Inspection·October 22, 2023

F 0558 Level of Harm - Minimal harm or potential for actual harm revealed the call light should have been placed next to the resident because she could fall and would not be able to press the call light. Observation on 10/19/23 at 3:53 PM revealed the call light was pinned to Resident #35's pillow and was out of reach for Resident #35. Residents Affected - Some An interview on 10/19/23 at 3:55 PM with Registered Nurse G revealed the way the call light was placed, Resident #35 would not have been able to reach the call light since it was pinned to pillow. She stated she was not sure why it was like that, but that it must have been the day shift who left it that way. She stated the call light had to be placed near all residents in order for them to be able to press the light if they needed help with anything. Resident #241 Record review of Resident #241's face sheet dated 10/20/2023 revealed a [AGE] year-old female with an initial admission date to the facility of 01/18/2023 and re-admission date of 10/16/2023. Record review of Resident #241's History and Physical dated 08/08/2023 revealed a diagnosis of Encephalopathy (disease affecting brain function that causes confusion and altered mental state) Parkinson's disease (condition that affects the brain causing problems with movement, balance, and coordination). Record review of Resident #241's records indicated MDS assessment was pending after recent admission of 10/17/2023. Record review of Resident #241's comprehensive care plan dated 09/18/2023 did not indicate her ADL needs. Observation on 10/17/23 at 9:50 AM revealed Resident # 241 lying in bed asleep. The call light was observed attached to an oxygen concentrator to the right side of the bed. The call light was not within reach of Resident #241 and was about a foot away. An interview on 10/17/23 at 9:57 AM with LVN H revealed Resident #241 had been re-admitted on [DATE]. She confirmed the call light was pinned to the oxygen concentrator but did not know who had placed it there. She stated the call light should not have been pinned to concentrator because Resident #241 would not have been able to reach it. She reported she did not know how long it had been pinned that way. The risk to residents could be that they could try to get up from bed, or they would not be able to call staff. Observation on 10/19/23 at 3:52 PM revealed Resident # 241 sleeping in bed with call light pinned to the bed sheet next to her head. The call light was observed out of Resident #241's reach. An interview on 10/19/23 at 3:58 PM with Registered Nurse G revealed Resident #241 was not able to move her hands and had to have the call light placed near her palm. She stated she did not know why it was near her head, but it was to be placed closer to her palm. She stated if the call lights were not placed near the residents, they would not be able to press it if they needed help. A follow-up interview on 10/20/23 at 10:11AM with LVN H revealed all call lights had to be placed near the residents and had to be within reach at all times. She stated it was important to do so (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 2 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0558 because if the residents needed something, they would not be able to receive it. Level of Harm - Minimal harm or potential for actual harm An interview on 10/22/23 at 3:45 PM with the CNA Supervisor revealed CNAs had to make sure that call lights were next to the residents, because if the residents needed anything, they needed to press the call light. He revealed the risk to the residents could be that if they needed care, they would not be able to let the staff know. The residents needed to be able to communicate with the staff. Residents Affected - Some An interview on 10/22/23 at 4:22 PM with the DON revealed she had trained her staff to ensure that call lights were in reach and answered in a timely manner. She stated the importance of making sure the call lights were in reach was for residents to be able to let staff know if they needed anything. The risk of not doing so would cause residents to not receive the care they needed. Record review of facility in-service dated 11/14/22 revealed Call lights in reach: All staff will respond to call light in a timely manner. All staff should make sure call lights are in reach of residents at all times. Record review of facility policy titled Call lights responding to revised May 5, 2023, read in part .when leaving the resident room, ensure the call light is placed within the resident's' reach. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 3 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Based on interview, and record review, the facility failed to make residents and residents family members aware of the grievances process and allowing them to exercise their right to file a grievance leading to the facility not addressing the grievances of residents for resident reviewed who attended Resident council Meetings (9 residents). 1. The facility failed to make residents and family members aware of how to file a grievance These failures put residents and family members at risk of decreased opportunities to present grievances and recommendations. Findings included: In a confidential interview on 10/18/2023 at 11:19 am with a group of residents from the facility they all stated that they were not aware of how to file a formal grievance. A resident stated he was under the impression the residents from the facility had to present their complaint to the resident council president and he would inform the social worker of any concerns. However, residents stated that they were not aware there was a grievance form that could be filled out if they wished to place a formal written complaint. A resident discussed several concerns that he discussed with staff members but felt they were just giving him the run around and nothing was being done and he was wondering if there was any formal document, he could fill out but verbalized not being aware of the grievance form. Interview on 10/18/23 at 12:45 pm with the Social Worker revealed the grievance form was updated on 1st of October 2023 and all the department supervisors had access to the form and had access to enter the information into the system. The social worker denied having the grievance form