Health inspection·September 27, 2023

F 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some acts, disrobing in public, throwing or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #1 was not listed as showing behaviors for refusing care. Resident #1 needs supervision with bed mobility such as moves to and from lying positions, turns side to side, and positions body while in bed or alternate sleep furniture such supervision would include: oversight, encouragement, or cueing. Resident #1 needs supervision for transfers and is listed as total dependent with a two person assist. Resident #1 is listed as not being steady and only able to stabilize with staff assistance during transitions and walking, this includes moving from seated to standing position, walking, surface to surface transfers. Resident #1 uses a wheelchair. Record review of Resident #1s Care Plan dated 08/01/2023 revealed Resident #1 had episodes of adverse behaviors of being physically aggressive; hitting, pinching, kicking, staff and resistive to care. Interventions: administer meds per order (updated 09/07/2023), anticipate behaviors and redirect when in close proximity to others that might invoke aggression (updated 09/07/2023), assess for pain (updated 09/07/2023), ensure family and MD aware of behaviors and or any increase in behaviors noted (updated on 09/07/2023), maintain calm environment (updated 09/07/2023), medication regimen review quarterly and PRN after any resident to resident behavior event (updated on 09/07/2023), monitor for early warning signs of behavior-approach in calm manner, call by name, remove from unwanted stimuli to a safe environment (updated on 09/07/2023), behaviors include hitting, being resistive to care, refusing food (updated 09/07/2023). Record review of Resident #1s Care Plan dated 07/24/2023 and a revision date of 09/07/2023 indicated Resident #1 had a potential for injury with a history of falls and is at risk for further falls with safety interventions. Interventions: administer meds as ordered, monitor labs, report abnormalities to MD, avoid use of restraints, bed in low position at all times, educated on noncompliance with safety interventions and explain possible risks/outcomes due to noncompliance issues, enlist family input regarding fall history and possible factors to help decrease; falls, ensure staff is aware of safety needs of the resident, fall mat at bedside at all times, keep personal items and frequently used items within reach. Record Review of Resident 1's Physician Order, dated 06/20/2023, revealed: Donepezil HCI oral tablet 5 mg for confusion. Resident 1's Physician Order dated 06/20/2023 Olanzapine oral tablet 5 mg for behaviors related to other schizoaffective disorders. Record Review of Resident #1's Progress notes dated 09/07/2023 at 5:40 pm and indicated incident date as of 08/30/2023, signed by RN revealed: Resident sister came to the nurse's station and asked CN if she knew why her brother had a black eye. CN immediately went to assess. Upon entering resident room CN noted right eye swollen shut with a small cut present to mid eyebrow with scanty amount of dry blood. [NAME] peri-orbital ecchymosis also noted. CN proceeded to perform a general assessment right eyebrow cleaned with NS. Resident #2: Record Review of Resident #2's face sheet documented she was a [AGE] year-old female who was originally admitted to the facility on [DATE] with a readmission date of 08/17/2023. Resident #2 was admitted with diagnoses which included: dementia, anxiety, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), schizoaffective disorder, major depressive disorder, type 2 diabetes, osteoarthritis (a type of arthritis that occurs when flexible tissue at the ends (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 2 of 47 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 676163 B. Wing (X3) DATE SURVEY COMPLETED A. Building 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0600 of bones wears down), bipolar disorder, high blood pressure, and acid reflux. Level of Harm - Immediate jeopardy to resident health or safety Record review of Resident #2's admission MDS dated [DATE] documented that Resident #2's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #2 has no difficulty in normal conversation, social interaction, or watching tv. Resident #1 is listed to not showing a change in mental status, disorganized thinking, or altered level of consciousness. Resident #2 did not exhibit behaviors such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #2 did not exhibit the behaviors of rejecting care. Resident #2 uses a wheelchair and has no upper and lower body extremity impairment. Resident #2 shows to need supervision for transfers such as bed mobility and transfers meaning oversight, encouragement, or cueing. Resident #2 is listed as not being steady when walking, surface to surface transfers and needs supervision but is able to stabilize without assistance. Residents Affected - Some Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had cognitive impairment with diagnosis of intellectual disability with impaired ability to make decision and is at risk for impaired communication and impaired safety awareness. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had a diagnosis of major depressive disorder and bipolar and is at risk for fluctuations in mood, little interest, or pleasure in doing things, and decreased socialization. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had episodes of anxiety and is at risk for fluctuation in moods, currently taking buspirone. Record review of Resident #2s Care Plan date revised 08/01/2023 revealed Resident #2 had episodes of adverse behaviors of being verbally and physically aggressive; hitting, pinching, kicking, staff and resistive to care. Record Review of Resident #2s Physician Orders dated 07/14/2023, revealed: Wellbutrin XL Oral tablet Extended Release 24-hour 300 mg, give 1 tablet by mouth one time a day for depression. Resident #3: Record Review of Resident #3's face sheet documented she was a [AGE] year-old female who was admitted to the facility on [DATE]. Resident #3 was admitted with diagnoses which included: dementia, acute respiratory failure, diabetes mellitus, chronic obstructive pulmonary disease (a group of lung diseases that block airflow and make it difficult to breathe), schizoaffective disorder, major depressive disorder, muscle weakness, tremor, hypothyroidism (a condition in which the thyroid gland does not produce enough thyroid hormone), hyperthyroidism (is the production of too much thyroxine hormone), anxiety, drug induced dyskinesia (an involuntary movement disorder), insomnia, high blood pressure, pain in joint, overactive bladder. Record review of Resident #3's admission MDS dated [DATE] documented that Resident #3's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #3 has moderate difficulty-speaker and must increase volume and speak distinctly. Resident #3 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 3 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #3 did not exhibit behaviors of rejecting care. Resident #3 uses a wheelchair and has no upper and lower body extremity impairment. Resident #3 shows a need of extensive assistance with resident involvement and staff to provide weight-bearing support for bed mobility, walking in room, and locomotion on unit, needing two people assist and resident highly involved in activity. Resident #3 is listed as not steady and only able to stabilize with staff assistance. Resident #3 is listed as not capable of increased independence. Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had episodes of anxiety and at risk for fluctuation in moods. Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had a diagnosis of major depression/schizoaffective disorder and am at risk for fluctuation in moods, little interest, or pleasure in doing things and decreased socialization. Record review of Resident #3s Care Plan date revised 08/15/2023 revealed Resident #3 had impaired understanding and reasoning for expressing information needs: ability is limited to making concrete requests. Resident #4: Record Review of Resident #4's face sheet documented she was a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #4 was admitted with diagnoses which included: type 2 diabetes, cardiac arrhythmias, muscle weakness, abnormalities of gait, gout, anemia, bipolar disorder, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in your blood), manic episode, rheumatoid arthritis, acid reflux, enlarged prostate, pseudobulbar affect (pathological laughing and crying), polyneuropathy the simultaneous malfunction of many peripheral nerves throughout the body. Record review of Resident #4's Annual MDS dated [DATE] documented that Resident #4's BIMS was a 15/15, meaning intact cognition. Resident #4 is not listed as showing a change in mental status for disorganized thinking and altered level of consciousness and disorganized thinking. Resident #4 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #4 is listed for significantly disrupt care or living environment, meaning would disrupt care of living environment. Resident #4 is listed as showing rejection of care for 1-3 days. Resident #4 is shows total dependence for bed mobility and transfers with wheelchair, standing position, and locomotion on the unit with setup only. Resident #4 uses a wheelchair and has impairment with lower extremities but no impairment for upper extremities. Resident #4 is listed as steady, but able to stabilize without staff assistance for walking and transfers between bed and wheelchair. Resident #4 is listed as not being capable of increased independence. Record review of Resident #4s Care Plan date revised 05/03/2023 revealed Resident #4 had a mood problem with disease process of bipolar disorder and manic episode. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 had cognitive (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 4 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0600 Level of Harm - Immediate jeopardy to resident health or safety impairment: memory problems: diagnosis of bipolar disorder and pseudobulbar affect (pathological laughing and crying), impaired mobility to make decisions and is at risk for impairment safety awareness. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 is at risk for adverse consequences with receiving psychotropic medications Klonopin, and multiple med use due to nine or more medications. Residents Affected - Some Record review of Resident #4s Care Plan date revised 08/14/2023 revealed Resident #4 had episodes of adverse behaviors. Inappropriate behavior. Resident with multiple urinals and multiple water pitchers in room at bedside. Resident adamant regarding removal of pitcher and urinal removal. Does not want pitchers and urinal to be removed. Resident with verbal outburst with nursing staff. Record review of Resident #4s Care Plan date revised 08/04/2023 revealed Resident #4 had problematic demeanor in which resident acts out characterized by ineffective coping, verbal/physical, aggression related to anger. Resident #5: Record Review of Resident #5's face sheet documented she was an [AGE] year-old female who was originally admitted to the facility on [DATE] and re-admitted on [DATE]. Resident #5 was admitted with diagnoses which included: Alzheimer's Disease, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), overactive bladder, iron deficiency, major depression, macular degeneration (an eye disease that causes vision loss), high blood pressure, pain in unspecified joint, muscle weakness, reduced mobility. Record review of Resident #5's Quarterly MDS dated [DATE] documented that Resident #5's BIMS was a 99, meaning the resident interview was not successful. Resident #5 has difficulty communicating some words or finishing thoughts but is able if prompted or given time. Resident #5 usually understands-misses some part-intent of message but comprehends most conversation. Resident #5 has the ability to recall memory after 5 minutes and 5 could recall long past. Resident #5 is moderately impaired-decisions poor, cues/supervision required for decision making. Resident #5 does show the behavior is present and fluctuates for inattention, disorganized thinking or incoherent. Resident #5 does not show altered level of consciousness. Resident #5 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #5 did exhibit the behavior of rejecting care for 1-3 days. Resident #5 shows the need for extensive assistance with one person assist for bed mobility and transfers but is listed as limited assistance with one person assist for locomotion on the unit. Resident #5 uses a wheelchair and shows no upper or lower extremity impairment. Resident #5 is listed as steady, but able to stabilize without staff assistance for walking and surface to surface transfers. Record review of Resident #5s Care Plan date revised 03/03/2023 revealed Resident #5 had a cognitive impairment, memory problems short/long term diagnosis of dementia and impaired safety awareness. Record review of Resident #5s Care Plan date revised 08/03/2023 revealed Resident #5 had a diagnosis of depression/mood disorder and is at risk for fluctuation in moods, little interest, or pleasure (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 5 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0600 in doing things and decreased socialization, currently receiving Remeron. Level of Harm - Immediate jeopardy to resident health or safety During an interview on 09/06/2023 at 3:09 pm, DON stated that for Resident #1 that she heard about the black eye the morning of 08/30/2023. DON stated that she thought it was a fall because Resident #1 has a history of falls. DON stated that resident #1 wasn't found on the floor or anything, he was found in bed. DON stated that they did not report because it was an unwitnessed fall. When asked if that is considered an injury of unknown origin, DON shook her head and stated, your right it is considered injury of unknown origin. When asked why it was not reported, DON stated they were thinking that it was just a fall. DON stated, your right we should have reported and didn't. DON stated that she was not in the facility at the time of the incident. DON stated that she is just helping out in the facility for a while. DON stated that the ADON had more details about the incident because it was reported to her, and she was not at work today. Residents Affected - Some During an interview on 09/06/2023 at 4:15 pm, Administrator stated that with Resident #1 she believed that he had a fall. Administrator stated that Resident #1 had a history of falls. Administrator stated that Resident #1 was found in bed and was not found on the floor. Administrator stated that she did not report the black eye for Resident #1 because she did not know about it. Administrator stated that she did not report when she had found out because she thought it was an unwitnessed fall. Administrator stated she guessed she should have reported and will go ahead and do that since she believed it to be an unwitnessed fall. Administrator stated she was not told it was a fall, Resident #1 just had a history of it. Administrator stated that she heard about Resident's black eye after the meeting the morning of 08/30/2023 by DON. During an interview on 09/07/2023 at 3:25 pm, CNA B stated that she had witnessed abuse recently. CNA B stated that she did report to the ADON that she had witnessed CNA A being rough with residents while providing care. CNA B stated that while working with CNA A she witnessed CNA A hold Resident #1 down by holding his arms down with CNA A body weight and the residents would fight C CNA B stated that she witnessed CNA A being aggressive when he would hold the residents down. CNA B stated that CNA A would hold down the resident's that would fight him. CNA B stated that she witnessed the resident would try and get up from CNA A holding them down and CNA A would not let them up. CNA B stated that Resident #1 is not the only resident that she witnessed CNA A holding down when they don't want to be held down. CNA B stated that she also witnessed CNA A being rough and holding down Resident #5 and Resident #6. CNA B stated that the resident would fight CNA A to get him off them. CNA B stated that when she reported the abuse to the ADON she was told to provide a statement, but she had forgotten to write a statement because she was tired. CNA B stated that she reported to the ADON after a meeting that staff had that was due to Resident #1 coming up with an unexplained black eye on CNA A's shift. CNA B stated that she did not intervene to stop CNA A because she was scared of CNA A, but she did report to the ADON. Interview with on 09/07/2023 at 4:26 pm, CNA C reported that she heard CNA A verbally abusing Resident #2 approximately 3 weeks ago. CNA C stated that CNA A was calling Resident #2 names and telling her to shut up and called her stupid and ugly. CNA C stated that she reported the incident to the ADON. CNA C stated that she could tell it bothered Resident #2 because she looked upset. CNA C stated that CNA A showed no interest in wanting to be there most of the time. CNA C stated that CNA A would get mad if he had to answer the call lights. During an interview on 09/07/2023 at 5:00 pm, RN stated that she has always known CNA A to have a bad attitude towards the residents and others. RN stated that she has heard by other staff members that CNA A would be rough with resident's by grabbing and yanking on their arms. RN stated that she (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 6 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some did not report what she had heard to anyone because she did not see it. RN stated that she had worked the night shift on 08/30/2023 and then next morning she was made aware by a family member that Resident #1 had a black eye. RN stated on this shift CNA A was working. RN stated that while she was assessing Resident #1 that Resident #4 had stated to RN that CNA A needed to be watched because when CNA A comes into change Resident #1, Resident #4 would hear a lot of rustling around and that Resident #1 acts scared around CNA A. RN stated that she was the nurse on shift working that night and she was not aware of any falls for Resident #1. RN stated that he was found in bed with a black eye. RN stated she did not remember seeing the black eye any time before that day. During an Interview on 09/07/2023 at 5:17 pm, Resident #2 stated that she had a problem with CNA A because he was mean. Resident #2 stated she thinks it was because he does not like her. Resident #2 stated that CNA A told her that she complains too much. Resident #2 stated that a couple of weeks ago that she had a bag of trash in her hand, and she was walking with her walker toward the door and CNA A was walking towards her and got in front of her. Resident #2 stated that CNA A told her, You better not put that trash in the hall. Resident #2 stated that she told CNA A that she was going to go throw it away. Resident #2 stated that CNA A grabbed the bag of trash out of her hand aggressively and then threw it back at her. Resident #2 stated CNA A called her stupid when he threw the trash at her. Resident #2 stated that on other occasions CNA A would tell her to shut up and stop pressing on the call light so much and he would hold her arms down roughly when he said it. Resident #2 stated that CNA A had called her stupid before. Resident #2 stated that she had told the ADON and Administrator and was told by both of them that it would be taken care of, but CNA A was still mean to her. Resident #2 stated she was scared of CNA A, and she didn't like having to rely on him for help. During