Health inspection·October 23, 2025

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete her leg causing her a burn and pain. Resident was noted to have significant area of discolored skin to her right shin, that resulted from the burn. Resident #1 stated she was in pain and asked to go to the hospital emergency room, but the nurse did not respond to her request. Resident #1 stated the doctor did not see her until almost a week later. An observation / review of photos dated 04/03/2025 and 04/07/2025 conducted on 10/21/2025 at 4:23 PM, revealed Resident #1's burn on her right leg showed full thickness burn through two layers of skin to indicate a second-degree burn.An interview was attempted with CNA A on 10/21/2025 at 5:14 PM, received voicemail and a message left to return call.An interview was attempted with LVN B on 10/21/2025 at 5:15 PM, received voicemail and a message was left to return call.In an interview conducted with CNA A on 10/22/2025 at 11: 24 AM, CNA A stated the burn incident in April 2025 with Resident #1 was a simple accident. CNA A explained that Resident #1 had asked for either tea, coffee, or soup; however, the CNA could not recall which one. She stated Resident #1 normally ate soup a lot. CNA A stated she obtained hot water from the dispenser in the coffee room next to the nurses' station and advised Resident #1 to let the water cool. CNA A reported she left the room to provide care for another resident and when she returned, Resident #1 had knocked over the cup and the liquid had spilled through the covers. CNA A stated she removed the covers and noted Resdent#1's leg was wet, and Resident #1 was hurting. CNA A stated she notified the LVN B charge nurse, who came to assess Resident #1. CNA A stated Resident #1 did not have any visible marks that day, however the following day, some marks were noted. An interview was attempted two more times with LVN B on 10/22/2025 at 12:29 and 12:40 PM, a voicemail was left to return call.In an interview conducted on 10/23/2025 at 4:11 PM, the ED/ADM stated he was responsible for reporting incidents to HHSC. He stated in the absence of the ED/ADM the DON or other Regional Staff would take on the responsibility. ED/ADM stated he does not know why the incident was not reported by the facility, he noted at the time of the incident there was a different ADM. ED/ADM stated not reporting incidents was potential for additional harm to residents.In an interview conducted on 10/23/2025 at 4:33 PM, the DON stated the ED reports incidents to HHSC. The DON stated if the ED is out, she will report to HHSC. The DON stated the incident happened prior to her being hired at the facility. The DON stated the potential harm for not reporting incidents to HHSC could leave residents at risk for more harm.Review of facility's Abuse Prevention-Reporting Protocol dated June 2013 reflected:1. The Abuse Prevention Coordinator will:a. Immediately (within 24 hours) report to The Department of Aging and Disability Services (DADS) and other appropriate authorities incidents of Patient Abuse as required under applicable regulations and regulatory guidance. Report events that cause reasonable suspicion of serious bodily injury immediately (within 2 hours) after forming the suspicion to The Department of Aging and Disability Services (DADS) and other appropriate authorities as required under applicable regulations and regulatory guidance. b. Immediately (within 24 hours) suspend the employee for an abuse allegation until an investigation is completed. Review of facility's Abuse, Neglect, Exploitation, and Misappropriation Prevention Program dated April 2021 reflected: 1. Identify and investigate all possible incidents of abuse, neglect, mistreatment, or misappropriation of resident property.2. Investigate and report any allegations within timeframes required by federal requirements.Record review of the Long-Term Care Regulation Provider Letter Title Abuse, Neglect Exploitation, Misappropriation of Resident Property and Other Incidents that a Nursing Facility Must Report to the Health and Human Services Commission reflected:Type of Incident to Report Neglect (Incident with or without serious bodily injury) When to report:Immediately, but not later than two hours after the incident occurs or is suspected. Event ID: Facility ID: 676323 If continuation sheet Page 2 of 8 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 676323 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Crescent 11353 Sugar Park Lane Sugar Land, TX 77478 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to ensure that each resident received adequate supervision and assistance devices to prevent accidents for 1 of 5 (Residents #1) reviewed for accidents hazards and supervision.The facility failed to ensure CNA A provided Resident #1 adequate supervision after she provided her with hot water for soup on 04/02/25, in which Resident #1 suffered 2nd/3rd degree burns on her right leg.The facility failed to have appropriate interventions in place to ensure hot water was tested for safe temperatures before being served to residents.These failures resulted in an Immediate