Inspection·November 5, 2025

F 0627 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some member stated because the facility had to start remolding the next day. FM #1 stated she went the next day no remolding was being done. FM #1 stated she also went to the facility a week later and saw another resident was in of R #4's room, and all residents were eating in the dining room of the locked unit. FM #1 stated she was not given a choice of what facilities R #4 could go. FM #1 stated another FM #2 was there and witnessed the staff coming into the room removing things from the room and putting them in a trash bag. FM #1 stated FM #3 then arrived at the time the facility was putting R #4 in the van and transferring her. FM #1 stated no paperwork was given to anyone to sign and no instructions were given, not anything. Resident #5Record review of R #5's Face Sheet dated 07/11/25 documented an [AGE] year-old female initially admitted on [DATE] and discharge date of 07/11/25 with the diagnoses of Alzheimer's Disease with late on set (a progressive disease that destroys memory and other important mental functions), Dementia (A group of thinking an social symptoms that interferes with daily functioning),Muscle weakness, and Cognitive communication deficit(a communication challenge resulting from impaired thinking skills like attention, memory, and problem-solving, rather than a language or speech problem). Record review of R #5's discharge MDS dated [DATE] revealed a BIMS score of 3. R #5 mood was depressed with little interest or pleasure in doing things. No behaviors of wandering took were presented or frequent. R#5's functional abilities reveal supervision need in areas of personal hygiene and in some areas was independent like transferring to shower or toilet. R#5 had history of falls with no injury. The active discharge plan was occurring for the resident to return to the community indicated yes. A referral was made to the Local Contact Agency. Record review of R #5's care plan dated 07/17/25 revealed care areas as follows: * Potential for a psychosocial well-being problem related to disease process of dementia. Intervention included take time to answer questions and to help verbalize feelings, perceptions, and fears. *R#5 is at risk for elopement risk/wanderer related to impaired safety awareness. Intervention included distract resident from wandering by offering pleasant diversions, structured activities, food, conversation, television, or a book. *R#5 is an antipsychotic medication related to agitation. Document episodes of behavior and side effects. Record review of R 5#'s Physician's orders dated 05/01/25 to 07/11/25 reveal no order which stated a discharge based on the endangerment of the safety or health of individuals in the facility was documented. Record review of R #5 's progress notes dated 06/04/2025 to 07/05/25 revealed on 07/11/2025 discharge instructions given to a nurse at the new facility, voiced understanding, medications sent with patient picked up by their transportation via wheelchair. R#5 discharge note revealed reason for discharging as just Transferring to new facility. Resident #6 Record review of Resident#6 face sheet revealed an [AGE] year-old female initially admitted on [DATE], with diagnosis of Dementia (A group of thinking an social symptoms that interferes with daily functioning), Epilepsy (a chronic neurological disorder characterized by recurrent seizures, which are sudden, uncontrolled electrical discharges in the brain). Record review of R #6's Care Plan date 07/16/25 revealed the following care areas:* Elopement risk/wanderer related to disoriented place. Intervention included Distract resident from wandering by offering participation in activities pleasant diversions, structured activities, food, conversation, and television. *The resident is Dependent on staff for activities, cognitive stimulation, social interaction, related to Cognitive deficits, Physical Limitations walks around the memory care unit with supervision. Record review of R 6#'s Comprehensive MDS assessment dated [DATE] revealed a BIMS Score of 11 indicated moderate cognitive impairment. R #6's mood interview revealed R#6 was feeling depressed with little interest in doing things. R #6's the behavior of wandering occurred for 1 to 3 days. Record review of Resident #6's Physician's orders dated 04/19/25 to 07/11/25 revealed no physician's order for discharge or reason for discharge. Record review of R (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675689 If continuation sheet Page 2 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 675689 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Village Healthcare and Rehabilitation 615 N Ware Rd McAllen, TX 78501 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 0627 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some #6's progress notes dated 07/02/25 to 08/02/25 revealed the following: * 07/11/25 at 10:21 A.M. written by RN B indicated Resident #6 was discharged , instructions given to the nurse at the new facility, voiced understanding, medications sent with patient picked up by their transportation via wheelchair. The resident is being discharged due to another facility. Record review of R #6's progress notes dated 07/02/25 to 08/02/25 revealed the following: * 07/11/25 at written by RN B at 10:21 A.M. indicated Resident #6 was discharged , instructions given to the nurse at the new facility, voiced understanding, medications sent with patient picked up by their transportation via wheelchair. The resident is being discharged due to another facility. Resident #7 5. Record review of Resident #7's face sheet, dated 11/05/2025, revealed an [AGE] year-old male who was admitted to the facility on [DATE]. Pertinent diagnoses included Dementia (a condition which affects memory, thinking, and the ability to perform daily activities), Alzheimer's Disease (a progressive disorder which was the most common cause of dementia, characterized by memory loss, cognitive decline, and behavioral changes), Delusional Disorder (a serious mental illness characterized by the presence of one or more persistent delusions which last for at least one month, without significant impairment in functioning) and Hypertensive Heart Disease and Chronic Kidney Disease (closely interconnected conditions, where unmanaged high blood pressure could lead to heart complications and worsen kidney function). Record review of Resident #7's care plan, initiated 01/04/2022, revealed an initial care plan for wishing to remain long-term, which included established a pre-discharge plan with resident, family/caregivers and evaluate progress and revise plan as needed, but there were no revisions on care plan or interventions to include planned discharge with resident, family/caregivers, as well as no interventions to include the RP or family was notified of planned discharge. Record review of Resident #7's discharge MDS, dated [DATE], revealed a BIMS score of 09, which indicated moderately impaired cognition. MDS also revealed Resident #7 had a planned discharge (MDS section A0310.G) to another skilled nursing facility (MDS section A2105). Record review of Resident #7's physician orders revealed no orders for transfer or discharge. Record review of Resident #7's discharge note, dated 07/11/2025, revealed planned discharge for 07/11/2025 for transferring to another facility. In an interview on 11/04/25 at 3:30 P.M., LVN C stated the nurse in charge of the unit was responsible for getting the discharged papers ready ensuring all steps have been completed and have the resident's responsible party sign to discharge from the resident from facility. LVN C stated the nurse was to prepare the resident's transfer sheets, get medications ready to be sent to facility if meds belong to the resident, call giving report to new facility, give transfer sheet to responsible party, educate responsible party of medications if resident is going home. The resident or responsible party should have a choice of where the resident wants to go. The resident or family should be told where the resident is going if facility-initiated transfer. LVN C stated the only reason he knew the residents were discharged from the locked unit was the remolding of the unit. LVN C stated he did not know how much time the resident or resident representative was to be given before transfer. LVN C did not know who the nurse was that discharged the residents for why the medical record for each resident discharged on 07/11/25 did not show the physician's order documented for discharge. In an interview on 01/04/25 at 4:30 P.M.with DON she stated the discharged in the unit we had decided to do some remodeling and would have numerous people coming in and out of the locked unit which increase the risk of a wandering resident eloping. The DON stated the unit was closed and all residents were moved. The social worker called RP's the day before the unit closed. The DON stated she did not know if the facility had a policy and procedure for discharge notices. The DON stated the alarms on the windows were being replaced so no elopement could take place in the lock unit. The windows would open, and the alarm would not sound off at (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675689 If continuation sheet Page 3 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 675689 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Village Healthcare and Rehabilitation 615 N Ware Rd McAllen, TX 78501 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 0627 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some times. The DON stated the facility never had a resident elope because the windows were locked. The DON stated the social worker sent an email to ombudsman to notify her of the residents' move to another facility. The DON stated the charge nurse is responsible for medication, instructions for the medications were packed, discharge instructions, and sign the discharge. The DON stated all the families were given a choice of two other facility here Mc [NAME]. The DON stated, No body was moved that was not notified. The [NAME] stated the facility nursing staff do not care plan a discharge to another facility or home and usually starts with the order from the Physician. The DON stated the facility sent out 7 residents from the facility locked unit to other facility locked unit. The [NAME] stated some residents did come back and were notified that the remodel was complete. The DON stated no mold had been removed or anything else to medically harm the resident's health. The DON doesn't know if Resident #4 was notified. The DON stated market was notifying the residents of unit opening. The DON stated No type of training for discharging residents are available