an Interview on 09/07/2023 at 5:33 pm, Resident #3 stated that she had a few staff members that she didn't care too much for because they were rude, but one staff member would call her names and hold her down when she didn't want care. Resident #3 stated that CNA A would tell her that she was the one in the bed needing help when she would use the call lights to get help. Resident #3 stated that CNA A had said Shut up stupid bitch. Resident #3 stated that she did get tired of the name calling so she started lashing out at CNA A verbally back at him. Resident #3 stated he made her upset and felt bad. Resident #3 stated that she had dealt with abuse in her younger days, so she knows what abuse is and CNA A was abusive. Resident #3 stated that people are there to get help not to be treated like animals. Resident #3 stated that she reported to the nursing staff about the incidents, but nothing ever changed. Resident #3 stated that CNA A continued to treat her like that. During an interview 09/07/2023 at 6:00 pm, CNA A stated that he had not witnessed any form of abuse or neglect. CNA A stated that he had been trained in abuse and neglect by in-services and these trainings occur approximately every three to four months. CNA A stated that the 5 types of abuse are: physical, emotional, sexual, verbal, and financial. CNA A stated that he is unsure why people would say that he is abusive when he's not. CNA A stated that he cannot control what other people say. CNA A stated that would handle difficult behaviors by redirecting and coming back to try to work with resident again after cooling off period. CNA A stated that he never held anyone down unless they were hitting him, and he just held them into place until they stopped hitting and then would let them go. CNA A stated that he did not feel that this is a restraint. CNA A stated that he has never been physically or verbally abusive. CNA A stated that he does not work a designated hall, that all staff just work all halls, and they help each other out. CNA A stated that he did work nights for a while but did not like it so he moved to days. During an interview 09/08/2023 at 10:59 am, ADON stated that Resident #1 did not have a fall. ADON stated that they believed that Resident #1 had a fall at the time because he had a (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 7 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some history of falls. ADON stated she was unsure if investigation was completed. ADON stated that she had been told by other staff members before that CNA A would hold down combative residents. ADON stated that she was told by some of the staff that CNA A would cross the resident's arms across their chest and then he would hold down the resident. ADON stated that she did not report this to the abuse coordinator (Administrator) because at that point it is just hearsay. ADON stated that she would report if the staff completed a written statement. ADON stated, I don't think that he was hurting the resident. ADON stated how else are you supposed to keep from getting hit by a resident? ADON stated she was unsure of what the policy stated about dealing with combative residents. ADON stated she would deal with combative behaviors by redirecting, walking away for a little bit if the resident was still combative, or get some help from another staff to see if the resident would respond differently to another staff. When asked if policy indicated that Resident could be held down, ADON stated, No, I don't think it says that. When asked ADON if it is considered a restraint to hold a resident down, ADON responded, Yeah, I guess it is. During an Interview 09/08/2023 at 11:19 am, Resident #4 stated that he did not witness his roommate Resident #1 being held down, but he could hear a lot of rustling around when CNA A would provide care. Resident #4 stated that he knew it was CNA A because he knows his voice. Resident #4 stated that he would hear a lot of banging, hitting the wall, and the resident groaning like he was hurting, and you could tell he was being hurt. Resident #4 stated that during the day when he was up and about that when CNA A would come around then Resident #1 would show fear by trying to move away from CNA A and just the fear in his eyes. Resident #4 stated you can see fear in someone. Resident #4 stated that CNA A was not the friendliest person and would get agitated easily. Resident #4 stated he would hear CNA A say stay still in a stern voice and hear all the rustling around. Resident #4 stated he was behind the curtain and could not easily get up to check what was going on. Resident #4 stated that he did tell the RN about this situation and to watch out for CNA A. During an interview 09/08/2023 at 4:28 pm. Administrator stated that she had heard from other staff members of CNA A holding down residents, but she thought that it was because the other staff didn't like CNA A. Administrator stated that she had not witnessed CNA A hold down residents. Administrator stated that Resident #3 did tell her that CNA A was calling her names. Administrator stated that Resident #3 would say things to CNA A like, You probably have a small penis. Administrator stated that she did not get any other reports from any other residents. Administrator stated that if you can't hold the residents, then how are you supposed to control when they are fighting you? Administrator stated she is not sure what the policy says, and she will have to read it to see what it says. Administrator stated that she has heard complaints from Resident #3 about CNA A, but she believes that she does not like him. Record Review of the facility provided policy revised on 12/2016, labeled, Abuse Prevention Program, revealed: Policy Statement: Our residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. This includes but is not limited to freedom from corporal punishment, involuntary seclusion, verbal, mental, sexual, or physical abuse, and physical or chemical restraint not required to treat the resident's symptoms. Policy Interpretation and Implementation: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 8 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0600 As part of the resident abusee prevention, the administration will: Level of Harm - Immediate jeopardy to resident health or safety 1. Protect our residents by anyone including but not necessarily limited to: facility staff, other resident's, consultants, volunteers, staff from other agencies, family members, legal representatives, friends, visitors, or any other individual . Residents Affected - Some 3. Develop and implement policies and procedures to aid out facility in preventing abuse, neglect, or mistreatment of our residents. 5. Implement measures to address factors that may lead to abusive situations, for example: B). Instruct staff regarding appropriate ways to address interpretive conflicts. Record Review of the facility provided policy revised on 07/2017, labeled, Abuse and Neglect-Clinical Protocol, revealed: 1. Abuse is defined at 483.5 as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. Abuse also includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain, or mental anguish. It includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse facilitated or enabled through the use of technology. 4. Willful, as defined at 483.5 and as used in the definition of abuse, means the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm. Assessment and Recognition: 1. The nurse will assess the individual and document related findings. Assessment data will include A). Injury assessment, B). pain assessment, C) Current behavior, D). Patient's age and sex, E). All current medications, F). Other platelet inhibitors, G). Vital Signs, H). Behavior over the last 24 hours, I). History of any tendency towards bruising, J). All active diagnosis, K). Any recent labs. 2. The nurse will report findings to the physician. As needed, the physician will assess the resident/patient to verify or clarify such findings, especially if the cause or source of the problem is unclear Treatment/Management: 1. The facility management and staff will institute measures to address the needs of residents/patients and minimize the possibility of abuse and neglect. 2. The management and staff, with the support of the physician, will address situations of suspected or identified abuse and report them in a timely manner to appropriate agencies, consistent with applicable laws and regulations. Record Review of CNA A Work Schedule for the dat[TRUNCATED] FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 9 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0604 Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. Level of Harm - Immediate jeopardy to resident health or safety **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on Interview and Record Review the facility failed to ensure that residents are free from physical or chemical restraints imposed for purpose of discipline or convenience and that are required to treat the resident's medical symptoms. Residents Affected - Some The facility failed to ensure that Resident #1, Resident #2, Resident #3, and Resident #5 was free from the use of restraints when CNA A was witnessed restraining residents by holding them down by crossing their arms across their chest and holding them down. An Immediate Jeopardy was identified on 09/08/2023 at 4:30 p.m. The IJ Template was provided to the facility on [DATE]. While the IJ was removed on 09/11/2023, the facility remained out of compliance at a severity level of actual harm and a scope of pattern due to the facility continuing to monitor the implementation and effectiveness of their Plan of Removal. These failures could affect all residents by placing them at risk of abuse, physical harm, pain, mental anguish, emotional distress, and serious harm. Findings Include: Resident #1: Record Review of Resident #1's face sheet documented he was a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #1 was admitted with diagnoses which included: Parkinson's Disease (disorder of the central nervous system that affects movements, often including tremors), neurocognitive disorder with Lewy bodies (a disease associated with abnormal deposits of a protein called alpha synuclein in the brain), dementia, muscle weakness, restlessness and agitation, schizoaffective disorders, intellectual disabilities. Record review of Resident #1's Significant Change in Status MDS dated [DATE] documented that Resident #1's BIMS was a 10/15, meaning moderately impaired cognition. According to the MDS, Resident #1 is listed to not having any change in mental status listed for disorganized thinking, for altered level of consciousness behavior is present and fluctuates. Resident #1 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually , verbal behavioral symptoms directed toward others such as, threatening others, screaming at others, cursing at others, other behavioral symptoms not directed towards others such as physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #1 was not listed as showing behaviors for refusing care. Resident #1 needs supervision with bed mobility such as moves to and from lying positions, turns side to side, and positions body while in bed or alternate sleep furniture such supervision would include: oversight, encouragement, or cueing. Resident #1 needs supervision for transfers and is listed as total dependent with a two person assist. Resident #1 is listed as not being steady and only able to stabilize with staff assistance during transitions and walking, this includes moving from seated to standing position, walking, surface to surface transfers. Resident #1 uses a wheelchair. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 10 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0604 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some Record review of Resident #1s Care Plan dated 08/01/2023 revealed Resident #1 had episodes of adverse behaviors of being physically aggressive; hitting, pinching, kicking, staff and resistive to care. Interventions: administer meds per order (updated 09/07/2023), anticipate behaviors and redirect when in close proximity to others that might invoke aggression (updated 09/07/2023), assess for pain (updated 09/07/2023), ensure family and MD aware of behaviors and or any increase in behaviors noted (updated on 09/07/2023), maintain calm environment (updated 09/07/2023), medication regimen review quarterly and PRN after any resident to resident behavior event (updated on 09/07/2023), monitor for early warning signs of behavior-approach in calm manner, call by name, remove from unwanted stimuli to a safe environment (updated on 09/07/2023), behaviors include hitting, being resistive to care, refusing food (updated 09/07/2023). Record review of Resident #1s Care Plan dated 07/24/2023 and a revision date of 09/07/2023 indicated Resident #1 had a potential for injury with a history of falls and is at risk for further falls with safety interventions. Interventions: administer meds as ordered, monitor labs, report abnormalities to MD, avoid use of restraints, bed in low position at all times, educated on noncompliance with safety interventions and explain possible risks/outcomes due to noncompliance issues, enlist family input regarding fall history and possible factors to help decrease; falls, ensure staff is aware of safety needs of the resident, fall mat at bedside at all times, keep personal items and frequently used items within reach. Record Review of Resident 1's Physician Order, dated 06/20/2023, revealed: Donepezil HCI oral tablet 5 mg for confusion. Resident 1's Physician Order dated 06/20/2023 Olanzapine oral tablet 5 mg for behaviors related to other schizoaffective disorders. Record Review of Resident #1's Progress notes dated 09/07/2023 at 5:40 pm and indicated incident date as of 08/30/2023, signed by RN revealed: Resident sister came to the nurse's station and asked CN if she knew why her brother had a black eye. CN immediately went to assess. Upon entering resident room CN noted right eye swollen shut with a small cut present to mid eyebrow with scanty amount of dry blood. [NAME] peri-orbital ecchymosis also noted. CN proceeded to perform a general assessment right eyebrow cleaned with NS. Resident #2: Record Review of Resident #2's face sheet documented she was a [AGE] year-old female who was originally admitted to the facility on [DATE] with a readmission date of 08/17/2023. Resident #2 was admitted with diagnoses which included: dementia, anxiety, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), schizoaffective disorder, major depressive disorder, type 2 diabetes, osteoarthritis (a type of arthritis that occurs when flexible tissue at the ends of bones wears down), bipolar disorder, high blood pressure, and acid reflux. Record review of Resident #2's admission MDS dated [DATE] documented that Resident #2's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #2 has no difficulty in normal conversation, social interaction, or watching tv. Resident #1 is listed to not showing a change in mental status, disorganized thinking, or altered level of consciousness. Resident #2 did not exhibit behaviors such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #2 did not exhibit the behaviors of rejecting care. Resident #2 uses a wheelchair and has no upper and lower body extremity (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 11 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0604 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some impairment. Resident #2 shows to need supervision for transfers such as bed mobility and transfers meaning oversight, encouragement, or cueing. Resident #2 is listed as not being steady when walking, surface to surface transfers and needs supervision but is able to stabilize without assistance. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had cognitive impairment with diagnosis of intellectual disability with impaired ability to make decision and is at risk for impaired communication and impaired safety awareness. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had a diagnosis of major depressive disorder and bipolar and is at risk for fluctuations in mood, little interest, or pleasure in doing things, and decreased socialization. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had episodes of anxiety and is at risk for fluctuation in moods, currently taking buspirone. Record review of Resident #2s Care Plan date revised 08/01/2023 revealed Resident #2 had episodes of adverse behaviors of being verbally and physically aggressive; hitting, pinching, kicking, staff and resistive to care. Record Review of Resident #2s Physician Orders dated 07/14/2023, revealed: Wellbutrin XL Oral tablet Extended Release 24-hour 300 mg, give 1 tablet by mouth one time a day for depression. Resident #3: Record Review of Resident #3's face sheet documented she was a [AGE] year-old female who was admitted to the facility on [DATE]. Resident #3 was admitted with diagnoses which included: dementia, acute respiratory failure, diabetes mellitus, chronic obstructive pulmonary disease (a group of lung diseases that block airflow and make it difficult to breathe), schizoaffective disorder, major depressive disorder, muscle weakness, tremor, hypothyroidism (a condition in which the thyroid gland does not produce enough thyroid hormone), hyperthyroidism (is the production of too much thyroxine hormone), anxiety, drug induced dyskinesia (an involuntary movement disorder), insomnia, high blood pressure, pain in joint, overactive bladder. Record review of Resident #3's admission MDS dated [DATE] documented that Resident #3's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #3 has moderate difficulty-speaker and must increase volume and speak distinctly. Resident #3 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #3 did not exhibit behaviors of rejecting care. Resident #3 uses a wheelchair and has no upper and lower body extremity impairment. Resident #3 shows a need of extensive assistance with resident involvement and staff to provide weight-bearing support for bed mobility, walking in room, and locomotion on unit, needing two people assist and resident highly involved in activity. Resident #3 is listed as not steady and only able to stabilize with staff assistance. Resident #3 is listed as not capable of increased independence. Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had episodes of anxiety and at risk for fluctuation in moods. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 12 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0604 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had a diagnosis of major depression/schizoaffective disorder and am at risk for fluctuation in moods, little interest, or pleasure in doing things and decreased socialization. Record review of Resident #3s Care Plan date revised 08/15/2023 revealed Resident #3 had impaired understanding and reasoning for expressing information needs: ability is limited to making concrete requests. Resident #4: Record Review of Resident #4's face sheet documented she was a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #4 was admitted with diagnoses which included: type 2 diabetes, cardiac arrhythmias, muscle weakness, abnormalities of gait, gout, anemia, bipolar disorder, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in your blood), manic episode, rheumatoid arthritis, acid reflux, enlarged prostate, pseudobulbar affect (pathological laughing and crying), polyneuropathy the simultaneous malfunction of many peripheral nerves throughout the body. Record review of Resident #4's Annual MDS dated [DATE] documented that Resident #4's BIMS was a 15/15, meaning intact cognition. Resident #4 is not listed as showing a change in mental status for disorganized thinking and altered level of consciousness and disorganized thinking. Resident #4 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #4 is listed for significantly disrupt care or living environment, meaning would disrupt care of living environment. Resident #4 is listed as showing rejection of care for 1-3 days. Resident #4 is shows total dependence for bed mobility and transfers with wheelchair, standing position, and locomotion on the unit with setup only. Resident #4 uses a wheelchair and has impairment with lower extremities but no impairment for upper extremities. Resident #4 is listed as steady, but able to stabilize without staff assistance for walking and transfers between bed and wheelchair. Resident #4 is listed as not being capable of increased independence. Record review of Resident #4s Care Plan date revised 05/03/2023 revealed Resident #4 had a mood problem with disease process of bipolar disorder and manic episode. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 had cognitive impairment: memory problems: diagnosis of bipolar disorder and pseudobulbar affect (pathological laughing and crying), impaired mobility to make decisions and is at risk for impairment safety awareness. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 is at risk for adverse consequences with receiving psychotropic medications Klonopin, and multiple med use due to nine or more medications. Record review of Resident #4s Care Plan date revised 08/14/2023 revealed Resident #4 had episodes of adverse behaviors. Inappropriate behavior. Resident with multiple urinals and multiple water pitchers in room at bedside. Resident adamant regarding removal of pitcher and urinal removal. Does not want pitchers and urinal to be removed. Resident with verbal outburst with nursing staff. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 13 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0604 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some Record review of Resident #4s Care Plan date revised 08/04/2023 revealed Resident #4 had problematic demeanor in which resident acts out characterized by ineffective coping, verbal/physical, aggression related to anger. Resident #5: Record Review of Resident #5's face sheet documented she was an [AGE] year-old female who was originally admitted to the facility on [DATE] and re-admitted on [DATE]. Resident #5 was admitted with diagnoses which included: Alzheimer's Disease, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), overactive bladder, iron deficiency, major depression, macular degeneration (an eye disease that causes vision loss), high blood pressure, pain in unspecified joint, muscle weakness, reduced mobility. Record review of Resident #5's Quarterly MDS dated [DATE] documented that Resident #5's BIMS was a 99, meaning the resident interview was not successful. Resident #5 has difficulty communicating some words or finishing thoughts but is able if prompted or given time. Resident #5 usually understands-misses some part-intent of message but comprehends most conversation. Resident #5 has the ability to recall memory after 5 minutes and 5 could recall long past. Resident #5 is moderately impaired-decisions poor, cues/supervision required for decision making. Resident #5 does show the behavior is present and fluctuates for inattention, disorganized thinking or incoherent. Resident #5 does not show altered level of consciousness. Resident #5 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #5 did exhibit the behavior of rejecting care for 1-3 days. Resident #5 shows the need for extensive assistance with one person assist for bed mobility and transfers but is listed as limited assistance with one person assist for locomotion on the unit. Resident #5 uses a wheelchair and shows no upper or lower extremity impairment. Resident #5 is listed as steady, but able to stabilize without staff assistance for walking and surface to surface transfers. Record review of Resident #5s Care Plan date revised 03/03/2023 revealed Resident #5 had a cognitive impairment, memory problems short/long term diagnosis of dementia and impaired safety awareness. Record review of Resident #5s Care Plan date revised 08/03/2023 revealed Resident #5 had a diagnosis of depression/mood disorder and is at risk for fluctuation in moods, little interest, or pleasure in doing things and decreased socialization, currently receiving Remeron. During an interview on 09/06/2023 at 3:09 pm, DON stated that for Resident #1 that she heard about the black eye the morning of 08/30/2023. DON stated that she thought it was a fall because Resident #1 has a history of falls. DON stated that resident #1 wasn't found on the floor or anything, he was found in bed. DON stated that they did not report because it was an unwitnessed fall. When asked if that is considered an injury of unknown origin, DON shook her head and stated, your right it is considered injury of unknown origin. When asked why it was not reported, DON stated they were thinking that it was just a fall. DON stated, your right we should have reported and didn't. DON stated that she was not in the facility at the time of the incident. DON stated that she is just helping out in the facility for a while. DON stated that the ADON had more details about the incident because it was reported to her, and she was not at work today. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 14 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0604 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some During an interview on 09/06/2023 at 4:15 pm, Administrator stated that with Resident #1 she believed that he had a fall. Administrator stated that Resident #1 had a history of falls. Administrator stated that Resident #1 was found in bed and was not found on the floor. Administrator stated that she did not report the black eye for Resident #1 because she did not know about it. Administrator stated that she did not report when she had found out because she thought it was an unwitnessed fall. Administrator stated she guessed she should have reported and will go ahead and do that since she believed it to be an unwitnessed fall. Administrator stated she was not told it was a fall, Resident #1 just had a history of it. Administrator stated that she heard about Resident's black eye after the meeting the morning of 08/30/2023 by DON. During an interview on 09/07/2023 at 3:25 pm, CNA B stated that she had witnessed abuse recently. CNA B stated that she did report to the ADON that she had witnessed CNA A being rough with residents while providing care. CNA B stated that while working with CNA A she witnessed CNA A hold Resident #1 down by holding his arms down with CNA A body weight and the residents would fight C CNA B stated that she witnessed CNA A being aggressive when he would hold the residents down. CNA B stated that CNA A would hold down the resident's that would fight him. CNA B stated that she witnessed the resident would try and get up from CNA A holding them down and CNA A would not let them up. CNA B stated that Resident #1 is not the only resident that she witnessed CNA A holding down when they don't want to be held down. CNA B stated that she also witnessed CNA A being rough and holding down Resident #5 and Resident #6. CNA B stated that the resident would fight CNA A to get him off them. CNA B stated that when she reported the abuse to the ADON she was told to provide a statement, but she had forgotten to write a statement because she was tired. CNA B stated that she reported to the ADON after a meeting that staff had that was due to Resident #1 coming up with an unexplained black eye on CNA A's shift. CNA B stated that she did not intervene to stop CNA A because she was scared of CNA A, but she did report to the ADON. During an interview on 09/07/2023 at 5:00 pm, RN stated that she has always known CNA A to have a bad attitude towards the residents and others. RN stated that she has heard by other staff members that CNA A would be rough with resident's by grabbing and yanking on their arms. RN stated that she did not report what she had heard to anyone because she did not see it. RN stated that she had worked the night shift on 08/30/2023 and then next morning she was made aware by a family member that Resident #1 had a black eye. RN stated on this shift CNA A was working. RN stated that while she was assessing Resident #1 that Resident #4 had stated to RN that CNA A needed to be watched because when CNA A comes into change Resident #1, Resident #4 would hear a lot of rustling around and that Resident #1 acts scared around CNA A. RN stated that she was the nurse on shift working that night and she was not aware of any falls for Resident #1. RN stated that he was found in bed with a black eye. RN stated she did not remember seeing the black eye any time before that day. During an Interview on 09/07/2023 at 5:17 pm, Resident #2 stated that she had a problem with CNA A because he was mean. Resident #2 stated she thinks it was because he does not like her. Resident #2 stated that CNA A told her that she complains too much. Resident #2 stated that a couple of weeks ago that she had a bag of trash in her hand, and she was walking with her walker toward the door and CNA A was walking towards her and got in front of her. Resident #2 stated that CNA A told her, You better not put that trash in the hall. Resident #2 stated that she told CNA A that she was going to go throw it away. Resident #2 stated that CNA A grabbed the bag of trash out of her hand aggressively and then threw it back at her. Resident #2 stated CNA A called her stupid when he threw the trash at her. Resident #2 stated that on other occasions CNA A would tell her to shut up and stop pressing on the call light so much and he would hold her arms down roughly when he said it. Resident #2 stated that CNA A had called her stupid before. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 15 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0604 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some Resident #2 stated that she had told the ADON and Administrator and was told by both of them that it would be taken care of, but CNA A was still mean to her. Resident #2 stated she was scared of CNA A, and she didn't like having to rely on him for help. During an Interview on 09/07/2023 at 5:33 pm, Resident #3 stated that she had a few staff members that she didn't care too much for because they were rude, but one staff member would call her names and hold her down when she didn't want care. Resident #3 stated that CNA A would tell her that she was the one in the bed needing help when she would use the call lights to get help. Resident #3 stated that CNA A had said Shut up stupid bitch. Resident #3 stated that she did get tired of the name calling so she started lashing out at CNA A verbally back at him. Resident #3 stated he made her upset and felt bad. Resident #3 stated that she had dealt with abuse in her younger days, so she knows what abuse is and CNA A was abusive. Resident #3 stated that people are there to get help not to be treated like animals. Resident #3 stated that she reported to the nursing staff about the incidents, but nothing ever changed. Resident #3 stated that CNA A continued to treat her like that. During an interview 09/07/2023 at 6:00 pm, CNA A stated that he had not witnessed any form of abuse or neglect. CNA A stated that he had been trained in abuse and neglect by in-services and these trainings occur approximately every three to four months. CNA A stated that the 5 types of abuse are: physical, emotional, sexual, verbal, and financial. CNA A stated that he is unsure why people would say that he is abusive when he's not. CNA A stated that he cannot control what other people say. CNA A stated that would handle difficult behaviors by redirecting and coming back to try to work with resident again after cooling off period. CNA A stated that he never held anyone down unless they were hitting him, and he just held them into place until they stopped hitting and then would let them go. CNA A stated that he did not feel that this is a restraint. CNA A stated that he has never been physically or verbally abusive. CNA A stated that he does not work a designated hall, that all staff just work all halls, and they help each other out. CNA A stated that he did work nights for a while but did not like it so he moved to days. During an interview 09/08/2023 at 10:59 am, ADON stated that Resident #1 did not have a fall. ADON stated that they believed that Resident #1 had a fall at the time because he had a history of falls. ADON stated she was unsure if investigation was completed. ADON stated that she had been told by other staff members before that CNA A would hold down combative residents. ADON stated that she was told by some of the staff that CNA A would cross the resident's arms across their chest and then he would hold down the resident. ADON stated that she did not report this to the abuse coordinator (Administrator) because at that point it is just hearsay. ADON stated that she would report if the staff completed a written statement. ADON stated, I don't think that he was hurting the resident. ADON stated how else are you supposed to keep from getting hit by a resident? ADON stated she was unsure of what the policy stated about dealing with combative residents. ADON stated she would deal with combative behaviors by redirecting, walking away for a little bit if the resident was still combative, or get some help from another staff to see if the resident would respond differently to another staff. When asked if policy indicated that Resident could be held down, ADON stated, No, I don't think it says that. When asked ADON if it is considered a restraint to hold a resident down, ADON responded, Yeah, I guess it is. During an Interview 09/08/2023 at 11:19 am, Resident #4 stated that he did not witness his roommate Resident #1 being held down, but he could hear a lot of rustling around when CNA A would provide care. Resident #4 stated that he knew it was CNA A because he knows his voice. Resident #4 stated that he would hear a lot of banging, hitting the wall, and the resident groaning like he was hurting, and you could tell he was being hurt. Resident #4 stated that during the day when he was up and about (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 16 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0604 Level of Harm - Immediate jeopardy to resident health or safety that when CNA A would come around then Resident #1 would show fear by trying to move away from CNA A and just the fear in his eyes. Resident #4 stated you can see fear in someone. Resident #4 stated that CNA A was not the friendliest person and would get agitated easily. Resident #4 stated he would hear CNA A say stay still in a stern voice and hear all the rustling around. Resident #4 stated he was behind the curtain and could not easily get up to check what was going on. Resident #4 stated that he did tell the RN about this situation and to watch out for CNA A. Residents Affected - Some During an interview 09/08/2023 at 4:28 pm. Administrator stated that she had heard from other staff members of CNA A holding down residents, but she thought that it was because the other staff didn't like CNA A. Administrator stated that she had not witnessed CNA A hold down residents. Administrator stated that Resident #3 did tell her that CNA A was calling her names. Administrator stated that Resident #3 would say things to CNA A like, You probably have a small penis. Administrator stated that she did not get any other reports from any other residents. Administrator stated that if you can't hold the residents, then how are you supposed to control when they are fighting you? Administrator stated she is not sure what the policy says, and she will have to read it to see what it says. Administrator stated that she has heard complaints from Resident #3 about CNA A, but she believes that she does not like him. Record Review of the facility provided policy revised on 12/2016, labeled, Abuse Prevention Program, revealed: Policy Statement: Our residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. This includes but is not limited to freedom from corporal punishment, involuntary seclusion, verbal, mental, sexual, or physical abuse, and physical or chemical restraint not required to treat the resident's symptoms. Policy Interpretation and Implementation: As part of the resident abusee prevention, the administration will: 1. Protect our residents by anyone including but not necessarily limited to: facility staff, other resident's, consultants, volunteers, staff from other agencies, family members, legal representatives, friends, visitors, or any other individual . 3. Develop and implement policies and procedures to aid out facility in preventing abuse, neglect, or mistreatment of our residents. 5. Implement measures to address factors that may lead to abusive situations, for example: B). Instruct staff regarding appropriate ways to address interpretive conflicts. Record Review of the facility provided policy revised on 07/2017, labeled, Abuse and Neglect-Clinical Protocol, revealed: 1. Abuse is defined at 483.5 as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. Abuse also includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. Instances of abuse of all residents, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 17 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0604 Level of Harm - Immediate jeopardy to resident health or safety irrespective of any mental or physical condition, cause physical harm, pain, or mental anguish. It includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse facilitated or enabled through the use of technology. 4. Willful, as defined at 483.5 and as used in the definition of abuse, means the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm. Residents Affected - Some Assessment and Recognition: 1. The nurse will assess the individual and document related findings. Assessment data will include A). Injury assessment, B). pain assessment, C) Current behavior, D). Patient's age and sex, E). All current medications, F). Other platelet inhibitors, G). Vital Signs, H). Behavior over the last 24 hours, I). History of any tendency towards bruising, J). All active diagnosis, K). Any recent labs. 2. The nurse will report findings to the physician. As needed, the physician will assess the resident/patient to verify or clarify such findings, especially if the cause or source of the problem is unclear Treatment/Management: 1. The facility management and staff will institute measures to address the needs of residents/patients and minimize the possibility of abuse and neglect. 