Inspection·November 24, 2025

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Resident #2's care plan dated 09/30/2025 indicated he had a potential to demonstrate physical behaviors related to his dementia and poor impulse control. Resident #2 was hit by another resident. During a confidential phone interview on 10/06/25, a non-staff person said wished to remain anonymous. The anonymous non-staff person said Resident #1 said that a man touched her breast and pointed at Resident #2 in front of the nurses. The anonymous non-staff person was unable to say exactly when this happened, unable to name staff and denied witnessing the event. The anonymous non-staff person denied reporting to the Administrator or the DON, said he didn't report that to the Administrator. The anonymous non-staff person said they just talked about the food being late and needing more staff in the kitchen that day. During an observation and interview during initial rounds on 10/06/25 at 9:30 a.m., Resident #1 was in the dining room, and she said she was ok. Her speech was clear and easy to understand. During an interview on 10/06/25 at 11:00 a.m., Resident #1 said some man touched her breast, but she pushed him away and he left her alone after that. She then pointed to Resident #2 across the dining room and said it was him. She said she got mad but was not afraid. She said he never did anything else to her. She was unable to say when this happened. She was unable to say what staff knew about it. During an interview on 10/06/25 at 2:15 p.m., CNA A said she overheard Resident #1 tell her family member that another resident touched her breast and said she pushed him away. CNA A said she had been trained on abuse and reporting abuse to the administrator and DON immediately. She denied knowing what date this happened, what date she overheard the conversation or if it happened. She stated, I reported to my charge nurse and the surveyor asked which nurse she had reported to. CNA A stated I did not report to the charge nurse, Administrator or the DON. I just thought Resident #1 was just confused. She said she over heard the conversation last week or a couple of weeks ago. CNA A said she should have reported it, and she will be in trouble. She said she had been trained to report to the Abuse coordinator which was the Administrator or to the DON. CNA A said since she didn't report what she overheard it could happened again or to another resident. During an interview on 10/07/25 at 10:00 a.m., Resident #2 denied touching anyone's breast. He said he had never touched breasts here. He said that it would be wrong if not married. Record review of the Provider Investigation Report, dated 10/06/25, indicated the incident on unknown shift and was reported to HHSC on 10/06/25 and the facility was still investigating and monitoring at the time of exit. During an interview on 10/07/25 at 9:40 a.m., the Administrator said there had not been an allegation of abuse reported which involved Resident #1 and Resident #2. He said this was not reported until surveyor intervention. The facility reported this allegation of abuse yesterday (10/06/25). The staff had been retrained about reporting allegations of abuse. The Administrator said all staff were responsible for reporting allegations of abuse immediately and had been trained on hire and annually before this incident. He said the facility was continuing to investigate this allegation and had increased monitoring. He said if he had been informed of this allegation he would have immediately reported, increased monitoring and investigated. During an interview on 10/07/25 at 11:30 a.m., the DON said she was not notified of the incident involving Resident #1 and Resident #2 until yesterday after surveyor intervention. She said all staff were trained on abuse on hire and retrained on abuse again since an allegation of sexual abuse occurred. She said her expectation was for the staff to report allegations of abuse to the DON and the Administrator immediately. She said the facility would have immediately reported, increased monitoring and investigated the sexual abuse allegation. Record review of the undated facility policy titled Abuse/Neglect indicated The resident has right to be free of abuse, neglect . It is each individual's responsibility to recognize, report and promptly investigate actual or alleged abuse . E. Reporting Any person having reasonable cause to believe an elderly or incapacitated (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676108 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 676108 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/24/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Vidor Health & Rehabilitation Center 470 Moore Dr Vidor, TX 77662 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 0609 Level of Harm - Minimal harm or potential for actual harm adult is suffering from abuse . must report this to the DON, administrator, state, and or adult protective services. Facility employees must report all allegations of: abuse, . a. If the allegations involves abuse or results in serious bodily injury, the report is to be made within 2 hours of the allegation. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676108 If continuation sheet Page 3 of 3