Jeopardy (IJ) situation on 10/22/2025. The IJ template was provided to the facility on [DATE] at 6:53PM. While the IJ was removed on 10/23/2025, the facility remained out of compliance at a scope of pattern and a severity level of potential harm with the potential for more than minimal harm that is not an Immediate Jeopardy, due to facility's need of more time to monitor the plan of removal for effectiveness.These failures could place residents at risk of physical harm.Record review of Resident #1's face sheet, dated 10/21/2025 reflected a [AGE] year-old female admitted to the facility on [DATE] with diagnoses of anxiety disorder (feeling of worry, fear), Proteus mirabilis (bacterial infection), rheumatoid arthritis (autoimmune disease that cause pain and stiffness in joints), muscle wasting and atrophy (loss of muscle mass and strength), hypertension (elevated blood pressure), and heart failure.Record Review of Resident #1's Significant change MDS assessment dated [DATE] reflected Resident #1 was assessed to have a BIMS score of 15 which indicated she was cognitively intact. Further review of the MDS reflected that Resident #1 had impairment in her upper extremity.Record review of Resident #1's comprehensive care plan, dated 10/21/2025, revealed that it was updated to identify a skin concern of non-pressure wound to right shin with the initiated date of 04/03/2025 and the care plan also identified a focus area of ADL self-care deficit noted resident required total staff assistance with eating initiated 06/24/2025. The care plan did not include interventions for being served hot liquids.Record Review of Resident #1 progress notes dated 04/02/2025 at around 7:33 PM, reflected LVN B was notified by a CNA that Resident #1 poured warmed broth on her body, LVN B noted Resident #1 in supine position crying with burn to leg. LVN B provided Resident #1 with PRN Acetaminophen - Codeine 300-30 mg x 1 tablet, notified DON and MD.Review of Resident #1's skin assessment dated [DATE] reflected non-pressure wound of the right shin undetermined thickness, size of 10 cm length by 17 cm width, area 170 cm2 undermining. Record Review of Resident #1's physician orders reflected an order dated 04/03/2025 Silver Sulfadiazine Cream 1 % Apply to Right shin topically every day shift for Wound Care Apply to wound on right shin.Record Review of Resident #1's progress noted dated 04/04/2025 reflected Resident #1 was assessed by wound nurse practitioner and facility TN. Resident was noted to have cluster of fluid filled blisters to right shin, new order noted for xeroform (wound dressing).Record Review of the facility's Incidents By Incident Type provided on 10/21/2025 for the months of 01/01/2025-10/21/2025 did not reflect Resident #1's burn incident.Record Review of staff in-services reflected on 04/03/2025 was completed with direct care staff on Safety of Hot Liquids by LVN /Nurse Unit Manager. The In-service reflected to Never give a resident any liquid hot enough to cause a burn. If a resident requests a liquid (drink or soup) to be warmed up, then WARMED is all it should be. If you can't hold the container of liquid, then it is too HOT to give to residents. Place on counter out of reach of resident until it cools to warm/room temperature.In an interview conducted on 10/21/2025 at 3:47 PM, Resident #1 stated she wanted her soup hot. She stated CNA A came and brought her some hot water from the coffee pot. She stated CNA A told her This is the water for your soup it is hot and do not waste it. Resident #1 stated it (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676323 If continuation sheet Page 3 of 8 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 676323 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Crescent 11353 Sugar Park Lane Sugar Land, TX 77478 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few was a 16-ounce cup. She stated she reached for her remote and the water accidentally fell on her leg. Resident #1 stated CNA A came back to check on her and noticed she had wasted the water and started removing the blanket. Resident #1 stated CNA A notified the nurse. Resident #1 stated she was in pain and asked to go to the hospital emergency room, but the nurse did not respond to her request. Resident #1 stated the doctor did not see her until almost a week later. In an interview conducted on 10/21/2025 at 4:15 PM with RP, RP stated Resident #1 received the burn on her right leg. He reported that he was called late in the evening on 04/02/2025 which was much later after the incident had occurred. RP stated he came on April 3rd and took pictures of the burns. He reported that the facility did not send Resident #1 out to the emergency room, stated they would provide treatment for Resident #1 at the facility and that there was no need to send resident out for treatment. RP stated in his opinion the burns were real bad and he sought legal advice. RP stated all treatment was completed at the facility. RP further stated he returned on 04/07/2025 to take more pictures, but the facility did not want him to take pictures. RP forwarded surveyor 4 photos taken on 04/03/2025 (cluster of large blisters on leg), 2 photos taken on 04/07/2025 (leg covered with gauze), and 6 photos taken on 04/08/2025 (showed significant burned skin damage, showed full thickness burn through two layers of skin to indicate a second degree burn ).An interview was attempted with CNA A on 10/21/2025 at 5:14 PM, received voicemail and a message left to return call.An interview was attempted with LVN B on 10/21/2025 at 5:15 PM, received voicemail and a message was left to return call.In an interview conducted with CNA A on 10/22/2025 at 11: 24 AM, CNA A stated the burn incident in April 2025 with Resident #1 was a simple accident. CNA A explained that Resident #1 had asked for either tea, coffee, or soup; however, the CNA could not recall which one. She stated Resident #1 normally ate soup a lot. CNA A stated she obtained hot water from the dispenser in the coffee room next to the nurses' station and advised Resident #1 to let the water cool. CNA A reported she left the room to provide care for another resident and when she returned, Resident #1 had knocked over the cup and the liquid had spilled through the covers. CNA A stated she removed the covers and noted Resdent#1's leg was wet, and Resident #1 was hurting. CNA A stated she notified the LVN B charge nurse, who came to assess Resident #1. CNA A stated Resident #1 did not have any visible marks that day, however the following day, some were noted. CNA A stated an in-service training was completed the next day on Resident #1 use of cup without a handle. CNA A was asked if she normally checked the temperature of liquids before giving them to a resident. CNA A responded that she placed the liquid on the side table to allow it to cool before Resident #1 consumed it. CNA A stated she felt bad about the incident and emphasized that it was not intentional. CNA A advised she had been trained on abuse and neglect, and she stated protocol is to notify the charge nurse of any incidents.Observation on 10/22/2025 at 12:00 pm and 12:07 PM, of the facility's Cafe [NAME] room revealed a hot water and coffee dispenser available to all residents. It further revealed the hot water available to all residents at the coffee station tested by the Nutritional Director was 167.6 degrees Fahrenheit. An interview was attempted two more times with LVN B on 10/22/2025 at 12:29 and 12:40 PM, a voicemail was left to return call.In an interview conducted with LVN C on 10/22/2025 at 12:54 PM. LVN C stated she has been with the facility since September 2024. LVN C reported to be the nurse Unit Manager. LVN C stated she conducted an in-service on handling hot liquids in April 2025 after being instructed to do so due to an incident in which a resident requested a warmed drink and, upon reaching for it, the liquid spilled. LVN C reported that she did not know which resident was involved at that time; she was only informed that an in-service was needed. LVN C stated the protocol for hot liquids is that the liquid cannot be smoking hot. When asked who was responsible for checking the temperature of liquids dispensed from the coffee (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676323 If continuation sheet Page 4 of 8 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 676323 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Crescent 11353 Sugar Park Lane Sugar Land, TX 77478 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few machine, LVN C stated she could not answer that question and did not know the process or who provided oversight to ensure the water temperature was safe for serving to residents. LVN C stated that if she obtained hot liquid from the kitchen and observed steam, she would not serve it to a resident. When asked what potential harm could occur if a resident were given a liquid that was too hot, LVN C stated that the resident could suffer a natural burn.In an interview conducted with the Nutritional Director on 10/22/2025 at 1:06 PM,. the Nutritional Director stated the dietary department is only responsible for replenishing supplies in the cafe coffee room. He explained that clinical and nursing staff are responsible for monitoring that area, and dietary staff were never assigned that responsibility. He further stated that residents had free access to the cafe coffee room and may enter the area at any time. The Nutritional Director reported that he was not aware of any incidents where a resident burned themselves in that area and did not know of anyone specifically designated to monitor the water temperature in the coffee machine. He explained that the dietary department checks hydration station temperatures in the dining areas each morning but not in the cafe coffee room. When asked about potential harm, he acknowledged that burns could occur if liquid temperatures are too hot, comparing it to someone spilling hot coffee on themselves, like at fast food restaurant. He added that some residents prefer their beverages to be hot. In an interview conducted with the DON on 10/22/2025 at 1:35 PM, the DON stated that nursing staff are responsible for monitoring the cafe coffee station area. She explained that the