2. The management and staff, with the support of the physician, will address situations of suspected or identified abuse and report them in a timely manner to appropriate agencies, consistent with applicable laws and regulations. Record Review of CNA A Work Schedule for the dates following: 08/29/2023-09/06/2023, revealed: 08/29/2023: In Day: 05:56 pm, out lunch: 00:01 am, In-Lunch: 01:02 am, Out Day: 06:25 am: (11:46) 09/01/2023 In Day: 06:03 pm, Out Lunch: 01:34 am, In Lunch: 01:48 AM, Out Day: 06:22AM: (11:32) 09/02/2023: Overtime 1 X 5 Premium: (5:34) 09/02/2023: In Day: 06:10 PM, Out Lunch: 00:02 AM, In Lunch: 1:08 AM, Out Day: 06:42 AM (11.44) 09/03/2023: In Day: 06:13 PM, Out Lunch: 00:36 AM, In Lunch: 01:48 AM, Out Day: 06:31 AM (11.10) 09/06/2023: In Day: 06:09 PM, Out Lunch: 02:11 AM, In Lunch: 03:12 AM, Out Day: 06:25 AM (11.25) 09/07/2023: In Day: 06:03 PM, Out L[TRUNCATED] FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 18 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. Level of Harm - Immediate jeopardy to resident health or safety **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on Interview and Record Review the facility failed to develop and implement written policies and procedures that prohibit and prevent abuse, neglect, and exploitation of residents and misappropriation of resident property. Residents Affected - Some The facility failed to ensure that Resident #1, Resident #2, Resident #3, and Resident #5 was free from abuse when CNA A was witnessed holding residents by holding them down by crossing their arms across their chest and holding them down. The facility failed to implement polikcies by not reporting, investigating allegations of abuse. The facility failed to implement policies by allowing CNA A to continue working with residents with allegations of abuse. (Resident #2 and Resident #3) An Immediate Jeopardy was identified on 09/08/2023 at 4:30 p.m. The IJ Template was provided to the facility on [DATE]. While the IJ was removed on 09/11/2023, the facility remained out of compliance at a severity level of actual harm and a scope of pattern due to the facility continuing to monitor the implementation and effectiveness of their Plan of Removal. These failures could affect all residents by placing them at risk of abuse, physical harm, pain, mental anguish, emotional distress, and serious harm. Findings include: Resident #1: Record Review of Resident #1's face sheet documented he was a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #1 was admitted with diagnoses which included: Parkinson's Disease (disorder of the central nervous system that affects movements, often including tremors), neurocognitive disorder with Lewy bodies (a disease associated with abnormal deposits of a protein called alpha synuclein in the brain), dementia, muscle weakness, restlessness and agitation, schizoaffective disorders, intellectual disabilities. Record review of Resident #1's Significant Change in Status MDS dated [DATE] documented that Resident #1's BIMS was a 10/15, meaning moderately impaired cognition. According to the MDS, Resident #1 is listed to not having any change in mental status listed for disorganized thinking, for altered level of consciousness behavior is present and fluctuates. Resident #1 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually , verbal behavioral symptoms directed toward others such as, threatening others, screaming at others, cursing at others, other behavioral symptoms not directed towards others such as physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #1 was not listed as showing behaviors for refusing care. Resident #1 needs supervision with bed mobility such as moves to and from lying positions, turns side to side, and positions body while in bed or alternate sleep furniture such supervision would include: oversight, encouragement, or (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 19 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some cueing. Resident #1 needs supervision for transfers and is listed as total dependent with a two person assist. Resident #1 is listed as not being steady and only able to stabilize with staff assistance during transitions and walking, this includes moving from seated to standing position, walking, surface to surface transfers. Resident #1 uses a wheelchair. Record review of Resident #1s Care Plan dated 08/01/2023 revealed Resident #1 had episodes of adverse behaviors of being physically aggressive; hitting, pinching, kicking, staff and resistive to care. Interventions: administer meds per order (updated 09/07/2023), anticipate behaviors and redirect when in close proximity to others that might invoke aggression (updated 09/07/2023), assess for pain (updated 09/07/2023), ensure family and MD aware of behaviors and or any increase in behaviors noted (updated on 09/07/2023), maintain calm environment (updated 09/07/2023), medication regimen review quarterly and PRN after any resident to resident behavior event (updated on 09/07/2023), monitor for early warning signs of behavior-approach in calm manner, call by name, remove from unwanted stimuli to a safe environment (updated on 09/07/2023), behaviors include hitting, being resistive to care, refusing food (updated 09/07/2023). Record review of Resident #1s Care Plan dated 07/24/2023 and a revision date of 09/07/2023 indicated Resident #1 had a potential for injury with a history of falls and is at risk for further falls with safety interventions. Interventions: administer meds as ordered, monitor labs, report abnormalities to MD, avoid use of restraints, bed in low position at all times, educated on noncompliance with safety interventions and explain possible risks/outcomes due to noncompliance issues, enlist family input regarding fall history and possible factors to help decrease; falls, ensure staff is aware of safety needs of the resident, fall mat at bedside at all times, keep personal items and frequently used items within reach. Record Review of Resident 1's Physician Order, dated 06/20/2023, revealed: Donepezil HCI oral tablet 5 mg for confusion. Resident 1's Physician Order dated 06/20/2023 Olanzapine oral tablet 5 mg for behaviors related to other schizoaffective disorders. Record Review of Resident #1's Progress notes dated 09/07/2023 at 5:40 pm and indicated incident date as of 08/30/2023, signed by RN revealed: Resident sister came to the nurse's station and asked CN if she knew why her brother had a black eye. CN immediately went to assess. Upon entering resident room CN noted right eye swollen shut with a small cut present to mid eyebrow with scanty amount of dry blood. [NAME] peri-orbital ecchymosis also noted. CN proceeded to perform a general assessment right eyebrow cleaned with NS. Resident #2: Record Review of Resident #2's face sheet documented she was a [AGE] year-old female who was originally admitted to the facility on [DATE] with a readmission date of 08/17/2023. Resident #2 was admitted with diagnoses which included: dementia, anxiety, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), schizoaffective disorder, major depressive disorder, type 2 diabetes, osteoarthritis (a type of arthritis that occurs when flexible tissue at the ends of bones wears down), bipolar disorder, high blood pressure, and acid reflux. Record review of Resident #2's admission MDS dated [DATE] documented that Resident #2's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #2 has no difficulty in normal conversation, social interaction, or watching tv. Resident #1 is listed to not showing a change in mental status, disorganized thinking, or altered level of consciousness. Resident #2 did not exhibit (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 20 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some behaviors such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #2 did not exhibit the behaviors of rejecting care. Resident #2 uses a wheelchair and has no upper and lower body extremity impairment. Resident #2 shows to need supervision for transfers such as bed mobility and transfers meaning oversight, encouragement, or cueing. Resident #2 is listed as not being steady when walking, surface to surface transfers and needs supervision but is able to stabilize without assistance. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had cognitive impairment with diagnosis of intellectual disability with impaired ability to make decision and is at risk for impaired communication and impaired safety awareness. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had a diagnosis of major depressive disorder and bipolar and is at risk for fluctuations in mood, little interest, or pleasure in doing things, and decreased socialization. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had episodes of anxiety and is at risk for fluctuation in moods, currently taking buspirone. Record review of Resident #2s Care Plan date revised 08/01/2023 revealed Resident #2 had episodes of adverse behaviors of being verbally and physically aggressive; hitting, pinching, kicking, staff and resistive to care. Record Review of Resident #2s Physician Orders dated 07/14/2023, revealed: Wellbutrin XL Oral tablet Extended Release 24-hour 300 mg, give 1 tablet by mouth one time a day for depression. Resident #3: Record Review of Resident #3's face sheet documented she was a [AGE] year-old female who was admitted to the facility on [DATE]. Resident #3 was admitted with diagnoses which included: dementia, acute respiratory failure, diabetes mellitus, chronic obstructive pulmonary disease (a group of lung diseases that block airflow and make it difficult to breathe), schizoaffective disorder, major depressive disorder, muscle weakness, tremor, hypothyroidism (a condition in which the thyroid gland does not produce enough thyroid hormone), hyperthyroidism (is the production of too much thyroxine hormone), anxiety, drug induced dyskinesia (an involuntary movement disorder), insomnia, high blood pressure, pain in joint, overactive bladder. Record review of Resident #3's admission MDS dated [DATE] documented that Resident #3's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #3 has moderate difficulty-speaker and must increase volume and speak distinctly. Resident #3 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #3 did not exhibit behaviors of rejecting care. Resident #3 uses a wheelchair and has no upper and lower body extremity impairment. Resident #3 shows a need of extensive assistance with resident involvement and staff to provide weight-bearing support for bed mobility, walking in room, and locomotion on unit, needing two people assist and resident highly involved in activity. Resident #3 is (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 21 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some listed as not steady and only able to stabilize with staff assistance. Resident #3 is listed as not capable of increased independence. Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had episodes of anxiety and at risk for fluctuation in moods. Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had a diagnosis of major depression/schizoaffective disorder and am at risk for fluctuation in moods, little interest, or pleasure in doing things and decreased socialization. Record review of Resident #3s Care Plan date revised 08/15/2023 revealed Resident #3 had impaired understanding and reasoning for expressing information needs: ability is limited to making concrete requests. Resident #4: Record Review of Resident #4's face sheet documented she was a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #4 was admitted with diagnoses which included: type 2 diabetes, cardiac arrhythmias, muscle weakness, abnormalities of gait, gout, anemia, bipolar disorder, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in your blood), manic episode, rheumatoid arthritis, acid reflux, enlarged prostate, pseudobulbar affect (pathological laughing and crying), polyneuropathy the simultaneous malfunction of many peripheral nerves throughout the body. Record review of Resident #4's Annual MDS dated [DATE] documented that Resident #4's BIMS was a 15/15, meaning intact cognition. Resident #4 is not listed as showing a change in mental status for disorganized thinking and altered level of consciousness and disorganized thinking. Resident #4 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #4 is listed for significantly disrupt care or living environment, meaning would disrupt care of living environment. Resident #4 is listed as showing rejection of care for 1-3 days. Resident #4 is shows total dependence for bed mobility and transfers with wheelchair, standing position, and locomotion on the unit with setup only. Resident #4 uses a wheelchair and has impairment with lower extremities but no impairment for upper extremities. Resident #4 is listed as steady, but able to stabilize without staff assistance for walking and transfers between bed and wheelchair. Resident #4 is listed as not being capable of increased independence. Record review of Resident #4s Care Plan date revised 05/03/2023 revealed Resident #4 had a mood problem with disease process of bipolar disorder and manic episode. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 had cognitive impairment: memory problems: diagnosis of bipolar disorder and pseudobulbar affect (pathological laughing and crying), impaired mobility to make decisions and is at risk for impairment safety awareness. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 is at risk for adverse consequences with receiving psychotropic medications Klonopin, and multiple med use due to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 22 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0607 nine or more medications. Level of Harm - Immediate jeopardy to resident health or safety Record review of Resident #4s Care Plan date revised 08/14/2023 revealed Resident #4 had episodes of adverse behaviors. Inappropriate behavior. Resident with multiple urinals and multiple water pitchers in room at bedside. Resident adamant regarding removal of pitcher and urinal removal. Does not want pitchers and urinal to be removed. Resident with verbal outburst with nursing staff. Residents Affected - Some Record review of Resident #4s Care Plan date revised 08/04/2023 revealed Resident #4 had problematic demeanor in which resident acts out characterized by ineffective coping, verbal/physical, aggression related to anger. Resident #5: Record Review of Resident #5's face sheet documented she was an [AGE] year-old female who was originally admitted to the facility on [DATE] and re-admitted on [DATE]. Resident #5 was admitted with diagnoses which included: Alzheimer's Disease, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), overactive bladder, iron deficiency, major depression, macular degeneration (an eye disease that causes vision loss), high blood pressure, pain in unspecified joint, muscle weakness, reduced mobility. Record review of Resident #5's Quarterly MDS dated [DATE] documented that Resident #5's BIMS was a 99, meaning the resident interview was not successful. Resident #5 has difficulty communicating some words or finishing thoughts but is able if prompted or given time. Resident #5 usually understands-misses some part-intent of message but comprehends most conversation. Resident #5 has the ability to recall memory after 5 minutes and 5 could recall long past. Resident #5 is moderately impaired-decisions poor, cues/supervision required for decision making. Resident #5 does show the behavior is present and fluctuates for inattention, disorganized thinking or incoherent. Resident #5 does not show altered level of consciousness. Resident #5 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #5 did exhibit the behavior of rejecting care for 1-3 days. Resident #5 shows the need for extensive assistance with one person assist for bed mobility and transfers but is listed as limited assistance with one person assist for locomotion on the unit. Resident #5 uses a wheelchair and shows no upper or lower extremity impairment. Resident #5 is listed as steady, but able to stabilize without staff assistance for walking and surface to surface transfers. Record review of Resident #5s Care Plan date revised 03/03/2023 revealed Resident #5 had a cognitive impairment, memory problems short/long term diagnosis of dementia and impaired safety awareness. Record review of Resident #5s Care Plan date revised 08/03/2023 revealed Resident #5 had a diagnosis of depression/mood disorder and is at risk for fluctuation in moods, little interest, or pleasure in doing things and decreased socialization, currently receiving Remeron. During an interview on 09/06/2023 at 3:09 pm, DON stated that for Resident #1 that she heard about the black eye the morning of 08/30/2023. DON stated that she thought it was a fall because Resident #1 has a history of falls. DON stated that resident #1 wasn't found on the floor or anything, he was found in bed. DON stated that they did not report because it was an unwitnessed fall. When asked if (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 23 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0607 Level of Harm - Immediate jeopardy to resident health or safety that is considered an injury of unknown origin, DON shook her head and stated, your right it is considered injury of unknown origin. When asked why it was not reported, DON stated they were thinking that it was just a fall. DON stated, your right we should have reported and didn't. DON stated that she was not in the facility at the time of the incident. DON stated that she is just helping out in the facility for a while. DON stated that the ADON had more details about the incident because it was reported to her, and she was not at work today. Residents Affected - Some During an interview on 09/06/2023 at 4:15 pm, Administrator stated that with Resident #1 she believed that he had a fall. Administrator stated that Resident #1 had a history of falls. Administrator stated that Resident #1 was found in bed and was not found on the floor. Administrator stated that she did not report the black eye for Resident #1 because she did not know about it. Administrator stated that she did not report when she had found out because she thought it was an unwitnessed fall. Administrator stated she guessed she should have reported and will go ahead and do that since she believed it to be an unwitnessed fall. Administrator stated she was not told it was a fall, Resident #1 just had a history of it. Administrator stated that she heard about Resident's black eye after the meeting the morning of 08/30/2023 by DON. During an interview on 09/07/2023 at 3:25 pm, CNA B stated that she had witnessed abuse recently. CNA B stated that she did report to the ADON that she had witnessed CNA A being rough with residents while providing care. CNA B stated that while working with CNA A she witnessed CNA A hold Resident #1 down by holding his arms down with CNA A body weight and the residents would fight C CNA B stated that she witnessed CNA A being aggressive when he would hold the residents down. CNA B stated that CNA A would hold down the resident's that would fight him. CNA B stated that she witnessed the resident would try and get up from CNA A holding them down and CNA A would not let them up. CNA B stated that Resident #1 is not the only resident that she witnessed CNA A holding down when they don't want to be held down. CNA B stated that she also witnessed CNA A being rough and holding down Resident #5 and Resident #6. CNA B stated that the resident would fight CNA A to get him off them. CNA B stated that when she reported the abuse to the ADON she was told to provide a statement, but she had forgotten to write a statement because she was tired. CNA B stated that she reported to the ADON after a meeting that staff had that was due to Resident #1 coming up with an unexplained black eye on CNA A's shift. CNA B stated that she did not intervene to stop CNA A because she was scared of CNA A, but she did report to the ADON. Interview with on 09/07/2023 at 4:26 pm, CNA C reported that she heard CNA A verbally abusing Resident #2 approximately 3 weeks ago. CNA C stated that CNA A was calling Resident #2 names and telling her to shut up and called her stupid and ugly. CNA C stated that she reported the incident to the ADON. CNA C stated that she could tell it bothered Resident #2 because she looked upset. CNA C stated that CNA A showed no interest in wanting to be there most of the time. CNA C stated that CNA A would get mad if he had to answer the call lights. During an interview on 09/07/2023 at 5:00 pm, RN