Health inspection·December 8, 2023

F 0567 Level of Harm - Minimal harm or potential for actual harm always equal the facilities cash box level. There shall be no mixing of cash with other cash on hand from other accounts, nor shall there be any borrowing from the fund . Each morning and at the end of the day, the box will be given to the business office. The business office associate will count the money, reconcile with the withdrawal tickets, and sign the cash count sheet. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 2 of 38 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 12/08/2023 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 0582 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure each resident was informed before, or at the time of admission, and periodically during the residents stay, of services available in the facility and of changes for those services, which included changes for services not covered under Medicare/Medicaid or by the facility's per diem rate for 3 of 3 residents (Resident #45, #263 and #24) reviewed for Medicare/Medicaid coverage. Residents Affected - Some The facility failed to ensure Residents #45, #263 and #24 were given a completed SNF ABN (a notice given to Medicare beneficiaries to transfer financial liability to the beneficiary before the SNF provides an item or service that would usually be paid for by Medicare, but Medicare was not likely to provide coverage because care was not medically reasonable and necessary, or was custodial in nature) when discharged from skilled services at the facility prior to covered days being exhausted. These failures could place residents at risk for not being aware of changes to provided services. Findings included: 1. Record review of Resident 45's electronic face sheet dated 12/07/2023 revealed resident was a [AGE] year-old male who was admitted on [DATE] with diagnoses that include: heart failure (heart disease), muscle weakness, age-related cognitive decline, lack of coordination, and chronic obstructive pulmonary disease (lung disease). Record review of Resident #45's quarterly MDS dated [DATE] revealed: Section B- Hearing, Speech, and Vision resident's vision was highly impaired, he was usually understood and could understand others; Section C- Cognitive Patterns Resident #45 had a BIMS score of 15 (cognitive intact). Record review of the SNF Beneficiary Protection Notification Review indicated Resident #45 received Medicare Part A Skilled Services on 5/05/2023 and his last covered day of Part A services was 6/23/2023. The SNF Beneficiary Protection Notification Review indicated the facility/provider initiated the discharge from Medicare Part A Services when benefit days were not exhausted. Record review of Resident #45's SNF ABN dated 6/21/2023 revealed no evidence that required information for care, reason Medicare may not pay, and estimated cost was completed . During an interview on 12/07/2023 at 09:55 a.m., Resident #45 stated he was told he stopped receiving therapy because insurance would not pay for it. He stated he was not informed of how much it would cost him to continue with therapy at that time. He stated he would like to know cost of therapy and felt he might have continued services had he known. 2. Record review of Resident 263's electronic face sheet dated 12/07/2023 revealed resident was a [AGE] year-old female who was originally admitted on [DATE] and most recently admitted on [DATE] with diagnoses that include: severe intellectual disabilities, memory deficit, concentration deficit, dysphagia (inability to swallow) and aphasia (inability to speak). Record review of Resident #263's significant change MDS dated [DATE] revealed: Section B- Hearing, Speech, and Vision resident was absent of spoken words and rarely/never understood verbal content; (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 3 of 38 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 12/08/2023 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 0582 Section C- Cognitive Patterns BIMS could not be performed. Level of Harm - Minimal harm or potential for actual harm Record review of the SNF Beneficiary Protection Notification Review indicated Resident #263 received Medicare Part A Skilled Services on 3/22/2023 and her last covered day of Part A services was 4/6/2023. The SNF Beneficiary Protection Notification Review indicated the facility/provider initiated the discharge from Medicare Part A Services when benefit days were not exhausted. Residents Affected - Some Record review of Resident #263's SNF ABN dated 4/4/2023 revealed no evidence that required information for care, reason Medicare may not pay, and estimated cost was completed. 3. Record review of Resident 24's electronic face sheet dated 12/07/2023 revealed resident was a [AGE] year-old female who was originally admitted on [DATE] and most recently admitted on [DATE] with diagnoses that include: chronic obstructive pulmonary disease (lung disease), diabetes, dysphagia (inability to swallow), and cognitive communication deficit. Record review of Resident #24's quarterly MDS dated [DATE] revealed: Section B- Hearing, Speech, and Vision resident had clear speech and could understand others; Section C- Cognitive Patterns Resident #24 had a BIMS score of 01 (severely impaired). Record review of the SNF Beneficiary Protection Notification Review indicated Resident #24 received Medicare Part A Skilled Services on 5/19/2023 and his last covered day of Part A services was 8/09/2023. The SNF Beneficiary Protection Notification Review indicated the facility/provider initiated the discharge from Medicare Part A Services when benefit days were not exhausted. Record review of Resident #24's SNF ABN dated 8/07/2023 revealed no evidence that required information for care, reason Medicare may not pay, and estimated cost was completed. During an interview on 12/06/2023 at 03:54 p.m., CRC stated that she and the [NAME] both were responsible for filling out information on ABN notices. She stated that she did not know why information had not been filled out on the notices. She could not provide documentation with information that was given to the resident or representative. She stated that facility did not have policy on ABN forms and stated that the facility used the CMS form instructions. During an interview on 12/7/2023 at 09:37 a.m., Corporate MDS Coordinator stated that she supervises CRC and [NAME] to make sure ABN notices were filled out and signed. She stated that corporate would perform random chart audits and education was provided to CRC and [NAME] when issues were found. She stated that it was her expectation that the table on ABN form with the care, reason Medicare may not pay, and estimated cost should be filled out prior to obtaining signature of resident or their responsible party. She stated that the resident or responsible party would then choose an option from the 3 options after being informed of the services and cost. She stated that effect that not filling out form correctly would be that the resident or their responsible party would not know what the residents were signing. She stated that she believed human error led to the failure of forms not being completed fully prior to obtaining signature of resident or their responsible party. She felt that more education was needed to correct the issue. Corporate MDS Coordinator stated that the facility did not have a policy related to the SNF ABN forms and that the facility used guidance found on CMS website. During an interview on 12/07/2023 at 10:00 a.m., [NAME] stated that she did administer ABN notices to some residents. She stated that she did not fill in information on the table in ABN form with the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 4 of 38 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 12/08/2023 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 0582 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some care, reason Medicare may not pay, and estimated cost prior to getting resident or their responsible party's signature. She stated that she would inform the residents of the cost of services verbally. She stated that she was not aware that information needed to be filled in the form. Review of CMS.gov accessed on 12/07/2023 at https://www.cms.gov/medicare/forms-notices/beneficiary-notices-initiative/ffs-snf-abn revealed: The SNFABN provides information to the beneficiary so that s/he can decide whether or not to get the care that may not be paid for by Medicare and assume financial responsibility. SNFs must use the SNFABN when applicable for SNF Prospective Payment System services (Medicare Part A) . Body A. Beginning On Blank/ Effective Date of Potential Non-coverage: In the blank that follows Beginning on ., the SNF enters the date on which the beneficiary may be responsible for paying for care that Medicare isn't expected to cover. Care Section: In this section, the SNF lists the care that it believes may not or won't be covered by Medicare. The description must be written in plain language that the beneficiary can understand. The care can be listed as inpatient stay at this facility, for example. C. Reason Medicare May Not Pay Section: The SNF must give the applicable Medicare coverage guideline(s) and a brief explanation of why the beneficiary's medical needs or condition do not meet Medicare coverage guidelines. The reason must be sufficient and specific enough to enable the beneficiary to understand why Medicare may deny payment. D. Estimated Cost Section: In this section, the SNF enters the estimated cost of the corresponding care that may not be covered by Medicare. The SNF should enter an estimated total cost or a daily, per item, or per service cost estimate. SNFs must make a good faith effort to insert a reasonable cost estimate for the care. The lack of a cost estimate entry on the SNFABN or an amount that is different than the final actual cost charged to the beneficiary does not invalidate the SNFABN . Option Boxes There are 3 options listed on the SNFABN with corresponding check boxes. The beneficiary must check only one option box. If the beneficiary is physically unable to make a selection, the SNF may enter the beneficiary's selection at his/her request and indicate on the notice that this was done for the beneficiary. Otherwise, SNFs are not permitted to select or pre-select an option for the beneficiary as this invalidates the notice. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 5 of 38 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 12/08/2023 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to develop a comprehensive care plan for each resident, consistent with resident rights, that included measurable objectives and time frames to meet residents' mental and psychosocial needs for 3 of 5 (Resident # 2, Resident #21 and Resident #25) residents reviewed for care plan completion. The facility failed to ensure Resident #2, Resident #21, and Resident #25, comprehensive care plans had measurable objectives and time frames identified to meet residents needs. This failure could place residents at risk for not receiving appropriate supervision. Findings included: Resident #2 Record review of Resident #2's electronic face sheet dated 12/08/2023 revealed resident was a [AGE] year-old male who was admitted on [DATE] with diagnoses that included: Paranoid Schizophrenia, Stroke , history of falls, anxiety, muscle weakness, psychotic disorder with delusions, hallucinations, and cognitive communication deficit. Review of Resident #2's Quarterly MDS dated [DATE] revealed: Section C- Cognitive Patterns Resident #2 had a BIMS score of 15 (cognitively intact); Section J- Health Conditions Resident was a current smoker. Record review of Resident #2s Safe Smoking assessment dated [DATE] revealed: Resident safe to smoke unsupervised, at this time. All smoking materials will be kept at the nurse's station. Care plan is up to date or updated. The evaluation has been discussed with the resident. Record review of Resident #2's Comprehensive Care Plan last revised on 10/27/2023 revealed: Focus: Potential for safety hazard, injury related to smoking. Resident assessed to be supervised smoker with traditional cigarettes. Resident will keep cigarettes and lighters oneself and smoke at unscheduled times unattended even after education of smoking policy. Resident will pick up cigarette buds and ask other resident for cigarettes continuously. Goal: Resident will not cause injury to self or others, or damage to property related smoking and desire through next 90 days. Interventions: Educate on smoking policy and ensure understanding, smoking material will remain in locked box. Resident will not possess any smoking items on person or in room. Smoking assessment at least quarter. Resident #21 Record review of Resident #21's electronic face sheet dated 12/06/2023 revealed resident was a [AGE] year-old male who was admitted on [DATE] and an original admission date of 09/27/2018 with diagnoses that included: Nicotine Dependence, muscle weakness, Quadriplegia, lack of coordination and cognitive communication deficit. Review of Resident #21's Quarterly MDS dated [DATE] revealed: Section C- Cognitive Patterns Resident #21 had a BIMS score of 04 (severe cognitive impairment); Section GG- Functional Abilities and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 6 of 38 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 12/08/2023 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Goals Resident #21 had upper and lower extremity impairment to one side of body and requires a wheelchair for mobility; Section J- Health Conditions Resident was a current smoker. Record review of Resident #21's Safe Smoking assessment dated [DATE] revealed: Resident not able to light smoking materials safely; Resident not able to extinguish smoking materials completely in an appropriate receptable; Resident is not able to dispose of ashes or their tobacco-related residue appropriately. Record review of Resident #21's Comprehensive Care Plan last revised on 10/27/2023 revealed: Focus: The resident is a smoker. Resident will keep cigarettes and lighters on self and smoke at unscheduled times unattended even after education of smoking policy. Goal: The Resident will not smoke without supervision through the review date. The Resident will not suffer injury from unsafe smoking practices through the review date. Interventions: Instruct resident about the facility policy on smoking: locations, times, safety concerns. Notify charge nurse immediately if its suspected resident has violated facility smoking policy. Observe clothing and skin for sings of cigarette burns. Resident #25 Record review of Resident #25's electronic face sheet dated 12/08/2023 revealed resident was a [AGE] year-old male who was admitted on [DATE] with diagnoses that included: Stroke, inability to move right dominant side, muscle weakness, lack of coordination and cognitive communication deficit. Review of Resident #25's Quarterly MDS dated [DATE] revealed: Section C- Cognitive Patterns Resident #21 had a BIMS score of 04 (severe cognitive impairment); Section GG- Functional Abilities and Goals Resident #21 had upper and lower extremity impairment to one side of body and requires a wheelchair for mobility; Section J- Health Conditions Resident was a current smoker. Record review of Resident #25's Safe Smoking assessment dated [DATE] revealed: Resident not able to light smoking materials safely; The resident is safe to smoke unsupervised. Record review of Resident #25's Comprehensive Care Plan last revised on 10/27/2023 revealed: Focus: The resident is a smoker. Resident will keep cigarettes and lighters on self and smoke at unscheduled times unattended even after education of smoking policy. Goal: The Resident will not smoke without supervision through the review date. The Resident will not suffer injury from unsafe smoking practices through the review date. Interventions: Instruct resident about the facility policy on smoking: locations, times, safety concerns. Notify charge nurse immediately if its suspected resident has violated facility smoking policy. Observe clothing and skin for sings of cigarette burns. During an observation and interview on 12/05/2023 at 10:05 a.m., Resident #2 stated that he helped other resident's light their cigarettes if they cannot. Resident #2 pushed Resident #25 into dining room and in the doorway Resident #25 dropped a lighter. An unknown staff member picked up lighter and handed to Resident #25. Resident #2 lit Resident #21's cigarette for him. During an observation on 12/05/2023 at 11:08 a.m., Resident #21 sitting alone and smoking unsupervised in smoking area. During an observation on 12/05/2023 at 11:08 a.m., Resident #25 walking around in smoking area smoking unsupervised with own smoking lighter and cigarettes. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 7 of 38 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 12/08/2023 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an observation on 12/05/2023 at 11:19 a.m., unidentified resident seen taking one of Resident #21's cigarettes out of Resident #21's container. Unidentified resident lit Resident #21's cigarette for him and both residents were unsupervised. During an interview on 12/06/2023 at 9:00 AM the MDS Coordinator stated she was responsible for completing care plans. The MDS Coordinator stated care plans were updated quarterly and as needed. The MDS Coordinator stated as assessments were updated the care plan should have been updated, and the care plan should correlate with the Smoking Assessment. The MDS Coordinators stated care plan were reviewed by the IDT team, which consisted of the DON, MDS Coordinator, Social Worker, Activity Director and Dietary. The MDS Coordinator stated the focus and the goal portion of the care plan should corelate, if the resident's smoking assessment stated they were to be supervised then the focus and the goal portion of the care plan would reflect they were supposed to be supervised. The MDS Coordinator stated the reason they did not match was human error. During an interview on 12/06/2023 at 10:09 AM the ADMN stated her expectation was that care plans be complete and accurate. The ADMN stated the care plans should match the smoking assessment and the focus and the goal should also match. The ADMN stated the MDS was responsible to complete the care plane. The ADMN stated the DON and ADON were to monitor completion of the care plans. The ADMN stated what led to failure was MDS Coordinator not ensuring the care plans were accurate and matched the smoking assessments. During an interview on 12/08/23 at 09:41 AM the DON stated care plans were completed quarterly and as needed. The DON stated the care plan should be accurate and complete. The DON stated the focus, and the goal should correlate with the smoking assessment. The DON stated she was responsible for monitoring care plans for accuracy. The DON stated what led to failure was a system breakdown and needed a better system. Record review of facility policy titled, Comprehensive Care Plan, dated 04/25/2021 revealed: Every resident will have an individualized interdisciplinary plan of care in place . 5. The Interdisciplinary Team will review the healthcare practitioner's notes and orders (e.g., dietary needs, medications, routine treatments, etc.) and implement a Comprehensive Care Plan to meet the residents' immediate care needs. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 8 of 38 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 12/08/2023 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure each resident received adequate supervision to prevent accidents for 5 of 7 (Residents #2, #20, #25, #45 and #262) residents reviewed for smoking safety. The facility failed to ensure Residents #21 assessed as supervised smokers were supervised when smoked. The facility failed to ensure Residents #2, #21, #25, #45, and #262 lighters and cigarettes were not stored on their person. These failures could affect residents who smoke at risk of serious bodily harm, physical impairment, or death. The findings included: Resident #1 Record review of Resident #2's electronic face sheet dated 12/08/2023 revealed resident was a [AGE] year-old male who was admitted on [DATE] with diagnoses that included: Paranoid Schizophrenia, Stroke, history of falls, anxiety, muscle weakness, psychotic disorder with delusions, hallucinations, and cognitive communication deficit. Review of Resident #2's Quarterly MDS dated [DATE] revealed: Section C- Cognitive Patterns Resident #2 had a BIMS score of 15 (cognitively intact). Record review of Resident #2s Safe Smoking assessment dated [DATE] revealed: Resident safe to smoke unsupervised, at this time. All smoking materials will be kept at the nurse ' s station. Care plan is up to date or updated. The evaluation has been discussed with the resident. Record review of Resident #2's Comprehensive Care Plan last revised on 10/27/2023 revealed: Focus: Potential for safety hazard, injury related to smoking. Resident assessed to be supervised smoker with traditional cigarettes. Resident will keep cigarettes and lighters oneself and smoke at unscheduled times unattended even after education of smoking policy. Resident will pick up cigarette buds and ask other resident for cigarettes continuously. Goal: Resident will not cause injury to self or others, or damage to property related smoking and desire through next 90 days. Interventions: Educate on smoking policy and ensure understanding, smoking material will remain in locked box. Resident will not possess any smoking items on person or in room. Smoking assessment at least quarter. Resident #2 Record review of Resident #21's electronic face sheet dated 12/06/2023 revealed resident was a [AGE] year-old male who was admitted on [DATE] and an original admission date of 09/27/2018 with diagnoses that included: Nicotine Dependence, muscle weakness, Quadriplegia, lack of coordination and cognitive communication deficit. