Health inspection·September 28, 2023

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some agency taking over. Resident #1 said the environmental issue that bothered him the most was the window blinds in his room do not cover the entire window as there are missing blind slates. HHSC Investigator observed up to eight missing slates for the vertical window blinds. Outside of the window was a view of the facility inner courtyard. It was also observed that seven of fourteen slates did not fully cover the window and were cut short allowing up to four inches of exposure. Resident #1 said he felt like he did not have full privacy although there were no incidents of anyone looking into his room from his knowledge. HHSC Investigator observed the inner sliding door of the closet was off the track and leaning inwards. Resident #1 said the door had been that way since he was admitted . Resident #1 said he was able to access a portion of the closet without having to move the inner door. Resident #1 said he did not have much clothing to hang and had not been harmed by inner door that was off the track. Resident #1 said he thought maintenance was aware of the door but does not know what the plan was to fix it. Review of facility maintenance work order book on 09/27/2023 at 2:15 p.m., revealed no pending work orders for Resident #1's bedroom. During an interview on 9/27/2023 at 2:20 p.m., the Director of Physical Plant (DPP) said he was not able to locate any work orders for Resident #1's bedroom. The DPP said he was aware of issues in the bedroom such as missing slates on the window blinds, hole in the wall, and closet door off the track. The DPP said he had been working at the facility for about six months and had inherited many maintenance issues including the ones in Resident #1's bedroom. The DPP said all maintenance needs are stored in his head and that all work order requests are word of mouth. The DPP said he did not have any document to show when he became aware of the maintenance issue in Resident #1's bedroom. The DPP said previous maintenance staff member cut the window slates short for some unknown reason. The DPP said maintenance needs are met by him putting in orders for supplies and equipment and based on budget allowances. The DPP said there are many environmental issues that he is addressing and was working to having Resident #1's bedroom renovated. The DPP said he does not know if the facility had a policy regarding work orders or maintenance expectations. The DPP said he did not have any documentation showing staff know the process on reporting any maintenance issues. During an interview on 9/28/2023 at 9:20 a.m., LVN C said if there are any maintenance issues, the process is to call the DPP. There was no other documentation needed other than to inform the DPP. During an interview on 09/28/2023 at 9:30 a.m., CNA D said the process if there are any maintenance issues is to call the DPP. CNA D said there was no documentation needed other than calling the DPP. During an interview on 09/28/2023 at 1:51 p.m., the Administrator said the facility building is old and had several ongoing maintenance issues that need to be addressed. The Administrator said the risk of not addressing the environmental issues in a timely manner was pest control, resident safety, and privacy. Review of facility provided Work Orders, Maintenance policy dated 04/2010, reads Maintenance work orders shall be completed in order to establish a priority of maintenance service. Implementation: 1) In order to establish a priority of maintenance service, work orders must be filled out and forwarded to the Maintenance Director. 2) It shall be the responsibility of the department directors to fill out and forward such work orders to the Maintenance Director. 3) A supply of work orders is maintained at each nurses' station. 4) Work order requests should be placed in the appropriate file basket at the nurses' station. Work orders are picked up daily. 5) Emergency requests will be given priority in making necessary repairs. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 2 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0622 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to ensure when transferring or discharging a resident, documentation was present in the resident's medical record by the resident's physician for 1 (Resident #11) of 3 residents reviewed for discharge requirement. There was no documentation from the physician which indicated the resident had specific needs that could not be met in the facility. This deficient practice could place residents at risk of discharged from the facility without reason. Findings Include: Review of Resident #11's face sheet dated 09/26/2023, revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Resident #11's diagnosis included systemic lupus erythematosus (an inflammatory diseases caused when the immune system attacks its own tissues), dementia (condition characterized by progressive or persistent loss of intellectual functioning, especially with impairment