coffee station is provided so residents can enjoy coffee and tea at their leisure. The DON stated that some residents typically wait for their liquids to cool before drinking them, while some independent residents prefer to take their drinks back to their rooms. The DON reported that she had not received any reports of residents sustaining burns from the coffee area. The DON stated she did not know who services or maintains the coffee machine located in that area. When asked about residents with cognitive impairment accessing the coffee room, the DON responded that if staff observed such residents entering the area, they are expected to intervene to ensure safety. The DON further stated that CNAs should notify a nurse to check the temperature of the hot water if there are any concerns. She said nurses could retrieve the thermometer from the kitchen for that purpose. When asked about the potential harm that could occur if water temperatures are not checked, the DON stated that a resident could sustain a burn if hot liquid were spilled.In an interview conducted with RN Treatment Nurse (TN) on 10/22/2025 at 1:45 PM, TN stated she had not worked at the facility for over two months. When asked if she remembered providing wound care for a resident with a burn in April 2025, she stated that she did recall the incident but could not recall specific details. The TN stated that if surveyors required specific information, they should review her nursing notes in the resident's chart. When asked if the wound had been staged or documented as a burn, the TN responded that it was but clarified that the chart and the wound care physician's notes would reflect the exact classification and treatment provided. She stated that the chart should indicate what treatment was performed and how the physician documented the wound. The TN added that the wound had resolved and healed, and that her main concern at the time was ensuring the wound healed properly.In an interview conducted with CNA K on 10/22/2025 at 5:50 PM, CNA K was asked about her understanding of serving hot liquids to residents. She stated that she warms liquids in the microwave just enough to ensure they are not too hot. When asked how she determines whether a liquid is too hot, CNA K stated that she touches the outside of the cup to assess the temperature. She further explained that she wraps a napkin around the cup to prevent it from being too hot to handle, then places the cup on the resident's table. In an interview conducted with CNA J on 10/22/2025 at 5:54 PM., CNA J stated she has worked for two years at the facility. CNA J reported to remember the incident that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676323 If continuation sheet Page 5 of 8 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 676323 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Crescent 11353 Sugar Park Lane Sugar Land, TX 77478 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few happened in April 2025 to Resident #1. CNA J stated they completed an in-service training on hot liquids. CNA J stated the in-service focused more on making sure the residents have an appropriate cup with a handle for hot liquids. CNA J stated they were not told how to test the temperature nor was a thermometer available to test the temperature. She stated she was unaware that a nurse was required to test the temperature of hot liquid prior to the liquid being served to residents. In an additional interview conducted with the DON on 10/22/2025 at 6:01 PM, the DON stated they do not have a temperature log at the nurse's station. She was asked where the nurses record the temperature after checking the hot liquid, she responded there has not been a request to check the temperature of hot liquids.Review of the facility's policy titled Accident/Incidents revealed: An Accident/Incident Report must be completed immediately upon Facility staff becoming aware of the occurrence of an accident/incident (to include medication errors) involving a Patient and, if necessary, the Patient's Care Plan must be updated. Each Accident/Incident Report must be reviewed at the Facility's daily stand-up meeting until all sections of the report are complete. Each Accident/Incident Report for an accident/incident occurring during a month must be signed by the Executive Director and Director of Nursing within 48 hours of the occurrence. A Witness Statement must be completed at the time of the accident/incident. An Accident/Incident Log must be maintained each month in which all accidents/incidents are logged Accidents/Incidents must be reported both internally and externally in accordance with the Reportable Incident Protocol (see Protocol 3-C).This was determined to be an Immediate Jeopardy (IJ) on 10/22/2025, the Administration was notified. The Administrator was provided with the IJ template on 10/22/20255 at 6:53 PM and a plan of removal was requested. The first draft of POR was received on 10/22/2025 at 8:23 PM.The following POR was accepted on 10/23/2025 at 1:00 PM. Plan of removalProblem: F689 Accidents/Supervision Immediate Action:Impact Statement:The facility failed to