Inspection·January 28, 2026

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Eplerenone Tablet 50 MG, give one tablet by mouth one time a day for hypertension with a start date of 01/11/2026 and discontinue date of 01/13/2026. Review reflected an order for Furosemide tablet 40 MG for edema, give by mouth one time a day for edema (swelling caused by fluid buildup) with a start date of 01/10/2026, discontinue date of 01/11/2026 and a start date of 01/12/2026 and discontinue date of 01/13/2026. Review reflected Resident #1 had an order for Glipizide for diabetes tablet 5 MG one time a day for diabetes with a start date of 01/10/2026 and discontinue date of 01/13/2026. Review reflected an order for Mirtazapine tablet 15 MG to give 1 tablet by mouth at bedtime for depression, with start date of 01/10/2026 and end date of 01/11/2026 and a separate order with a start date of 01/12/2026 and discontinue date of 01/13/2026. Review reflected an order for potassium chloride tablet 20 MEQ give 1 tablet by mouth one time a day for supplement with a start date and discontinue date of 01/13/2026, additional order with a start date of 01/10/2026 and discontinue date of 01/11/2026. Review reflected an order for Amoxicillin-Potassium Clavulanate 875-125 MG give 1 tablet by mouth every 12 hours for pneumonia for 10 days until finished with a start date of 01/10/2026 and discontinue date of 01/13/2026. Review of Resident #1's MAR reflected an order for Divalproex Sodium delayed release sprinkle 125 MG, give 2 capsule by mouth three times a day for psychosis with a start date of 01/10/2026 and discontinue date of 01/13/2026 and a separate order with a start and end date of 01/13/2026. Review of Resident #1's MAR reflected an order for Alprazolam tablet .5 MG give 1 tablet by mouth every 12 hours as needed for anxiety / agitation with a start date of 01/09/2026 and discontinue date of 01/13/2026 and separate order to start on 01/20/2026. Review of Resident #1's progress note by RN C dated 01/17/2026 reflected the FM asked about alprazolam and was notified that medication had been discontinued. During an interview on 01/28/2026 at 10:32 AM, Resident #1's FM stated that she was not notified of changes to Resident #1's medications. The FM stated that several of Resident #1's medications were removed and she felt it was not beneficial. The FM stated it was only when she specifically asked about the medications on 01/17/2026 that it was mentioned that Resident #1 was no longer taking anti-depression or mood stabilizer medication. The FM stated the MD never spoke with her regarding discontinuing medications. The FM stated that she had provided the facility a MPOA for Resident #1 upon admission. During an interview on 01/28/2026 at 3:11 PM, LVN A stated that she recalled working with Resident #1. LVN A stated the MD usually visited the facility on Monday or Tuesday and she recalled the MD asking about Resident #1. LVN A stated she reported that Resident #1 looked okay and had no behaviors. LVN A stated the MD stated he was going to review mediations and make changes. LVN A stated she did not understand why or what happened for the MD to make changes to the medications. LVN A stated she did not ask the MD what changes he was going to make. LVN A stated that when medications were discontinued, if the resident was their own RP then the resident was notified, and if not then the resident's RP would be notified. LVN A stated that the NP or MD would normally call and follow up and speak with the resident's family. During an interview on 01/28/2026 at 3:36 PM, LVN B stated that the resident and POA were notified of medications changes to see if they agreed. LVN B stated it was the nurse's responsibility to notify the family of medication changes. LVN B stated that the discontinued medication would pop up on the MAR and would say who discontinued the medication. LVN B stated it was important to notify the family to keep them updated on the residents' care and they had a right to know what was going on and to answer any questions or concerns. During an interview on 01/28/2026 at 4:19 PM, the DON stated that if a nurse discontinued medication they should call and let either the POA or resident know depending on if the resident was their own responsible party or not. The DON stated if the MD discontinued medication it was the nurse's responsibility to notify the resident if self-responsible or the RP if not. The DON stated that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676271 If continuation sheet Page 2 of 3 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 676271 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/28/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Onion Creek Nursing and Rehabilitation Center 1700 Onion Creek Pkwy Austin, TX 78748 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete the discontinued medication would show on the queue in PCC (electronic health record) for the nurses. The DON stated if the doctor mentioned medications changes, the nurse should ask the doctor if they talked with the family. During an interview on 01/28/2026 at 5:02 PM, the ADM stated if the resident was their own responsible party then she would expect staff to let the resident know and if they had an RP then staff would need to let that person know of any medication changes as well. The ADM stated it was important because it was a resident's right and family also had a right to know about their care and be involved in treatment. During an interview on 01/28/2026 at 5:08 PM, the MD stated that he saw Resident #1 on 01/13/2026 and discontinued a bunch of meditations because the resident was acutely altered based on reviewed records. The MD stated he felt other conditions may have been exacerbated, so to get an understanding of Resident #1's baseline to try to help Resident #1 improve, medications were discontinued. The MD stated he did not reach out to the POA or family unless the specifically requested and the process was that the nurses usually made the notification for changes he was going to make. The MD stated that once he notified the nurse of the changes, then they would notify the family. Review of facility in-service dated 12/17/2026 reflected the topic family should be notified of any medications changes, change in condition, appointments, refusal of medications/showers completed with nursing. Review of facility policy titled Change in Condition with revision date of 04/2025 reflected the resident / resident representative will be notified of the change of condition and any changes in the resident's medical or nursing care. Event ID: Facility ID: 676271 If continuation sheet Page 3 of 3