Health inspection·November 18, 2025

F 0760 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some State. Family Member A said she wanted all investigation findings and communications to be given to Resident #1 and Family Member B. An interview on 10/07/2025 at 11:50 a.m. with Resident #1's family member indicated Family Member B said when Resident #1 was admitted on [DATE] she reported to the staff that Resident #1 was allergic to Hydrocodone. Family Member B said she was aware that Resident #1 had a urinary tract infection during her stay at the facility. Family Member B could not recall the name of the staff member she reported Resident #1 allergies too. She said Resident #1 reported to her that she was not forced to take the Hydrocodone but was told the Hydrocodone would not affect her because she would be sleeping. Family Member B said she was not present at any of the times Hydrocodone was administered. An interview on 10/07/2025 at 12:07 p.m. indicated Nurse Practitioner C said a person with a true medication allergy could have a skin rash, itching, hives, and or shortness of breath. She said people sometimes list medications they did not like taking under allergies, so they would not be given the medication even though it was not a true allergy. She said she would not have approved a resident with an allergy to Hydrocodone to receive Codeine to prevent a potential allergic reaction. Nurse Practitioner C said Resident #1 was given Hydrocodone first during her 04/17/2025 hospital stay before admitting to facility. and was not ordered Hydrocodone by the facility. Nurse Practitioner C said she cannot prescribe Hydrocodone, only the Physician can. She cannot recall if Resident #1 had any skin rashes, itching, hives, or shortness of breath, or negative effects from receiving 10 doses of Hydrocodone. An interview on 10/07/2025 at 2:00 p.m. indicated Pharmacist #1 said a true medication allergy is different from a side effect. He said most common symptoms of drug allergy are hives, rash, itching and fever. Pharmacist #1 said if a resident has a true drug allergy, they could potentially experience hives, rash, and itching. He said he would not recommend residents with a Codeine or Hydrocodone allergy to receive a dose of Hydrocodone. An interview on 10/07/2025 at 2:45 p.m. indicated the ADON said Resident #1's Medication administration record showed she was given 10 doses of Hydrocodone Oral Tablet 5-325 MG. The ADON said she reviewed Resident #1's allergies and said she should not have been given Hydrocodone. She said the potential harm to Resident #1 receiving Hydrocodone could be her having skin hives, skin rashes, and or itching. An interview on 10/07/2025 at 2:55 p.m. indicated the Administrator said Resident #1 had an allergy to Hydrocodone and should not have been given any Hydrocodone. She said Resident #1 could have had an allergic reaction causing her itching, skin rashes, and or skin hives. An interview on 10/08/2025 at 1:00 p.m. indicated Resident #1 said she did not know she had received a dose of Hydrocodone in the hospital. She said she didn't know she had received 10 doses of Hydrocodone at the facility. Resident #1 said staff did inform and educate her on medications before administering them to her. Resident #1 said she had a lot of allergies and had an active urinary tract infection during her 04/23/2025 stay at the facility. Resident #1 said she was not forced to take Hydrocodone. Resident #1 said she didn't know she had mental disturbances when she took the Hydrocodone. She said Family Member B told her she had mental disturbances when she took Hydrocodone. Resident #1 said when she was admitted to the facility, Family Member B told staff she was allergic to Hydrocodone. Resident #1 could not recall which staff her family member reported her allergies to. Record review of In- service training report on the topic of Allergies dated: 05/13/2025 indicated When getting new medication orders make sure to check the residents' allergies. If resident is allergic ask for alternative medication. Conducted by the Director of Nurses. Record review of the facility's policy General Guidelines for Medication Administration. revision dated: 08/2020 indicated (in part):Policy: Medications are administered as prescribed in accordance with good nursing principles and practices and only by persons legally authorized to administer.7. a.- Working with the resident or their representative and appropriate (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676094 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 676094 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/18/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Orange 4201 Fm 105 Orange, TX 77630 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 0760 Level of Harm - Minimal harm or potential for actual harm clinicians (i.e., the consultant pharmacists, attending physician, medical director, etc.) the facility should determine the most appropriate method for administering medications that considers each resident's safety, needs, medications, schedule, preferences, and functional ability. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676094 If continuation sheet Page 3 of 3