stated that she has always known CNA A to have a bad attitude towards the residents and others. RN stated that she has heard by other staff members that CNA A would be rough with resident's by grabbing and yanking on their arms. RN stated that she did not report what she had heard to anyone because she did not see it. RN stated that she had worked the night shift on 08/30/2023 and then next morning she was made aware by a family member that Resident #1 had a black eye. RN stated on this shift CNA A was working. RN stated that while she was assessing Resident #1 that Resident #4 had stated to RN that CNA A needed to be watched because when CNA A comes into change Resident #1, Resident #4 would hear a lot of rustling around and that Resident #1 acts scared around CNA A. RN stated that she was the nurse on shift working that night and she (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 24 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some was not aware of any falls for Resident #1. RN stated that he was found in bed with a black eye. RN stated she did not remember seeing the black eye any time before that day. During an Interview on 09/07/2023 at 5:17 pm, Resident #2 stated that she had a problem with CNA A because he was mean. Resident #2 stated she thinks it was because he does not like her. Resident #2 stated that CNA A told her that she complains too much. Resident #2 stated that a couple of weeks ago that she had a bag of trash in her hand, and she was walking with her walker toward the door and CNA A was walking towards her and got in front of her. Resident #2 stated that CNA A told her, You better not put that trash in the hall. Resident #2 stated that she told CNA A that she was going to go throw it away. Resident #2 stated that CNA A grabbed the bag of trash out of her hand aggressively and then threw it back at her. Resident #2 stated CNA A called her stupid when he threw the trash at her. Resident #2 stated that on other occasions CNA A would tell her to shut up and stop pressing on the call light so much and he would hold her arms down roughly when he said it. Resident #2 stated that CNA A had called her stupid before. Resident #2 stated that she had told the ADON and Administrator and was told by both of them that it would be taken care of, but CNA A was still mean to her. Resident #2 stated she was scared of CNA A, and she didn't like having to rely on him for help. During an Interview on 09/07/2023 at 5:33 pm, Resident #3 stated that she had a few staff members that she didn't care too much for because they were rude, but one staff member would call her names and hold her down when she didn't want care. Resident #3 stated that CNA A would tell her that she was the one in the bed needing help when she would use the call lights to get help. Resident #3 stated that CNA A had said Shut up stupid bitch. Resident #3 stated that she did get tired of the name calling so she started lashing out at CNA A verbally back at him. Resident #3 stated he made her upset and felt bad. Resident #3 stated that she had dealt with abuse in her younger days, so she knows what abuse is and CNA A was abusive. Resident #3 stated that people are there to get help not to be treated like animals. Resident #3 stated that she reported to the nursing staff about the incidents, but nothing ever changed. Resident #3 stated that CNA A continued to treat her like that. During an interview 09/07/2023 at 6:00 pm, CNA A stated that he had not witnessed any form of abuse or neglect. CNA A stated that he had been trained in abuse and neglect by in-services and these trainings occur approximately every three to four months. CNA A stated that the 5 types of abuse are: physical, emotional, sexual, verbal, and financial. CNA A stated that he is unsure why people would say that he is abusive when he's not. CNA A stated that he cannot control what other people say. CNA A stated that would handle difficult behaviors by redirecting and coming back to try to work with resident again after cooling off period. CNA A stated that he never held anyone down unless they were hitting him, and he just held them into place until they stopped hitting and then would let them go. CNA A stated that he did not feel that this is a restraint. CNA A stated that he has never been physically or verbally abusive. CNA A stated that he does not work a designated hall, that all staff just work all halls, and they help each other out. CNA A stated that he did work nights for a while but did not like it so he moved to days. During an interview 09/08/2023 at 10:59 am, ADON stated that Resident #1 did not have a fall. ADON stated that they believed that Resident #1 had a fall at the time because he had a history of falls. ADON stated she was unsure if investigation was completed. ADON stated that she had been told by other staff members before that CNA A would hold down combative residents. ADON stated that she was told by some of the staff that CNA A would cross the resident's arms across their chest and then he would hold down the resident. ADON stated that she did not report this to the abuse coordinator (Administrator) because at that point it is just hearsay. ADON stated that she would report if the staff completed a written statement. ADON stated, I don't think that he was hurting the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 25 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0607 Level of Harm - Immediate jeopardy to resident health or safety resident. ADON stated how else are you supposed to keep from getting hit by a resident? ADON stated she was unsure of what the policy stated about dealing with combative residents. ADON stated she would deal with combative behaviors by redirecting, walking away for a little bit if the resident was still combative, or get some help from another staff to see if the resident would respond differently to another staff. When asked if policy indicated that Resident could be held down, ADON stated, No, I don't think it says that. When asked ADON if it is considered a restraint to hold a resident down, ADON responded, Yeah, I guess it is. Residents Affected - Some During an Interview 09/08/2023 at 11:19 am, Resident #4 stated that he did not witness his roommate Resident #1 being held down, but he could hear a lot of rustling around when CNA A would provide care. Resident #4 stated that he knew it was CNA A because he knows his voice. Resident #4 stated that he would hear a lot of banging, hitting the wall, and the resident groaning like he was hurting, and you could tell he was being hurt. Resident #4 stated that during the day when he was up and about that when CNA A would come around then Resident #1 would show fear by trying to move away from CNA A and just the fear in his eyes. Resident #4 stated you can see fear in someone. Resident #4 stated that CNA A was not the friendliest person and would get agitated easily. Resident #4 stated he would hear CNA A say stay still in a stern voice and hear all the rustling around. Resident #4 stated he was behind the curtain and could not easily get up to check what was going on. Resident #4 stated that he did tell the RN about this situation and to watch out for CNA A. During an interview 09/08/2023 at 4:28 pm. Administrator stated that she had heard from other staff members of CNA A holding down residents, but she thought that it was because the other staff didn't like CNA A. Administrator stated that she had not witnessed CNA A hold down residents. Administrator stated that Resident #3 did tell her that CNA A was calling her names. Administrator stated that Resident #3 would say things to CNA A like, You probably have a small penis. Administrator stated that she did not get any other reports from any other residents. Administrator stated that if you can't hold the residents, then how are you supposed to control when they are fighting you? Administrator stated she is not sure what the policy says, and she will have to read it to see what it says. Administrator stated that she has heard complaints from Resident #3 about CNA A, but she believes that she does not like him. Record Review of the facility provided policy revised on 12/2016, labeled, Abuse Prevention Program, revealed: Policy Statement: Our residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. This includes but is not limited to freedom from corporal punishment, involuntary seclusion, verbal, mental, sexual, or physical abuse, and physical or chemical restraint not required to treat the resident's symptoms. Policy Interpretation and Implementation: As part of the resident abusee prevention, the administration will: 1. Protect our residents by anyone including but not necessarily limited to: facility staff, other resident's, consultants, volunteers, staff from other agencies, family members, legal representatives, friends, visitors, or any other individual . (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 26 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0607 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some 3. Develop and implement policies and procedures to aid out facility in preventing abuse, neglect, or mistreatment of our residents. 5. Implement measures to address factors that may lead to abusive situations, for example: B). Instruct staff regarding appropriate ways to address interpretive conflicts. Record Review of the facility provided policy revised on 07/2017, labeled, Abuse and Neglect-Clinical Protocol, revealed: 1. Abuse is defined at 483.5 as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. Abuse also includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain, or mental anguish. It includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse facilitated or enabled through the use of technology. 4. Willful, as defined at 483.5 and as used in the definition of abuse, means the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm. Assessment and Recognition: 1. The nurse will assess the individual and document related findings. Assessment data will include A). Injury assessment, B). pain assessment, C) Current behavior, D). Patient's age and sex, E). All current medications, F). Other platelet inhibitors, G). Vital Signs, H). Behavior over the last 24 hours, I). History of any tendency towards bruising, J). All active diagnosis, K). Any recent labs. 2. The nurse will report findings to the physician. As needed, the physician will assess the resident/patient to verify or clarify such findings, especially if the cause or source of the problem is unclear Treatment/Management: 1. The facility management and staff will institute measures to address the needs of residents/patients and minimize the possibility of abuse and neglect. 2. The management and staff, with the support of the physician, will address situations of suspected or identified abuse and report them in FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 27 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on Interview and Record Review the facility failed to ensure allegations of abuse, neglect or mistreatment, including injuries of unknown origin was reported immediately but not later than 24 hours after the allegations was made for 4 out of 6 residents reviewed for reporting alleged abuse and neglect. (Resident #1, Resident #2, Resident #3, Resident #5). The Facility failed to report to HHSC allegations of abuse made from staff members RN, CNA B, and CNA C to the ADON for Residents #1, #2, #3, and #5. The facility failed to report abuse for Resident #2 and Resident #3 when Resident stated that CNA A verbally and physically abused her. The facility failed to report abuse of Resident #1 and Resident #5 when CNA B witnessed CNA A holding down residents and being rough. The facility failed to report when CNA C witnessed CNA A verbally abusing Resident #2 This failure could affect all residents by placing them at risk of abuse, physical harm, pain, mental anguish, emotional distress, and serious harm. Findings Include: Resident #1: Record Review of Resident #1's face sheet documented he was a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #1 was admitted with diagnoses which included: Parkinson's Disease (disorder of the central nervous system that affects movements, often including tremors), neurocognitive disorder with Lewy bodies (a disease associated with abnormal deposits of a protein called alpha synuclein in the brain), dementia, muscle weakness, restlessness and agitation, schizoaffective disorders, intellectual disabilities. Record review of Resident #1's Significant Change in Status MDS dated [DATE] documented that Resident #1's BIMS was a 10/15, meaning moderately impaired cognition. According to the MDS, Resident #1 is listed to not having any change in mental status listed for disorganized thinking, for altered level of consciousness behavior is present and fluctuates. Resident #1 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually , verbal behavioral symptoms directed toward others such as, threatening others, screaming at others, cursing at others, other behavioral symptoms not directed towards others such as physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #1 was not listed as showing behaviors for refusing care. Resident #1 needs supervision with bed mobility such as moves to and from lying positions, turns side to side, and positions body while in bed or alternate sleep furniture such supervision would include: oversight, encouragement, or cueing. Resident #1 needs supervision for transfers and is listed as total dependent with a two (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 28 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 Residents Affected - Few person assist. Resident #1 is listed as not being steady and only able to stabilize with staff assistance during transitions and walking, this includes moving from seated to standing position, walking, surface to surface transfers. Resident #1 uses a wheelchair. Record review of Resident #1s Care Plan dated 08/01/2023 revealed Resident #1 had episodes of adverse behaviors of being physically aggressive; hitting, pinching, kicking, staff and resistive to care. Interventions: administer meds per order (updated 09/07/2023), anticipate behaviors and redirect when in close proximity to others that might invoke aggression (updated 09/07/2023), assess for pain (updated 09/07/2023), ensure family and MD aware of behaviors and or any increase in behaviors noted (updated on 09/07/2023), maintain calm environment (updated 09/07/2023), medication regimen review quarterly and PRN after any resident to resident behavior event (updated on 09/07/2023), monitor for early warning signs of behavior-approach in calm manner, call by name, remove from unwanted stimuli to a safe environment (updated on 09/07/2023), behaviors include hitting, being resistive to care, refusing food (updated 09/07/2023). Record review of Resident #1s Care Plan dated 07/24/2023 and a revision date of 09/07/2023 indicated Resident #1 had a potential for injury with a history of falls and is at risk for further falls with safety interventions. Interventions: administer meds as ordered, monitor labs, report abnormalities to MD, avoid use of restraints, bed in low position at all times, educated on noncompliance with safety interventions and explain possible risks/outcomes due to noncompliance issues, enlist family input regarding fall history and possible factors to help decrease; falls, ensure staff is aware of safety needs of the resident, fall mat at bedside at all times, keep personal items and frequently used items within reach. Record Review of Resident 1's Physician Order, dated 06/20/2023, revealed: Donepezil HCI oral tablet 5 mg for confusion. Resident 1's Physician Order dated 06/20/2023 Olanzapine oral tablet 5 mg for behaviors related to other schizoaffective disorders. Record Review of Resident #1's Progress notes dated 09/07/2023 at 5:40 pm and indicated incident date as of 08/30/2023, signed by RN revealed: Resident sister came to the nurse's station and asked CN if she knew why her brother had a black eye. CN immediately went to assess. Upon entering resident room CN noted right eye swollen shut with a small cut present to mid eyebrow with scanty amount of dry blood. [NAME] peri-orbital ecchymosis also noted. CN proceeded to perform a general assessment right eyebrow cleaned with NS. Resident #2: Record Review of Resident #2's face sheet documented she was a [AGE] year-old female who was originally admitted to the facility on [DATE] with a readmission date of 08/17/2023. Resident #2 was admitted with diagnoses which included: dementia, anxiety, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), schizoaffective disorder, major depressive disorder, type 2 diabetes, osteoarthritis (a type of arthritis that occurs when flexible tissue at the ends of bones wears down), bipolar disorder, high blood pressure, and acid reflux. Record review of Resident #2's admission MDS dated [DATE] documented that Resident #2's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #2 has no difficulty in normal conversation, social interaction, or watching tv. Resident #1 is listed to not showing a change in mental status, disorganized thinking, or altered level of consciousness. Resident #2 did not exhibit behaviors such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually threatening (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 29 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 Residents Affected - Few others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #2 did not exhibit the behaviors of rejecting care. Resident #2 uses a wheelchair and has no upper and lower body extremity impairment. Resident #2 shows to need supervision for transfers such as bed mobility and transfers meaning oversight, encouragement, or cueing. Resident #2 is listed as not being steady when walking, surface to surface transfers and needs supervision but is able to stabilize without assistance. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had cognitive impairment with diagnosis of intellectual disability with impaired ability to make decision and is at risk for impaired communication and impaired safety awareness. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had a diagnosis of major depressive disorder and bipolar and is at risk for fluctuations in mood, little interest, or pleasure in doing things, and decreased socialization. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had episodes of anxiety and is at risk for fluctuation in moods, currently taking buspirone. Record review of Resident #2s Care Plan date revised 08/01/2023 revealed Resident #2 had episodes of adverse behaviors of being verbally and physically aggressive; hitting, pinching, kicking, staff and resistive to care. Record Review of Resident #2s Physician Orders dated 07/14/2023, revealed: Wellbutrin XL Oral tablet Extended Release 24-hour 300 mg, give 1 tablet by mouth one time a day for depression. Resident #3: Record Review of Resident #3's face sheet documented she was a [AGE] year-old female who was admitted to the facility on [DATE]. Resident #3 was admitted with diagnoses which included: dementia, acute respiratory failure, diabetes mellitus, chronic obstructive pulmonary disease (a group of lung diseases that block airflow and make it difficult to breathe), schizoaffective disorder, major depressive disorder, muscle weakness, tremor, hypothyroidism (a condition in which the thyroid gland does not produce enough thyroid hormone), hyperthyroidism (is the production of too much thyroxine hormone), anxiety, drug induced dyskinesia (an involuntary movement disorder), insomnia, high blood pressure, pain in joint, overactive bladder. Record review of Resident #3's admission MDS dated [DATE] documented that Resident #3's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #3 has moderate difficulty-speaker and must increase volume and speak distinctly. Resident #3 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #3 did not exhibit behaviors of rejecting care. Resident #3 uses a wheelchair and has no upper and lower body extremity impairment. Resident #3 shows a need of extensive assistance with resident involvement and staff to provide weight-bearing support for bed mobility, walking in room, and locomotion on unit, needing two people assist and resident highly involved in activity. Resident #3 is listed as not steady and only able to stabilize with staff assistance. Resident #3 is listed as not (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 30 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 capable of increased independence. Level of Harm - Minimal harm or potential for actual harm Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had episodes of anxiety and at risk for fluctuation in moods. Residents Affected - Few Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had a diagnosis of major depression/schizoaffective disorder and am at risk for fluctuation in moods, little interest, or pleasure in doing things and decreased socialization. Record review of Resident #3s Care Plan date revised 08/15/2023 revealed Resident #3 had impaired understanding and reasoning for expressing information needs: ability is limited to making concrete requests. Resident #4: Record Review of Resident #4's face sheet documented she was a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #4 was admitted with diagnoses which included: type 2 diabetes, cardiac arrhythmias, muscle weakness, abnormalities of gait, gout, anemia, bipolar disorder, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in your blood), manic episode, rheumatoid arthritis, acid reflux, enlarged prostate, pseudobulbar affect (pathological laughing and crying), polyneuropathy the simultaneous malfunction of many peripheral nerves throughout the body. Record review of Resident #4's Annual MDS dated [DATE] documented that Resident #4's BIMS was a 15/15, meaning intact cognition. Resident #4 is not listed as showing a change in mental status for disorganized thinking and altered level of consciousness and disorganized thinking. Resident #4 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #4 is listed for significantly disrupt care or living environment, meaning would disrupt care of living environment. Resident #4 is listed as showing rejection of care for 1-3 days. Resident #4 is shows total dependence for bed mobility and transfers with wheelchair, standing position, and locomotion on the unit with setup only. Resident #4 uses a wheelchair and has impairment with lower extremities but no impairment for upper extremities. Resident #4 is listed as steady, but able to stabilize without staff assistance for walking and transfers between bed and wheelchair. Resident #4 is listed as not being capable of increased independence. Record review of Resident #4s Care Plan date revised 05/03/2023 revealed Resident #4 had a mood problem with disease process of bipolar disorder and manic episode. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 had cognitive impairment: memory problems: diagnosis of bipolar disorder and pseudobulbar affect (pathological laughing and crying), impaired mobility to make decisions and is at risk for impairment safety awareness. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 is at risk for adverse consequences with receiving psychotropic medications Klonopin, and multiple med use due to nine or more medications. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 31 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 Residents Affected - Few Record review of Resident #4s Care Plan date revised 08/14/2023 revealed Resident #4 had episodes of adverse behaviors. Inappropriate behavior. Resident with multiple urinals and multiple water pitchers in room at bedside. Resident adamant regarding removal of pitcher and urinal removal. Does not want pitchers and urinal to be removed. Resident with verbal outburst with nursing staff. Record review of Resident #4s Care Plan date revised 08/04/2023 revealed Resident #4 had problematic demeanor in which resident acts out characterized by ineffective coping, verbal/physical, aggression related to anger. Resident #5: Record Review of Resident #5's face sheet documented she was an [AGE] year-old female who was originally admitted to the facility on [DATE] and re-admitted on [DATE]. Resident #5 was admitted with diagnoses which included: Alzheimer's Disease, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), overactive bladder, iron deficiency, major depression, macular degeneration (an eye disease that causes vision loss), high blood pressure, pain in unspecified joint, muscle weakness, reduced mobility. Record review of Resident #5's Quarterly MDS dated [DATE] documented that Resident #5's BIMS was a 99, meaning the resident interview was not successful. Resident #5 has difficulty communicating some words or finishing thoughts but is able if prompted or given time. Resident #5 usually understands-misses some part-intent of message but comprehends most conversation. Resident #5 has the ability to recall memory after 5 minutes and 5 could recall long past. Resident #5 is moderately impaired-decisions poor, cues/supervision required for decision making. Resident #5 does show the behavior is present and fluctuates for inattention, disorganized thinking or incoherent. Resident #5 does not show altered level of consciousness. Resident #5 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #5 did exhibit the behavior of rejecting care for 1-3 days. Resident #5 shows the need for extensive assistance with one person assist for bed mobility and transfers but is listed as limited assistance with one person assist for locomotion on the unit. Resident #5 uses a wheelchair and shows no upper or lower extremity impairment. Resident #5 is listed as steady, but able to stabilize without staff assistance for walking and surface to surface transfers. Record review of Resident #5s Care Plan date revised 03/03/2023 revealed Resident #5 had a cognitive impairment, memory problems short/long term diagnosis of dementia and impaired safety awareness. Record review of Resident #5s Care Plan date revised 08/03/2023 revealed Resident #5 had a diagnosis of depression/mood disorder and is at risk for fluctuation in moods, little interest, or pleasure in doing things and decreased socialization, currently receiving Remeron. During an interview on 09/06/2023 at 3:09 pm, DON stated that for Resident #1 that she heard about the black eye the morning of 08/30/2023. DON stated that she thought it was a fall because Resident #1 has a history of falls. DON stated that resident #1 wasn't found on the floor or anything, he was found in bed. DON stated that they did not report because it was an unwitnessed fall. When asked if that is considered an injury of unknown origin, DON shook her head and stated, your right it is considered injury of unknown origin. When asked why it was not reported, DON stated they were thinking (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 32 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 Residents Affected - Few that it was just a fall. DON stated, your right we should have reported and didn't. DON stated that she was not in the facility at the time of the incident. DON stated that she is just helping out in the facility for a while. DON stated that the ADON had more details about the incident because it was reported to her, and she was not at work today. During an interview on 09/06/2023 at 4:15 pm, Administrator stated that with Resident #1 she believed that he had a fall. Administrator stated that Resident #1 had a history of falls. Administrator stated that Resident #1 was found in bed and was not found on the floor. Administrator stated that she did not report the black eye for Resident #1 because she did not know about it. Administrator stated that she did not report when she had found out because she thought it was an unwitnessed fall. Administrator stated she guessed she should have reported and will go ahead and do that since she believed it to be an unwitnessed fall. Administrator stated she was not told it was a fall, Resident #1 just had a history of it. Administrator stated that she heard about Resident's black eye after the meeting the morning of 08/30/2023 by DON. During an interview on 09/07/2023 at 3:25 pm, CNA B stated that she had witnessed abuse recently. CNA B stated that she did report to the ADON that she had witnessed CNA A being rough with residents while providing care. CNA B stated that while working with CNA A she witnessed CNA A hold Resident #1 down by holding his arms down with CNA A body weight and the residents would fight C CNA B stated that she witnessed CNA A being aggressive when he would hold the residents down. CNA B stated that CNA A would hold down the resident's that would fight him. CNA B stated that she witnessed the resident would try and get up from CNA A holding them down and CNA A would not let them up. CNA B stated that Resident #1 is not the only resident that she witnessed CNA A holding down when they don't want to be held down. CNA B stated that she also witnessed CNA A being rough and holding down Resident #5 and Resident #6. CNA B stated that the resident would fight CNA A to get him off them. CNA B stated that when she reported the abuse to the ADON she was told to provide a statement, but she had forgotten to write a statement because she was tired. CNA B stated that she reported to the ADON after a meeting that staff had that was due to Resident #1 coming up with an unexplained black eye on CNA A's shift. CNA B stated that she did not intervene to stop CNA A because she was scared of CNA A, but she did report to the ADON. Interview with on 09/07/2023 at 4:26 pm, CNA C reported that she heard CNA A verbally abusing Resident #2 approximately 3 weeks ago. CNA C stated that CNA A was calling Resident #2 names and telling her to shut up and called her stupid and ugly. CNA C stated that she reported the incident to the ADON. CNA C stated that she could tell it bothered Resident #2 because she looked upset. CNA C stated that CNA A showed no interest in wanting to be there most of the time. CNA C stated that CNA A would get mad if he had to answer the call lights. During an interview on 09/07/2023 at 5:00 pm, RN stated that she has always known CNA A to have a bad attitude towards the residents and others. RN stated that she has heard by other staff members that CNA A would be rough with resident's by grabbing and yanking on their arms. RN stated that she did not report what she had heard to anyone because she did not see it. RN stated that she had worked the night shift on 08/30/2023 and then next morning she was made aware by a family member that Resident #1 had a black eye. RN stated on this shift CNA A was working. RN stated that while she was assessing Resident #1 that Resident #4 had stated to RN that CNA A needed to be watched because when CNA A comes into change Resident #1, Resident #4 would hear a lot of rustling around and that Resident #1 acts scared around CNA A. RN stated that she was the nurse on shift working that night and she was not aware of any falls for Resident #1. RN stated that he was found in bed with a black eye. RN stated she did not remember seeing the black eye any time before that day. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 33 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 Residents Affected - Few During an Interview on 09/07/2023 at 5:17 pm, Resident #2 stated that she had a problem with CNA A because he was mean. Resident #2 stated she thinks it was because he does not like her. Resident #2 stated that CNA A told her that she complains too much. Resident #2 stated that a couple of weeks ago that she had a bag of trash in her hand, and she was walking with her walker toward the door and CNA A was walking towards her and got in front of her. Resident #2 stated that CNA A told her, You better not put that trash in the hall. Resident #2 stated that she told CNA A that she was going to go throw it away. Resident #2 stated that CNA A grabbed the bag of trash out of her hand aggressively and then threw it back at her. Resident #2 stated CNA A called her stupid when he threw the trash at her. Resident #2 stated that on other occasions CNA A would tell her to shut up and stop pressing on the call light so much and he would hold her arms down roughly when he said it. Resident #2 stated that CNA A had called her stupid before. Resident #2 stated that she had told the ADON and Administrator and was told by both of them that it would be taken care of, but CNA A was still mean to her. Resident #2 stated she was scared of CNA A, and she didn't like having to rely on him for help. During an Interview on 09/07/2023 at 5:33 pm, Resident #3 stated that she had a few staff members that she didn't care too much for because they were rude, but one staff member would call her names and hold her down when she didn't want care. Resident #3 stated that CNA A would tell her that she was the one in the bed needing help when she would use the call lights to get help. Resident #3 stated that CNA A had said Shut up stupid bitch. Resident #3 stated that she did get tired of the name calling so she started lashing out at CNA A verbally back at him. Resident #3 stated he made her upset and felt bad. Resident #3 stated that she had dealt with abuse in her younger days, so she knows what abuse is and CNA A was abusive. Resident #3 stated that people are there to get help not to be treated like animals. Resident #3 stated that she reported to the nursing staff about the incidents, but nothing ever changed. Resident #3 stated that CNA A continued to treat her like that. During an interview 09/07/2023 at 6:00 pm, CNA A stated that he had not witnessed any form of abuse or neglect. CNA A stated that he had been trained in abuse and neglect by in-services and these trainings occur approximately every three to four months. CNA A stated that the 5 types of abuse are: physical, emotional, sexual, verbal, and financial. CNA A stated that he is unsure why people would say that he is abusive when he's not. CNA A stated that he cannot control what other people say. CNA A stated that would handle difficult behaviors by redirecting and coming back to try to work with resident again after cooling off period. CNA A stated that he never held anyone down unless they were hitting him, and he just held them into place until they stopped hitting and then would let them go. CNA A stated that he did not feel that this is a restraint. CNA A stated that he has never been physically or verbally abusive. CNA A stated that he does not work a designated hall, that all staff just work all halls, and they help each other out. CNA A stated that he did work nights for a while but did not like it so he moved to days. During an interview 09/08/2023 at 10:59 am, ADON stated that Resident #1 did not have a fall. ADON stated that they believed that Resident #1 had a fall at the time because he had a history of falls. ADON stated she was unsure if investigation was completed. ADON stated that she had been told by other staff members before that CNA A would hold down combative residents. ADON stated that she was told by some of the staff that CNA A would cross the resident's arms across their chest and then he would hold down the resident. ADON stated that she did not report this to the abuse coordinator (Administrator) because at that point it is just hearsay. ADON stated that she would report if the staff completed a written statement. ADON stated, I don't think that he was hurting the resident. ADON stated how else are you supposed to keep from getting hit by a resident? ADON stated she was unsure of what the policy stated about dealing with combative residents. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 34 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 ADON stated she would deal with combative behaviors by redirecting, walking away for a little bit if the resident was still combative, or get some help from another staff to see if the resident would respond differently to another staff. When asked if policy indicated that Resident could be held down, ADON stated, No, I don't think it says that. When asked ADON if it is considered a restraint to hold a resident down, ADON responded, Yeah, I guess it is. Residents Affected - Few During an Interview 09/08/2023 at 11:19 am, Resident #4 stated that he did not witness his roommate Resident #1 being held down, but he could hear a lot of rustling around when CNA A would provide care. Resident #4 stated that he knew it was CNA A because he knows his voice. Resident #4 stated that he would hear a lot of banging, hitting the wall, and the resident groaning like he was hurting, and you could tell he was being hurt. Resident #4 stated that during the day when he was up and about that when CNA A would come around then Resident #1 would show fear by trying to move away from CNA A and just the fear in his eyes. Resident #4 stated you can see fear in someone. Resident #4 stated that CNA A was not the friendliest person and would get agitated easily. Resident #4 stated he would hear CNA A say stay still in a stern voice and hear all the rustling around. Resident #4 stated he was behind the curtain and could not easily get up to check what was going on. Resident #4 stated that he did tell the RN about this situation and to watch out for CNA A. During an interview 09/08/2023 at 4:28 pm. Administrator stated that she had heard from other staff members of CNA A holding down residents, but she thought that it was because the other staff didn't like CNA A. Administrator stated that she had not witnessed CNA A hold down residents. Administrator stated that Resident #3 did tell her that CNA A was calling her names. Administrator stated that Resident #3 would say things to CNA A like, You probably have a small penis. Administrator stated that she did not get any other reports from any other residents. Administrator stated that if you can't hold the residents, then how are you supposed to control when they are fighting you? Administrator stated she is not sure what the policy says, and she will have to read it to see what it says. Administrator stated that she has heard complaints from Resident #3 about CNA A, but she believes that she does not like him. Record Review of the original reported statement by RN of incident dated 08/30/2023 stated: At approximately 9:15 am I went into Resident #1's room to assess an eye injury when Resident #4 stated to RN, You need to watch CNA A because on several occasions when he has been in to change Resident #1, Resident #4 have heard a lot of commotion and rustling going on. Above reported to ADON. Signed by RN. Record Review of the facility Disciplinary Action Form for ADON dated 09/08/2023 stated: The date of occurrence 08/30/2023. Under nature of offense: failed to report suspected abuse and neglect that may have been reported to her to the Administrator. The other box was checked and stated: Failed to report suspected abuse & neglect to Administrator. Under action taken written warning. Signed by ADON, Administrator, and DON, dated 09/08/2023. Record Review of the facility Disciplinary Action Form for RN dated 09/08/2023 stated: The date of occurrence 08/30/2023. Under nature of offense: Did not report resident c/o possible abuse to another resident in a timely manner. The other box