Inspection·July 3, 2025

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Task Profile dated 6/2/2025 thru 7/1/2025 for Personal Daily Hygiene - nail care, oral care, brushing/combing hair, shaving, washing face and hands, reflected the resident had not refused personal hygiene during that period. Observation and interview on 7/1/2025 at 11:42 AM with Resident #2 sitting in her wheelchair in dining room. The resident had facial hair along her chin that was approximately 1cm in length. When asked about her chin hair, she said, I want these whiskers trimmed. They do not do it and I do not ask. She was unable to recall the last time she was shaved.3.Review of Resident #3's face sheet dated 7/1/2025, reflected a [AGE] year-old female re-admitted to the facility on [DATE] with diagnoses including Type 2 Diabetes (body does not produce enough insulin), Vascular Dementia (decline in thinking skills caused by damaged blood vessels and reduced blood flow to the brain), Atherosclerotic Heart Disease of Native Coronary Artery (plaque build-up narrows the coronary arteries). Review of Resident #3's quarterly MDS assessment dated [DATE], reflected a BIMS score of twelve (12) which indicated moderately impaired cognition. Section GG reflected the resident was dependent for assistance with personal hygiene. Review of Resident #3's care plan dated 6/20/2025 reflected she had an ADL Self Care Deficit related to CVA with goals to maintain or improve her ability to participate in her care with ADLs. An intervention dated 6/21/2024 included, Dressing and Grooming - 1 (one) person assist. The care plan did not specifically address shaving. Review of Resident #3's Task Profile dated 6/2/2025 thru 7/1/2025 for Personal Daily Hygiene - nail care, oral care, brushing/combing hair, shaving, washing face and hands, reflected the resident had not refused personal hygiene during that period. Observation and interview on 7/1/2025 at 12:30 PM with Resident #3 sitting at dining table. The resident had facial hair along her chin that was approximately 1cm in length. When asked about her chin hair, she said she could not remember when she was last shaved and These whiskers are driving me crazy and I want them shaved. During an interview on 7/3/2025 at 11:15 AM CNA-C employed by the facility for three-years, said treating residents with dignity meant honoring their wishes, dressing, and grooming them in a way that made them feel like themselves. She said residents were shaved on their assigned shower days or more often if they had noticed hair growth. She said it was important for female residents to have their chin hair shaved because they wanted smooth skin. She said the effects on residents were that they might feel less beautiful, not like themselves and it may bother them.During an interview on 7/3/2025 at 11:27 AM CNA-D employed by the facility for one-month, said treating residents with dignity meant showing respect, treating them as she would want to have been treated, like a person. She said it was not okay for female residents to have whiskers. She said it was important to shave female residents because it was a dignity issue. She said it could have made the residents feel less confident, more depressed, and not wanted to be seen by others.During an interview on 7/3/2025 at 11:39 AM LVN-E employed at the facility for four-years, said if a female resident did not want to be shaved, it should have been on the resident's care plan. She said shaving female residents was a dignity issue and it would have given them their faces back and made them feel more like themselves. She said female residents might have been ashamed if they had whiskers. During an interview on 7/3/2025 at 12:10 PM the DON employed by the facility for four-months, said it was okay for female residents to have whiskers only if they wanted it. She said this could have caused body image issues for female residents with whiskers and her expectation was that staff should have asked the residents if they wanted their facial hair removed during care.During an interview on 7/3/2025 at 12:18 PM interim ADM-B, said his expectation was for staff to follow the ADL policy as it could have led to dignity issues for female residents who had chin whiskers.Record Review of the facility's policy titled, Respect and Dignity, dated February 2017 reflected the following: Compliance Guidelines:The community promotes care for residents in a manner and environment that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675909 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 675909 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/03/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harker Heights Nursing & Rehabilitation 415 Indian Oaks Dr Harker Heights, TX 76548 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 0677 Level of Harm - Minimal harm or potential for actual harm enhances each residents' dignity and respect in full recognition of his or her individuality.Dignity means that the team members carry-out activities that assist the resident to maintain and enhance self-esteem and self-worth. To achieve this goal, the community strives to achieve the following:Hygiene and appearance:Residents are groomed as they wish (e.g., hair combed and styled, beards shaved/trimmed, nails clean and clipped). Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675909 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 675909 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/03/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harker Heights Nursing & Rehabilitation 415 Indian Oaks Dr Harker Heights, TX 76548 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observations, interviews, and record reviews, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for one of one kitchen reviewed for food labeling and storage in that: The facility failed to ensure the foods were labeled and dated in the kitchen refrigerator. This deficient practice could place residents at risk of foodborne illness. An observation on 7/02/2025 at 9:17 AM of the facility's only refrigerator revealed the following: - Salad greens in a metal container covered with clear, plastic wrap did not have a label containing the opened on and discard by dates. - Pasta noodles in a metal container covered with tinfoil did not have a label containing the opened on and discard by dates. - A yellow, non-opaque liquid, with chunks (like creamed corn) in a metal container covered with tinfoil did not have a label containing the opened on and discard by dates. During an interview on 7/02/2025 at 9:18 AM the DM stated, Those containers should have been labeled and dated and everyone was responsible for labeling and storage. During an interview on 7/3/2025 at 12:18 PM interim ADM-B, said his expectation was for staff to follow the policy and everything should have been labeled and dated. He said if items were not labeled the kitchen staff would not have known when food went bad, and they could have served spoiled food to the residents. Review of the U.S. Public Health Service Food Code, dated 2022, revealed:3-501.18 Ready-to-Eat, Time/Temperature Control for Safety Food, Disposition. (A)A FOOD specified in 3-501.17(A) or (B) shall be discarded if it: (2) Is in a container or PACKAGE that does not bear a date or day; Event ID: Facility ID: 675909 If continuation sheet Page 4 of 4