Health inspection·December 1, 2025

F 0774 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few her doctor's appointment on 10/14/25. He said he did not know the reason why the facility did not take her to her appointment, but it was concerning, because Resident #1 was so upset. During an interview on 10/28/25 at 1:51 P.M., with Resident #1, she said on 10/14/25, she had an appointment at 10:00 A.M. to go see a surgeon about getting a colostomy. She said the facility knew about her appointment two weeks before the date and that morning they told her they did not have a driver to take her to her appointment. She said that made her so angry, because they knew she needed to go to that appointment and they waited to the last minute to tell her they did not have a driver to take her. During an interview on 10/28/25 at 3:18 P.M., with EDOO, she said the incident happened on 10/14/25 with Resident #1, she wanted to say she had an appointment, and it was an issue with a transportation service, and they canceled . During an interview on 10/28/25 at 3:54 P.M., with EDOO, she said Maintenance Man A was going to drive the facility van the day of Resident #1's appointment, but he called in sick; then the backup driver came in a little later and took another resident to their doctor's appointment. At that point MRC had already rescheduled Resident#1's appointment, because her MD charged a $50.00 fee if appointments were not canceled. She said the backup transportation driver came in after Resident #1's appointment. She said Maintenance Man A notified MRC early that morning he was not going to be able to come in to take Resident #1 to her appointment, but they could not get the backup driver to come in soon enough to get Resident #1 to her appointment. During an interview on 10/28/25 at 4:05 P.M. with MRC, she said she was not sure what happened when Resident #1 missed her appointment on 10/14/25. She said she thought maybe the transportation service was cancelled, due to their van not working. During an interview on 10/28/25 at 5:00 P.M., with MRC she said the facility did have a transportation aide who took the residents to their appointments, but she quit without notice. She said on 10/14/25 they had one person available to drive and he called in. She said Maintenance Man A was the van driver currently. He was currently the only driver they had. She said he contacted her at 7:08 A.M. that morning on 10/14/25 to let her know he was not coming to work, and he was not going to be able to do the transport. She said Resident #1's appointment was scheduled for 10:00 A.M. that morning, so they should have left the facility about 9:15 A.M., but she canceled the appointment. She said prior to canceling Resident #1's appointment, she called a local emergency medical service and local transportation service to see if she could get them to take Resident #1 to her appointment. She said the facility currently did not have a backup driver; they were talking about cross training her to be the backup driver. She said the appointment Resident #1 missed was a consultation for a colostomy (a surgical procedure creating an opening [stoma] in the abdomen to divert waste out of the body and into a collection pouch.) She said she was not sure what Resident #1's previous health was or the reason for getting the colostomy (a surgical procedure creating an opening [stoma] in the abdomen to divert waste out of the body and into a collection pouch. During an interview on 10/28/25 at 5:23 P.M., with RDOCS she said the facility would do whatever was needed to meet the residents' needs. She said she understood things that came up. She said she did not know when the resident was going to the doctor, and she did not know Resident #1's medical history to know what the appointment was for exactly. She said she agreed to a colostomy (a surgical procedure creating an opening (stoma) in the abdomen to divert waste out of the body and into a collection pouch.) consultation was probably a very important appointment. She said she was not sure where LVN C got that diagnosis from in Resident #1's progress notes of sweal bowel ischemia. She said the risk of Resident #1 missing her appointment was if a resident had bile ischemia (damage to the bile ducts caused by insufficient blood supply) it could lead to bile blockage. During an interview on 10/28/25 at 5:33 P.M. with the EDOO she said her expectations were the facility would schedule the appointments and got (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675602 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 675602 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care of Gilmer 623 Hwy 155n Gilmer, TX 75644 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 0774 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete our residents to their appointments. She said Maintenance Man A was the driver, and he was the only driver they had right now. She said she had an aide who was a PRN driver, and she resigned last week. She said they did not currently have a backup driver. She said the MRC would be trained this week to be the backup driver. She said the risk of Resident #1 missing her appointment was a delay in care. She said the facility was currently running an ad for transportation aid. Record review of the facility's Transportation, Diagnostic Services Policy, revised December 2008, reflected Our facility will assist residents in arranging transportation to/from diagnostic appointments when necessary.Should it become necessary for the facility to provide transportation, the Social Service Designee will be responsible for arranging the transportation through the business office. Record review of the facility's Resident Rights Policy, revised December 2016, Resident Rights reflected Employees shall treat all residents with kindness, respect, and dignity. Federal and state laws guarantee certain basic rights to all residents of this facility. f. communication with and access to people and services, both inside and outside the facility. Event ID: Facility ID: 675602 If continuation sheet Page 3 of 3