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 9 of 38 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 12/08/2023 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Review of Resident #21's Quarterly MDS dated [DATE] revealed: Section C- Cognitive Patterns Resident #21 had a BIMS score of 04 (severe cognitive impairment); Section GG- Functional Abilities and Goals Resident #21 had upper and lower extremity impairment to one side of body and requires a wheelchair for mobility. Record review of Resident #21's Safe Smoking assessment dated [DATE] revealed: Resident not able to light smoking materials safely; Resident not able to extinguish smoking materials completely in an appropriate receptable; Resident is not able to dispose of ashes or their tobacco-related residue appropriately. Record review of Resident #21's Comprehensive Care Plan last revised on 10/27/2023 revealed: Focus: The resident is a smoker. Resident will keep cigarettes and lighters on self and smoke at unscheduled times unattended even after education of smoking policy. Goal: The Resident will not smoke without supervision through the review date. The Resident will not suffer injury from unsafe smoking practices through the review date. Interventions: Instruct resident about the facility policy on smoking: locations, times, safety concerns. Notify charge nurse immediately if its suspected resident has violated facility smoking policy. Observe clothing and skin for sings of cigarette burns. Resident #3 Record review of Resident #25's electronic face sheet dated 12/08/2023 revealed resident was a [AGE] year-old male who was admitted on [DATE] with diagnoses that included: Stroke, inability to move right dominant side, muscle weakness, lack of coordination and cognitive communication deficit. Review of Resident #25's Quarterly MDS dated [DATE] revealed: Section C- Cognitive Patterns Resident #21 had a BIMS score of 04 (severe cognitive impairment); Section GG- Functional Abilities and Goals Resident #21 had upper and lower extremity impairment to one side of body and requires a wheelchair for mobility. Record review of Resident #25's Safe Smoking assessment dated [DATE] revealed: Resident not able to light smoking materials safely; The resident is safe to smoke unsupervised. Record review of Resident #25's Comprehensive Care Plan last revised on 10/27/2023 revealed: Focus: The resident is a smoker. Resident will keep cigarettes and lighters on self and smoke at unscheduled times unattended even after education of smoking policy. Goal: The Resident will not smoke without supervision through the review date. The Resident will not suffer injury from unsafe smoking practices through the review date. Interventions: Instruct resident about the facility policy on smoking: locations, times, safety concerns. Notify charge nurse immediately if its suspected resident has violated facility smoking policy. Observe clothing and skin for sings of cigarette burns.[TM(2] Resident #45 Record review of Resident 45's electronic face sheet dated 12/07/23 revealed resident was a [AGE] year-old male who was admitted on [DATE] with diagnoses that including: heart failure (heart disease), muscle weakness, age-related cognitive decline, lack of coordination, and chronic obstructive pulmonary disease (lung disease). Record review of Resident #45's quarterly MDS dated [DATE] revealed: Section B- resident ' s vision was highly impaired; Section C- Cognitive Patterns Resident #45 had a BIMS score of 15 (cognitive (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 10 of 38 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 12/08/2023 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 0689 intact); Section G- Functional Abilities required cane for mobility. Level of Harm - Minimal harm or potential for actual harm Record review of Resident #45 ' s Safe Smoking assessment dated [DATE] revealed: Resident is safe to smoke unsupervised, all smoking materials will be kept at the nurse's station. Care plan is up to date or updated. The evaluation has been discussed with the resident. The evaluation has been explained to the family / responsible party. Residents Affected - Some Record review of Resident #45 ' s Comprehensive Care Plan last revised on 10/27/2023 revealed: Focus: Resident is an occasional smoker. Resident will keep cigarettes and lighters on self and smoke at unscheduled times unattended even after education of smoking policy. Goal: Resident will remain free from smoking related injuries through next evaluation. Intervention: Smoking evaluation will be completed upon admission by license nurse. Smoking policy will be reviewed with resident upon admission to include repercussions of smoking violations. Resident #262 Record review of Resident 262's electronic face sheet dated 12/07/23 revealed resident was a [AGE] year-old female who was admitted on [DATE] with diagnoses that including: multiple sclerosis (neurological disease that can cause numbness, fatigue, and impair muscular coordination), diabetes, anxiety, and history of falling. Record review of Resident #262 ' s baseline care plan dated 11/30/23 revealed: had impaired vision, needed staff supervision for personal hygiene and mobility, needed staff setup or clean-up for eating and oral hygiene, was alert and cognitively intact, always had urinary incontinence, had history of falls, and smoked unsupervised. Record review of Resident #262 ' s clinical assessments on 12/05/23 revealed no Safe Smoking Assessment. Observation on 12/06/2023 at 9:45 AM of medication room revealed a lock box that contained one package of cigarettes. During an observation and interview on 12/05/2023 at 10:05 a.m., Resident #2 stated that he helped other resident ' s light their cigarettes if they cannot. Resident #2 pushed Resident #25 into dining room and in the doorway Resident #25 dropped lighter. An unknown staff member picked up the lighter and handed to Resident #25. Resident #2 lit Resident #21 ' s cigarette for him. During an observation on 12/05/2023 at 11:08 a.m., Resident #21 sitting alone and smoking unsupervised in smoking area. During an observation on 12/05/2023 at 11:08 a.m., Resident #25 walking around in smoking area smoking unsupervised with own smoking lighter and cigarettes. During an observation on 12/05/2023 at 11:19 a.m., unidentified resident seen taking one of Resident #21 ' s cigarettes out of Resident #21 ' s container. Unidentified resident lit Resident #21 ' s cigarette for him and both residents were unsupervised. During an observation and interview on 12/05/2023 at 09:18 a.m., Resident #262 stated that she had her own cigarette lighter and cigarettes in the top pocket of her shirt while she was sitting in (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 11 of 38 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 12/08/2023 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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some wheelchair in her room. Resident #262 stated she had seen other residents storing their cigarette lighters and cigarettes on their person and in their rooms. Resident #262 showed surveyor her cigarettes and lighter in pocket. During an interview on 12/05/2023 at 10:05 a.m., Resident #6 stated that residents keep their own cigarettes and lighters. Resident #6 stated that there are smoking times, but residents are able to smoke whenever they want. During an observation on 12/05/2023 at 03:53 p.m., Resident #262 seen sitting in wheelchair in CRC ' s office and dropped package of cigarettes on the floor. The CRC picked up cigarette package and handed to Resident #262. No staff observed taking up cigarette lighter or cigarettes after observation. During an interview on 12/05/2023 at 09:46 a.m., Resident #45 stated that he went outside to smoke unattended. During an observation on 12/05/2023 at 09:58 a.m., Resident #45 seen in smoking area smoking cigarette unattended. During an interview on 12/06/2023 at 9:00 AM the MDS Coordinator stated at this time there were no residents who facility staff were concerned with burning themselves or their clothes. The MDS Coordinator stated residents were not supposed to have their own cigarettes or lighters, they should be kept in a lock box. The MDS Coordinator stated it was hard to enforce the policy because residents were able to go on pass and purchase their own cigarettes and lighters. During an interview on 12/06/2023 at 9:45 AM LVN D stated residents who were supposed to be supervised while smoking do have scheduled smoking times. LVN D stated their cigarettes are locked in the medication room with their lighters and at smoking times they will come get their cigarettes and lighters. LVN D stated no residents had asked for their lighter today and if they were seen with a lighter, they either had it hidden in room or borrowed one from another resident. LVN D stated it was impossible to prevent residents from keeping their lighters and cigarettes in their room, because they can go and buy them when they want, and they cannot go through their belongings to confiscate. LVN D stated she knew that certain residents do keep their cigarettes and lighters on their person. LVN D Stated residents having lighters on their person could have caused safety issues, it could have caused something to catch on fire. LVN D she does not have any residents on her hall that have cigarette burns or burns in their clothes. LVN D stated charge nurses were responsible for completing smoking assessments. LVN D stated that if the smoking assessment stated a resident was not able to safely light their own cigarette, then the resident should be coded as a supervised smoker. During an interview on 12/06/2023 at 10:09 AM the ADMN stated there were no residents they were concerned with burning themselves or their clothes. The ADMN stated what led to failure it was impossible to monitor which residents kept their own cigarettes and lighters, they were able to go the store next door and purchase them themselves and the staff were not allowed to go thru resident belongings. The ADMN stated staff were supposed to monitor residents who were assessed as supervised smokers. The ADMN stated failure of residents not being supervised was that residents will go out with other residents and get cigarettes and lighters from other residents. The ADMN stated staff should have been watching residents throughout the day to ensure supervised residents were supervised. The ADMN stated staff assumed residents smoking unsupervised were assessed to smoke unsupervised led to the failure. The ADMN stated residents having their own lighters could have been a safety hazards that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 12 of 38 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 12/08/2023 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 0689 could have caused a fire or resident burning themselves. Level of Harm - Minimal harm or potential for actual harm During an interview on 12/08/23 at 09:41 AM the DON stated assessments should be done when a resident was admitted and then quarterly. The DON stated her expectation was that assessments were completed accurately. The DON stated that residents should have been supervised when smoking if they were unable to light their own cigarette. She stated that it was the DONs responsibility to ensure that assessments were completed. The DON stated that staff needing more education led to the failure. The DON stated that unsupervised smoking could have been unsafe and lead to different problems. Residents Affected - Some Record review of facility policy titled, Smoking dated 10-12-22 revealed: It is the policy of this community to accommodate residents who desire to smoke, including electronic cigarettes by taking reasonable precautions, providing a safe environment for them, and protecting the non-smoking residents. Incendiary devices will be stored by the facility staff. Residents will not be allowed to possess any lighters, cigarettes, or other smoking material. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 13 of 38 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 12/08/2023 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 0695 Provide safe and appropriate respiratory care for a resident when needed. 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 ensure that a resident who needed respiratory care, was provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, and/or the residents' goals and preferences, for 1 of 1 (Resident #10) reviewed for respiratory care. Residents Affected - Few The facility failed to ensure that Resident #10's oxygen tubing had been changed and dated once weekly. This failure placed residents that used oxygen at risk of respiratory complications and/or possible respiratory infections. Findings included: Record review of Resident #10's Facesheet dated 12/06/2023 revealed: A [AGE] year-old female, last admitted to the facility on [DATE] and an original admit date of 4/17/2017. A DX list included: Shortness of breath, Dependence on Supplemental Oxygen, weakness, generalized weakness and COPD. Record review of Resident #10's annual MDS dated [DATE] revealed: Section C; BIMS of 09 meaning moderate cognitive impairment. Section GG; Resident #10's ADLs were scored at a 2 on most OBRA/Interim Performance, meaning Substantial/maximal assistance. Section O; Oxygen use while a resident. Record review of Resident #10's Care Plan last revised on 11/16/2023 revealed resident required oxygen therapy related to COPD. The care plan did not include an intervention that included changing oxygen tubing or humidifier bottles on a weekly basis. Record review of Resident #10's Physician orders dated 12/06/2023 revealed: 1. Clean/Change oxygen concentrator filters every night shift every Sunday, Active 06/06/2021. 2. Oxygen tubing change every night shift every Sunday, Active 06/06/2021. During an observation on 12/05/2023 at 11:00 AM the oxygen tubing was dated 11/26/2023 (Sunday). During an observation on 12/07/23 at 10:02 AM the oxygen tubing revealed the date of 12/05/2023 (Tuesday). During an interview on 12/07/23 10:08 AM the ADON stated the night shift charge nurses were responsible for changing the oxygen tubing. She stated, herself and the DON monitored the oxygen tubing dates, to make sure they had been changed when requested and per policy. She stated the oxygen tubing should be changed out weekly on the evening shift and staff should never go past that 7th day. The ADON stated she had no documentation of when they observe or monitor the tubing. She stated she was not sure if the nurses had in-services on changing the oxygen tubing on time per the Dr's orders. The (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 14 of 38 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 12/08/2023 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 0695 Level of Harm - Minimal harm or potential for actual harm ADON stated the Respiratory technician would usually come from outside of the facility for the staff trainings. She stated the possible harm to residents could lead to infections and was not sure where the failure occurred. The ADON stated her expectations were for the tubing to be changed was every Sunday or as per Dr's order. Residents Affected - Few Record review of Oxygen Orders in-services dated 07/26/2023 revealed: Facilitator's Name: ADON Objectives of the In-Service: When using oxygen order needs to be placed under batch orders. Oxygen needs to be changed every Sunday Record review of Night Shift/Oxygen in-services dated 07/27/2023 revealed: Facilitator's Name: ADON Objectives of the In-Service: Charge nurses every Sunday Oxygen needs to be changed. CPAP/BPAP/and concentrators also need to be cleaned/wiped down to prevent infection. Record review of Respiratory Oxygen Therapy Policy dated 04/2021 revealed: Policy It is the policy of this community to ensure all oxygen administration is conducted in a safe manner. Procedure 7. Document resident's response to prn Oxygen therapy: a. Date and time of Oxygen administration . 9. Change the reservoir, Oxygen Cannula and tubing every 7 days. During an exit interview on 12/08/2023 at 12:55 PM with ADMN, DON, and Regional MDS coordinator, they said they did not have any more documentation or policies and procedures to provide as evidence. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 15 of 38 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 12/08/2023 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, interview, and record review the facility failed to store all drugs and biologicals in locked compartments under proper temperature controls and permit only authorized personnel to have access to medications in medication cart 1 of 4 and in 2 of 2 medication rooms , and 2 biohazard rooms reviewed for label and storage of drugs and biologicals. The facility failed to ensure medication cart #1 was locked when unattended on 12/5/2023. The facility failed to ensure discontinued medication was locked in medication rooms. This failure could place residents at risk of having access to unauthorized medications and/or lead to possible harm or drug diversions. Findings included: During an observation and interview on 12/05/2023 at 1:30PM the medication cart was left unattended and unlocked by LVN E. The LVN E was observed looking at her phone sitting at the nurses station while the surveyors were at the unlocked medication cart opening the drawers. The LVN E stated it was her cart and she had left it unlocked. The LVN E proceeded to leave the nurses station and walked to another room out of the sight of the unlocked medication cart. The LVN E stated she felt it was okay to walk off with the surveyors at the cart. The LVN E also stated that she did not know what medications were in the cart as she was working as an agency nurse, and her first day at this facility. During an observation on 12/05/2023 at 09:40 AM A cardboard box labeled discontinued meds was observed in biohazard closet #1 and biohazard closet #2. Both doors had a code to get in, the maintenance man has access to the code and opens the door for surveyor upon request. During an interview on 12/06/2023 at 11:00 AM LVN D stated that all regular medications to be discarded go into the boxes located in the med room, until DON comes and gets them for destruction. Controlled meds that are discontinued go directly to DONs office, where they are locked and only DON and ADON have keys. During an interview on 12/06/2023 at 1:50 PM Interview with ADON stated that all discontinued medications go to the medication rooms and are placed in a cardboard box to return to the pharmacy. Only nurses and medication aides have keys to med rooms. Discontinued narcotics are locked in DON office in a locked cabinet, only DON and ADON have access to DON office. ADON stated discontinued medications should not be in the biohazard closets. ADON stated that no one should have access to the discontinued medications other than nurses and med aides. ADON stated that she was unsure who put the boxes in the biohazard closets, but they should not be there. The ADON stated her expectation was that all medication carts are locked when unattended. ADON stated that there was a recent in-service regarding medication carts. During an interview on 12/06/2023 at 2:52 PM the DON stated that discontinued medications, excluding narcotics, are to be placed in the cardboard box in medication rooms. Then they are scanned and returned to pharmacy. The DON stated she does not know why discontinued medications are in the biohazard closets. The DON stated that nurses, aides, and maintenance have access to biohazard rooms. The (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 16 of 38 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 12/08/2023 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 0761 DON stated that no one should have access to medications that are not prescribed to them. The DON stated her expectation was that all medication carts are locked when unattended. Level of Harm - Minimal harm or potential for actual harm Review of the facility's policy, titled Storage of Medications, revised August 2020, reflected (in part): Residents Affected - Some Policy Statement: Medications and biologicals are stored safely, securely, and properly, following manufacturer's recommendations or those of the supplier. The medication supply is accessible only to licensed nursing personnel, pharmacy personnel, or staff members lawfully authorized to administer medications. General Guidance: 1. Only licensed nurses, pharmacy personnel, and those (such as medication aides) are permitted to access medications. Medication rooms, carts, and medication supplies are locked when they are not attended by persons with authorized access. 2. Outdated, contaminated, or deteriorated medications and those in containers that are cracked, soiled, or without secure closures are immediately removed from inventory, disposed of according to procedures for medication disposal, and reordered from the pharmacy if a current order exists. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 17 of 38 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 12/08/2023 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 0801 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Based on interview and record review, the facility failed to employ sufficient staff with the appropriate competencies, and skills set to carry out the functions of the food and nutrition service for 1 of 1 (DM) reviewed for qualified dietary staff. The facility failed to ensure the facility's DM met the requirements for a certified dietary manager. This failure could place residents at risk of not having their nutritional needs met and placed them at risk for food born illnesses. Findings included: Record Review of the DM's employee file on 12/06/2023 revealed a hire date of 10/127/2023 as the DM. There was no documented evidence of a Dietary Manager Certificate found in the file. During an interview on 12/07/2023 at 2:00 PM the DM stated she had not started on her dietary manager certification. The DM stated she had been the DM over a month and had not been given a time frame to complete her DM certification. During an interview on 12/08/23 at 9:24 AM the ADMN stated her expectation would have been completed within 90 days, she stated she was not aware of what regulation or policy stated. The ADMN stated the DM not having certification could cause residents to become ill. The ADMN stated she was responsible to monitor the DM's certification. The ADMN stated what led to failure was that she failed to monitor. Record review of facility job description titled, Dietary Service Manager without a signature revealed; The Food Service Manager is a qualified supervisor licensed by this state and is knowledgeable and trained in food procurement storage, handling, preparation and deliver. Record review of the DM's Texas Food Safety Manager Certification Examination revealed a completion date of 12/08/2023. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 18 of 38 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 12/08/2023 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 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure that each resident received food that is palatable, attractive, and at a safe and appetizing temperature for 1 of 1 lunch meal tested for nutritive value, flavor, and appearance: Residents Affected - Few The facility failed to provide palatable food served at an appetizing temperature to residents, on 3/9/22. The facility failed to ensure the recipe was followed when prepared pureed Oven Fried Chicken. This deficient practice could affect the residents who ate food from the facility kitchen by placing them at risk of poor food intake and/or dissatisfaction of the meals served. The findings included: During an observation and interview on 12/05/2023 at 12:40 PM the DM took the temperature of the food on the test tray. The temperature of the chicken was 112.4 degrees Fahrenheit. The DM stated the chicken should have been warmer. The DM tasted the chicken, broccoli and stated that the chicken was not flavorful. Observation on 12/05/23 at 11:35 AM [NAME] A added cold milk to fried chicken and steamed broccoli while he prepared the chicken and broccoli puree. During a confidential group meeting on 12/07/2023 at 9:28 AM residents stated the food tasted horrible, that meat was tough and the food had no flavor. During an interview on 12/07/23 at 02:00 PM the DM sated her expectation was that kitchen staff should have followed the recipes. The DM stated [NAME] A should have not added cold milk to the chicken puree. The DM stated adding the cold milk could have affected the resident diet by altering the flavor of the food. The DM stated staff not following recipe led to failure. During an interview on 12/08/23 at 9:24 AM the ADMN stated her expectation was that the cooks were to follow the recipes when preparing food and food should have been of good quality and have been flavorful. The ADMN stated the food could have lost flavor and nutrient value that could have led residents to weight loss. The ADMN stated that the DM and the dietician were responsible for monitoring the cooks. The ADMN stated the DM's lack of supervision led to failure of [NAME] not following the recipe. Record review of facility recipe titled Oven Fired Chicken for lunch on 12/5/23 revealed: Place portions needed into a food processor. Process to a fine texture Prepare a slurry with cup of thickener and of hot liquid; mix well with a wire whip. Add ½ of slurry too the meat. Record review of facility policy titled standardized Recipes without a date revealed: Only tested, standardized recipes will be used to prepare foods. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 19 of 38 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 12/08/2023 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews the facility failed to properly store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed. The facility failed to ensure foods were sealed and/or labeled properly in refrigerators. The facility failed to ensure storage of ice scoop with handle was outside of ice cooler. These failures could place residents that eat out of the kitchen at risk for food borne illnesses. Findings included: Observation on 12/05/2023 between 8:50 AM and 9:30 AM revealed: Refrigerator #1 1. An open container of Sour Cream with a use by date of 10/11/2023 2. Two bags of shredded carrots with a use by date of 11/19/2023 3. A plastic bag with a zipper that was not sealed with no description or an open date. Freezer #1 1. 14 packages of hot dog buns with use by date of 9/07/2023 2. 1 package of hamburger buns with a preparation date of 10/13/2023 3. 1 package of hamburger buns with a preparation date of 11/03/2023 4. 1 package of hamburger buns with a preparation date of 11/06/2023 Freezer #2 1. 10 brown bags without description or a use by date. 2. 2 plastic bags with a seal containing broccoli did not have an item description or a use by date. 3. 3 plastic bags with a seal containing chicken did not have an item description or a use by date. 4. 3 plastic bags with a seal containing fish did not have an item description or a use by date. 5. 4 plastic bags with a seal containing Hamburger patties did not have an item description or a use by date. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 20 of 38 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 12/08/2023 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 0812 4. 4 plastic bags with a seal containing ground beef did not have an item description or a use by date. Level of Harm - Minimal harm or potential for actual harm During an observation on 12/05/2023 at 12:15 p.m., ice scoop was stored in ice cooler that was sitting in dining room. Unknown resident was observed getting ice out of cooler with no supervision and put scoop back into ice when finished filling her pitcher. Residents Affected - Some During an observation on 12/06/2023 at 10:24 a.m., an ice scoop was seen stored in ice cooler sitting in dining room. During an interview on 12/06/2023 at 01:29 p.m., ADON stated that she was the IP. She stated that it was her expectation that ice scoop be stored outside of ice container. She stated that she felt that in-services and meetings should be mandatory and felt that staff lack of attendance issues led to the failure. She stated that she was responsible for training staff. She stated that the effect these failures could have on the residents is spread of infection from cross contamination. ADON resigned from her position on 12/07/2023. During an interview on 12/07/23 at 2:00 PM the DM sated her expectation was that food items were labeled with a description and a used by date if out of original packaging. The DM stated residents could have gotten sick if served food past its use by date. The DM stated what led to the failure of food items not being labeled correctly was staff just did not do it, and that there had been a turnover in management. The DM stated the Cooks and herself were supposed to monitor. During an interview on 12/08/2023 at 09:03 a.m., DON stated that it was her expectation ice scoop to not be stored in ice cooler. She stated that ADON resigned from her positions on 12/07/2023. She stated that staff turnover led to the failure. She stated that the failure could cause residents to have infections. During an interview on 12/08/23 at 9:24 AM the ADMN stated her expectation was that food was to be discarded when past its use by date. The ADMN stated the DM was responsible to monitor the kitchen staff. The ADMN stated lack of supervision by the DM led to failures in kitchen. The ADMN stated resident could have gotten sick if food was served past use by date. Record review of facility policy titled, Food Receiving and Storage dated December 2008 revealed: All foods stored in the refrigerator or freezer will be covered, labeled and dated(use by date). Review of the FDA Food Code 2022 https://www.fda.gov/food/retail-food-protection/fda-food-code accessed 12/08/2023 revealed: 3-602.11 Food Labels. (A) FOOD PACKAGED in a FOOD ESTABLISHMENT, shall be labeled as specified in LAW, including 21 CFR 101 - Food labeling, and 9 CFR 317 Labeling, marking devices, and containers. (B) Label information shall include: (1) The common name of the FOOD, or absent a common name, an adequately descriptive identity statement; (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 21 of 38 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 12/08/2023 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 0812 Level of Harm - Minimal harm or potential for actual harm (2) If made from two or more ingredients, a list of ingredients and sub-ingredients in descending order of predominance by weight, including a declaration of artificial colors, artificial flavors and chemical preservatives, if contained in the FOOD; (3) An accurate declaration of the net quantity of contents; Residents Affected - Some (4) The name and place of business of the manufacturer, [NAME], or distributor; and (5) The name of the FOOD source for each MAJOR FOOD ALLERGEN contained in the FOOD unless the FOOD source is already part of the common or usual name of the respective ingredient. Pf (6) Except as exempted in the Federal Food, Drug, and Cosmetic Act § 403(q)(3) - (5), nutrition labeling as specified in 21 CFR 101 - Food Labeling and 9 CFR 317 Subpart B Nutrition Labeling. (7) For any salmonid FISH containing canthaxanthin or astaxanthin as a COLOR ADDITIVE, the labeling of the bulk FISH container, including a list of ingredients, displayed on the retail container or by other written means, such as a counter card, that discloses the use of canthaxanthin or astaxanthin. Time/temperature control for safety refrigerated foods must be consumed, sold or discarded by the expiration date. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 22 of 38 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 12/08/2023 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 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, and record review the facility failed to maintain medical records on each resident, in accordance with accepted professional standards and practices, that were complete and accurate for 3 (Resident #21, Resident #25 and Resident #262) of 5 residents reviewed for resident records. The facility failed to ensure smoking assessments were completed for Resident #262. The facility failed to ensure smoking assessments were accurate for Resident #21 and Resident #25. This failure could place residents at risk of having errors in care and treatment. Findings included: Resident #21 Record review of Resident #21's electronic face sheet dated 12/06/2023 revealed resident was a [AGE] year-old male who was admitted on [DATE] and an original admission date of 09/27/2018 with diagnoses that included: Nicotine Dependence, muscle weakness, Quadriplegia, lack of coordination and cognitive communication deficit. Review of Resident #21's Quarterly MDS dated [DATE] revealed: Section C- Cognitive Patterns Resident #21 had a BIMS score of 04 (severe cognitive impairment); Section GG- Functional Abilities and Goals Resident #21 had upper and lower extremity impairment to one side of body and requires a wheelchair for mobility; Section J- Health Conditions Resident was a current smoker. Record review of Resident #21's Safe Smoking assessment dated [DATE] revealed: Resident not able to light smoking materials safely; Resident not able to extinguish smoking materials completely in an appropriate receptable; Resident is not able to dispose of ashes or their tobacco-related residue appropriately. Record review of Resident #21's Comprehensive Care Plan last revised on 10/27/2023 revealed: Focus: The resident is a smoker. Resident will keep cigarettes and lighters on self and smoke at unscheduled times unattended even after education of smoking policy. Goal: The Resident will not smoke without supervision through the review date. The Resident will not suffer injury from unsafe smoking practices through the review date. Interventions: Instruct resident about the facility policy on smoking: locations, times, safety concerns. Notify charge nurse immediately if its suspected resident has violated facility smoking policy. Observe clothing and skin for sings