of memory and abstract thinking resulting from organic disease of the brain), anxiety disorder (mental disorder characterized by feelings of worry, anxiety, or fear that are strong enough to interfere with one's daily activities), paranoid personality disorder (a mental health condition marked by a pattern of distrust and suspicion of others without adequate reason to be suspicious), and major depressive disorder (persistently low or depressed mood, or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, agitation, sleep disturbances, or suicidal thoughts). Review of Resident #11's quarterly MDS dated [DATE], revealed BIMS score of 13 indicating resident was cognitively intact. Review of Resident #11's care plan, dated 10/23/2019, revealed Resident #11 wished to remain at the facility. Interventions included: Encourage the resident to discuss feelings and concerns with impending discharge. Monitor for and address episodes of anxiety, fear, distress. Evaluate and discuss with the resident/family/caregivers the prognosis for independent or assisted living. Identify, discuss, and address limitations, risks benefit and needs for maximum independence. Review of Resident #11's progress notes dated 02/06/2023 at 3:04 p.m., written by SW H reads in part (Resident #11) asked the reason why she was going to be transferred. (Resident #11) was notified that resident did not leave her wander guard on and for her safety she would be better off in a secure unit. Review of Resident #11's Note written on 02/06/2023 at 9:25 p.m., written by LVN I reads in part Resident #11 was discharged today and left around 5:15 p.m. to another facility. Review of Resident #11's Physician Discharge summary dated [DATE], revealed there was no information documented on the following sections: Discharge Disposition, Rehabilitation Potential, Summary of Care, or Prognosis. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 3 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0622 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete During an interview on 09/27/2023 at 2:32 p.m., the SW E said she looked for all documentation and only found the entry in the progress notes related to the discharge and an incomplete Physician Discharge Summary. Review of facility provided Transfer or Discharge Notice policy dated 12/2016, reads in part The reasons for transfer or discharge will be documented in the resident's medical record. Event ID: Facility ID: 675910 If continuation sheet Page 4 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0623 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to ensure before transferring or discharging a resident, the notice of transfer or discharge was made by the facility at least 30 days before the resident was transferred or discharged for 1 (Resident #11) of 3 residents reviewed for discharge requirement. There was no documentation from the physician which indicated the resident had specific needs that could not be met in the facility. This deficient practice could place residents at risk of discharged from the facility without reason. Findings Included: Review of Resident #11's face sheet dated 09/26/2023, revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Resident #11's diagnosis included systemic lupus erythematosus (an inflammatory diseases caused when the immune system attacks its own tissues), dementia (condition characterized by progressive or persistent loss of intellectual functioning, especially with impairment of memory and abstract thinking resulting from organic disease of the brain), anxiety disorder (mental disorder characterized by feelings of worry, anxiety, or fear that are strong enough to interfere with one's daily activities), paranoid personality disorder (a mental health condition marked by a pattern of distrust and suspicion of others without adequate reason to be suspicious), and major depressive disorder (persistently low or depressed mood, or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, agitation, sleep disturbances, or suicidal thoughts). Review of Resident #11's quarterly MDS dated [DATE], revealed BIMS score of 13 indicating resident was cognitively intact. Review of Resident #11's care plan, dated 10/23/2019, revealed Resident #11 wished to remain at the facility. Interventions included: Encourage the resident to discuss feelings and concerns with impending discharge. Monitor for and address episodes of anxiety, fear, distress. Evaluate and discuss with the resident/family/caregivers the prognosis for independent or assisted living. Identify, discuss, and address limitations, risks benefit and needs for maximum independence. Review of Resident #11's progress notes dated 02/06/2023 at 3:04 p.m., written by SW H reads in part (Resident #11) asked the reason why she was going to be transferred. (Resident #11) was notified that resident did not leave her wander guard on and for her safety she would be better off in a secure unit. Review of Resident #11's Note written on 02/06/2023 at 9:25 p.m., written by LVN I reads in part