because every discharge is so different. In an interview on 11-04-2 at 5:41 the ADON stated she had the position of social services until the middle of August of 2025. The ADON stated she got the list of wanders and made the calls to the family members but could not remember if she had documentation about the calls. The ADON stated the residents were all sent to a choice of two facilities. The ADON could not remember if some residents left the day of the phone call or were notified of the transfer the day of transfer to the new facility . The ADON stated a 48-hour last coverage date insurance notice was the only notice she knew to give to the resident she knew what the time frame was for a discharge. The ADON stated she usually only handled resident insurance discharges and did not know how long the advance notice was. The ADON stated she received training for discharge for short term, and resident insurance discharges. The ADON stated care planning meetings are done for a resident or RP about discharges and usually starts with the physician ordering the discharge. The ADON stated the discharge started at admission, she would send notification to ombudsman monthly of all discharges. The ADON stated the RP signature for a resident transfer or discharges. The ADON stated she was not sure if the nurse had all the paperwork ready to RP at the time of discharge. The DON stated they knew about the remolding 30 days in advance but did not know exactly when the remolding was to begin. The ADON stated the staff only got two day notice of when the remolding was to begin. In an interview with the administrator 11/5/25 at 10:06 AM he stated all transfers were made via telephone for the 07/11/25 transfers out of the locked unit The administrator stated the process of discharge began when the physician orders the discharge, then the SW notifies family by phone not in written form. The administrator stated the care plan is documented by RN SW or DON would ensure the care plan of discharge. The administrator stated there should be an MDS as well The administrator stated the residents' RPs were called with two choices of where to go and told their family members the resident was being moved. The administrator stated not sure why residents face sheet transfer discharge orders were not documented. The administrator stated the residents in the locked unit stayed if the facility did not contact the family and made them aware of the transfer. The administrator stated typically, a discharged resident's family will be notified by phone. The administrator stated the administrator stated the SW notified families of the residents of the facility transfer always by phone.Record Review of the facility's Discharge policy and procedure dated 12/2023 revealed It is the policy of this Facility and not be transferred or discharged unless the discharge or transferred unless the discharge or transfer is appropriate as per the existing criteria. When the Facility transfers or discharges a resident, the Facility shall ensure that the transfer or discharges a resident, the Facility shall ensure that the transfer or discharge is documented in the resident's medical record and appropriate information is (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675689 If continuation sheet Page 4 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 675689 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Village Healthcare and Rehabilitation 615 N Ware Rd McAllen, TX 78501 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 0627 communicated to the receiving health care institution or provider. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675689 If continuation sheet Page 5 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 675689 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Village Healthcare and Rehabilitation 615 N Ware Rd McAllen, TX 78501 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 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to provide and document sufficient preparation and orientation of resident representative to ensure safe and orderly transfers or discharges from the facility for 5 of 5 residents (Resident #2, Resident #4, Resident #5, Resident #6, and Resident #7) reviewed for transfer and discharge. The facility failed to notify the residents and their responsible parties of the transfers or discharges with the reasons for the move in writing in a language and manner they understand. This failure placed residents at risk of not receiving an advocate who could inform them of their options, rights, and the added protection from being inappropriately transferred or discharged .The findings included: 1. Record review of Resident #2's face sheet, dated 11/05/2025, revealed a [AGE] year-old female re-admitted to the facility on [DATE]. Pertinent diagnoses included Type 2 Diabetes (a chronic condition which affects how your body metabolizes sugar, or glucose, leading to high blood sugar levels and various health complications), Myocardial Infarction (commonly known as a heart attack, occurs when blood flow to a part of the heart muscle was blocked, leading to tissue damage), Alzheimer's Disease (a progressive disorder which was the most common cause of dementia, characterized by memory loss, cognitive decline, and behavioral changes), Dementia (a condition which affects memory, thinking, and the ability to perform