Health inspection·March 22, 2024

F 0625 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Record review of Resident #1's admission packet did not reflect a bed hold policy was given upon admission. During an interview on 03/22/24 at 9:46 AM, Resident #1's Family Member stated Resident #1 had fallen twice since she was at the facility. He said he didn't have the specific dates but believed the first fall happened around 02/07/24 around lunchtime. He said the second fall happened on 02/21/24 around lunchtime. He said he became displeased when Resident #1 fell the second time. He said because of the second fall, he wanted her to complete therapy somewhere else but was not opposed to Resident #1 returning to the facility at the time of the fall. He said he intended for the resident to return to the facility after therapy and only to take a few items from the nursing facility. He wanted things she would need immediately, such as shampoos, soaps and a few personal items while she completed therapy at another facility. He said he picked a place of therapy closer to him so he could visit the resident more, possibly during his lunch break. He said when he explained this to the ADM and the staff at the facility, he was made to feel like Resident #1 was just a number. He said the ADM told him she needed the bed in case another resident needed it. He said he knew he saw in the past where other family members who were related to him had a room held for them. He said he was never given a written notice or anything concerning the bed hold policy . During an interview on 03/22/24 at 12:08 PM, the ADM stated Resident #1 went to the hospital each time she fell in the facility. She said when the second fall occurred, she had a conversation with the Family member that included Resident #1's therapy could be provided at the facility. She said they did not have a bed hold policy and the Family member discharged Resident #1 from the facility/hospital himself . She said they anticipated her returning to the facility each time Resident #1 went to the hospital. She said the Family member expressed he felt like Resident #1 was just a number, but she did not know why because all the staff loved and cared for Resident #1. She stated all of the resident's items were packed up and sent because the Family member requested all of the items, and if Resident #1 was discharged , all of her items needed to go with her. During an interview on 03/22/24 at 1:11 PM, Resident #1 said she remembered falling and went to the hospital but didn't know anything about the bed hold policy. 2. Record review of Resident #2's face sheet, dated 03/22/24, reflected a [AGE] year-old female with an admission date of 01/31/24. Resident #2 had diagnoses which included: lack of coordination and cognitive communication deficit. Record review of the EMR, under the MDS tab, reflected the following: On 12/01/23 a MDS was completed under the description of discharge return anticipated. On 12/18/23 a MDS was completed under the description of discharge return anticipated. On 01/02/24 a MDS was completed under the description of discharge return anticipated. On 01/27/24 a MDS was completed under the description of discharge return anticipated. Record review of Resident #2's Comprehensive MDS assessment, dated 12/30/23, reflected Resident #2 BIMs was a 07, which indicated her cognitive state was severely impaired. Record review of Resident #2's care plan, dated 02/2/24, reflected Resident #2 had an ADL self-care (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675716 If continuation sheet Page 2 of 5 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 675716 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/22/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Post Nursing & Rehab Center 605 W 7th St Post, TX 79356 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 0625 performance deficit due to confusion, hemiplegia (paralysis of one side) and impaired balance. Level of Harm - Minimal harm or potential for actual harm Record review of Resident #2's Clinical Census report, dated 03/22/24, reflected she was transferred to a local hospital on [DATE], 12/01/23, 12/18/23, 01/02/24 and 01/27/24. The report was signed and confirmed by the DON. Residents Affected - Few Record review of Resident #2 progress notes reflected the following on the specified dates: LVN A documented on 12/01/23 at 10:54 AM, Resident #2 requested to go to the hospital, she was very weak and hallucinating. The ambulance was called and she left the faciity on a gurney. LVN B documented on 12/18/23 at 2:27 PM the local ambulance was notified for transport and change in condition. LVN B documented on 1/02/24 at 2:03 PM, received a call from dialysis center stating they are sending resident out due to doctor's orders for tremors and increase. LVN A documented on 01/27/24 at 06:41 PM, the dialysis center called and left message which stated Resident #2 was sent to hospital. Record review of Resident #2 physician order's, dated 04/26/24, reflected the following: Send to the emergency room to evaluate and treat hardware displacement with fracture to the left knee. Record review of Resident #2's admission packet reflected it included bed hold Information and Practice guidelines/ Bed Hold policy signed by Resident #2 as of 02/17/23. During an interview on 03/22/24 at 1:48 PM, Resident #2 stated she had never received written notice about the facility's bed hold policy. She said she had never worried about it because she knew her bed would always be available but no one had ever told her this. During an interview on 03/22/24 at 2:24 PM AM, the DON stated she did not give a written notice of when residents went to the hospital. She stated she did not personally give Resident #1 or Resident #2 a notice when they transferred to the hospital. She said for each resident, she did anticipate each resident returning to the facility. She said she was unaware giving a written notice at the time of transfer was a requirement. She said she was actively reading her policy on this date . She said the potential negative outcome to the resident could be their room could be given to another resident or the resident's property could be lost or moved. She said she was unaware the notice had not been given. She said their facility did not have a system for issuing written notices for bed holds. She said she was unsure, but she believed the bed hold may be in the admission packet . She said she had not received any training regarding issuing a written notice. She said she expected they as the facility staff should communicate with families about the facility's bed hold policy. She said she didn't think they had an actual policy with specifics. She said she remembered there were some families who were confused with the bed hold policy in the past, so they did away with it . She said this was why she believed they never had an issue with it before. She said as a