Health inspection·December 3, 2025

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few electronic medical records dated 12/03/2025 reflected the following blood pressure vitals: 66/45 on 11/24/2025 at 8:07 PM, 66/45 on 11/24/2025 at 8:16 PM. Interview on 12/03/2025 at 12:30 PM with Physician C revealed that the facility did not notify the physician of the low blood pressure for Resident # that was discovered on 11/29/2025. The physician stated that blood pressure can affect internal organs if it stays low long enough. She stated it can cause chronic kidney failure. She stated that the low blood pressure could have been a sign of an underlying infection. She stated had she of known that his blood pressure was low on 11/29/2025 she would have informed the facility to send Resident #1 to the hospital for further evaluation. She stated it might not have been severe, but it would have been out of caution until. She stated that no matter what they should have informed the physician or nurse practitioner of consecutive low blood pressure readings that require the facility staff to withhold the low blood pressure medications. She stated that the facility should have notified her even with Resident #1's history of low blood pressure. She stated that the risk would be low, but necessary to consider so that residents can receive the proper care and monitoring earlier to prevent a more serious outcome. While discussing the change in conditions that occurred on 11/29/2025 and 11/30/2025 it was discovered that Resident #1 had other instances of low blood pressure readings that Physician C was not notified of. She stated that she also should have been notified of the low blood pressure readings on 11/24/2025 and 22/25/2025. Interview on 12/03/2025 at 1:00 PM with Director of Nursing B revealed that Resident #1 was taking midodrine 5mg tablets for low blood pressure. He had a history of low blood pressure and was to receive the low blood pressure medication every day to raise his blood pressure. If his blood pressure is low at the time of medication pass, he will not receive his blood pressure medication at that time. Director of Nursing G stated that Medication Aide E and RN F would have been the staff members that took vitals for Resident #1 on 11/29/2025 an 11/30/2025. She stated that she did not think this was a failure of them failing to follow their notification policy because Resident #1 had a history of low blood pressure and that the low blood pressure readings on 11/29/2025 to 11/30/2025 was his normal. Director of Nursing B was informed via telephone on 12/03/2025 at 1:10 PM by Nurse Practitioner G that the staff failed to notify Nurse Practitioner G or Physician C of the low blood pressure readings that began on 11/29/2025 and continued until 11/30/2025. Director of Nursing G stated that she would train the staff to make physician notifications for a resident change in vital conditions. Interview on 12/03/2025 at 1:10 PM with Nurse Practitioner G revealed that the facility staff did not notify her of Resident #1's low blood pressure readings on 11/29/2025. She stated that the facility staff should have contacted the physician's office to let them know that Resident #1 was having continuous low blood pressure readings and that his low blood pressure medication was being withheld. She stated that when she reviewed Resident #1's chart to determine whether or not he needed to be sent to the hospital for an unrelated event she discovered that his blood pressure had been consistently low for more than 24 hours. In an interview on 12/03/2025 at 2:00 PM, Administrator A stated that he understood that Medication Aide E and RN F should have notified Physician C of Resident #1's low blood pressure on 11/29/2025 prior to when Physician C discovered that Resident #1 had low blood pressure on 11/30/2025. Interview on 12/03/2025 at 2:30 PM with RN F was attempted. Voice Messages were left requesting a call back. Interview on 12/03/2025 at 2:44 PM with RN F was attempted. Voice Messages were left requesting a call back. Record review of the facility Change in Condition policy reflected The practitioner needs a detailed description of the patient's condition to determine whether a symptom is problematic or simply a normal or expected variant. 1.Changes in condition of the patient are determined by current and past medical conditions, medical orders, patient safety factors and/or by assessments. 1. Vital Signs As part of (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676096 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 676096 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/03/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Baybrooke Village Care and Rehab Center 8300 Eldorado Parkway West McKinney, TX 75070 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 0580 Level of Harm - Minimal harm or potential for actual harm the interdisciplinary team, Certified Nursing Assistants (CNAs) and Certified Medication Technician (CMTs) are expected to report findings that might represent an acute change in condition. An acute change in condition (ACOC) is a sudden, clinically important deviation from a patient's baseline in physical, cognitive, behavioral, or functional domain. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676096 If continuation sheet Page 3 of 3