readily accessible to residents and to residents' family members, stated they would need to go address their concerns with a department supervisor and they would fill it out for them, and the corresponding department head would address it. The families/residents can file a Grievance without them having to complete a form. The Grievance form can be completed by the facility when they become aware of any concern. Record review of facility policy titled Complaints/Grievances Process revised June 6, 2023, in part read the facility leadership will support the resident's right to voice complaints/grievances to the facility of other agencies/entities that hear grievances regarding concerns they have about services and treatment received including but not limited to the following: treatment, care, advance care directives, management of funds, lost of articles, services related to returning to the community, behavior of other patient/residents, violation or resident rights, environmental issues, and behavior of staff. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 4 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure all alleged violations involving abuse, neglect, exploitation were thoroughly investigated for 1 (Resident #242) of 6 residents reviewed for neglect. Residents Affected - Few -The facility failed to thoroughly investigate an incident on 08/12/23 when Resident #242 complained of leg pain and was found to have a broken femur. This failure could place residents at risk of abuse and neglect if incidents are not thoroughly investigated. Findings included: Record review of Resident #242's face sheet dated 10/20/2023 revealed a [AGE] year-old female with an initial admission date to the facility of 05/11/2021 and re-admission date of 07/06/2023. Record review of Resident #242's History and Physical dated 09/06/2022 revealed a diagnosis of osteoarthritis and vitamin D deficiency. She also had a history of right femur fracture which she got surgery intervention for. Record review of Resident #242's Quarterly MDS assessment dated [DATE] revealed a BIMS score of 3 indicating a severe cognitive impairment. It also revealed her diagnosis of dementia and osteoarthritis. Record review of Review #242's comprehensive care plan dated 08/12/2023 revealed Resident #242 had a fracture to her left femur related to history of falls. The goal was for Resident #242's left affected extremity would remain with palpable pulses, pink in color, and warm to touch. Interventions included to ensure immobilizer was in place to left lower extremity. Record review of Resident #242's progress notes dated 08/10/2023 at 5:30 PM revealed Skin tear to LLE reported by cna transferring resident from shower to bed 2x5 cm clean with normal saline pat dry apply TAO and cover with 2x2. Record review of Resident #242's progress notes dated 08/12/2023 at 2:38 PM revealed This nurse was notified that [Resident #242] was complaining of pain when the resident was being repositioned. Upon assessment resident was noted with facial grimacing and stated mi pierna, mi pierna (my leg, my leg) 7/10 pain using pain scale. Minimal swelling was noted to left knee, no redness or discoloration noted to site at this time. Unable to move LLE without patient complaining of pain. Vitals as follows: BP126/74 P:62 RR:20 O2:94% T:97.4. Tylenol 650mg PO as per MAR. NP and ADON notified. new order per NP for x-ray to left shoulder, hip, femur, knee and tib& fib. Xray called in . procedure pending. [Resident#242] is in bed resting with no s/s of distress or SOB. Bed is at the lowest position and the call light is within reach. Record review of Resident #242's progress notes dated 08/12/2023 at 11:01 PM revealed Xray results in house, results reported to NP new order to send [Resident#242] to ER for left femur fracture, DON notified, and RP notified by DON. [Resident#242] was transferred to local hospital via ambulance . Record review of Resident #242's progress notes dated 08/13/2023 at 3:28 AM revealed [Resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 5 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 - Minimal harm or potential for actual harm Residents Affected - Few #242] returned from ER per ER nurse, [Resident#242] does have a mildly displaced distal femoral (upper leg fracture) but per physician, [Resident #242] is DNR status and not a candidate for surgery due to her age . Review of TULIP (website for intakes) revealed the facility had self-reported an incident of neglect to HHSC with the following narrative The client had complaints of pain in her hip. The skilled nurse ordered x-rays and she was sent out to the hospital for further treatment and evaluation. The results later yielded a fracture. MD and RP were notified. Record review of Provider Investigator Report dated 08/20/2023 revealed After investigating, a cna reported that she helped get the resident off the floor with another CNA 3 days back. Upon monitoring, there were no complaints of pain. Once pain was verbalized an x-ray was ordered that revealed a hip fracture. The resident is on PT/OT and the pain is being managed with Tylenol, tramadol and hydrocodone. Record review of witness statement written by CNA K dated 08/12/2023 revealed On Thursday August 10th of 2023 I was working in the 300 hall from 2PM to 10PM in the middle section of the hall. During my shift I was working with [CNA L] and [CNA M] . At around 8PM [CNA L] asked for my help to assist [Resident #242] where she was found sitting on the bedside fall mat. I assisted in placing Resident #242 in bed and told [CNA L] to report this to [LVN N]. I left the room and continued my job in the hallway. Record review of witness statement written by LVN N dated 10/20/2023 revealed .On 10/19/2023 I was interviewed by the State on [Resident#242]. I was asked if [Resident #242] had a fall in my shift 2-10 on August 10-11, 2023. I told her that fall was reported to me that a skin tear to the left forearm was reported to me by [CNA L] .On August 14, 2023 [DON] sent me a text at 3 asking did anyone reported to you that [Resident #242] had a fall this past week I replied no On August 17, 2023 [DON] gave me a list of assignments to do: .Moorse fall for 08/10/2023. I asked why I had to do the Moorse fall if a fall didn't happen on my shift and [DON] told me they found that [Resident#242] sustained