ensure Resident #1 was free from accidents when Resident #1 suffered 2nd/3rd degree burns after she was provided with hot water to make soup that spilled on her knee Please accept this as a Plan of Removal for the alleged Immediate Jeopardy related to failure to provide supervision to prevent accidents. Systematic Approach:1. Immediate Action Resident #1 was immediately assessed on 4/2/2025 by licensed nurse. Licensed nurse notified physician and initiated treatment plan per order for mild burn to left leg. 4/3/25- Saw by MD wound measurements- 10x17x not measurable/ Surface area 170.00 cm2; open ulceration area of 119.00 cm2 The Executive Director notified the facility Medical Director of the Immediate Jeopardy on 10/22/2025. An emergency QAPI meeting was held on 10/22/2025. On 10/22/2025 DON/Designee immediately initiate hot liquid safety assessment with all facility residents. 38 Facility residents deemed at risk will have appropriate interventions in place per facility hot liquids assessment policy. All facility care plans will be updated as at risk or not at risk with appropriate personalized interventions. DON/Designee will evaluate all patients upon admission and at least quarterly. Maintenance Director removed the coffee machines from the cafe's on 10/23/2025 and put them in storage in an abundance of caution until facility can establish a safe temperature and process for temping hot liquid distributed from the coffee machine for future use. Facility will initiate process for temping On 10/22/2025 DON/Designee in-serviced ALL nursing staff, PRN, new staff, agency on patients at risk, or not at risk for hot liquids per hot liquids assessment. DON/Designee placed binder at each nurse's station for staff to reference to ensure the safety of all patients. DON/Designee will review/update binder daily, weekend supervisor/designee will review/update binder on weekends.Each employee will complete a post-test after their education was completed to ensure staff comprehend in-services.2. Assessment On 10/22/2025 DON/Designee immediately initiate hot liquid safety assessment with all facility residents. Facility residents deemed at risk will have appropriate interventions (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676323 If continuation sheet Page 6 of 8 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 676323 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Crescent 11353 Sugar Park Lane Sugar Land, TX 77478 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few in place per facility hot liquids assessment policy. All facility care plans will be updated as at risk or not at risk with appropriate personalized interventions. DON/Designee will evaluate all patients upon admission and at least quarterly. Maintenance Director removed the coffee machines from the cafe's on 10/23/2025 and put them in storage in an abundance of caution until facility can establish a safe temperature and process for temping of hot liquid distributed from the coffee machine for future use. On 10/22/2025 DON/Designee in-serviced ALL nursing staff on patients at risk, or not at risk for hot liquids per hot liquids assessment. DON/Designee placed binder at each nurse's station for staff to reference to ensure the safety of all patients. DON/Designee will review/update binder daily, weekend supervisor/designee will review/update binder on weekends. Each employee will complete a post-test after their education was completed to ensure staff comprehend in-services. If the employee did not pass the test with at least 90% correctly answered the staff member was re-educated and re-tested until at least 90% pass rate was met. DON/Designee will utilize a staff roster to ensure 100% compliance with education. Licensed nurses and CNA/CMA's will not be allowed to work until in-services completed by DON/Designee. Who will be responsible: Director of Nursing/RDCS Who Will monitor: Executive Director/RVP Target Completion Date 10/22/20253. Monitoring Effective 10/22/2025 DON/Designee will review in daily clinical IDT stand-up new admission, or patients with a change in condition to ensure a hot liquids risk assessment is completed to identity if patient is or is not at risk. Weekend Supervisor/Designee will review weekend admissions to ensure hot liquids assessment is completed timely with appropriate interventions in place for patients deemed at risk.4. Policy and Procedures Policy and procedures were reviewed by [NAME] President of Operations, Director of Regulatory and Compliance, Regional Director of Clinical Services, Executive Director, and Director of Nursing. These policies include Hot Liquids Safety. No policies needed any revisions.Monitored the POR on 10/23/2025 as follows:An observation on 10/23/2025 at 2:30 PM revealed the coffee machine was removed from the cafe and only cold liquids were noted.In an interview on 10/23/2025 at 3 PM, the ED/ADM stated all assessments and in- services were completed and provided surveyors with the plan of removal binder.In an interview on 10/23/2025 at 3:45 PM, the RVP stated he inserviced the facility ED/ADM and DON, stated that he conducted an