of cigarette burns. Resident #25 Record review of Resident #25's electronic face sheet dated 12/08/2023 revealed resident was a [AGE] year-old male who was admitted on [DATE] with diagnoses that included: Stroke, inability to move right dominant side, muscle weakness, lack of coordination and cognitive communication deficit. Review of Resident #25's Quarterly MDS dated [DATE] revealed: Section C- Cognitive Patterns Resident #21 had a BIMS score of 04 (severe cognitive impairment); Section GG- Functional Abilities and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 23 of 38 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 12/08/2023 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 0842 Level of Harm - Minimal harm or potential for actual harm Goals Resident #21 had upper and lower extremity impairment to one side of body and requires a wheelchair for mobility; Section J- Health Conditions Resident was a current smoker. Record review of Resident #25's Safe Smoking assessment dated [DATE] revealed: Resident not able to light smoking materials safely; The resident is safe to smoke unsupervised. Residents Affected - Some Record review of Resident #25's Comprehensive Care Plan last revised on 10/27/2023 revealed: Focus: The resident is a smoker. Resident will keep cigarettes and lighters on self and smoke at unscheduled times unattended even after education of smoking policy. Goal: The Resident will not smoke without supervision through the review date. The Resident will not suffer injury from unsafe smoking practices through the review date. Interventions: Instruct resident about the facility policy on smoking: locations, times, safety concerns. Notify charge nurse immediately if its suspected resident has violated facility smoking policy. Observe clothing and skin for sings of cigarette burns. Resident #262 Record review of Resident 262's electronic face sheet dated 12/07/23 revealed resident was a [AGE] year-old female who was admitted on [DATE] with diagnoses that including: multiple sclerosis (neurological disease that can cause numbness, fatigue, and impair muscular coordination), diabetes, anxiety, and history of falling. Record review of Resident #262's baseline care plan dated 11/30/23 revealed: had impaired vision, needed staff supervision for personal hygiene and mobility, needed staff setup or clean-up for eating and oral hygiene, was alert and cognitively intact, always had urinary incontinence, had history of falls, and smoked unsupervised. Record review of Resident #262's clinical assessments on 12/05/23 revealed no Safe Smoking Assessment. During an interview on 12/06/2023 at 9:45 AM LVN D stated charge nurses were responsible for completing smoking assessments. LVN D stated that if the smoking assessment stated a resident was not able to safely light their own cigarette, then the resident should be coded as a supervised smoker. During an interview on 12/08/23 at 09:41 AM the DON stated assessments should be done when a resident was admitted and then quarterly. The DON stated her expectation was that assessments were completed accurately. The DON stated that residents should have been supervised when smoking if they were unable to light their own cigarette. She stated that it was the DONs responsibility to ensure that assessments were completed. The DON stated that staff needing more education led to the failure. The DON stated that unsupervised smoking could have been unsafe and lead to different problems. Record review of facility policy titled Smoking last revised on 10/12/2022 revealed: A Licensed Nurse will complete a Resident Smoking Assessment to assess residents who express a desire to smoke, including electronic cigarettes, upon admission, quarterly, annually and upon significant change of condition. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 24 of 38 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 12/08/2023 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 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 maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment to help prevent the development and transmission of communicable diseases and infections for two (CNA B and CNA C) of 4 staff reviewed for infection control practices. Residents Affected - Some The facility failed to ensure CNA B and CNA C performed hand hygiene when changing gloves at the appropriate times while providing incontinence care for Resident #9. The facility failed to ensure CNA C performed hand hygiene in between filling ice into resident's pitchers on A hall for multiple residents. These failures could affect the residents by placing them at risk for the spread of infection. Finding included: 1.Review of Resident #9's electronic face sheet dated 12/07/2023 revealed he was a [AGE] year-old male originally admitted on [DATE] and most recently admitted on [DATE] with diagnoses that include: hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side (left sided weakness / immobility following stroke), reduced mobility, and general muscle weakness. Review of Resident #9's quarterly MDS dated [DATE] revealed: Section C- Cognitive Patterns had BIMS of 12 meaning moderately impaired; Section GG- Functional Abilities and Goals had resident dependent on staff for personal hygiene, rolling left to right, sitting to lying, lying to sitting, and bed to chair transfers; Section H- Bladder and Bowel had frequently urine incontinence and always bowel incontinence. Review of Resident #9's care plan dated 07/17/2020 revealed he had self-care performance deficit related to disease processes. Resident #9 needs extensive assistance with 2 persons assist on toileting. Resident #9 was totally dependent x2 transfer Hoyer lift. During an observation on 12/06/2023 at 09:50 a.m., CNA A and CNA B performed incontinent care on Resident #9. CNA A and CNA B performed hand hygiene and put on gloves after entering room and before care performed. CNA B then set up supplies by placing fresh wipes, gloves, brief, and dry wash cloths in plastic see-through bag on bed and another plastic trash bag placed. CNA B cleaned Resident #9's skin using one wipe at a time starting with the front of resident then disposed wipe into trash bag. CNA A assisted with rolling resident to left side and CNA B took her gloves off and put on new gloves without performing hand hygiene. CNA B cleansed back of resident and around rectum using one wipe at a time and disposing into trash bag. She used dry cloth to dry area prior to placing new brief under resident. CNA A rolled resident onto new brief while CNA B touched different clothing in closet looking for pants and shirt. CNA A and CNA B changed Resident #9's pants and shirt then placed a clean hoyer sling under resident. CNA A and CNA B transferred Resident #9 using hoyer lift (machine used to transfer resident) into wheelchair. CNA A and CNA B removed gloves then performed hand hygiene. CNA A took soiled trash bag out of room and placed in lidded bin outside of room. CNA A performed hand hygiene after disposing of trash. During an observation on 12/06/2023 at 09:13 a.m., CNA B passed ice on A hall to residents. CNA B (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 25 of 38 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 12/08/2023 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some passed ice to rooms without performing hand hygiene in between filling multiple resident's water pitchers and in between changing rooms. During an interview on 10/06/2023 at 10:09 a.m., CNA B stated that she did pass ice on A hall earlier. She stated that she performed hand hygiene prior to passing the ice and at the end of passing the ice. She stated that she did not know that hand hygiene needed to by performed in between residents or changing rooms. CNA B stated that she did perform hand hygiene prior to performing incontinent care and after but she did not perform in between changing gloves. She stated that she did not know hand hygiene needed to be performed when changing gloves on same resident. She stated that the effect of cross contamination could have on residents was that the residents could get infections. During an interview on 10/06/2023 at 10:09 a.m., CNA A stated that hand hygiene should be performed in between changing gloves. She voiced that the effect on resident could be infection from cross contamination. She stated that she has had training on hand hygiene. During an interview on 12/06/2023 at 01:29 p.m., ADON stated that she was the IP. She stated that staff trainings on hand hygiene were held monthly with in-services or town hall meetings. She stated that it was her expectation staff perform hand hygiene when leaving resident rooms, when changing gloves, upon entering resident rooms. She stated that she felt that in-services and meetings should be mandatory and felt that staff lack of attendance issues led to the failure. She stated that she was responsible for training staff. She stated that the effect these failures could have on the residents is spread of infection from cross contamination. ADON resigned from her position on 12/07/2023. During an interview on 12/08/2023 at 09:03 a.m., DON stated that it was her expectation for staff to perform hand hygiene in between filling up resident ice pitchers.DON stated that staff should perform had hygiene when changing gloves. She stated that she and ADON monitored that infection control was followed by staff. She stated that ADON resigned from her positions on 12/07/2023. She stated that staff turnover led to the failure. She stated that the failure could cause residents to have infections. Record review of facility policy titled Handwashing/Hand Hygiene dated August 2015 revealed: All personnel shall be trained and regularly in-services on the importance of hand hygiene in preventing the transmission of healthcare-associated infections. All personnel shall follow the handwashing/hand hygiene procedures to help prevent the spread of infections to other personnel, residents, and visitors . Use an alcohol-based hand rub containing at least 62% alcohol; or, alternatively, soap (antimicrobial or non-antimicrobial) and water for the following situations: a. Before and after coming on duty; b. Before and after direct contact with residents; c. Before preparing or handling medications; d. Before performing any non-surgical invasive procedures; e. Before and after handling an invasive device (e.g., urinary catheters, IV access sites); f. Before donning sterile gloves; g. Before handling clean or soiled dressings, gauze pads, etc.; h. Before moving from a contaminated body site to a clean body site during resident care; i. After contact with a resident's intact skin; j. After contact with blood or bodily fluids; k After removing gloves; n. o. Before and after eating or handling food; p. Before and after assisting a resident with meals; and q. The use of gloves does not replace hand washing/hand hygiene. Integration of glove use along with routine hand hygiene is recognized as the best practice for preventing healthcare-associated infections . Single-use disposable gloves should be used: a. Before aseptic procedures; b. When anticipating contact with blood or body fluids; and c. When in contact with a resident, or the equipment or environment of a resident, who is on contact precautions. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 26 of 38 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 12/08/2023 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 0941 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members. During an interview on 12/08/2023 at 10:46 AM, the RCN stated the facility staff had done trainings at townhall meetings. That at this time would be when they would catch up on all of the annual trainings for staff. The RCN stated the ADON told the DON she could not find the binder and had no documentation of trainings. She stated the upper management have trained the staff, and also had a clinical educator with corporate that sent all of the trainings to the ADON then follow up with staff. She stated the ADON resigned the previous day or 12/07/2023 thus unable to find the paperwork needed. The RCN stated with staff not having trainings could lead to residents getting sick from illnesses as well as Abuse and/or treating residents with good care. She stated the ADON and IP monitor the trainings for staff. She stated the failure occurred in not being able to obtain and monitor since the prior survey, as well as not verifying the ADON had the trainings completed. The RCN stated her expectations were for new hires have a checkoff lists and have orientation. During an interview on 12/08/23 at 11:10 AM The ADMN stated she felt the staff was trained and was not aware there were no documentation until. She stated the failure occurred with the ADON because she was in charge of the staff trainings. The ADMN stated with trainings not completed could open a window with infections and getting sick, possibly spreading germs and infecting each other. She stated the failure not monitoring staff and following up with trainings correctly. She stated her expectations would be for staff to abide by all facility policies. Record review of facility policy labeled On-the-Job Training dated, 01/2008 revealed: Policy: On-the job training programs will be conducted when necessary to assist employees in performing their assigned tasks. Policy Interpretation and Implementation: 1. On the job training is provided to train each employee in his/her respective job assignment and our methods of performing such tasks. 2. Dept directors will be responsible for on-the-job training to assure that our established training schedules are followed 3. On the job training begins on the first day of employment and is completed when the department director is satisfied that the employee can perform his/her assigned duties, within the time frame allotted for each particular function without any further supervision. 4. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 27 of 38 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 12/08/2023 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 0941 Insofar as practical, on the job training will be conducted during the employee' normal working hours. Level of Harm - Minimal harm or potential for actual harm 5. Residents Affected - Some Each employee is required to participate in our on-the-job training program, unless otherwise excused by the department director and HR Director. 6. All training programs and classes attended by an employee shall be entered on his/her Employee Training Attendance Record. 7. Training Records will be filed in the employee's personnel file or may be maintained by the department supervisor. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 28 of 38 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 12/08/2023 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 0942 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents. Based on interview and record review, the facility failed to provide the required education on the rights of the resident and the responsibilities of a facility to properly care for its resident for 7 of 18 employees (SW, DM, MS, LVN-H, CNA-J, CNA-K, and HS) reviewed for training. The facility failed to ensure education on the rights of the resident and the responsibilities of a facility to properly care for its residents was provided to SW, DM, MS, LVN-H, CNA-J, CNA-K, and HS. This failure could affect residents and place them at risk of being uninformed due to lack of staff training. Findings included: Record review of the personnel file for SW revealed a hire date of 04/14/2014 and no evidence of new hire training on resident rights and facility responsibilities. Record review of the personnel file for DM revealed a hire date of 07/15/2019 and no evidence of new hire training on resident rights and facility responsibilities. Record review of the personnel file for MS revealed a hire date of 09/12/2019 and no evidence of new hire training on resident rights and facility responsibilities. Record review of the personnel file for LVN-H revealed a hire date of 09/28/2018 and no evidence of new hire training on resident rights and facility responsibilities. Record review of the personnel file for CNA-J revealed a hire date of 09/28/2018 and no evidence of new hire training on resident rights and facility responsibilities. Record review of the personnel file for CNA-K revealed a hire date of 09/28/2018 and no evidence of new hire training on resident rights and facility responsibilities. Record review of the personnel file for HS revealed a hire date of 09/28/2018 and no evidence of new hire training on resident rights and facility responsibilities. During an interview on 12/08/2023 at 10:46 AM, the RCN stated the facility staff had done trainings at townhall meetings. That at this time would be when they would catch up on all of the annual trainings for staff. The RCN stated the ADON told the DON she could not find the binder and had no documentation of trainings. She stated the upper management have trained the staff, and also had a clinical educator with corporate that sent all of the trainings to the ADON then follow up with staff. She stated the ADON resigned the previous day or 12/07/2023 thus unable to find the paperwork needed. The RCN stated with staff not having trainings could lead to residents getting sick from illnesses as well as Abuse and/or treating residents with good care. She stated the ADON and IP monitor the trainings for staff. She stated the failure occurred in not being able to obtain and monitor since the prior survey, as well as not verifying the ADON had the trainings completed. The RCN stated her expectations were for new hires have a checkoff lists and have orientation. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 29 of 38 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 12/08/2023 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 0942 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an interview on 12/08/23 at 11:10 AM The ADMN stated she felt the staff was trained and was not aware there were no documentation until. She stated the failure occurred with the ADON because she was in charge of the staff trainings. The ADMN stated with trainings not completed could open a window with infections and getting sick, possibly spreading germs and infecting each other. She stated the failure not monitoring staff and following up with trainings correctly. She stated her expectations would be for staff to abide by all facility policies. Record review of facility policy labeled On-the-Job Training dated, 01/2008 revealed: Policy: On-the job training programs will be conducted when necessary to assist employees in performing their assigned tasks. Policy Interpretation and Implementation: 1. On the job training is provided to train each employee in his/her respective job assignment and our methods of performing such tasks. 2. Dept directors will be responsible for on-the-job training to assure that our established training schedules are followed 3. On the job training begins on the first day of employment and is completed when the department director is satisfied that the employee can perform his/her assigned duties, within the time frame allotted for each particular function without any further supervision. 4. Insofar as practical, on the job training will be conducted during the employee' normal working hours. 5. Each employee is required to participate in our on-the-job training program, unless otherwise excused by the department director and HR Director. 6. All training programs and classes attended by an employee shall be entered on his/her Employee Training Attendance Record. 7. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 30 of 38 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 12/08/2023 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 0942 Training Records will be filed in the employee's personnel file or may be maintained by the department supervisor. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 31 of 38 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 12/08/2023 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 0945 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program. Based on interviews and record reviews, the facility failed to implement and maintain an effective Infection Control training program for all new and existing staff for 11 of 18 (DON, SW, DM, MS, RN-F, RN-G, LVN-H, CNA-I, CNA-J, CNA-K, HS) personnel files reviewed for training. The facility failed to train for Infection Control for DON, SW, DM, MS, RN-F, RN-G, LVN-H, CNA-I, CNA-J, CNA-K, and HS. These failures placed residents at risk for unmet needs due to untrained staff. Findings included: Record review of Personnel Files revealed: DON-Hire date of 02/24/2015 - Had no Infection Control training. SW-Hire date of 04/14/2014 - Had no Infection Control training. DM- Hire date of 07/15/2019- Had no Infection Control training. MS- Hire date of 09/12/2019 - Had no Infection Control training. RN-F - Hire date of 9/23/2015 - Had no Infection Control training. RN-G - Hire date of 04/25/2023 - Had no Infection Control training. LVN-H - Hire date of 09/28/2018 Had no Infection Control training. CNA-I-Hire date of 01/25/2013- Had no Infection Control training. CNA-J-Hire date of 11/06/2018- - Had no Infection Control training. CNA-K-Hire date of 10/11/2022- - Had no Infection Control training. HS-Hire date of 01/24/2020- Had no Infection Control training. Findings included: During an interview on 12/08/2023 at 10:46 AM, the RCN stated the facility staff had done trainings at townhall meetings. That at this time would be when they would catch up on all of the annual trainings for staff. The RCN stated the ADON told the DON she could not find the binder and had no documentation of trainings. She stated the upper management have trained the staff, and also had a clinical educator with corporate that sent all of the trainings to the ADON then follow up with staff. She stated the ADON resigned the previous day or 12/07/2023 thus unable to find the paperwork needed. The RCN stated with staff not having trainings could lead to residents getting sick from illnesses as well as Abuse and/or treating residents with good care. She stated the ADON and IP monitor the trainings for staff. She stated the failure occurred in not being able to obtain and monitor since the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 32 of 38 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 12/08/2023 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 0945 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some prior survey, as well as not verifying the ADON had the trainings completed. The RCN stated her expectations were for new hires have a checkoff lists and have orientation. During an interview on 12/08/23 at 11:10 AM The ADMN stated she felt the staff was trained and was not aware there were no documentation until. She stated the failure occurred with the ADON because she was in charge of the staff trainings. The ADMN stated with trainings not completed could open a window with infections and getting sick, possibly spreading germs and infecting each other. She stated the failure not monitoring staff and following up with trainings correctly. She stated her expectations would be for staff to abide by all facility policies. Record review of facility policy labeled On-the-Job Training dated, 01/2008 revealed: Policy: On-the job training programs will be conducted when necessary to assist employees in performing their assigned tasks. Policy Interpretation and Implementation: 1. On the job training is provided to train each employee in his/her respective job assignment and our methods of performing such tasks. 