Health inspection·December 9, 2025

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 10/30/2025 at 11:22 AM, Resident #4 stated Medication Aids always left her medications for her to take without them there. Resident #4 stated she did not know what the medications were in the pill cup. She stated she always had her breathing treatments and inhalers in her room. Resident #5Record Review of Resident #5's Face Sheet, dated 10/20/2025, revealed a [AGE] year-old female, admitted [DATE], readmitted [DATE], with diagnoses including unspecified dementia, psychotic disturbance, mood disturbance and anxiety.Record review of Resident #5's Annual MDS. dated 09/19/2025, revealed in Section C - C0500, Cognitive Patterns, Resident #5 had a BIMS Summary Score of a 14 indicating the resident was cognitively intact.Review of Resident #5's physician orders with a start date of 11/27/2022 revealed: Amlodipine Besylate Tablet 2.5 MG, Give 1 tablet by mouth one time a day for HTN.Calcium Carbonate-Vit D Tablet 600-400 MG-UNIT, Give 1 tablet by mouth one time a day for vitamin deficiency.Esomeprazole Magnesium Oral Capsule 20 MG, Give 20 MG by mouth one time a day for GERD.Furosemide Tablet 20 MG, Give 1 tablet by mouth one time a day for Edema.Lisinopril Tablet 20 MG, Give 1 tablet by mouth one a day for HTN.Lorazepam oral Tablet 0.5 MG, Give 0.25by mouth one time a day for anxiety.During an observation and interview on 10/30/2025 at 11:30 AM, Resident #5 had an open pill cup with six medications on her bedside table. Resident #5 she must have been asleep, and the nurse left them there . Resident Record review of Resident #5's electronic medical record on 10/30/2025 revealed no evidence of a completed assessment for self-administering of medication.During a confidential interview on 10/30/2025 at 11:35 AM, she stated the medication aids had left her medications on her bedside table multiple times and walked out of the room without them being administered to her. She stated she felt the staff should not have left medications without making sure they were taken. The confidential resident stated she thought the rules must've changed.During a second confidential interview on 10/30/2025 at 11:52 AM, a resident stated she had seen multiple residents on her hall with pill cups with medications left at multiple residents' bedside without the supervision being provided. During an interview on 10/30/2025 at 2:40 PM, the MA stated the protocol for medication that was refused or if resident was unable to take them was to go back and try again. If the resident refused three times she should waste the medication afterwards. The MA stated the possible harm in leaving medications in resident rooms without being supervised when taking them could have been, another resident taking the wrong medication, and the possibility of resident having an adverse reaction to medication. During an interview on 10/30/2025 at 1:59 PM, the DON stated she heard there were tums left at a resident's bedside. She stated, if there were residents with medications at bedside, they should have an assessment noting they were allowed to do so, and if they were able, they should be in a lock box, so no other residents were able to take them. The DON stated it should also have been addressed in their care plan if they were allowed to administer their own medications. She stated Resident #4 and Resident #5 had not had self-administration assessments. The DON stated the med aids, and the charge nurses were responsible for monitoring medications. The DON stated she performed a monthly set of trainings for staff to complete, associated with their discipline. She stated the potential harm to the residents was an adverse effect such as an allergic reaction. She stated her expectations were for medications to never be left at bedside, and if the resident refused the MA or nurse should hold them. The DON stated the failure was the nurses had not monitored the medications if the resident refused or was unavailable.Record Review of facility policy, Medication Administration and General Guidelines, dated 2025, revealed, Policy-Medications are administered as prescribed, in accordance with State Regulations using good nursing principles and practices only by persons legally authorized to do so. Personnel authorized to administer medications do so only after they have familiarized themselves with the medication. Procedure-.9. Except for single unit dose packet distribution (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675959 If continuation sheet Page 2 of 3 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 675959 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Songbird Lodge 2500 Songbird Cir Brownwood, TX 76801 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 FORM CMS-2567 (02/99) Previous Versions Obsolete systems, only the licensed or legally authorized personnel who prepare a medication may administer it. 10. Medications are administered within one hour of the scheduled time, unless the physician specifies a specific time then the med must be given 30 minutes after the specified time. Unless otherwise specified by the physician, routine medications are administered precisely as ordered. Unless otherwise specified by the physician medications are administered according to the established medication administration schedule for the facility.12. If a dose of regularly scheduled medication is withheld, refused, or given at other than the scheduled time, (e.g. resident not in facility at scheduled dosed time, initial dose of antibiotic) .13. Medication supplied for one resident are never administered to another resident. 14. For residents not in their rooms or otherwise unavailable to receive medication on the pass, the MAR is flagged with tags, colored plastic strips, or paperclips/or if electronic the system will alert personnel to the missed medication(s). After completing the medication pass, the nurse returns to the missing resident to administer the medication. This must be done during the 1 hour before or 1 hour after medication pass time.Checklist for completing proper steps in the administration of medications; .Observes the resident take the medication. Event ID: Facility ID: 675959 If continuation sheet Page 3 of 3