in-service training for the Administrator and the Director of Nursing (DON) on the Hot Liquid Safety Policy, reviewing the policy's explanation and compliance guidelines. The RVP stated that he also trained the Administrator and DON on the Hot Liquid Safety Binder, which is to be kept at each nurses' station for staff reference. This binder is intended to ensure the safety of all residents, including those identified as at risk and not at risk for burns related to hot liquids. The RVP reported that both the Administrator and the DON completed the Hot Liquid Safety Policy Quiz, each achieving a score of 100%. He further stated that the Administrator and DON are responsible for training all nursing staff on identifying residents who are at risk or not at risk per the hot liquid assessment, as well as instructing staff on the proper use of the binder. Following the in-service, employees are required to complete a post-test and must achieve a score of at least 90% to demonstrate competency. In an interview on 10/23/2025 at 3:50 PM, the ED/ADM stated that he was in-serviced by the Regional [NAME] President (RVP) on the Hot Liquid Safety Policy and the safe handling of hot liquids with residents. The ED/ADM demonstrated understanding of the policy and was able to explain the required interventions, the purpose of the Hot Liquid Safety Binder, its location, and who is responsible for maintaining and updating it. He stated that he and the Director of Nursing (DON) are responsible for training nursing staff-including RNs, LVNs, CNAs-and all department heads on the policy and procedures related to hot liquid safety. The ED/ADM further stated that all staff are required to complete a post-test following the in-service and must achieve a (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676323 If continuation sheet Page 7 of 8 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 676323 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/23/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Crescent 11353 Sugar Park Lane Sugar Land, TX 77478 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete passing score.In an interview on 10/23/2025 at 4:15 PM, the DON stated she was in serviced by the RVP on Policy for Hot liquids and safely handling hot liquids with the resident. DON stated she and ED/ADM completed in-services with the nurse managers, nursing staff, 2 ADON, Unit Manager, Department Heads to include Dietary, Social Worker, MDS Coordinator, Business Office, Human Resources, Housekeeping, Medical Records, Activity Director, and Admissions Coordinator. DON stated 2 Monitor Hot Liquids Risk Binders were placed at each nurse's station. DON stated assessments will be completed at admission and quarterly. DON stated the DON, ADON, Nurse Unit Manger and weekend supervisor will monitor.Interviews conducted on 10/23/2025 with nurses from 6/2, 2/10, and 10/6 shifts between 4:35 PM -5:40 PM [LVN C, LVN D, LVN E, LVN G, LVN H, and RN I] indicated they participated in the mandatory in service training about Policy for Hot liquids and safely handling hot liquids with the resident. Each stated they completed quizzes following the in-services. They stated they received training on the Hot Liquid Safety Binder of at risk and not at risk binder located at the two nurse's stations. Interviews conducted on 10/23/2025 with 9 CNAs who worked the 6/2, 2/10, and 10/6 shift between 4:00PM-5:48 PM [CNA J, CNA K, CNA L, CNA M, CNA N, CNA O, CNA P, CNA Q, CNA R] indicated they participated in an in-service training on Policy for Hot liquids and safely handling hot liquids with the resident. The CNAs summarized the topic of discussion stating understanding handling of hot liquids and safety. Each CNA stated they completed the post test with passing scores.Interviews attempted via outbound calls to additional 5 CNAs and 1 RN the calls were unanswered and forwarded to an automated service that prompted to leave a voicemail. A return call was not received prior to the exit on 10/23/2025.Record Review of QAPI meeting attendance sheet (ED/ADM, RVP, DON, Unit Manager, ADON, and Regional Director of Clinical Services).Record Review on 10/23/2025 of the In-Service Training Sheets dated 10/23/2025 reflected all facility staff had been in-serviced on all training topics listed on the plan of removal. About 3 percent of signatures were still needed as those employees had not worked a shift, those employees will reconfirm understanding of the training and sign off prior to working their shift. Record Review on 10/23/2025 of Hot Liquid Evaluation dated 10/23/2025 reflected all 73 residents of the facility had been completed.Record Review of care plans on 10/23/2025 reflected the 38 residents considered at risk from hot liquid evaluation was updated in the comprehensive care plan.The ED/ADM and DON were informed the Immediate Jeopardy was removed on 10/23/25 at 7:20 PM. The facility remained out of compliance at a severity level of no actual harm with a potential for more than minimal harm that is not immediate jeopardy and scope of isolated. Event ID: Facility ID: 676323 If continuation sheet Page 8 of 8