Inspection·February 27, 2026

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some after working doubles. She said her narcotic drug count had always been correct and never had any issues with the count not being accurate. She said the potential risk was drug diversion if the documentation was not completed. During an interview on 02/27/2026 at 9:35 a.m., LVN B said she was responsible for signing the controlled drug sheet at the beginning of her shift and at the end of her shift. She said she could not recall why she did not sign the controlled drug sheet on 01/09/2026 for shift 10:00 p.m.- 6:00 a.m., 02/20/2026, 02/21/2026, 02/22/2026 for shift 10:00 p.m.- 6:00 a.m., and 02/05/2026 for shift 7:00 a.m.- 7:00 p.m. LVN B said she always counted the controlled medication cart before taking responsibility for the controlled medications and had never had any issues with the count being accurate. She said the potential risk was drug diversion if the documentation was not completed. A phone interview was attempted with MA D on 02/27/2026 at 9:43 a.m., there was no answer, voicemail was left. A interview was attempted with LVN E on 02/27/2026 at 10:12 a.m., there was no answer, voicemail was left. During an interview on 02/27/2026 at 10:20 a.m., the DON said she expected the nurses and MA's to sign in and sign off on the controlled drug (medic ation) sheet to ensure the controlled drugs are being counted and accurate to prevent the potential for drug diversion. She said she and the ADON were responsible for reviewing the controlled drug count sheets every Monday and Fridays. She said the drug count sheets had been overlooked because she was still adjusting to her role as DON. She said the controlled drug count sheets should have been signed by the nursing staff that was responsible for medication and reviewed by her and the ADON to ensure it was completed correctly and accurately. During an interview on 02/27/2026 at 10:40 a.m., the Administrator said all nurses and MA's were responsible for signing in and out on the controlled drug count sheet. He said the potential risk was drug diversion and missing medications. During an interview on 02/27/2026 at 5:00 p.m., LVN A said she was responsible for signing the controlled drug sheet at the beginning of her shift and at the end of her shift. She said she could not recall why she did not sign the controlled drug sheet on the dates of 01/7/2026 for shift 10:00 p.m.- 6:00 a.m. She said the potential risk was drug diversion by staff, visitors, or residents. She said she had no issues with the controlled drug count and always had an accurate count of controlled drugs (medications.) An interview attempt was made, but the ADON was off and unavailable to interview. Record review of the facility policy titled: Controlled Substances revision date November 2022 indicated: Policy StatementThe facility complies with all laws, regulations, and other requirements related to handling, storage, disposal, and documentation of controlled medications (listed as Schedule II-V of the Comprehensive Drug Abuse Prevention and Control Act of 1976).Policy Interpretation and ImplementationDispensing and Reconciling Controlled Substances Controlled substance inventory is monitored and reconciled to identify loss or potential diversion in a manner that minimizes the time between loss/diversion and detection/follow-up.The system of reconciling the receipt, dispensing and disposition of controlled substances includes the following:Records of personnel access and usage;Medication administration records;Declining inventory records; andDestruction, waste and return to pharmacy records.Nursing staff count controlled medication inventory at the end of each shift, using these records to reconcile the inventory count.The nurse coming on duty and the nurse going off duty make the count together and document and report any discrepancies to the director of nursing services.The director of nursing services documents irreconcilable discrepancies in a report to the administrator.If a major discrepancy or a pattern of discrepancies occurs, or if there is apparent criminal activity, the director of nursing notifies the administrator and consultant pharmacist immediately.The administrator, consultant pharmacist, and/or director of nursing services determine whether other action(s) are needed, e.g., notification of police or other enforcement personnel.The medication regimen of residents using (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675595 If continuation sheet Page 2 of 3 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 675595 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/27/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harmony Care at Beaumont 2660 Brickyard Rd Beaumont, TX 77703 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 0755 Level of Harm - Minimal harm or potential for actual harm medications that have such discrepancies are reviewed to assure the resident has received all medications ordered and the goal of therapy is met (example: a resident receiving a pain medication complains of unrelieved pain).The director of nursing services consults with the provider pharmacy and the administrator to determine whether any further legal action is indicated. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675595 If continuation sheet Page 3 of 3