daily activities), Hallucinations (perception of having seen, heard, touched, tasted or smelled something which wasn't actually there), and Paranoid Personality Disorder (a mental health condition characterized by a pervasive pattern of distrust and suspicion of others, often without sufficient reason). Record review of Resident #2's annual MDS, dated [DATE], revealed a BIMS score of 10, which indicated moderately impaired cognition. Resident #2's discharge MDS, dated [DATE], revealed Resident #2 had an unplanned discharge (MDS section A0310) to a short-term general hospital (MDS section A2105) with an acute change in mental status (MDS section C1310). Section Q of the MDS discharge assessment, dated 10/24/2025, Section A0310. F. indicated discharge assessment with return anticipated; G. indicated unplanned discharge. Section A2105 Discharge status indicated Resident #2 discharged to a short-term general hospital. Section Q0400 indicated no discharge planning. Record review of Resident #2's care plan, dated 09/30/2025, revealed Resident #2 had Delirium or an acute confusional episode related to hallucinations and paranoia. The facility attempted to send Resident #2 to the emergency room for evaluation and treatment, but the resident refused. The care plan dated 10/23/2025 revealed Resident #2 was paranoid and thought kitchen staff were looking in her window, poisoning her, and raping her. Resident #2 refused to go to the emergency room and refused counseling services. Interventions included discussing concerns, fears, and/or issues with family or caregivers, and caregiver to provide opportunity for positive interaction. Resident #2 continued to refuse medications and recommendations from the physician. There was a care plan for pre-discharge that was established on 09/01/2024, but that care plan had not been revised since 09/04/2024. Record review of Resident #2's progress note, dated 10/24/2025, revealed Resident #2 was transferred to the ER on [DATE] via stretcher due to hallucinations, delusions, and paranoia which began on 10/20/2025. Progress note also revealed the RP was notified. Record review of Resident #2's physician orders, dated 10/24/2025, revealed Resident #2 was transferred to the ER for medical clearance with section 28. In an interview on 11/05/2025 at 4:53 PM, Resident #2's family member stated they were not told their family member was getting transferred or discharged until it happened. They stated the SW was supposed to call them back regarding all the details of where their family member went, and when their family member would get to return, but no one ever called them back. They also stated they were never given any written discharge or transfer (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675689 If continuation sheet Page 6 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 675689 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Village Healthcare and Rehabilitation 615 N Ware Rd McAllen, TX 78501 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 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some notifications or paperwork regarding their family member. 2. Record review of Resident #4's face sheet, dated 11/0420/25, revealed an [AGE] year-old female initially admitted on [DATE]. Pertinent diagnoses included Vascular Dementia (a type of dementia caused by damage to the blood vessels in the brain), Delusional Disorders (a type of serious mental illness called a psychotic disorder the inability to tell what is real from what is imagined), Mood Disorder (A group of conditions of mental and behavioral disorder where the main underlying characteristic is a disturbance in the person's mood), and Alzheimer's Disease with late on set (a progressive disease that destroys memory and other important mental functions). Record review of Resident #4's progress note, dated 07/11/2025, revealed Resident #4 was scheduled to be transferred to a new facility, and the nurse practitioner and responsible party were made aware. Discharge instructions were given to the nurse at the new facility, and medications were sent with Resident #4. Resident #4's discharge note revealed the reason for discharging was transferring to local nursing home. Record review of Resident #4's care plan, dated 07/16/2025, revealed Resident #4 had an elopement and wandering risk related to impaired safety awareness, and resident wandered aimlessly. Interventions included distracting the residents from wandering by offering pleasant diversions, structured activities, food, conversation, television, and books. Resident #4 had potential for a behavior problem and potential for mood problems secondary to mood disorder; administer Resident #4's medications as ordered, as well as monitor and document for side effects and effectiveness. No documentation of a discharge care plan or order from the physician. Record review of Resident #4's physician orders revealed no orders for transfer or discharge. Record review of Resident #4's discharge note, dated 07/11/2025, revealed planned discharge for 07/11/2025 for transferring to another facility. 