Resident #11 was discharged today and left around 5:15 p.m. to another facility. Review of Resident #11's progress notes from 12/19/2022 to 02/06/2023 revealed there were no notes showing resident or representative was provided a 30-day written notice of impending transfer. Review of Resident #11's Physician Discharge summary dated [DATE], revealed there was no (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 5 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0623 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few information documented on the following sections: Discharge Disposition, Rehabilitation Potential, Summary of Care, or Prognosis. During an interview on 09/27/2023 at 2:32 p.m., the SW E said there was no 30-day written notice of transfer of Resident #11. The SW E said she had been in the SW E position since July 2023 and Resident #11 was transferred to another facility prior to her becoming the SW. The SW E said she did not know why the 30-day notice of transfer was not done. The SW E said she looked for all documentation and only found the entry in the progress notes related to the discharge and an incomplete Physician Discharge Summary. During an interview on 09/28/2023 at 1:15 p.m., the Ombudsman said she was unaware that Resident #11 was transferred to another facility. The Ombudsman said she had not received any notice regarding Resident #11's transfer from the facility. The Ombudsman said this was concerning because it was unclear if the resident knew her rights to appeal the transfer. Review of facility provided Transfer or Discharge Notice policy dated 12/2016, reads in part Our facility shall provide a resident and/or the resident's representative (sponsor) with a thirty (30)-day written notice of an impending transfer or discharge. The resident and/or representative will be notified in writing of the following information: a) reason for the transfer or discharge, b) effective date of the transfer or discharge, 3) the location to which the resident is being transferred or discharge including (2) information about how to obtain, complete and submit an appeal form and (3) how to get assistance completing the appeal process. A copy of the notice will be sent to the Office of State Long-term Care Ombudsman. The reasons for transfer or discharge will be documented in the resident's medical record. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 6 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0919 Make sure that a working call system is available in each resident's bathroom and bathing area. 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 allow residents to call for staff assistance through a communication system which relays the call directly to a staff member or to a centralized staff work area for 3 (Resident #15, #16, and #17) out of 8 resident rooms reviewed for environment. Residents Affected - Some -The facility failed to have a working call light that would light up when the residents pushed the call bell for residents' room [ROOM NUMBER] and #44. This failure could place residents at risk of not being able to notify staff when care is needed. The findings included: Resident #15 Review of Resident #15's face sheet, dated 09/28/2023, revealed a [AGE] year-old male admitted to the facility on [DATE] with diagnoses that included traumatic brain injury (brain dysfunction caused by an outside force, gastrostomy status (an opening into the stomach from the abdominal wall made surgically for introduction of food), and tracheostomy status (a procedure to help air and oxygen reach the lungs by creating an opening into the trachea from outside the neck). Review of Resident #15's quarterly MDS, dated [DATE], revealed BIMS of 09 indicating moderate cognitive impairment. Section G. revealed Resident #15 required supervision with bed mobility, transfer, dressing, toilet use, and personal hygiene. Review of Resident #15's care plan dated 07/27/2022, revealed resident was a moderate risk for increased fall and fractures as evidence by not steady in transfer. Intervention steps included anticipate and meet the resident's needs. Resident #16 Review of Resident #16's face sheet, dated 09/28/2023, revealed a [AGE] year-old male admitted to the facility on [DATE] with diagnoses that included: pain (physical suffering or discomfort caused by illness or injury), need for assistance with personal care, unsteadiness on feet, hypertension (high blood pressure). Review of Resident #16's quarterly MDS, dated [DATE], revealed BIMS of 15 indicating person is cognitively intact. Section G. revealed Resident #16 required supervision with bed mobility, transfer, dressing, eating, toilet use and personal hygiene. Review of Resident #16's care plan dated 06/20/2023, revealed resident is moderate risk for increased falls and fractures. Intervention steps included anticipate and meet the resident's needs. Resident #17 Review of Resident #17's face sheet, dated 09/28/2023, revealed a [AGE] year-old male admitted to the facility on [DATE] with diagnoses that