a fall on August 10, 2023 2-10 shift that [CNA K] and [CNA L] had failed to report to her . Record review of witness statement written by the DON dated 10/22/2023 revealed I [DON] did not ask any of my nurses to do a Moorse fall for [Resident #242]. An interview on 10/19/23 at 2:50 PM with LVN N revealed she worked the evening shift from 2PM-10 PM Monday through Friday. She revealed she had been assigned to Resident #242 on 08/10/2023 and 08/11/2023. She revealed that on 08/10/2023 CNA L had reported a small skin tear that had been discovered after Resident #242's shower. Resident #242 was her normal self and did not appear to be in pain. She denied that Resident #242 had a fall on 08/10/2023 and anything related to a fall had been reported to her. She also revealed that on 08/11/2023 there had been no change of condition with Resident #242, nor had she had a fall. She revealed that after Resident #242's fracture had been found and a fall had been suspected, the DON told her to go back into Resident #242's chart and document a post-fall assessment for 08/10/2023. She revealed she did not know why she had to document that if Resident #242 had not fallen on her shift on 08/10/2023. A telephone interview on 10/19/23 at 3:07 PM with CNA M revealed she did not know about the incident with Resident #242 until her co-workers told her that Resident #242 had to be put back in bed, but that is all the information she knew about incident. She stated she did not know what had occurred. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 6 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 - Minimal harm or potential for actual harm Residents Affected - Few An interview on 10/20/23 at 9:46 AM with LVN P revealed she worked the morning shift 6AM-2PM and was assigned to Resident #242 on 08/11/2023. She stated the only change that was reported for the resident was that she had a skin tear to her left arm that was discovered while she was getting a shower. She denied that she had been reported of Resident #242 having an unwitnessed fall the day before. She revealed Resident #242 did not appear to have a change of condition nor was she complaining of pain throughout her shift. An interview on 10/20/23 at 1:46 PM with CNA O revealed she worked the morning shift 6 AM - 2 PM and was assigned to Resident #242 on 08/11/2023. She revealed she had not been reported that Resident #242 had a fall the day before. A telephone interview on 10/20/23 at 2:10 PM with CNA L revealed she had not worked at the facility for the last 3-4 months. She stated she worked the 2PM-10PM shift and confirmed to have worked on 08/10/2023. She denied that there had been any incident or fall during her shift. She denied that Resident #242 was found on the floor or that CNA K had helped her get Resident #242 off the floor. She stated that the DON had fired her over the phone because CNA K had alleged that Resident #242 had fallen. She stated she did not understand why that had occurred if Resident #242 had not fallen. She stated the DON had not done an investigation and had just concluded that from one statement. She stated it was a lie that Resident #242 had fallen. She stated if the resident would have fallen, she would have reported it to the nurse. An interview on 10/20/23 at 2:24 PM with the DON revealed on 08/12/2023, Resident #242 was complaining of pain in the left leg and orders were given for x-rays by MD to rule out any fractures. She revealed she spoke to LVN N and all that had been reported to her by CNAs was the skin tear. The DON stated she asked questions to staff but they stated nothing had occurred to Resident #242 on 08/10/2023 08/11/2023 . She stated the x-ray results had come back on 08/12/2023 and they showed a possible fracture to the left femur. She stated Resident #242 was sent out for an evaluation and treatment; however, she was not a candidate for surgery due to her age and her pain would be managed with medication. The DON revealed she had conducted the investigation to see what exactly had occurred. The DON revealed she had asked CNA K to write a witness statement, however the DON revealed she had not read it until the interview with the surveyor on 10/20/23 at 2:24 PM. At that point, the DON was asked to read the witness statement. When asked about her investigative process, the DON revealed she was not aware of the process of conducting an investigation for a self-report. She revealed she had asked corporate how to carry out an investigation and they advised her to gather witness statements. She could not remember how she had received the witness statement because the staff would usually slide documents under her door and stated that was probably how she got the witness statements. She revealed she did not have any notes of interviews she conducted with staff because she stated she wrote them in her notebook and had gotten rid of her notes. She denied ever telling LVN N to complete a fall assessment for 08/10/2023 and could not explain why Resident #242 had a post-fall assessment. She revealed the conclusion of her investigation was injury of unknown origin. She revealed she was not able to find how Resident #242 had obtained her femur fracture. A telephone interview on 10/22/23 at 4:25 PM with CNA K revealed she had worked on 08/10/2023 with CNA L in the 300 hall. She revealed CNA L had come to her and asked for her help in getting Resident #242 into bed. She stated she walked into the room, and she saw Resident #242 leaning against the bed and sitting on the fall mat. She asked CNA L if she had notified LVN and she said she had cleared for CNA L to get her into the bed. CNA K could not remember if the DON had asked her to write a statement, however she had asked her about the incident, but CNA K could not remember what she had told her. On 8/12/2023 she was going to get Resident #242 up for her shower when she began to complain (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 7 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 - Minimal harm or potential for actual harm Residents Affected - Few of pain in her leg. She notified the nurse and x-rays were done to her leg. She stated she believed Resident #242 went to the hospital. An interview on 10/22/23 at 6:38 PM with the Administrator revealed she was the abuse coordinator and was responsible for reporting incidents