Inspection·December 19, 2025

F 0908 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few orders from MD B:- Admit to [Hospice] under services of [doctor], admitting diagnosis Parkinsons Disease. Discontinued 10/24/25.- Suction orally per yankauer (type of suction tube for mouth) PRN Q6hr. Discontinued 10/18/25.Record review of CR #1's current Physician Orders as of 12/4/25 revealed the following orders from MD B:- DNR (code status). Ordered 10/31/25.- Oxygen at 2-3L per NC PRN for s/s of SOB/Comfort and to keep O2 sat 92%, as needed for shortness of breath. Ordered on 10/28/25.Hyoscyamine Sulfate Tablet Sublingual 0.125mg (medication to decrease secretion), 1 tablet SL Q2hr PRN increased secretions, Do not exceed 1.5mg in 24hr. Ordered on 11/16/25.In an interview on 12/4/25 at 1:45pm, CR #1's RP said staff were attempting to suctions secretions from CR #1's mouth on 11/29/25, but the suction machine in the room was not working. She said there was no reason why the machine in the room should not have been working. The RP said staff had to go get the suction machine from the crash cart and it took them too long to get it.In an interview on 12/4/25 at 2:06pm, the DON said CR #1 was on hospice and had a suction machine in her room because all hospice residents had suction machines in their room as part of a bundle. The DON said the resident was removed from hospice, but the daughter wanted to keep the suction machine in her room, so they kept it in her room even though there was not an order for it. She said she was told by her staff that on 11/29/25 they attempted to use the suction in the room, and it did not work so they had to get the suction machine from the crash cart. The DON said it would have only taken 1-2 minutes to get the crash cart, and she would not have had a suction machine in her room normally, they just allowed CR #1 to keep hers in the room. The DON said she performed an audit of all three suction machines on 12/3/25, and they were functional.In an interview on 12/4/25 at 2:56pm, RN H said she tried to suction CR #1 on 11/29/25, but the machine in the room did not work, so she went and grabbed the crash cart. She said it took less than one minute to grab the crash cart.Record review performed on 12/19/25 revealed an in-service given by the DON completed on 12/1/25 regarding How to Properly Connect a Suction Machine-Return Demonstration. There were notes that stated, Back up suction machine located on the crash cart-100 hall time clock room. There was an Oral Suctioning Competency Checklist given to each nurse.In an interview on 12/19/25 at 1:19pm, RN W said, [CR #1] had a lot of blood tinged secretions so she went to use the suction machine, and it didn't work. She said another nurse brought the new suction machine in from the crash cart.In an interview on 12/19/25 at 1:45pm, the DON said they did not have a policy for checking the functioning of suction machines, and that whoever put the suction machine in the room should check it. She said if a suction machine did not work, they would get the crash cart and that would only delay treatment by a couple of minutes.In an interview on 12/19/25 at 3:50pm, the ADM said they did not have a policy on checking/maintaining equipment.Record review of the facility's policy and procedures on Suctioning (revised August 2014) read in part: The purpose of this procedure is to help prevent nosocomial infections associated with suctioning and to prevent transmission of such infections to residents and staff.Suction machines must be available at the bedside of residents who require suctioning because they cannot clear nasal, oral, and/or respiratory secretions by themselves and also at the bedside of all tracheostomy and ventilator residents.When suction machines are available for use, the following items should be available: Supply of exam gloves; Supply of sterile gloves, if tracheal suction is anticipated; Supply of suction catheters; Supply of sterile distilled water with which to flush suction catheters; and Appropriate trash receptacle for used catheters.Record review of the facility's policy and procedures on Physical Environment (revised January 2023) read in part: The community provides sufficient space and equipment to enable team members to provide residents with needed services as required by each resident's plan of care.The community is designed, constructed, equipped, and maintained to protect the health and safety of residents, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676153 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 676153 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/19/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of League City 2620 W Walker League City, TX 77573 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 0908 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete personnel, and the public.The community has a preventive maintenance program that ensures that all essential mechanical, electrical, and patient-care equipment is in safe operating condition. The preventive maintenance program is characterized by the following: It is ongoing and under the direction of a qualified and experienced maintenance director. Routine testing and maintenance of all equipment is scheduled, and records of the testing and maintenance are kept in an organized manner. Essential equipment.is kept in safe operating condition. Equipment is maintained according to manufacturer's recommendations. Nonoperating equipment is fixed or replaced in a timely manner. Nonoperating or damaged equipment is tagged and locked as soon as it is identified to prevent resident, visitor, or team member accident or injury. Event ID: Facility ID: 676153 If continuation sheet Page 3 of 3