included schizoaffective disorder (a mental health including schizophrenia and mood disorder symptoms), seizures (a sudden, uncontrolled burst of electrical (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 7 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0919 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some activity in the brain), blindness of one eye, depression (a depressed mood, or loss of pleasure or interest in activities for long periods of time), and catatonic disorder (a behavioral syndrome marked by an inability to move normally). Review of Resident #17's quarterly MDS, dated [DATE], revealed a BIMS of 15 indicating person is cognitively intact. Section G. revealed Resident #17 required supervision for bed mobility, transfer, and toilet use. Resident #17 required limited assistance with dressing, eating, and personal hygiene. During observations on 09/26/2023 at 1:30 p.m., ceiling tile outside with call light dome outside of room [ROOM NUMBER] was cracked. Resident was not in the room at the time of the observation. room [ROOM NUMBER] observed with hole in ceiling tile with exposed wires and missing a call light dome. During an interview and observation on 09/26/2023 at 1:45 p.m., Resident #15 said his current room is #44. Resident #15 said he noticed about a week ago that his call light outside of his room was missing and that it was not working. Resident #15 said he did not know what happened to the call light. Resident #15 said he is independent with ambulating and his needs have been met. Resident said he has not had any incidents such as falls nor had anything happen to him while the call light had not been working. Resident #15 said facility staff provided him with a handheld bell to use while the call light system is being fixed. Resident #15 was observed demonstrating use of the handheld bell. Resident #15 said he believes maintenance is aware of the issue and working on it but does not know any other details. The call button in room [ROOM NUMBER] was pushed and it was noted that the call light in vacant room [ROOM NUMBER] was turning on. Multiple staff were observed responding to the vacant room call light and then walking down the hall and being informed by Resident #15 that the call button to his room was pushed. During an interview and observation on 09/26/2023 at 2:51 p.m., the DPP said room [ROOM NUMBER] call light issue had been like that for four days. The DPP said that the system is old, and it was hard to get parts for it. The DPP said a specialist programmer is coming on 09/28/2023 to check out the system and hopefully fix it. The DPP said residents in room [ROOM NUMBER] are supposed to have a handheld bell to call for assistance. HHSC Investigator observed a handheld bell on a tray table. HHSC Investigator asked the DPP to press the call button in room [ROOM NUMBER]. It was observed the call light was not working on outside of door with cracked ceiling. The call light panel located at the nursing station showed room a call light pressed in room [ROOM NUMBER] when the button in room [ROOM NUMBER] was pressed. The DPP said resident in room [ROOM NUMBER] was also provided a handheld bell days before to call if assistance was needed. The DPP was heard using his phone and calling the outside company verifying that a technician will be coming by the facility to check on the call light system. HHSC Investigator requested for the DPP to provide a policy regarding call lights. During an interview and observation on 09/26/2023 at 3:05 p.m., Resident #16 entered room [ROOM NUMBER]. Resident #16 said he does not share his room with any other residents. Resident #16 said he was aware his call light system was not functioning correctly. Resident #16 said he is independent with ambulation, transfers, and does not need to use the call light button to have his needs met. Resident #16 said the facility is aware of the issue and they provided him with a handheld bell to use temporarily. Resident #16 said he had not had any falls, or any incidents related to a delay in response for assistance. Resident #16 again said he is very independent and come and go from his room without difficulty and have his needs met. During observation on 09/26/2023 at 3:15 p.m., rooms located in D-hall where rooms #42 and #44 were (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 8 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0919 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some located were checked for call light functioning. Rooms #38, #41, #43, #46, #47, and #48 were tested and all call light worked without any issues noted. No other call light issues noted throughout the facility. During an interview and observation on 09/26/2023 at 3:30 p.m., Resident #17, who resides in room [ROOM NUMBER] (roommate with Resident #15), said he was aware the call light system for his room was not working. Resident #17 said his needs are being met as he is independent in transferring and ambulating around the facility and can communicate needs to staff. Resident #17 said he had not been involved in any incidents since the call light system was not working, which had been about a week. Resident #17 said the facility provided him with a handheld bell to use if needed. Resident #17 observed demonstrating use of the bell. Resident #17 said he does not know what happened to the call light or when it was going to get fixed. Review of facility maintenance work order book on 09/27/2023 at 2:15 p.m., revealed no pending work orders for call lights for room [ROOM NUMBER] or #44. Observation and interview on 09/28/2023 at 8:30 a.m., technician observed working on call light system in D-hall. The DPP said that technician identified that room [ROOM NUMBER] had call light switch boxes changed from other room which explained why the call light switch triggered the call light from vacant room [ROOM NUMBER]. The DPP said technician also noted that call light switch in room [ROOM NUMBER] was taken from room [ROOM NUMBER] which explained why the button triggered call light panel showing room [ROOM NUMBER]. The technician was testing the remainder of the facility. During an interview on 09/28/2023 at 1:51 p.m., the Administrator said the facility does not have a call light policy. The Administrator said if the call lights are not working, she had bells that were given to the residents used to call for assistance. The Administrator said there had been no reported incidents or injuries. The Administrator said she had increased rounds frequency as well and increased one CNA in the hall where the rooms are located. The Administrator said the call system issue started about two weeks ago. The Administrator said she learned that buttons were being fixed out and that building had old equipment which was causing some delay. The Administrator said the risk of the call system not working properly was safety to residents and health risk having their needs met in a timely manner. The Administrator said the hall is mainly for independent resident. The Administrator said she did not report the issue to the State because she was not aware she needed to. Review of facility provided Abuse policy dated 01/01/2023, reads in part Procedures: The administrator and/or designee are responsible for identification of possible problems that need investigation, investigating the allegations and reporting incidents, investigations, and facility response to results of investigation within mandated time frames. By the time of exit on 09/28/2023 at 3:15 p.m., a policy on call lights or maintenance of call lights was not provided. The DPP and Administrator said they were not able to locate any policy on call lights. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 9 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public for three (halls A, B, and D) of four halls reviewed for environment, in that: -Three of four hallways show signs of needing repairs or maintenance with holes in the walls and missing covers. -Several resident bedrooms with holes in the ceiling, walls, and missing covers. These failures could place residents and staff at risk of living in an unsafe, unsanitary, and uncomfortable environment Findings included: Observation on 9/26/2023 at 10:53 a.m., the D-hall thermostat had no cover on the housing to the thermostat. The baseboard near room [ROOM NUMBER] was pulling inwards from the corner and the wall cracked just above the baseboard. room [ROOM NUMBER] had an unused electric outlet without a cover, a 2-inch hole in ceiling tile, and 4 inches by 2 inches hole in another ceiling tile. Observation on 9/26/2023 at 10:55 a.m., the A-hall room [ROOM NUMBER] door had bottom edging of door bent and sharp piece exposed. room [ROOM NUMBER] had a crack in the wall that was approximately 4-inches long that had dry plaster and two small holes in the wall. Observation on 9/26/2023 at 10:58 a.m., the B-hall room [ROOM NUMBER] had broken tile in restroom wall. A grab bar was loose in the restroom. Wall damage with open holes behind the restroom sink. room [ROOM NUMBER] had an electrical outlet with no cover. The backboard handrail in B-hallway had a pink and sticky substance. Review of facility maintenance work order book undated, revealed no pending work orders for physical environmental issues noted during observations. There was no record of orders being completed or what took place. The logbook had scattered information from 5/2023 and blank spots until 9/8/2023. During an interview on 9/27/2023 at 2:20 p.m., the Director of Physical Plant (DPP) said he was not able to locate any work orders for any of the observed physical environment issues. The DPP said he was aware of physical environment issue throughout the facility including holes in the ceiling tile, holes in the walls, missing covers and items that need to be replaced. The DPP said he had been working at the facility for about six months and had inherited many maintenance issues. The DPP said any facility maintenance needs are verbally reported to him and he stores the information in his head. He said all work order requests are word of mouth. The DPP said he did not have any document to show when he became aware of the maintenance issues. The DPP said maintenance needs are met by him putting in orders for supplies and equipment and based on budget allowances. The DPP said there are many environmental issues. The DPP said he does not know if the facility had a policy regarding work orders or maintenance expectations. The DPP said he did not have any documentation showing staff know the process on reporting any maintenance issues. The DPP said that he had no way of verifying the status of a work order. The DPP said the facility did not have an environmental policy. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 10 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete During an interview on 09/28/2023 at 1:51 p.m., the Administrator said the facility building was old and had several ongoing maintenance issues that need to be addressed. The Administrator said the risk of not addressing the environmental issues in a timely manner was pest control, resident safety, and privacy. The Administrator said the facility did not have an environmental policy. Review of facility provided Work Orders, Maintenance policy dated 04/2010, reads Maintenance work orders shall be completed in order to establish a priority of maintenance service. Implementation: 1) In order to establish a priority of maintenance service, work orders must be filled out and forwarded to the Maintenance Director. 2) It shall be the responsibility of the department directors to fill out and forward such work orders to the Maintenance Director. 3) A supply of work orders is maintained at each nurses' station. 4) Work order requests should be placed in the appropriate file basket at the nurses' station. Work orders are picked up daily. 5) Emergency requests will be given priority in making necessary repairs. Event ID: Facility ID: 675910 If continuation sheet Page 11 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to maintain an effective ongoing pest control program for 1 of 1 facility reviewed for pests. Residents Affected - Some The facility failed to have pest control treat the building for rodents and insects. The noncompliance began on 03/03/2023 and ended on 09/19/2023. The facility had corrected the noncompliance before the survey began. These deficient practices could place residents at risk of exposure to pests, diseases, infections, and diminished quality of life. Findings included: Review of Resident #1's face sheet dated 09/27/2023, revealed a [AGE] year-old male who was admitted to the facility on [DATE]. Resident 1's diagnosis included anxiety disorder (mental disorder characterized by feelings of worry, anxiety, or fear that are strong enough to interfere with one's daily activities), dementia (condition characterized by progressive or persistent loss of intellectual functioning, especially with impairment of memory and abstract thinking resulting from organic disease of the brain), and hypertension (high blood pressure). Review of Resident #1's MDS dated [DATE], revealed a BIMS score of 14 indicating Resident #1 was cognitively intact. Section D revealed resident had symptoms of feeling down, depressed, or hopeless at a frequency of several days. Section G. revealed resident required supervision with bed mobility, walking in room, and eating. Resident 1 required limited assistance with transferring, dressing, toilet use and personal hygiene. During an interview on 09/26/2023 at 9:00 a.m., the Ombudsman said the recent issues reported at the facility by residents she had spoken with was regarding pest at the facility. The Ombudsman said she reported this concern to facility administration. The Ombudsman said she does not know what if any action the facility had taken to address the issue. During an interview on 09/27/2023 at 10:15 a.m., Resident #1 said when he was first admitted there were mice in his bedroom and that three mice were caught on a glue board placed by pest control. Resident #1 said he had noticed improvements since a new pest control agency was started and now had not seen any mice in over a month. Resident #1 said he had seen bugs in his room possibly coming from the ceiling or through the hole in the wall. Resident #1 said this had also improved with the new pest control agency taking over. During an interview on 09/27/2023 at 2:20 p.m., the DPP said that he had been working at the facility for about six months. The DPP said when he first started the facility was using [company A] Pest Control but there were reports of mice and insects throughout the building. The DPP said the [company A] was used up to 06/20/2023. The DPP said that a decision was made by him to start using another pest control agency called [company B] Pest Control. The DPP said that there had been a huge difference since [company B] Pest Control started on 07/12/2023. The DPP said that there have been no new mice sightings or evidence of mice since [company B] Pest started to address the issue. The DPP said that the