Health inspection·February 19, 2026

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to provide pharmaceutical services, including procedures that assured the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals, to meet the needs of each resident for 1 of 6 residents (Resident #32) reviewed for pharmacy services. The facility failed to administer the injectable Repatha (a prescription-strength, injectable used to significantly lower bad [LDL-low density lipoprotein] cholesterol and reduce the risk of heart attack and stroke) for Resident #32 on 01/26/2026. This failure could place residents at risk for not receiving the intended therapeutic benefit of their medications.Findings include: Record review of Resident #32's, undated, face sheet revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Resident #32 had diagnoses which included CVA (stroke, occurs when blood flow to the brain is blocked or a vessel ruptures, causing brain tissue damage), hemiplegia (form of paralysis affecting one side of the body, caused by brain or spinal cord damage such as stroke, trauma, or congenital conditions), and hyperlipidemia (condition characterized by abnormally high levels of lipids [fats] in the blood). Record review of Resident #32's admission MDS assessment, dated 12/18/2025, revealed Resident #32 had a BIMS of 13, which indicated no cognitive impairment. She required substantial (helper does more than half the work) assistance with ADLs. Record review of care plan, dated 12/12/2025, revealed Resident #32 had interventions to administer medications as ordered. Monitor/document for side effects and effectiveness. Record review of Resident #32's MAR, dated January 2026, revealed Resident #32's Repatha 140mg/ml (1) syringe subcutaneous every 2 weeks was not administered on 01/26/2026 by LVN A. Record review of consolidated physician orders, dated February 2026, revealed Resident #32 had an order for an injection of Repatha 140mg/ml (1) syringe subcutaneous every 2 weeks for hyperlipidemia. During an interview on 02/19/2026 at 10:12 a.m., Resident #32 stated she missed her cholesterol medication injection at the end of January and no one called the MD to let her know. Resident #32 stated it was very important to get the injection because she had strokes in the past from having blockages in her arteries from cholesterol build up. She stated her family brought the medication to the facility the day after it was due. She stated she worried about it for two weeks until she got another injection. Resident #32 stated it had not caused her to miss sleep, miss meals, or be tearful to have missed the injection. During an interview on 02/19/2026 at 11:00 a.m., LVN A stated she missed giving Resident #32 the injection of Repatha which was due at 10:00 a.m. on 01/26/2026. She stated the family provided the medication and the weather would not permit the family member to bring it until 01/28/2026. LVN A stated she signed the medication out as not given but failed to make a note about the missed dose and did not contact the MD. LVN A stated she was unaware she needed to call the MD. LVN A stated she was counseled by the DON on the proper way to handle an available medication and in the future would call the MD if a medication was unavailable. She stated the next dose given to Resident #32 was on 02/09/2026, which was the next (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 676187 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 676187 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/19/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Heritage House of Marshall Health & Rehabilitation 5915 Elysian Fields Road Marshall, TX 75672 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)