with allegations of abuse or neglect within 2 hours to state office. She stated for any investigation she would do interviews with staff, would notify MD and family if need be. She revealed that with the incident of Resident #242, the DON and herself went to 300 hall and asked Resident#242 about her leg and what had occurred. Resident #242 denied falling or having pain in her leg. The Administrator asked the nurses and aides, and they also did not report a fall. She checked the 24-hour reports and there had been no reports of falls. She revealed that CNA K told the DON that she picked Resident #242 up from the floor and unto the bed. She revealed that the DON obtained witness statements and gave them to her and did not know if the DON had read them. She stated the witness statements should have been looked over since they were part of the investigation. She revealed the allegation of neglect was unfounded based on their investigation because they could not determine if the resident had fallen. Record review of facility policy titled Abuse, Neglect, Exploitation or Mistreatment dated 11/1/2017 read in part .Employees/witnesses will be interviewed by designated facility staff and the interviewer will record all witness accounts in a document, written, dated and signed by interviewer all documents pertaining to the investigation must be compiled and stored in the administrator's office . interview individuals having first-hand knowledge of the incident and write-out summaries of the interviews . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 8 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0623 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to send a copy of the notice of discharge and the reasons for the move in writing to a representative of the Office of the State Long-Term Care Ombudsman for one (Resident #294) of 18 residents reviewed for admission/transfer/discharge rights. The facility failed to ensure the Long-Term Care Ombudsman was notified that Resident #294 was denied readmission after being sent to the hospital. This failure could put residents at risk of not having the opportunity to appeal discharge, not having their rights honored regarding facility-initiated discharges, and homelessness. Findings included: Closed record review of Resident #294's face sheet dated 10/18/2023 revealed he was [AGE] years old, was admitted to the facility on [DATE] and discharged to a local hospital on [DATE]. Record review of Resident #294's clinic referral dated 08/23/2023 revealed he was alert, oriented only to person, unable to follow directions and delusional.? He had diagnoses including memory deficit. In an interview on 10/22/2023 at 11:30 AM the DON revealed that no baseline care plan was completed for Resident #294. Record review of Resident #294's progress note dated 9/05/2023 at 02:00 AM revealed he had behaviors including taking his clothes off in another patient's room, urinating and defecating on the floor in a resident's room, throwing chairs, parts of a wheelchair and a concentrator, hitting his roommate with a shirt, attempting elopement and throwing a toilet cover. Record review of Resident #294's progress note dated 09/05/2023 1:05 PM revealed the resident was being transferred to a local hospital's geriatric behavioral unit for further evaluation. In a telephone interview on 10/19/23 at 02:12 PM the GBU RN revealed that Resident #294 was brought to the GBU on 09/05/2023 because he was physically aggressive toward staff. On admission to the GBU the resident had pacing behaviors but none of the behaviors described by facility staff. The GBU RN said she contacted the facility representative [Marketer] on 09/29/2023 to let them know Resident #294's behavior was controlled, and he was ready to return to the facility. On 09/29/2023 the GBU nurse was told by the facility representative the facility would not accept Resident #294 back because of his past behaviors. The GBU RN said Resident #294's discharge from the GBU was delayed until 10/5/2023 due to the failure of the facility to accept him.? She stated the resident was discharged to a local homeless shelter. In a telephone interview on 10/20/23 at 10:02 AM the Ombudsperson revealed she was advised by the GBU RN on 09/05/2023 that the facility did not want to accept Resident #294 back from the GBU. The Ombudsperson said she went to the facility and spoke to the DON who said Resident #294 was sent to the GBU because on 09/05/2023 he had become violent and hit a facility nurse. This Ombudsperson said she advised the facility DON regarding the proper procedures for discharge. The Ombudsperson stated (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 9 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0623 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few that she was not informed in writing by the facility of Resident #294's discharge to the hospital, and that she had confirmed with the other Ombudsman that he had not received a verbal or written notice from the facility of Resident #294's discharge. In an interview on 10/22/23 at 06:34 PM the Administrator revealed that Resident #294 was sent to the GBU on 09/05/2023. She said monitoring of resident readiness for discharge from the hospital back to the facility was done by marketers and ADONS. The Administrator said she did not know the facility had reached out to the Ombudsman regarding Resident #294 not being accepted back to the facility. She said it would be the responsibility of the social worker to contact the Ombudsman regarding this matter. The Administrator said she was not aware there was a requirement that the Ombudsman be notified in writing of facility-initiated discharges. In an interview on 10/22/23 at 06:43 PM the Social Worker revealed she was not aware that contact with the Ombudsman regarding facility-initiated discharges was required and did not contact the Ombudsman or notify them in writing of Resident #294's discharge. Record review of the facility policy Discharge/Transfer revised 07/01/2016 revealed in the case of involuntary discharge the facility would complete and provide a written notice of transfer/discharge to the office of the State Long-Term Care Ombudsman. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 10 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0655 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to develop and implement a baseline care plan within 48 hours of a resident's admission for one (Resident #294) of 18 residents reviewed for baseline care plans. The facility failed to develop and implement a baseline care plan within 48 hours after admission for Resident #294. This failure could put residents at risk of not having their care needs identified and met. Findings included: Record review of Resident #294's face sheet dated 10/18/2023 revealed he was [AGE] years old, was admitted to the facility on [DATE] and discharged to a local hospital on [DATE]. Record review of Resident #294's clinic referral dated 08/23/2023 revealed he was alert, oriented only to person, unable to follow directions and delusional.? He had diagnoses including memory deficit. Record review of Resident #294's clinical records revealed no baseline care plan. Record review of Resident #294's progress note dated 9/05/2023 at 02:00 AM revealed he had behaviors including taking his clothes off in another patient's room, urinating and defecating on the floor in a resident's room, throwing chairs, parts of a wheelchair and a concentrator, hitting his roommate with a shirt, attempting elopement, and throwing a toilet cover. Record review of Resident #294's progress note dated 09/05/2023 1:05 PM revealed the resident was being transferred to a local hospital's geriatric behavioral unit for further evaluation. In an interview on 10/22/23 at 04:09 PM, the DON revealed no baseline care plan addressing the care needs for Resident #294 was completed during his time in the facility. In an interview on 10/22/23 at 04:44 PM the DON revealed the baseline care plan was to be completed within 24 hours of admission. She did not know why Resident #249's care plan was not completed by the admission nurse, who was responsible for its completion. The DON stated the ADONs ran reports to make sure the baseline care plans were done but did not know why this one was missed. The DON said the purpose of the baseline care plan was to identify resident's needs and served as a reference point to look back to see the resident's incoming condition. She said that lacking the baseline care plan could result in missing information for resident's care and in not identifying changes in the resident. Record review of the facility policy Care Plan Process, Person-Centered Care revised 05/05/2023 revealed the facility would develop and implement a baseline care plan for each resident that included the instructions needed to provide effective and person-centered care that met professional standards of quality care.? The baseline care plan would be developed and implemented within 48 hours of a resident's admission and include the minimum healthcare information necessary to properly care for the resident. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 11 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to develop and implement comprehensive person-centered care plan that includes measurable objectives and time frames to meet a resident medical and nursing needs to be furnished to attain or maintain the residents highest practicable physical, mental, and psychosocial well-being for 2 of 12 residents (Resident #89 and Resident #241) reviewed for care plans in that: 1. The facility failed to ensure that Resident #89's comprehensive care plan included his behavior of pulling out his G-Tube. 2. The facility failed to ensure that Resident #241's comprehensive care plan included her ADL needs. These failures could place residents in the facility at risk of not receiving the necessary care or services and not having personalized plans developed to address their needs. Findings included: Resident #89 Closed record review of Resident #89's face sheet dated 10/21/2023 revealed he was [AGE] years old, was admitted to the facility on [DATE] and discharged on 07/27/2023. He had diagnoses including encounter for attention to gastrostomy (feeding tube), dysphagia (difficulty swallowing), and dementia. Record review of Resident #89's quarterly MDS assessment dated [DATE] documented he had a BIMS of 6 (severe cognitive impairment). He had intermittent periods of inattention, disorganized thinking and altered level of consciousness. Active diagnoses included Alzheimer's disease and non-Alzheimer's dementia. He had problems swallowing resulting in coughing or choking during meals or when swallowing medications and did not have a G-Tube. Record review of Resident #89's physician orders revealed multiple orders related to the resident's feeding tube including: enteral tube site care once a day dated 09/08/2021 through 07/26/2023; enteral feeding formula orders dated 01/11/2023 through 05/19/2023 and 07/26/2023 through 08/10/2023. Record review of Resident #89's progress note date 05/27/2023 revealed that the resident had pulled out his feeding tube and was sent to the hospital to have it replaced. Record review of Resident #89's progress note date 07/08/2023 revealed that the resident had pulled out his feeding tube and was sent to the hospital to have it replaced. Record review of Resident #89's care plan for the date range of 03/10/2021 through 10/11/2023 revealed no documented care plans to address the resident's behavior of pulling out his g-tube. In an interview on 10/22/23 at 02:53 PM, the DON revealed Resident #89 had no care plan for his behavior of pulling out his g-tube. She said the purpose of the care plan was to make sure behaviors were identified and tracked. She said the care plan let staff know what to do to address the behavior (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 12 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0656 Level of Harm - Minimal harm or potential for actual harm and was important for the safety of the resident. She said without the care plan, the facility would not know that it was something that kept happening with the resident. She said the MDS nurses were responsible for putting together the care plan. The DON stated that there was no system in place and no one person responsible for monitoring whether Care Plans were correct. Residents Affected - Few Resident #241 Review of Resident #241's face sheet dated 10/20/2023 revealed a [AGE] year-old female with an initial admission date to the facility of 01/18/2023 and re-admission date of 10/16/2023. Review