insect problem has also decreases significantly as [company B] Pest Control had treated the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 12 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0925 Level of Harm - Minimal harm or potential for actual harm facility interior and exterior. The DPP said the facility did not have a pest control policy but kept a logbook with documentation from pest control visits. The surveyor determined the facility was in non-compliance from 03/03/2023 to 09/19/2023. The facility took the following actions to correct the non-compliance. Residents Affected - Some The facility completed the following corrective actions to address the non-compliance after the incident occurred but prior to the surveyor entering: During observations on 09/26/2023 to 09/28/2023 there were no identified issues with pest or rodents noted. Review of the pest control binder undated, revealed the following pest control service notes: -09/19/2023 from [company B] Pest Control noted the mouse issues seem to have gone away and very little American roach sightings. -8/21/2023 the facility requested additional service from [company B] Pest Control as mice were reported in halls B and D. 8 holes stuffed plugged up. Multiple glue boards used. Routine service from Perfect Pest Control provided -8/14/2023 Routine service from [company B] Pest Control. -07/12/2023 Routine service from [company B] Pest Control provided. Further review revealed [company A] had been used before on the following service dates: 06/20/2023, 05/08/2023, 04/04/2023, and 03/03/2023. During an interview on 09/26/2023 at 2:30 p.m., Resident #15 said there had been roaches in the past but had not seen any pests or rodents in about a month. During an interview on 09/26/2023 at 3:05 p.m., Resident #16 said he had not seen any mice or other insects for about a month. Resident #16 said there were mice before in the building. During an interview on 09/26/2023 at 3:15 p.m., Resident #3 said she had not seen any mice or insects for the last few weeks. During an interview on 09/26/2023 at 3:20 p.m., Resident #4 said there were insects in the building before but had not seen very many anymore in the last few weeks. During an interview on 09/26/2023 at 3:26 p.m., Resident #5 said he had not seen any insects in his room or anywhere in the building he had been to. During an interview on 09/27/2023 at 9:11 a.m., Resident #18 said he had not seen any rodents or insects in over a month or so. During an interview on 09/28/2023 at 11:57 a.m., Resident #17 said he had no concerns with any pests or rodents. During an interview on 09/28/2023 at 9:20 a.m., LVN C said that she had not seen any mice, roaches, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 13 of 14 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 675910 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Hogan Park 3203 Sage St Midland, TX 79705 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 0925 or other insects in the building in the last few weeks. Level of Harm - Minimal harm or potential for actual harm During an interview on 09/28/2023 at 9:30 a.m., CNA D said she had not seen any mice or evidence of any rodents in months. CNA D said she had not seen any insects recently in the building. Residents Affected - Some During an interview on 09/28/2023 at 1:51 p.m., the Administrator said she was aware of the rodent problem in the building. The Administrator said there were mice everywhere in the building. The Administrator said the DPP started to use a new pest control agency to address the issue. The Administrator said that the last mouse sighting was about a month ago and the DPP immediately called the pest control agency to come address the issue. The Administrator said this goes for insects as well. The Administrator said there was a problem with insects especially roaches in the building but since the change of pest control agency it seems that the new agency has been effective combatting the problem. The Administrator said the on-going plan was if there were any sightings of roaches or insects, then a work order will be placed and the DPP will contact the pest control agency to immediately come take care of the problem outside of their monthly routine services. Review of facility provided Work Orders, Maintenance policy dated 04/2010, read Maintenance work orders shall be completed in order to establish a priority of maintenance service. Implementation: 1) In order to establish a priority of maintenance service, work orders must be filled out and forwarded to the Maintenance Director. 2) It shall be the responsibility of the department directors to fill out and forward such work orders to the Maintenance Director. 3) A supply of work orders is maintained at each nurses' station. 4) Work order requests should be placed in the appropriate file basket at the nurses' station. Work orders are picked up daily. 5) Emergency requests will be given priority in making necessary repairs. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 14 of 14