Health inspection·February 12, 2026

F 0550 Level of Harm - Minimal harm or potential for actual harm ImplementationFederal and state laws guarantee certain basic rights to all residents of this facility. These rights include the resident's right to:a dignified existence to be treated with respect, kindness, and dignityt. privacy and confidentiality Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676077 If continuation sheet Page 2 of 4 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 676077 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/12/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Stonewall Living Center 931 N Broadway Aspermont, TX 79502 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 observation, interview, and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in the facility's 1 of 1 kitchen reviewed for food safety. The facility failed to ensure food items in the refrigerator (x1), and freezers (x5), were labeled and stored in accordance with the professional standards for food service. These failures could place residents at risk for food-borne illness and cross contamination.Findings included: During kitchen tour observations on 2/10/26 that began at 11:08 a.m. and concluded at 11:59 a.m., revealed the following: Reach-in refrigerator revealed the following: What resembled pecan pie (undated, unlabeled), chocolate cake (undated, unlabeled), and [NAME] cake (no use by date) in different clear plastic bags. Reach-in freezer #1 revealed the following: What resembled sausages (undated), hamburger patties, hot dogs, double chocolate cookies, omelets, and french fries in different clear plastic bags with no use by date. Reach-in freezer #2 revealed the following: What resembled cookies (undated, unlabeled), waffles (undated, unlabeled), and pancakes (no use by date) in different clear plastic bags. Reach-in freezer #3 revealed the following:What resembled chocolate chips (unlabeled), sweet potatoes, corn flakes, and Italian style vegetable in different clear plastic bags with no use by date. Reach-in freezer #4 revealed the following:What resembled diced onion (unlabeled), organic multicolor rice, corn flakes, and cauliflower in different clear plastic bags with no use by date. Reach-in freezer #5 revealed the following:What resembled purple onion, and beef in different clear plastic bags with no use by date. During an interview on 2/12/2026 at 1:43 p.m., regarding kitchen observations, the DM stated, it is the cook's responsibility for dating and labelling of all food items whenever the truck comes in, and I jump in to help them. The DM further stated that the food items should have been labelled and dated, I really feel that this is an isolated event, we were short staffed, the truck came in on Monday - 02/9/26, I was not here so the kitchen staff were making sure to get the truck unloaded, cook breakfast and then serve the residents. When asked about who is responsible for monitoring the dating and labelling of the food items she stated, that is my responsibility, that is what I meant by if my staff misses something, I am the one to catch it. She further stated that she has the kitchen policy and been trained to label and date food items. The DM stated, numerous things like food borne illness, and residents might not like to eat the food resulting to weight loss, when asked the potential negative outcome serving residents meals not labelled /dated. During an interview on 2/12/2026 at 2:20 p.m., with [NAME] A regarding kitchen observations, she stated everyone in the kitchen were responsible for dating and labelling all food items, that everything was supposed to be labelled and dated, and that the DM was responsible for monitoring that. When asked about the kitchen policy she stated, I have come across the policy. She further stated that not dating /labelling of the food items will potentially cause food borne illnesses because we don't know how long the food items have been there. During a phone interview on 2/12/2026 at 2:29 p.m., with the RD, regarding kitchen observations, she stated, all the kitchen staff were responsible for dating and labelling the food items. When asked if the staff have been trained on such tasks, the RD stated, yes, I believe so. She further stated that everything was supposed to be labelled /dated. When asked about who is responsible for monitoring the dating and labelling of the food items she stated, I think all the staff should, but on a daily work shift should be the DM. The RD stated that food items not labeled or dated would potentially cause food borne illness to the residents or not tasty food because it is old or spoiled, resulting in resident's weight loss. She further stated, the kitchen staff were supposed to be using the 'fifo (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676077 If continuation sheet Page 3 of 4 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 676077 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/12/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Stonewall Living Center 931 N Broadway Aspermont, TX 79502 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 FORM CMS-2567 (02/99) Previous Versions Obsolete method', first in, first out. During an interview on 2/12/2026 at 3:14 p.m., with the ADM regarding kitchen observations, she stated, all kitchen staff were responsible for ensuring food was stored and dated properly, and they were all trained on that. When asked why the food items were not labelled/dated, she stated, I can't say why they missed it. She further stated, the DM is responsible for monitoring the dating/labelling of the food items. The ADM stated the potential negative outcomes to the residents was, using or serving expired food on those residents could be potentially harmful to the residents. Record review of the facility's policy and procedure titled, Food Storage, dated March 2021, reflected the following: Policy: Refrigerators and freezers will be kept clean and sanitized. The procedures to maintain the proper temperatures for storing cold foods will be strictly followed to prevent food borne illness. Procedure:6. Food must be stored in a properly covered container with a date and label identifying what is in the container. Foods may remain in the [NAME] box as long as content and dates are easily visible on the box. Any foods removed from the [NAME] box must be dated and labeled. 15. All of the following terms will be considered expiration dates for cold food products: Expires by date Best Used by date Use by date Sell by date. Event ID: Facility ID: 676077 If continuation sheet Page 4 of 4