of Resident #241's History and Physical dated 08/08/2023 revealed a diagnosis of Encephalopathy (disease affecting brain function that causes confusion and altered mental state) Parkinson's disease (condition that affects the brain causing problems with movement, balance, and coordination). Review of Resident #241's Quarterly MDS assessment dated [DATE] revealed Resident #241 required ADL assistance such as extensive assistance with bed mobility, toileting, dressing and personal hygiene. Review of Resident #241's comprehensive care plan dated 09/18/2023 did not indicate that she required assistance with ADLS. Observation on 10/17/2023 at 10:50 AM revealed Resident #241 was not interviewable and was unable to answer questions. An interview on 10/20/23 at 5:05 PM with MDS Nurse A revealed comprehensive care plans should have included ADL needs, major diagnosis that affects ADLs, physician orders and medications residents were on. She revealed it was important to ensure the care plans included all that information because any staff member could look up the care plan and use it as part of residents' care. She revealed it was important to include the residents ADL needs because their care could be overlooked. The care plan had to paint a picture of the resident. A follow-up interview on 10/22/23 at 6:02 PM with MDS Nurse A revealed Resident #241's comprehensive care plan d had not been updated to show that she needed assistance with care. She could not state why it had not been updated, but revealed her care plan should have been personalized to her needs. Record review of the facility policy Care Plan Process, Person-Centered Care revised 05/05/2023 revealed the facility would develop a comprehensive care plan for each resident that included instructions needed to provide effective and person-centered care that met professional standards of quality care.The comprehensive care plan would include objectives and time frames to meet a resident's medical, nursing and mental and psycho-social needs identified in the comprehensive assessment. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 13 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure a resident who is unable to carry out activities of daily living receives the necessary services to maintain good nutrition, grooming, and personal and oral hygiene for 2 (Resident #9 and Resident #15) of 6 residents observed for assistance with ADL's. Residents Affected - Few The facility failed to ensure Resident #9 and Resident # 15, who required assistance with ADLs, and were not observed to have long nails. This failure could affect residents who were dependent on assistance with ADLs and could result in poor care, lack of dignity, and skin tears due to long nails. Findings included: Record review of Resident #9's face sheet dated 10/20/2023 revealed a [AGE] year-old male with an initial admission date to the facility of 07/13/2017 and re-admission date of 03/02/2023. Record review of Resident #9's History and Physical dated 08/17/2023 revealed a diagnosis of cerebral infarction (stroke) and contracture of muscle. It also revealed he required assistance with ADLs. Record review of Resident #9's Comprehensive MDS assessment dated [DATE] revealed a BIMS score of 6, indicating a severe cognitive impairment. It also revealed he required extensive assistance from staff with personal hygiene. Record review of Resident #9's comprehensive care plan dated 09/05/2023 revealed Resident #9 required assistance with daily ADL's due to limitations in mobility following CVA. The goal was that Resident #9 would maintain its current level of function. Interventions included Resident #9 required assistance from staff for dressing, bathing and showering. Record review of Resident #9's physician order dated 03/19/2020 revealed Nail Check Completed .once a day on Thursday. Record review of nail check documentation for October 2023 revealed 10/12/23 Podiatry Consult requested and 10/19/23 Podiatry consult requested. Observation and interview on 10/18/23 at 8:26 AM of Resident #9 revealed his fingernails appeared about 0.25 - 0.5 cm long. Resident # 9 was asked if he wanted his nails cut and he said yaaaah. He could not state if his fingernails had been cut recently or if the nurses had asked to cut his fingernails. An interview on 10/20/23 at 9:59 AM with LVN H revealed she was not aware of Resident # 9's fingernails being long, but stated she would be cutting them since she last cut them earlier in October 2023. She stated that CNAs were to report to her if nails were getting long, that way, she could place order for podiatry or cut them herself. She stated the staff would be able to cut his fingernails. She revealed there was no reason why his fingernails had not been cut, but stated they should have been. She stated he was able to voice if he wanted his fingernails cut, but he had not done so (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 14 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few recently. She stated it was important to address the needs of residents with ADL dependency because they were not able to complete their needs. She stated the nurses had to assess their needs and make sure they were being met. Risks to residents were that they could cut their skin with long nails if it was not being addressed. An interview on 10/20/23 at 10:56 AM with CNA I revealed she knew Resident# 9's fingernails had been getting long but she did not know how long they had been that way. She revealed the CNA staff had to communicate with the nurses when they noticed the nails of residents were getting long. She could not state why she had not notified the nurse. She stated she had seen the nurse cut his fingernails but could not remember when. She stated the risk of not providing fingernail care to residents that required assistance could be that residents could cut their skin with their long nails. Resident #15 Record review of Resident #15's face sheet dated 10/20/2023 revealed a [AGE] year-old male with an admission date to the facility of 02/01/2019. Record review of Resident #15's History and Physical dated 05/19/2023 revealed a diagnosis of hemiplegia (paralysis) and hemiparesis (weakens) affecting left side and a history of stroke. It also revealed he required assistance with ADLs. Record review of Resident #15's Quarterly