2. Dept directors will be responsible for on-the-job training to assure that our established training schedules are followed 3. On the job training begins on the first day of employment and is completed when the department director is satisfied that the employee can perform his/her assigned duties, within the time frame allotted for each particular function without any further supervision. 4. In so far as practical, on the job training will be conducted during the employee' normal working hours. 5. Each employee is required to participate in our on-the-job training program, unless otherwise excused by the department director and HR Director. 6. All training programs and classes attended by an employee shall be entered on his/her Employee Training Attendance Record. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 33 of 38 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 12/08/2023 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 0945 7. Level of Harm - Minimal harm or potential for actual harm Training Records will be filed in the employee's personnel file or may be maintained by the department supervisor. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 34 of 38 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 12/08/2023 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 0946 Provide training in compliance and ethics. Level of Harm - Minimal harm or potential for actual harm Based on interviews and record reviews, the facility failed to implement and maintain an effective Compliance and Ethics training program for all new and existing staff for 16 of 18 (ADMN, DON, SW, DM, MS, RN-F, RN-G, LVN-D, LVN-H, CNA-I, CNA-J, CNA-K, HS, CNA-L, CNA-M, and CNA-N) personnel files reviewed for training. Residents Affected - Some The facility failed to train for Compliance and Ethics for ADMN, DON, SW, DM, MS, RN-F, RN-G, LVN-D, LVN-H, CNA-I, CNA-J, CNA-K, HS, CNA-L, CNA-M, and CNA-N These failures placed residents at risk for unmet needs due to untrained staff. Findings included: Record review of Personnel Files revealed: ADMN-Hire date of 11/29/2022- had no Compliance & Ethics training. DON-Hire date of 02/24/2015 - had no Compliance & Ethics training. SW-Hire date of 04/14/2014 - had no Compliance & Ethics training. DM- Hire date of 07/15/2019- had no Compliance & Ethics training. RN-F - Hire date of 9/23/2015 - had no Compliance & Ethics training. RN-G - Hire date of 04/25/2023 - had no Compliance & Ethics training. LVN-H - Hire date of 09/28/2018 had no Compliance & Ethics training. CNA-I-Hire date of 01/25/2013- had no Compliance & Ethics training. CNA-J-Hire date of 11/06/2018- had no Compliance & Ethics training. CNA-K-Hire date of 10/11/2022- had no Compliance & Ethics training. HS-Hire date of 01/24/2020- had no Compliance & Ethics training. CNA-L-Hire date of 06/19/2018 - had no Compliance & Ethics training. CNA-M-Hire date of 05/31/2021- had no Compliance & Ethics training. CNA-N-Hire date of 11/15/2022- had no Compliance & Ethics training. Findings included: During an interview on 12/08/2023 at 10:46 AM, the RCN stated the facility staff had done trainings at townhall meetings. That at this time would be when they would catch up on all of the annual trainings for staff. The RCN stated the ADON told the DON she could not find the binder and had no (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 35 of 38 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 12/08/2023 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 0946 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some documentation of trainings. She stated the upper management have trained the staff, and also had a clinical educator with corporate that sent all of the trainings to the ADON then follow up with staff. She stated the ADON resigned the previous day or 12/07/2023 thus unable to find the paperwork needed. The RCN stated with staff not having trainings could lead to residents getting sick from illnesses as well as Abuse and/or treating residents with good care. She stated the ADON and IP monitor the trainings for staff. She stated the failure occurred in not being able to obtain and monitor since the prior survey, as well as not verifying the ADON had the trainings completed. The RCN stated her expectations were for new hires have a checkoff lists and have orientation. During an interview on 12/08/23 at 11:10 AM The ADMN stated she felt the staff was trained and was not aware there were no documentation until. She stated the failure occurred with the ADON because she was in charge of the staff trainings. The ADMN stated with trainings not completed could open a window with infections and getting sick, possibly spreading germs and infecting each other. She stated the failure not monitoring staff and following up with trainings correctly. She stated her expectations would be for staff to abide by all facility policies. Record review of facility policy labeled On-the-Job Training dated, 01/2008 revealed: Policy: On-the job training programs will be conducted when necessary to assist employees in performing their assigned tasks. Policy Interpretation and Implementation: 1. On the job training is provided to train each employee in his/her respective job assignment and our methods of performing such tasks. 2. Dept directors will be responsible for on-the-job training to assure that our established training schedules are followed FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 36 of 38 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 (X3) DATE SURVEY COMPLETED A. Building 12/08/2023 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 0947 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. Based on interview and record review, the facility failed to ensure 7 of 18 (CNA-I, CNA-J, CNA-K, CNA-L, CNA-M, and CNA-N) employees whose in-service records were reviewed had received the required minimum 12 hours annual in-service, and received training that addressed the care of the cognitively impaired for nurse aides providing services to individuals with cognitive impairment. The facility failed to provide the required annual performance care training to CNA-I, CNA-J, CNA-K, CNA-L, CNA-M, and CNA-N. These failures placed residents at risk for unmet needs due to untrained staff. Findings included: Record review of Personnel Files revealed: CNA-I-Hire date of 01/25/2013- did not receive cognitive impairment training. CNA-J-Hire date of 11/06/2018- did not receive cognitive impairment training. CNA-K-Hire date of 10/11/2022- did not receive cognitive impairment training. CNA-L-Hire date of 06/19/2018 - did not receive cognitive impairment training. CNA-M-Hire date of 05/31/2021- did not receive cognitive impairment training. CNA-N-Hire date of 11/15/2022- did not receive cognitive impairment training. Findings included: During an interview on 12/08/2023 at 10:46 AM, the RCN stated the facility staff had done trainings at townhall meetings. That at this time would be when they would catch up on all of the annual trainings for staff. The RCN stated the ADON told the DON she could not find the binder and had no documentation of trainings. She stated the upper management have trained the staff, and also had a clinical educator with corporate that sent all of the trainings to the ADON then follow up with staff. She stated the ADON resigned the previous day or 12/07/2023 thus unable to find the paperwork needed. The RCN stated with staff not having trainings could lead to residents getting sick from illnesses as well as Abuse and/or treating residents with good care. She stated the ADON and IP monitor the trainings for staff. She stated the failure occurred in not being able to obtain and monitor since the prior survey, as well as not verifying the ADON had the trainings completed. The RCN stated her expectations were for new hires have a checkoff lists and have orientation. During an interview on 12/08/23 at 11:10 AM The ADMN stated she felt the staff was trained and was not aware there were no documentation until. She stated the failure occurred with the ADON because she was in charge of the staff trainings. The ADMN stated with trainings not completed could open a window with infections and getting sick, possibly spreading germs and infecting each other. She stated the failure not monitoring staff and following up with trainings correctly. She stated her expectations would be for staff to abide by all facility policies. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 37 of 38 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 12/08/2023 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 0947 Record review of facility policy labeled On-the-Job Training dated, 01/2008 revealed: Level of Harm - Minimal harm or potential for actual harm Policy: Residents Affected - Some On-the job training programs will be conducted when necessary to assist employees in performing their assigned tasks. Policy Interpretation and Implementation: 1. On the job training is provided to train each employee in his/her respective job assignment and our methods of performing such tasks. 2. Dept directors will be responsible for on-the-job training to assure that our established training schedules are followed 3. On the job training begins on the first day of employment and is completed when the department director is satisfied that the employee can perform his/her assigned duties, within the time frame allotted for each particular function without any further supervision. 4. Insofar as practical, on the job training will be conducted during the employee' normal working hours. 5. Each employee is required to participate in our on-the-job training program, unless otherwise excused by the department director and HR Director. 6. All training programs and classes attended by an employee shall be entered on his/her Employee Training Attendance Record. 7. Training Records will be filed in the employee's personnel file or may be maintained by the department supervisor. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675910 If continuation sheet Page 38 of 38