Health inspection·September 13, 2025

F 0835 Administer the facility in a manner that enables it to use its resources effectively and efficiently. Level of Harm - Minimal harm or potential for actual harm Based on interviews and record review, the facility failed to ensure effective administration to maintain the highest practicable well-being of each resident. The facility operated without an administrator from 08/20/25 to 09/13/25, in the 1 of 1 facility reviewed for administration.Record review of personnel records revealed the Former Administrator was terminated on 08/19/2025, there was no record of a licensed interim or permanent replacement appointed from the period of 08/20/2025 - 09/13/2025. During an interview on 09/13/2025 @ 10:30am with the nurse supervisor, she stated that the facility had not had a facility administrator, since 08/2025. She stated that DON, who was not a state-licensed nursing home administrator, was informally made responsible for the Administrator's tasks. During interview on 09/13/2025 @ 1:00pm with DON, stated that the prior facility administrator was terminated 08/19/2025. She stated she was not aware if Human Resources staff had documentation of a designated full-time acting Administrator since the prior Administrator was terminated. She stated that she was informed the facility had a thirty-day window period to hire an Administrator; and a new Administrator was expected to start at the facility on 09/ 29/ 2025. She stated that administrative duties were reassigned informally among the facility department heads. She stated the VP of Operations holds a state administrator license and had been in contact with the department heads. Attempted telephone interview on 09/13/2025 @ 1:45pm with Human Resources Staff was unsuccessful; voicemail requested a return follow up call. During telephone interview on 09/13/2025 @ 2:35pm with the facility's VP of Operations, he stated that the Former Administrator was terminated on 08/19/2025. He stated the facility had no full-time, state-licensed nursing home Administrator on staff since the Former Administrator was terminated. He stated that the facility had a thirty-day window to hire an Administrator; and a new licensed administrator was hired and expected to assume Administrator role and duties on 09/ 29/ 2025. He stated the facility department's heads were provided with his contact information. He stated that he holds a state administrator license and had last visited the facility on 08/19/2025. He stated nursing leadership (DON and department heads) had been in regular communication with him via a group text message created. He stated the DON and department heads were not licensed administrators. During interviews on 09/13/2025 at various times, staff (CNA S, CNA O, CNA T, Nurse A, Nurse J, Nurse I) stated that the facility had not had a facility administrator, since 08/2025 and they were not aware of a designated acting Administrator responsible for carrying out administrative duties. Staff interviews confirmed that several administrative duties had been reassigned informally to the facility's DON. The staff stated that the DON was the person they report to for administrative issues that presented since the Former Administrator left the facility.During interviews on 09/13/2025 at various times, residents (1, #2, #3, #4 and #5) stated that they did not know who the Administrator was since the Former Administrator left. Residents reported no immediate safety concerns. All residents interviewed stated they would report any concerns to the facility DON. The signed Administrator's job description was requested from the facility's VP of Operations on Residents Affected - Many (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 3 Event ID: 675700 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 675700 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harmony Care at Brookshire 710 Hwy 359 S Brookshire, TX 77423 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)