MDS assessment dated [DATE] revealed a BIMS score of 13 indicating he was cognitively intact. It also revealed he was totally dependent on staff for personal hygiene activities. Record review of Resident #15's comprehensive care plan dated 05/28/2023 revealed Resident #15 required assistance with ADLs and self-care performance as evidenced by stroke related to hemiplegia. The goal was that Resident#15 would maintain current level of function in bed mobility, transfers, dressing, eating, toilet use and personal hygiene with restorative nursing plan. Interventions included that resident required total assistance for dressing and grooming related to hemiplegia. Record review of Resident #15's physician order dated 03/21/2020 revealed Nail Check Completed .once a day on Saturday. Record review of nail check documentation for October 2023 revealed 10/14/23 No intervention needed and 10/21/23 No intervention needed. Observation and interview on 10/22/23 at 11:00 AM revealed Resident #15's fingernails on his left hand appeared about 0.25 cm long. His fingernails on his right hand appeared to be recently cut as they were short in length. He was asked if staff had cut his nails recently and he said si (Spanish for yes). He was asked why the staff had not cut his nails on his left hand and he was unable to answer. He was unable to state who had cut his nails. He denied having pain in his fingernails. An interview on 10/22/23 at 11:08 AM with Registered Nurse J revealed she was not sure who was assigned to cut Resident #15's fingernails. She stated she was not aware that he had long nails and she stated she had checked his fingernails on 10/21/23. She stated she had checked his fingernails and documented that he did not need interventions for his fingernails. She could not state why she had documented that. She stated that both CNAs and nurses were able to cut fingernails but did not state why she had not cut his fingernails during nail check. She stated she would be cutting fingernails on (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 15 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 10/22/23. She stated if residents did not get their nail care needs met, they could get wounds to their hand from the long nails. An interview on 10/22/23 at 4:36 PM with the DON revealed the nursing staff had to make sure that residents' fingernails were short per residents' preferences. She stated that nurses were allowed to cut residents' fingernails and there was no reason they should not have been cut for Resident #9 and Resident #15. She stated that for any resident, their needs had to be met because it was part of their basic needs, and for them to be comfortable. Record review of facility policy titled Activities of Daily Living, Optimal Function dated 8/20/2017 read in part .The facility provides necessary care to all residents that are unable to carry out activities of daily living on their own to ensure they maintain proper .grooming .facility staff develop and implement interventions in accordance with the resident's assessed needs .grooming . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 16 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure that a resident who needs respiratory care is provided such care, consistent with professional standards of practice and the comprehensive person-centered care plan for one (Resident #33) of 5 residents reviewed for respiratory care. Residents Affected - Few The facility failed to ensure that Resident #33's oxygen concentrator was delivering oxygen at the physician-ordered rate (liters per minute). This failure could put residents at risk of oxygen toxicity. Findings included. Record review of Resident #33's face sheet dated 10/18/2023 revealed she was [AGE] years old and admitted to the facility on [DATE]. Record review of Resident #33's History and Physical dated 08/18/2023 revealed that the resident had medical history including lung cancer and diagnoses including chronic obstructive pulmonary disease (COPD - disease that blocks airflow in the lungs). She was receiving breathing treatments and was dependent on supplemental oxygen via nasal cannula (a tube delivering oxygen to the nose). Record review of Resident #33's admission MDS assessment dated [DATE] revealed she received oxygen therapy prior to and while at the facility. Record review of Resident #33's care plan dated 08/25/2023 revealed that she had a diagnosis of COPD (disease that blocks airflow in the lungs), was receiving inhalation nebulizer treatments (breathing treatment) and that staff were to monitor her saturation levels (amount of oxygen in the blood). Record review of Resident #33's physician order dated 10/13/2023 revealed she was to receive oxygen at 2 liters per minute via nasal cannula. Record review of Resident #33's October 2023 MAR (reviewed 10/18/2023) revealed she received oxygen at 2 liters per minute via nasal canula every shift from 10/13/2023 through 10/17/2023. Observation on 10/17/2023 at 9:58 AM revealed Resident #33 was in bed with an oxygen canula in her nose. Observation of the flow meter on the oxygen concentrator to which the oxygen canula was attached was set at 4.25 LPM. In an observation and interview on 10/17/2023 at 10:17 AM, LVN C said the flow meter for Resident #33's oxygen concentrator should have been set at 2 LPM. He said he checked Resident #33's oxygen concentrator at 9:00 AM and it was set at 2 LM. He stated that sometimes the CNAs would change the oxygen settings on concentrators although they were trained not to do that. LVN C was observed looking at the flow meter on Resident #33's oxygen concentrator. He stated that the flow meter was set at 4.5 LPM but should be set at 2 LPM. LVN C stated he did not think the higher oxygen concentration posed a risk to the resident. LVN C stated that CNAs would turn the oxygen concentrator on or off when transferring residents from using the oxygen concentrator to the oxygen tank, or vice versa, but were not to touch the flow meter. He stated if he had found the flow meter set higher than ordered he would have checked with the nurse from the previous shift and checked the resident's orders in case (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 17 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0695 there had been a change in the physician's order for oxygen. Level