general rule, if they knew the resident was coming back, they did not give the residents bed up. She said she believed most facilities had to get rid of the resident items within 24-48 hours, but if they knew the resident was returning, they kept it as long as possible. She said regarding Resident #1, the family member was (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675716 If continuation sheet Page 3 of 5 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 675716 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/22/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Post Nursing & Rehab Center 605 W 7th St Post, TX 79356 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 0625 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few up in the air about whether or not Resident #1 was coming back. She said written notices were not given because this was something they had never practiced before with anyone. During an interview on 03/22/24 at 2:38 PM AM, the ADM stated their facility was not the ones that always sent residents to the hospital, for example, regarding Resident #2 the dialysis center would send her out. She said upon admission, the residents were told about the bed hold policy. She stated the residents, which included the family members, should have received the bed hold policy upon admission. She said it was her facility policy expectation they gave out the written notice of the bed hold twice. She said they gave it out upon admission and if the policy changed. She said nothing had changed regarding the policy. She said she knew the policy was not changed because she pulled it off the company website. She said she believed the policy had not changed in the last 2 years. She said the policy may have been changed in 2019. No indication was provided in tracking changes if the policy did not have a date. She said regarding Residents #1 and #2, they always anticipated both residents would return to the facility. She said she was aware of the regulation, but her written policy stated every resident was made aware upon admission into the facility. She said they had the residents sign and keep a copy of the bed hold policy. She said she did not see a potential negative outcome for residents because they explained there was no charge. She said whoever completed the admission was responsible for explaining the bed hold policy. She said she had not received any formal training. The ADM stated she did not have anything to support her system of providing the old bed policy only upon admission. During an interview on 03/22/24 at 3:05 PM, the Activity Director stated she had multiple roles in the facility. She said she did human resources work on top of her CNA and transportation duties. She stated Resident #2 received the bed hold policy upon admission. She said she never issued a written notice to Resident #1 or Resident #2 before their hospital transfer. The Activity Director said she was not sure who was responsible for issuing the bed hold notices. She said she was unaware of a system for issuing the written notice of the bed hold. She said she was not trained to issue the written notice before transfers. She said she did not personally issue any written notices and did not know why it was not completed. She stated they anticipated Resident #1 coming back to the facility. She stated they anticipated Resident #2 coming back to the facility. She stated she was aware of the regulation that written notice must be given before transfer. She said she did not know the potential negative outcome of not giving residents notice of the facility bed hold policy. She said she was unaware of who was responsible. She said she was unaware of a system to monitor the written bed holds for residents and their representatives. She said she was unaware of a system for residents who was in emergent situations. She said she was trained to issue the written bed holds prior to transfers but only went over them at admission. She said she had just read and signed them and was unaware of any changes. Record review of the facility's, undated, bed-hold and information and practice guidelines reflected the following: The facility's leadership will provide a written bed hold notice at the time of transfer of a resident for hospitalization or therapeutic leave. The facility's leadership will readmit a resident according to applicable state and federal guidelines if the residents hospitalization exceed the bed hold policy. Practice guidelines: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675716 If continuation sheet Page 4 of 5 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 675716 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/22/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Post Nursing & Rehab Center 605 W 7th St Post, TX 79356 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 0625 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 2 written notices are provided to resident or legal representative regarding the bed hold policy in the event of hospitalization or therapeutic leave. The first notice is given at admission and re-issued in the event that the policy was to change. The second notice is provided at the time of transfer for hospitalization or therapeutic leave and specifies the duration of the bed hold period. In the event of an emergency transfer the family or representative are provided written notice within 24 hours of the transfer, which can include sending a notice with other documents accompanying the resident. Record review of the facility's, undated, policy titled, Bed Hold Policy and Initiation reflected, after placement in the nursing facility, it sometimes becomes necessary for the resident to go out of the facility for brief periods of hospitalization or home visits. It is the policy of this facility to hold beds and readmit residents as follows: Private pay residents can go and come from the facility as often and for as many days as desired. Medicaid residents: When admitted to the hospital for a period excess of 24 hours, the resident's applied income will be used as authorized by the resident and/or his/her responsible party has the right to reserve their bed. Medicaid/Medicare/ Insurance reimbursed resident is admitted to the hospital in excess of 24 hours, the resident's applied income will be used, as authorized by the resident and/or her/his/ responsible party to reserve his/her bed. Medicare insurance does not pay to hold a resident's bed when the resident is admitted to the hospital. A bed will be reserved for the resident as long as the bed hold charges are paid when he/she is out of the facility. Bed hold charges may be discontinued at any time if the resident and or responsible party notifies the business office and removes all personal belongings within 24 hours and all claim to the resident's bed is released. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675716 If continuation sheet Page 5 of 5