3. Record review of Resident #5's face sheet, dated 11/05/2025, revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Pertinent diagnoses included Alzheimer's Disease (a progressive disorder which was the most common cause of dementia, characterized by memory loss, cognitive decline, and behavioral changes), Dementia (a condition which affects memory, thinking, and the ability to perform daily activities), and Cognitive Communication Deficit (difficulties in communication which arise from impaired cognitive processes, such as attention, memory, organization, and executive functioning). Record review of Resident #5's care plan, dated 04/11/2025, revealed an initial care plan for wishing to remain long-term with interventions which included established a pre-discharge plan with resident, family/caregivers and evaluate progress and revise plan as needed, but there were no revisions on the care plan or interventions to include planned discharge with resident, family/caregivers, as well as no interventions to include the RP or family was notified of planned discharge. Record review of Resident #5's discharge MDS, dated [DATE], revealed a BIMS score of 03, which indicated severely impaired cognition. MDS also revealed Resident #5 had a planned discharge (MDS section A0310.G) to another skilled nursing facility (MDS section A2105). Record review of Resident #5's physician orders revealed no orders for transfer or discharge. Record review of Resident #5's discharge note, dated 07/11/2025, revealed planned discharge for 07/11/2025 for transferring to another facility. 4. Record review of Resident #6's face sheet, dated 11/05/2025, revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Pertinent diagnoses included Dementia (a condition which affects memory, thinking, and the ability to perform daily activities), Type 2 Diabetes (a chronic condition which affects how your body metabolizes sugar (glucose), leading to high blood sugar levels and various health complications) and Epilepsy (a chronic neurological disorder characterized by recurrent, unprovoked seizures caused by abnormal electrical activity in the brain). Record review of Resident #6's care plan, dated 04/21/2025, revealed an initial care plan for wishing to be discharged to home or another facility which included established a (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675689 If continuation sheet Page 7 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 675689 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Village Healthcare and Rehabilitation 615 N Ware Rd McAllen, TX 78501 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 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some pre-discharge plan with resident, family/caregivers and evaluate progress and revise plan as needed, but there were no revisions to the care plan or interventions to include planned discharge with resident, family/caregivers, as well as no interventions to include the RP or family was notified of planned discharge. Record review of Resident #6's discharge MDS, dated [DATE], revealed a BIMS score of 11, which indicated moderately impaired cognition. MDS also revealed Resident #6 had a planned discharge (MDS section A0310.G) to another skilled nursing facility (MDS section A2105). Record review of Resident #6's physician orders revealed no orders for transfer or discharge. Record review of Resident #6's discharge note, dated 07/11/2025, revealed planned discharge for 07/11/2025 for transferring to another facility. In an interview on 11/05/25 at 3:30 PM, a family member for both Resident #5 and Resident #6, who were related, stated only a verbal notification via the telephone was received on 07/11/2025, which was the date both residents were discharged and transferred to another facility. The family member stated they were not given a choice of where the residents were to be placed and was never given any kind of discharge notice or education in writing. 5. Record review of Resident #7's face sheet, dated 11/05/2025, revealed an [AGE] year-old male who was admitted to the facility on [DATE]. Pertinent diagnoses included Dementia (a condition which affects memory, thinking, and the ability to perform daily activities), Alzheimer's Disease (a progressive disorder which was the most common cause of dementia, characterized by memory loss, cognitive decline, and behavioral changes), Delusional Disorder (a serious mental illness characterized by the presence of one or more persistent delusions which last for at least one month, without significant impairment in functioning) and Hypertensive Heart Disease and Chronic Kidney Disease (closely interconnected conditions, where unmanaged high blood pressure could lead to heart complications and worsen kidney function). Record review of Resident #7's care plan, initiated 01/04/2022, revealed an initial care plan for wishing to remain long-term, which included established a pre-discharge plan with resident, family/caregivers and evaluate progress and revise plan as needed, but there were no revisions on care plan or interventions to include planned discharge with resident, family/caregivers, as well as no interventions to include the RP or family was notified of planned discharge. Record review of Resident #7's discharge MDS, dated [DATE], revealed a BIMS score of 09, which indicated moderately impaired cognition. MDS also revealed Resident #7 had a planned discharge (MDS section A0310.G) to another skilled nursing facility (MDS section A2105). Record review of Resident #7's physician orders revealed no orders for transfer or discharge. Record review of Resident #7's discharge note, dated 