected or witnessed abuse to the ADM. She stated if she did not see any protection interventions put in place that she would follow up with management and or the abuse coordinator. LVN B stated Resident #1 and Resident #2 shared the same room after the incident up until she was instructed to place Resident #2 on 1:1 supervision. LVN B stated no other incidents occurred with Resident #1 and Resident #2 after the verbal incident on the unknown date that she was aware of. She stated before the incident that occurred with Resident #1 and Resident #2, she had received training on the facility's ANE policy.During the investigation held on 8/14/25-8/15/25 there were no observation of any interactions between Resident #1 and Resident #2. Resident #1 and Resident #2 were observed in their separate rooms during the visit. Record review of the facility's Form 3614 (Provider Investigation Report), dated 7/17/25, revealed:Incident Date: 7/11/25Person(s) or Resident(s) involved:Resident #1 Alleged Perpetrator: None listed.Witnesses:CNA ADescription of the Allegation: Resident #1's roommate cusses at her and tries to make her clean up the bathroom. Assessment:7/13/25: Resident has no injuries. Provider Response: Resident #2 was placed on one-to-one monitoring immediately upon receiving report from Resident #1's family. Resident #1 was assessed for any injuries-none noted. Physician notified. Family, physician and psychiatry notified for Resident #2.Investigation Summary: Resident #1's family reported to LVN B, that they had been finding Resident #1 bathroom with bowel and urine on the floor and they had been bringing toilet paper because she had not had toilet paper and sometimes paper towels. LVN B notified the ADM via phone of the concern. The ADM later received a call from Family Member B stating what family had reported and added that Resident #2 had been yelling and cussing at Resident #1. LVN B was aware that one evening she heard raised voices and sent CNA A to see what was going on but nothing was ever reported to LVN B about cussing or demanding residents to het on her knees and clean up the bathroom. CNA A was suspended pending investigation and will be (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675527 If continuation sheet Page 37 of 38 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 675527 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Whisperwood Nursing & Rehabilitation Center 5502 W 4th St Lubbock, TX 79416 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 - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete terminated for failure to report. Both residents lack capacity to make informed decisions. Room changes were done, and Resident #2 remained one to one until the room changes were done. Referral was made to the behavior center for Resident #2. No issues since Resident #2 does not have a roommate. Facility Investigation Findings: UnconfirmedProvider Action Taken Post-Investigation: Continue to monitor resident and re-education with staff on abuse, neglect and reporting procedures.Record review of CNA A's witness statement, dated 7/14/25, revealed: I was in the room talking to my nurse, LVN B, when I heard Resident #2 yelling and cussing, saying Get your fucking ass in that goddamn bathroom and clean up that mess right now. I'm sick of this shit. LVN B had asked me to go see who she was talking to. I walked to the door and saw Resident #1 standing in front of Resident #2. I motioned for Resident #1 to come out in the hall. I then told LVN B she was talking to Resident #1. LVN B then asked Resident #2 what was going on and Resident #2 stated Resident #1 had peed on the bathroom floor and had done it before, and she wanted her to clean it up. LVN B told Resident #2 that Resident #1 could not do that because she could fall. I had went to get a towel to clean up the urine and Resident #2 stated to me that Resident #1 needed to get on her hands and knees and clean that shit up because she was tired of her doing that. I had advised Resident #2 that Resident #1 was not able to do so. I told Resident #2 if it happened again for her to let me or any aide that is on the hall and we would clean it up. Resident #2 then told me as long as we keep babying her and not making her clean up her mess then she would never stop. I walked out of the room and nothing more was said. Record review of Resident #2's 1:1 monitoring supervision sheet, dated 7/13/25-, revealed:Resident #2 was on 1:1 monitoring from 7/13/25 at 9:49 PM until 7/14/25 [TRUNCATED] Event ID: Facility ID: 675527 If continuation sheet Page 38 of 38