Health inspection·May 30, 2025

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Record review of Resident #28 MAR for the month of May 2025 reflected the facility was giving medication Tylenol ES 500mg 2 tablets by mouth every 12 hours at 8:00AM and 8:00PM. Observation on 05/28/25 at 10:50 AM of Resident #28 sitting on the side of her bed waiting for her morning medications. At this time resident was observed requesting her medication Tylenol ES from MA A saying it was time for the medication. Observation on 05/28/25 at 10:53AM of medication pass for Resident #28 by MA A. MA administered Resident #28's medication acetaminophen 500mg extra strength 2 tablets by mouth. Interview on 05/28/25 at 10:58AM with MA A who said she was late passing Resident #28's medication acetaminophen. MA A said the reason she was late was because some of the residents sometimes liked to talk and she therefore got behind. Interview on 05/28/25 at 11:00AM with the DON who said she would have to call Resident #29's physician for the medication acetaminophen extra strength provided late to inform of the incident. The DON said she would also have to do a medication variance. Further interview with the DON said when a medication was not administered per physician orders, it was considered a medication error especially if there was a specific time for the medication to be administered. The DON said medication could be administered 1 hour before or 1 hour after the set time. The DON said MA A could have called herself or the ADON to assist her with medication pass. The DON said when a resident pain medication was not administered at the scheduled time, it placed the resident (s) particularly at risk for pain. Interview on 05/28/25 at 1:43AM with MA A said she worked at the facility full time on the morning shift from 8:00AM-8:00PM. MA A said she realized around 9:30AM that she was getting behind on her medication pass but did not reach out for help because the surveyor was observing her. MA A said when a resident pain medication was not administered at the schedule time, it placed resident at risk for increase pain and their blood pressure becoming elevated. Record review of the facility policy on Administration of Medication revised 04/09/24 reflected in part: .Medications ordered for specific times will be given as ordered. Medications with specific times may be given 1 hour before the assigned time to 1 hour after the assigned time . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675777 If continuation sheet Page 2 of 4 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 675777 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkway Place 1321 Park Bayou Dr Houston, TX 77077 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 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections, for two Residents (Resident #7 and Resident #28, and Resident #29), of 6 residents observed for care and procedures, in that: Residents Affected - Few The facility failed when MA A failed to sanitize a blood pressure machine prior to and after taking Resident #7, Resident #28, and Resident #29's blood pressure on 05/28/2025. This failure placed residents at risk for cross contamination and infections. Findings included: Record review of Resident #7 face sheet dated 05/30/25 revealed a [AGE] year-old female admitted to the facility on [DATE]. Resident diagnoses included: acute kidney failure (sudden loss of kidney function when the kidneys cannot filter waste from the blood)), hemiplegia (paralysis or severe weakness on one side of the body), cerebral infarction (disruption in blood flow to the brain), and hypertension (high blood pressure). Record review of Resident #28's face sheet dated 05/28/25 revealed an [AGE] year-old female admitted to the facility on [DATE]. Resident diagnoses included the following: contusion (injury to soft tissue involving the blood vessels, causing blood to leak into surrounding areas resulting in swelling, pain, and discoloration) of left lower leg, hypertension (high blood pressure), osteoarthritis (when the tissue at the ends of bones began to wear down causing stiffness and pain) of left knee, and cellulitis (bacterial infection of the skin and tissues beneath the skin) of left lower limb (arms and legs). Record review of Resident #29's face sheet dated 05/28/25 revealed a [AGE] year-old female admitted to the facility on [DATE]. Resident diagnoses included A-Fib (irregular often fast heart rate that commonly cause poor blood flow), osteoarthritis (flexible tissue at the ends of the bones wears done), hypertension (high blood pressure), and glaucoma (eye condition that damages the nerve in the eye that could lead to vision loss). Observation on 05/28/25 at 10:21AM MA A removed the blood pressure machine from the top of the medication cart and went to Resident #28's room to take resident blood pressure without sanitizing the blood pressure machine. MA A went back to the medication cart and placed the blood pressure machine on top of the cart and sanitized her hands. MA A did not sanitize the blood pressure machine. MA A began to prepare Resident #28 medications for administration. When done administering Resident #28 medication, she proceeded down the hallway. Observation on 05/28/25 at 10:44AM MA A going into Resident 7's room to take resident blood pressure without sanitizing the blood pressure machine. Resident #7 had enhanced barrier precaution infection control signage on her door. MA A went into the room and took Resident #7's blood pressure. When MA A was done taking resident blood pressure, she came out of the room and placed the blood pressure machine on top of the medication cart and sanitized her hands but did not sanitize the blood pressure machine. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675777 If continuation sheet Page 3 of 4 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 675777 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkway Place 1321 Park Bayou Dr Houston, TX 77077 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Observation on 05/28/25 at 11:03AM MA A went to Resident #29's room to take resident blood pressure. MA A did not sanitize the blood pressure machine prior to usage or afterwards. When done taking resident blood pressure, MA A left the room, sanitized her hands, and placed the blood pressure machine on top of the medication cart. Interview on 05/28/25 at 11:53AM with LVN C said all residents care equipment (blood pressure machine, blood sugar machine, etc.) should be sanitized prior to and after usage due to equipment being used on more than one resident. LVN C said this was done to avoid cross contamination and infections. Interview on 05/28/25 at 1:43AM with MA A said she worked at the facility full time on the morning shift from 8:00AM-8:00PM. MA A said she was supposed to sanitize resident care equipment in between usage. MA A said when the resident care equipment was not sanitized prior to and afterward usage, it placed the resident at risk for infections. MA A said the last time she received in-service on infection control was a week ago. Interview on 05/28/25 at 1:50PM with the DON said nursing staff should be sanitizing resident care equipment before and after each use to prevent cross contamination and infections. The surveyor requested from the DON the facility policy on the sanitizing of resident care equipment. Record review of the facility policy on Infection Control revised January 23.2025 reflected in part: .Standard Precautions are used when caring for residents at all times, regardless of their suspected or confirmed infection status . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675777 If continuation sheet Page 4 of 4