07/11/2025, revealed planned discharge for 07/11/2025 for transferring to another facility. In an interview on 11/04/2025 at 4:15 PM, the Ombudsman stated she received discharge logs monthly from the facility, but the facility was not consistent with sending the logs. She stated the discharge logs consisted of resident names, discharge date s, discharge locations, and name of RP notified. The reason for discharge was vague and did not typically list any detailed information. In an interview on 11/04/25 at 5:42 PM, the ADON stated she worked as social services until the end of July 2025, then moved into the ADON role. She stated all her discharge and transfer notifications with the RPs were done verbally via telephone. She stated she never sent any written discharge or transfer notifications to the residents, families, or RPs. In an interview on 11/05/2025 at 11:01 AM, the Administrator stated these residents had not been given 30 day notice as one of the residents was transferred out due to mental health issues, and the other residents were transferred out due to they needed to be placed in a facility with a locked unit as they were starting construction such as painting and fixing window alarms on the locked unit at their facility. In an interview on 11/05/2025 at 11:27 AM, the DON stated the SW (or the social services nurse) was the one who discussed with residents, families, or RPs via (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675689 If continuation sheet Page 8 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 675689 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Village Healthcare and Rehabilitation 615 N Ware Rd McAllen, TX 78501 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 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete telephone to let them know their loved one was being transferred or discharged from the facility. The DON also stated no written discharge or transfer notifications were given to the residents, the families, or their RPs regarding any of these discharges or transfers because it was not something the facility did and was not part of the facility's process or policy. In an interview on 11/05/2025 at 4:05 PM, RN-B stated he gave some discharging residents, as well as the receiving facility, paperwork which included their medications and how they were to be transferred but did not give or send the RPs any discharge or transfer notifications or paperwork. Record review of the facility's Transfer and Discharge Policy, Revised 12/2023, revealed Facility initiated transfer or discharge - A transfer or discharge which the resident objects to, or did not originate through a resident's verbal or written request, and/or is not in alignment with the resident's stated goals for care and preferences. 2. If the resident (and/or their representative) exercises their right to appeal a transfer or discharge notice, the facility shall not transfer or discharge the resident while the appeal is pending, unless the failure to discharge or transfer would endanger the health or safety of the resident or other individuals in the facility. The facility shall document the danger that failure to transfer, or discharge would pose. A refusal to readmit the resident to the facility is considered a discharge, and the requirements of 42 CRF Section 483.15 in terms of documentation, notice before transfer, and orientation for transfer/discharge apply. S483.15(c)(3) Notice before transfer. Before a facility transfers or discharges a resident, the facility must (i) Notify the resident and the resident's representative(s) of the transfer or discharge and the reasons for the move in writing and in a language and manner they understand. The facility must send a copy of the notice to a representative of the Office of the State Long-Term Care Ombudsman. (ii) Record the reasons for the transfer or discharge in the resident's medical record in accordance with paragraph (c)(2) of this section; and (iii) Include in the notice the items described in paragraph (c)(5) of this section. S483.15(c)(5) Contents of the notice. The written notice specified in paragraph (c)(3) of this section must include the following: (i) The reason for transfer or discharge; (ii) The effective date of transfer or discharge; (iii) The location to which the resident is transferred or discharged ; (iv) A statement of the resident's appeal rights, including the name, address (mailing and email), and telephone number of the entity which receives such requests; and information on how to obtain an appeal form and assistance in completing the form and submitting the appeal hearing request; (v) The name, address (mailing and email) and telephone number of the Office of the State Long-Term Care Ombudsman; (vi) For nursing facility residents with intellectual and developmental disabilities or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with developmental disabilities established under Part C of the Developmental Disabilities Assistance and [NAME] of Rights Act of 2000 (Pub. L. 106-402, codified at 42 U.S.C. 15001 et seq.); and (vii) For nursing facility residents with a mental disorder or related disabilities, the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with a mental disorder established under the Protection and Advocacy for Mentally Ill Individuals Act. Event ID: Facility ID: 675689 If continuation sheet Page 9 of 9