was checked and stated: Not reporting abuse to abuse coordinator in a timely fashion. Under action taken written warning. Signed by RN, Administrator, and DON, dated 09/08/2023. Record Review of the facility Disciplinary Action Form for CNA C dated 09/08/2023 stated: The date of occurrence 08/30/2023. Under nature of offense: failed to report suspected abuse and neglect to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 35 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 Residents Affected - Few the Administrator. The other box was checked and stated: Failed to report suspected abuse & neglect to Administrator. Under action taken written warning. Signed by Administrator and DON on 09/08/2023 and stated that CNA C was presented the write up verbally on 09/09/2023 at 12:31 pm. Record Review of the facility Disciplinary Action Form for CNA B dated 09/08/2023 stated: The date of occurrence 08/30/2023. Under nature of offense: failed to report suspected abuse and neglect to the Administrator immediately. The other box was checked and stated: Failed to report suspected abuse & neglect to Administrator. Under action taken written warning. Signed by Administrator and DON on 09/08/2023 and stated that CNA C was presented the write up verbally on 09/09/2023 at 1:02 pm. Record Review of the facility Disciplinary Action Form for CNA A dated not provided (left blank) stated: The date of occurrence was listed as 09/06/2023 and the actual date of occurrence was 08/30/2023. Under nature of offense: Abuse allegation. The other box was checked and stated: suspected resident abuse & neglect. Under action taken termination. Signed by Administrator on 09/09/2023 and stated that CNA A was attempted phone calls on 09/08/2023 at 6:42 pm and 09/09/2023 at 12:20 pm. Administrator stated that CNA A came into facility on 09/11/2023 and she was able to terminate CNA A at that time. Record Review of Provider Investigation Report dated 09/07/2023 for Resident #1 revealed: Under description of Injury and Assessment stated: Resident has history of frequent falls. On the Morning of 08/30/2023, it was brought to our attention that resident had a black eye over left eye. It was reported the resident had a fall the previous night. When the nurse working the shift was notified, they stated they forgot to complete the risk management form. MD was notified, orders to monitor resident were received. There were no inju[TRUNCATED] FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 36 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0610 Respond appropriately to all alleged violations. Level of Harm - Immediate jeopardy to resident health or safety **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on Interview and Record Review the facility failed to thoroughly investigated, prevent further potential abuse, neglect, exploitation, or mistreatment, while the investigation is in progress, report the results of all investigations to the administrator or his or her designated representative and to other officials in accordance with State Law, including to the State Survey Agency, within 5 working days of the incident, and if the alleged violation is verified appropriate corrective action must be taken. Residents affected by allegations of abuse were 4 out of 6 residents reviewed for abuse and neglect. (Resident #1, Resident #2, Resident #3 and Resident #5). Residents Affected - Some The facility failed to investigate and report allegations of abuse for Resident #1, Resident #2, and Resident #3 and Resident #5. An Immediate Jeopardy was identified on 09/08/2023 at 4:30 p.m. The IJ Template was provided to the facility on [DATE]. While the IJ was removed on 09/11/2023, the facility remained out of compliance at a severity level of actual harm and a scope of pattern due to the facility continuing to monitor the implementation and effectiveness of their Plan of Removal. These failures could affect all residents by placing them at risk of abuse, physical harm, pain, mental anguish, emotional distress, and serious harm. Findings Include: Resident #1: Record Review of Resident #1's face sheet documented he was a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #1 was admitted with diagnoses which included: Parkinson's Disease (disorder of the central nervous system that affects movements, often including tremors), neurocognitive disorder with Lewy bodies (a disease associated with abnormal deposits of a protein called alpha synuclein in the brain), dementia, muscle weakness, restlessness and agitation, schizoaffective disorders, intellectual disabilities. Record review of Resident #1's Significant Change in Status MDS dated [DATE] documented that Resident #1's BIMS was a 10/15, meaning moderately impaired cognition. According to the MDS, Resident #1 is listed to not having any change in mental status listed for disorganized thinking, for altered level of consciousness behavior is present and fluctuates. Resident #1 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually , verbal behavioral symptoms directed toward others such as, threatening others, screaming at others, cursing at others, other behavioral symptoms not directed towards others such as physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #1 was not listed as showing behaviors for refusing care. Resident #1 needs supervision with bed mobility such as moves to and from lying positions, turns side to side, and positions body while in bed or alternate sleep furniture such supervision would include: oversight, encouragement, or cueing. Resident #1 needs supervision for transfers and is listed as total dependent with a two person assist. Resident #1 is listed as not being steady and only able to stabilize with staff (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 37 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some assistance during transitions and walking, this includes moving from seated to standing position, walking, surface to surface transfers. Resident #1 uses a wheelchair. Record review of Resident #1s Care Plan dated 08/01/2023 revealed Resident #1 had episodes of adverse behaviors of being physically aggressive; hitting, pinching, kicking, staff and resistive to care. Interventions: administer meds per order (updated 09/07/2023), anticipate behaviors and redirect when in close proximity to others that might invoke aggression (updated 09/07/2023), assess for pain (updated 09/07/2023), ensure family and MD aware of behaviors and or any increase in behaviors noted (updated on 09/07/2023), maintain calm environment (updated 09/07/2023), medication regimen review quarterly and PRN after any resident to resident behavior event (updated on 09/07/2023), monitor for early warning signs of behavior-approach in calm manner, call by name, remove from unwanted stimuli to a safe environment (updated on 09/07/2023), behaviors include hitting, being resistive to care, refusing food (updated 09/07/2023). Record review of Resident #1s Care Plan dated 07/24/2023 and a revision date of 09/07/2023 indicated Resident #1 had a potential for injury with a history of falls and is at risk for further falls with safety interventions. Interventions: administer meds as ordered, monitor labs, report abnormalities to MD, avoid use of restraints, bed in low position at all times, educated on noncompliance with safety interventions and explain possible risks/outcomes due to noncompliance issues, enlist family input regarding fall history and possible factors to help decrease; falls, ensure staff is aware of safety needs of the resident, fall mat at bedside at all times, keep personal items and frequently used items within reach. Record Review of Resident 1's Physician Order, dated 06/20/2023, revealed: Donepezil HCI oral tablet 5 mg for confusion. Resident 1's Physician Order dated 06/20/2023 Olanzapine oral tablet 5 mg for behaviors related to other schizoaffective disorders. Record Review of Resident #1's Progress notes dated 09/07/2023 at 5:40 pm and indicated incident date as of 08/30/2023, signed by RN revealed: Resident sister came to the nurse's station and asked CN if she knew why her brother had a black eye. CN immediately went to assess. Upon entering resident room CN noted right eye swollen shut with a small cut present to mid eyebrow with scanty amount of dry blood. [NAME] peri-orbital ecchymosis also noted. CN proceeded to perform a general assessment right eyebrow cleaned with NS. Resident #2: Record Review of Resident #2's face sheet documented she was a [AGE] year-old female who was originally admitted to the facility on [DATE] with a readmission date of 08/17/2023. Resident #2 was admitted with diagnoses which included: dementia, anxiety, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), schizoaffective disorder, major depressive disorder, type 2 diabetes, osteoarthritis (a type of arthritis that occurs when flexible tissue at the ends of bones wears down), bipolar disorder, high blood pressure, and acid reflux. Record review of Resident #2's admission MDS dated [DATE] documented that Resident #2's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #2 has no difficulty in normal conversation, social interaction, or watching tv. Resident #1 is listed to not showing a change in mental status, disorganized thinking, or altered level of consciousness. Resident #2 did not exhibit behaviors such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 38 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0610 Level of Harm - Immediate jeopardy to resident health or safety pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #2 did not exhibit the behaviors of rejecting care. Resident #2 uses a wheelchair and has no upper and lower body extremity impairment. Resident #2 shows to need supervision for transfers such as bed mobility and transfers meaning oversight, encouragement, or cueing. Resident #2 is listed as not being steady when walking, surface to surface transfers and needs supervision but is able to stabilize without assistance. Residents Affected - Some Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had cognitive impairment with diagnosis of intellectual disability with impaired ability to make decision and is at risk for impaired communication and impaired safety awareness. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had a diagnosis of major depressive disorder and bipolar and is at risk for fluctuations in mood, little interest, or pleasure in doing things, and decreased socialization. Record review of Resident #2s Care Plan date revised 03/30/2023 revealed Resident #2 had episodes of anxiety and is at risk for fluctuation in moods, currently taking buspirone. Record review of Resident #2s Care Plan date revised 08/01/2023 revealed Resident #2 had episodes of adverse behaviors of being verbally and physically aggressive; hitting, pinching, kicking, staff and resistive to care. Record Review of Resident #2s Physician Orders dated 07/14/2023, revealed: Wellbutrin XL Oral tablet Extended Release 24-hour 300 mg, give 1 tablet by mouth one time a day for depression. Resident #3: Record Review of Resident #3's face sheet documented she was a [AGE] year-old female who was admitted to the facility on [DATE]. Resident #3 was admitted with diagnoses which included: dementia, acute respiratory failure, diabetes mellitus, chronic obstructive pulmonary disease (a group of lung diseases that block airflow and make it difficult to breathe), schizoaffective disorder, major depressive disorder, muscle weakness, tremor, hypothyroidism (a condition in which the thyroid gland does not produce enough thyroid hormone), hyperthyroidism (is the production of too much thyroxine hormone), anxiety, drug induced dyskinesia (an involuntary movement disorder), insomnia, high blood pressure, pain in joint, overactive bladder. Record review of Resident #3's admission MDS dated [DATE] documented that Resident #3's BIMS was a 15/15, meaning intact cognition. According to the MDS, Resident #3 has moderate difficulty-speaker and must increase volume and speak distinctly. Resident #3 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #3 did not exhibit behaviors of rejecting care. Resident #3 uses a wheelchair and has no upper and lower body extremity impairment. Resident #3 shows a need of extensive assistance with resident involvement and staff to provide weight-bearing support for bed mobility, walking in room, and locomotion on unit, needing two people assist and resident highly involved in activity. Resident #3 is listed as not steady and only able to stabilize with staff assistance. Resident #3 is listed as not capable of increased independence. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 39 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had episodes of anxiety and at risk for fluctuation in moods. Record review of Resident #3s Care Plan date revised 07/08/2023 revealed Resident #3 had a diagnosis of major depression/schizoaffective disorder and am at risk for fluctuation in moods, little interest, or pleasure in doing things and decreased socialization. Residents Affected - Some Record review of Resident #3s Care Plan date revised 08/15/2023 revealed Resident #3 had impaired understanding and reasoning for expressing information needs: ability is limited to making concrete requests. Resident #4: Record Review of Resident #4's face sheet documented she was a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #4 was admitted with diagnoses which included: type 2 diabetes, cardiac arrhythmias, muscle weakness, abnormalities of gait, gout, anemia, bipolar disorder, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in your blood), manic episode, rheumatoid arthritis, acid reflux, enlarged prostate, pseudobulbar affect (pathological laughing and crying), polyneuropathy the simultaneous malfunction of many peripheral nerves throughout the body. Record review of Resident #4's Annual MDS dated [DATE] documented that Resident #4's BIMS was a 15/15, meaning intact cognition. Resident #4 is not listed as showing a change in mental status for disorganized thinking and altered level of consciousness and disorganized thinking. Resident #4 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #4 is listed for significantly disrupt care or living environment, meaning would disrupt care of living environment. Resident #4 is listed as showing rejection of care for 1-3 days. Resident #4 is shows total dependence for bed mobility and transfers with wheelchair, standing position, and locomotion on the unit with setup only. Resident #4 uses a wheelchair and has impairment with lower extremities but no impairment for upper extremities. Resident #4 is listed as steady, but able to stabilize without staff assistance for walking and transfers between bed and wheelchair. Resident #4 is listed as not being capable of increased independence. Record review of Resident #4s Care Plan date revised 05/03/2023 revealed Resident #4 had a mood problem with disease process of bipolar disorder and manic episode. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 had cognitive impairment: memory problems: diagnosis of bipolar disorder and pseudobulbar affect (pathological laughing and crying), impaired mobility to make decisions and is at risk for impairment safety awareness. Record review of Resident #4s Care Plan date revised 08/03/2023 revealed Resident #4 is at risk for adverse consequences with receiving psychotropic medications Klonopin, and multiple med use due to nine or more medications. Record review of Resident #4s Care Plan date revised 08/14/2023 revealed Resident #4 had episodes (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 40 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some of adverse behaviors. Inappropriate behavior. Resident with multiple urinals and multiple water pitchers in room at bedside. Resident adamant regarding removal of pitcher and urinal removal. Does not want pitchers and urinal to be removed. Resident with verbal outburst with nursing staff. Record review of Resident #4s Care Plan date revised 08/04/2023 revealed Resident #4 had problematic demeanor in which resident acts out characterized by ineffective coping, verbal/physical, aggression related to anger. Resident #5: Record Review of Resident #5's face sheet documented she was an [AGE] year-old female who was originally admitted to the facility on [DATE] and re-admitted on [DATE]. Resident #5 was admitted with diagnoses which included: Alzheimer's Disease, hyperlipidemia (an elevated level of lipids like cholesterol and triglycerides in the blood), overactive bladder, iron deficiency, major depression, macular degeneration (an eye disease that causes vision loss), high blood pressure, pain in unspecified joint, muscle weakness, reduced mobility. Record review of Resident #5's Quarterly MDS dated [DATE] documented that Resident #5's BIMS was a 99, meaning the resident interview was not successful. Resident #5 has difficulty communicating some words or finishing thoughts but is able if prompted or given time. Resident #5 usually understands-misses some part-intent of message but comprehends most conversation. Resident #5 has the ability to recall memory after 5 minutes and 5 could recall long past. Resident #5 is moderately impaired-decisions poor, cues/supervision required for decision making. Resident #5 does show the behavior is present and fluctuates for inattention, disorganized thinking or incoherent. Resident #5 does not show altered level of consciousness. Resident #5 did not exhibit behaviors for physical behavioral symptom directed towards others such as hitting, scratching, pushing, kicking, grabbing, abusing others sexually, threatening others, screaming at others, cursing at others, physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing, or smearing food or bodily wastes, or verbal/vocal such as screaming or disruptive sounds. Resident #5 did exhibit the behavior of rejecting care for 1-3 days. Resident #5 shows the need for extensive assistance with one person assist for bed mobility and transfers but is listed as limited assistance with one person assist for locomotion on the unit. Resident #5 uses a wheelchair and shows no upper or lower extremity impairment. Resident #5 is listed as steady, but able to stabilize without staff assistance for walking and surface to surface transfers. Record review of Resident #5s Care Plan date revised 03/03/2023 revealed Resident #5 had a cognitive impairment, memory problems short/long term diagnosis of dementia and impaired safety awareness. Record review of Resident #5s Care Plan date revised 08/03/2023 revealed Resident #5 had a diagnosis of depression/mood disorder and is at risk for fluctuation in moods, little interest, or pleasure in doing things and decreased socialization, currently receiving Remeron. During an interview on 09/06/2023 at 3:09 pm, DON stated that for Resident #1 that she heard about the black eye the morning of 08/30/2023. DON stated that she thought it was a fall because Resident #1 has a history of falls. DON stated that resident #1 wasn't found on the floor or anything, he was found in bed. DON stated that they did not report because it was an unwitnessed fall. When asked if that is considered an injury of unknown origin, DON shook her head and stated, your right it is considered injury of unknown origin. When asked why it was not reported, DON stated they were thinking that it was just a fall. DON stated, your right we should have reported and didn't. DON stated that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 41 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some she was not in the facility at the time of the incident. DON stated that she is just helping out in the facility for a while. DON stated that the ADON had more details about the incident because it was reported to her, and she was not at work today. During an interview on 09/06/2023 at 4:15 pm, Administrator stated that with Resident #1 she believed that he had a fall. Administrator stated that Resident #1 had a history of falls. Administrator stated that Resident #1 was found in bed and was not found on the floor. Administrator stated that she did not report the black eye for Resident #1 because she did not know about it. Administrator stated that she did not report when she had found out because she thought it was an unwitnessed fall. Administrator stated she guessed she should have reported and will go ahead and do that since she believed it to be an unwitnessed fall. Administrator stated she was not told it was a fall, Resident #1 just had a history of it. Administrator stated that she heard about Resident's black eye after the meeting the morning of 08/30/2023 by DON. During an interview on 09/07/2023 at 3:25 pm, CNA B stated that she had witnessed abuse recently. CNA B stated that she did report to the ADON that she had witnessed CNA A being rough with residents while providing care. CNA B stated that while working with CNA A she witnessed CNA A hold Resident #1 down by holding his arms down with CNA A body weight and the residents would fight C CNA B stated that she witnessed CNA A being aggressive when he would hold the residents down. CNA B stated that CNA A would hold down the resident's that would fight him. CNA B stated that she witnessed the resident would try and get up from CNA A holding them down and CNA A would not let them up. CNA B stated that Resident #1 is not the only resident that she witnessed CNA A holding down when they don't want to be held down. CNA B stated that she also witnessed CNA A being rough and holding down Resident #5 and Resident #6. CNA B stated that the resident would fight CNA A to get him off them. CNA B stated that when she reported the abuse to the ADON she was told to provide a statement, but she had forgotten to write a statement because she was tired. CNA B stated that she reported to the ADON after a meeting that staff had that was due to Resident #1 coming up with an unexplained black eye on CNA A's shift. CNA B stated that she did not intervene to stop CNA A because she was scared of CNA A, but she did report to the ADON. Interview with on 09/07/2023 at 4:26 pm, CNA C reported that she heard CNA A verbally abusing Resident #2 approximately 3 weeks ago. CNA C stated that CNA A was calling Resident #2 names and telling her to shut up and called her stupid and ugly. CNA C stated that she reported the incident to the ADON. CNA C stated that she could tell it bothered Resident #2 because she looked upset. CNA C stated that CNA A showed no interest in wanting to be there most of the time. CNA C stated that CNA A would get mad if he had to answer the call lights. During an interview on 09/07/2023 at 5:00 pm, RN stated that she has always known CNA A to have a bad attitude towards the residents and others. RN stated that she has heard by other staff members that CNA A would be rough with resident's by grabbing and yanking on their arms. RN stated that she did not report what she had heard to anyone because she did not see it. RN stated that she had worked the night shift on 08/30/2023 and then next morning she was made aware by a family member that Resident #1 had a black eye. RN stated on this shift CNA A was working. RN stated that while she was assessing Resident #1 that Resident #4 had stated to RN that CNA A needed to be watched because when CNA A comes into change Resident #1, Resident #4 would hear a lot of rustling around and that Resident #1 acts scared around CNA A. RN stated that she was the nurse on shift working that night and she was not aware of any falls for Resident #1. RN stated that he was found in bed with a black eye. RN stated she did not remember seeing the black eye any time before that day. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 42 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some During an Interview on 09/07/2023 at 5:17 pm, Resident #2 stated that she had a problem with CNA A because he was mean. Resident #2 stated she thinks it was because he does not like her. Resident #2 stated that CNA A told her that she complains too much. Resident #2 stated that a couple of weeks ago that she had a bag of trash in her hand, and she was walking with her walker toward the door and CNA A was walking towards her and got in front of her. Resident #2 stated that CNA A told her, You better not put that trash in the hall. Resident #2 stated that she told CNA A that she was going to go throw it away. Resident #2 stated that CNA A grabbed the bag of trash out of her hand aggressively and then threw it back at her. Resident #2 stated CNA A called her stupid when he threw the trash at her. Resident #2 stated that on other occasions CNA A would tell her to shut up and stop pressing on the call light so much and he would hold her arms down roughly when he said it. Resident #2 stated that CNA A had called her stupid before. Resident #2 stated that she had told the ADON and Administrator and was told by both of them that it would be taken care of, but CNA A was still mean to her. Resident #2 stated she was scared of CNA A, and she didn't like having to rely on him for help. During an Interview on 09/07/2023 at 5:33 pm, Resident #3 stated that she had a few staff members that she didn't care too much for because they were rude, but one staff member would call her names and hold her down when she didn't want care. Resident #3 stated that CNA A would tell her that she was the one in the bed needing help when she would use the call lights to get help. Resident #3 stated that CNA A had said Shut up stupid bitch. Resident #3 stated that she did get tired of the name calling so she started lashing out at CNA A verbally back at him. Resident #3 stated he made her upset and felt bad. Resident #3 stated that she had dealt with abuse in her younger days, so she knows what abuse is and CNA A was abusive. Resident #3 stated that people are there to get help not to be treated like animals. Resident #3 stated that she reported to the nursing staff about the incidents, but nothing ever changed. Resident #3 stated that CNA A continued to treat her like that. During an interview 09/07/2023 at 6:00 pm, CNA A stated that he had not witnessed any form of abuse or neglect. CNA A stated that he had been trained in abuse and neglect by in-services and these trainings occur approximately every three to four months. CNA A stated that the 5 types of abuse are: physical, emotional, sexual, verbal, and financial. CNA A stated that he is unsure why people would say that he is abusive when he's not. CNA A stated that he cannot control what other people say. CNA A stated that would handle difficult behaviors by redirecting and coming back to try to work with resident again after cooling off period. CNA A stated that he never held anyone down unless they were hitting him, and he just held them into place until they stopped hitting and then would let them go. CNA A stated that he did not feel that this is a restraint. CNA A stated that he has never been physically or verbally abusive. CNA A stated that he does not work a designated hall, that all staff just work all halls, and they help each other out. CNA A stated that he did work nights for a while but did not like it so he moved to days. During an interview 09/08/2023 at 10:59 am, ADON stated that Resident #1 did not have a fall. ADON stated that they believed that Resident #1 had a fall at the time because he had a history of falls. ADON stated she was unsure if investigation was completed. ADON stated that she had been told by other staff members before that CNA A would hold down combative residents. ADON stated that she was told by some of the staff that CNA A would cross the resident's arms across their chest and then he would hold down the resident. ADON stated that she did not report this to the abuse coordinator (Administrator) because at that point it is just hearsay. ADON stated that she would report if the staff completed a written statement. ADON stated, I don't think that he was hurting the resident. ADON stated how else are you supposed to keep from getting hit by a resident? ADON stated she was unsure of what the policy stated about dealing with combative residents. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 43 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some ADON stated she would deal with combative behaviors by redirecting, walking away for a little bit if the resident was still combative, or get some help from another staff to see if the resident would respond differently to another staff. When asked if policy indicated that Resident could be held down, ADON stated, No, I don't think it says that. When asked ADON if it is considered a restraint to hold a resident down, ADON responded, Yeah, I guess it is. During an Interview 09/08/2023 at 11:19 am, Resident #4 stated that he did not witness his roommate Resident #1 being held down, but he could hear a lot of rustling around when CNA A would provide care. Resident #4 stated that he knew it was CNA A because he knows his voice. Resident #4 stated that he would hear a lot of banging, hitting the wall, and the resident groaning like he was hurting, and you could tell he was being hurt. Resident #4 stated that during the day when he was up and about that when CNA A would come around then Resident #1 would show fear by trying to move away from CNA A and just the fear in his eyes. Resident #4 stated you can see fear in someone. Resident #4 stated that CNA A was not the friendliest person and would get agitated easily. Resident #4 stated he would hear CNA A say stay still in a stern voice and hear all the rustling around. Resident #4 stated he was behind the curtain and could not easily get up to check what was going on. Resident #4 stated that he did tell the RN about this situation and to watch out for CNA A. During an interview 09/08/2023 at 4:28 pm. Administrator stated that she had heard from other staff members of CNA A holding down residents, but she thought that it was because the other staff didn't like CNA A. Administrator stated that she had not witnessed CNA A hold down residents. Administrator stated that Resident #3 did tell her that CNA A was calling her names. Administrator stated that Resident #3 would say things to CNA A like, You probably have a small penis. Administrator stated that she did not get any other reports from any other residents. Administrator stated that if you can't hold the residents, then how are you supposed to control when they are fighting you? Administrator stated she is not sure what the policy says, and she will have to read it to see what it says. Administrator stated that she has heard complaints from Resident #3 about CNA A, but she believes that she does not like him. Record Review of the facility provided policy revised on 12/2016, labeled, Abuse Prevention Program, revealed: Policy Statement: Our residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. This includes but is not limited to freedom from corporal punishment, involuntary seclusion, verbal, mental, sexual, or physical abuse, and physical or chemical restraint not required to treat the resident's symptoms. Policy Interpretation and Implementation: As part of the resident abusee prevention, the administration will: 1. Protect our residents by anyone including but not necessarily limited to: facility staff, other resident's, consultants, volunteers, staff from other agencies, family members, legal representatives, friends, visitors, or any other individual . 3. Develop and implement policies and procedures to aid out facility in preventing abuse, neglect, or mistreatment of our residents. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 44 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0610 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some 5. Implement measures to address factors that may lead to abusive situations, for example: B). Instruct staff regarding appropriate ways to address interpretive conflicts. Record Review of the facility provided policy revised on 07/2017, labeled, Abuse and Neglect-Clinical Protocol, revealed: 1. Abuse is defined at 483.5 as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. Abuse also includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain, or mental anguish. It includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse facilitated or enabled through the use of technology. 4. Willful, as defined at 483.5 and as used in the definition of abuse, means the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm. Assessment and Recognition: 1. The nurse will assess the individual and document related findings. Assessment data will include A). Injury assessment, B). pain assessment, C) Current behavior, D). Patient's age and sex, E). All current medications, F). Other platelet inhibitors, G). Vital Signs, H). Behavior over the last 24 hours, I). History of any tendency towards bruising, J). All active diagnosis, K). Any recent labs. 2. The nurse will report findings to the physician. As needed, the physician will assess the resident/patient to verify or clarify such findings, especially if the cause or source of the problem is unclear Treatment/Management: 1. The facility management and staff will institute measures to address the needs of residents/patients and minimize the possibility of abuse and neglect. 2. The management and staff, with the support of the physic[TRUNCATED] FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 45 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0921 Level of Harm - Minimal harm or potential for actual harm Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Based on observation, interviews, and record review the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public. Residents Affected - Some The facility failed to maintain clean lint traps for both dryer #1 and #2. Staff admitted to only cleaning lint traps once a day. Dryers #1 and #2 had excessive buildup of lint. Dryer #2 had a broken on/off switch with plastic strap hanging out of it to keep it propped to the on cycle. This failure could place residents and staff at risk due to the possibility of fire hazards and placing all residents and staff at risk for fire, and for laundry not dry quickly fast putting residents on hold to obtain their clean laundry. Findings Include: Observation of the laundry room on 09/07/2023 at 10:20 am revealed dryer #1 with excessive lint buildup with approximately 3 to 4 inches of lint buildup on the screen and falling onto the base of the lint box. Dryer #2 had approximately 2 to 3 inches of lint build up on the lint screen with lint falling onto the base of the dryer lint box. During an Interview on 09/07/2023 at 10:27 am, Laundry Aide I stated she was trained to clean the lint traps once a shift. Laundry Aide I stated that she did not realize that the buildup of lint could cause a fire. Laundry Aide I stated that she will start cleaning the lint traps more often now that she knows. Laundry Aide I stated she could see how it might start a fire. Laundry Aide I stated that when she was trained , It was basically really quick in one day by her Supervisor. Laundry Aide I stated that the button on dryer #2 was broken since she has worked there, and the Facility needed new dryers because it makes it hard to get the laundry done when the equipment does not work properly. Laundry Aide I stated that it was hard to check on the lint boxes because the cover has a broken lock on it so they have to use a tool to pry open the door. Laundry Aide I stated that her supervisor is aware of the broken doors and button on the laundry machines and have notified the Administrator but nothing had been done. Laundry Aide I stated that they only clean the screens once because their shifts had been shortened to only 7 hours instead of 8 hours, and there was no one there to clean them. During and Interview on 09/07/2023 at 10:34 am, Laundry staff J stated she did not realize that the lint traps needed cleaning more often but will do that. Laundry staff member J is the attending supervisor of the laundry. Laundry staff member J stated they were always so busy it was hard to remember to do that. Laundry Staff J stated she will update the schedule to clean the lint traps more often than once a day. Laundry staff J stated she does realize it could cause a fire. Laundry staff stated she wasn't really trained it was just something that she knew. Laundry Staff J stated she did have to cut the hours for staff down to 7 hours a shift. Laundry Staff Member J stated she has made a request a few times to the Administrator about the broken lint doors and the broken button on the dryer and she has not heard anything about it. During an Interview on 09/08/2023 at 4:28 pm., the Administrator stated she was not sure what the policy stated as to how often lint screens were to be checked. The Administrator stated she would expect the staff to change as often as needed to prevent a fire hazard. The Administrator stated her expectation was to not let the lint build up, and it was not acceptable to let the lint build up. The (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 46 of 47 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 676163 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/27/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesquite Post Acute Care 4510 27th St Lubbock, TX 79410 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 0921 Level of Harm - Minimal harm or potential for actual harm Administrator stated she does understand how it can be a fire hazard. Administrator stated when something needs to be fixed the staff will come to her to make a request, and then she will make the request to Corporate. Administrator stated she was not aware that the button on the dryer was not working and the doors on the lint box were broken. Administrator stated all requests for parts and request to get machines fixed or replaced must go through Corporate. Residents Affected - Some Record Review of the laundry facility schedule, no date provided, revealed: 1st shift: 2:00: clean dryer lint. Record Review of the facility provided policy revised on 05/2011, labeled, Fire Safety and Prevention, revealed: Policy Statement: All personnel must learn methods of fire prevention and must report conditions that could result in a potential fire hazard. Overheating: b) Keep filters on heating systems, dryers, etc. free of lint. 4. All personnel must report observations of: e). Malfunctioning equipment and supplies, h). violation of fire safety rules. 5. The safety coordinator will be responsible for the prompt investigation of such condition(s). Hazardous conditions must be corrected as soon as practical. Appropriate departments, such as building engineers/maintenance, etc. shall be responsible for the prompt correction of electrical, plumbing, or structural hazards. 6. Any hazardous condition requiring more than twenty-four (24) hours to correct must be reported to the Administrator, in writing, outlining what corrections will be mad, methods of correction, and when the hazardous condition is expected to be corrected. 7. The safety coordinator and administration will identify and document any hazardous or explosive materials that are stored in locked areas. No one should store any hazardous or explosive materials in locked areas without the prior approval of the Safety coordinator and management. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676163 If continuation sheet Page 47 of 47