of Harm - Minimal harm or potential for actual harm In an interview on 10/19/23 at 09:36 AM, CNA E revealed that the morning of 10/17/2023 the first thing she did was work with another CNA to give Resident #33 a bed bath. CNA E said she did not remember if she did anything to the oxygen concentrator while assisting Resident #33 with the bed bath. The CNA said she usually noticed whether resident's oxygen concentrators were turned on when providing care to residents and might ask nurses about the oxygen if there was a concern. CNA E did not recall talking with Nurse C about Resident 33's oxygen levels or concentrator the morning of 10/17/2023. Residents Affected - Few In an interview on 10/22/23 at 05:08 PM, the DON revealed she had been made aware by her staff that Resident #33's oxygen LPM was set too high. She said the resident might get more oxygen than needed as a result of the concentrator flow meter being set too high. The DON said the concentrator flow meter being set too high could result in hyperoxia (an excess supply of oxygen in the tissues and organs - oxygen toxicity).? FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 18 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, interviews, and record review, the facility failed to store biologicals under proper temperature controls for 1 medication cart (300 Hall) of 3 medication carts reviewed for medication storage. -The facility failed to ensure that a container of thickened water was kept under appropriate temperatures after it was opened. This failure could cause a decline in health in residents if medications were to be given after not being stored at correct temperatures. Findings included: Observations on 10/19/23 at 9:37 AM of the 300 hall medication cart with CMA Q revealed a container of Ready Care Thickened Water dated as opened on 10/17/23. The container was stored in the last drawer and was not refrigerated. Directions on the side of the container that read .After opening, may be kept up to 7 days under refrigeration. An interview on 10/19/23 at 9:41 AM with MA Q revealed she checked the medication cart once a week to make sure the medication carts did not have expired medications, ensure they were clean. She stated the thickened water containers, once they are opened, should have been kept in the refrigerator after opening because it could have gone bad and not be thickened like it was meant to be. She did not know who had left the opened container of thickened water in the medication cart and denied it had been hers. An interview on 10/22/23 at 4:40 PM with the DON revealed she had spoken with the former dietary manager that the thickened water did not have to be refrigerated after opening. The DON stated she would ask him for the policy that reflected that thickened water did not have to be refrigerated after opening. The DON did not state the risk to the residents of having thickened water out of refrigerator. A follow-up interview on 10/22/23 at 7:10 PM with the DON revealed she could not find the policy to indicate that the thickened water could remain out of the refrigerator. Record review of www.lyonsreadycare.com website dated 2023 revealed Thickened Water, Shelf life: 7 months from date of manufacture. Refrigerate after opening and use within 7 days. Record review of facility policy titled Nursing policies and procedures: Medication management program dated 7/1/2016 read in part .Items requiring refrigeration may be kept in an ice bath on the top of the cart .The authorized staff member or licensed nurse will retrieve refrigerated items needed for administration prior to initiating the medication pass. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 19 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to maintain clinical records that were complete and accurately documented for 1 (Resident #30) of 18 residents reviewed for clinical records. 1. The facility failed to document on 08/13/23 when CNA reported resident #30 had a swollen left ankle. 2. The facility failed to document a pain assessment on 08/13/23 when Resident #30 complained of pain to left ankle. 3. The facility failed to document the administration of Diclofenac Sodium Gel that was administered to Resident #30 on 08/13/23 for pain to left ankle. This failure could put residents at risk of not receiving prescribed pain medications as ordered. Findings include: Record review of undated face sheet revealed Resident #30 [AGE] year-old female was admitted on [DATE]; re-admitted [DATE] from hospital. Review of Hospital Records for Resident #30 revealed: Encounter Date 08/14/23. Encounter Diagnosis: Fracture of distal end of left tibia. Unwitnessed fall. Dementia. Safety Awareness: Impaired due to cognition. Pt. coming from nursing home for LLE swelling onset yesterday, leg is broken per X-ray done at nursing facility. Ankle X-ray Left Ankle 08/14/23 revealed soft tissue swelling. Diffuse osteopenia (a loss of mineral density that weakens bones). There was a nondisplaced fracture involving the distal medial aspect of the tibia (a fracture shin bone where the bones remain aligned). Evidence of a nondisplaced fracture involving the distal fibula (ankle fracture). Impression: Osteoporosis. Hard cast was placed. Record Review admission History & Physical dated 08/21/2023 revealed Resident #30 was a re-admission, after hospitalization fracture LLE (X-ray performed in the ER shows presence of distal tibia and fibula fracture and now has hard cast). Patient with diffuse bruising to upper extremities as well as top of head. Past Medical History: Anxiety disorder, Parkinson's disease, Major Depressive disorder, Psychotic disorder with delusions, muscle wasting and atrophy, unsteadiness on feet, lack of coordination, repeated falls. Confused. Plan: Fall prevention in place. Review of Review PPS 5-day MDS assessment dated [DATE] for Resident #30 revealed reentry from hospital; unclear speech; usually makes self-understood; usually understands-others; BIMS 11-Cognitive ability moderately impaired; Inattention; ADLs requires extensive assistance of two persons bed mobility; extensive assistance of one person with locomotion on unit, dressing, eating, toilet use, personal hygiene; total assistance of one person with bathing; Functional Limitation in range of motion to lower extremities; mobility device-wheelchair; received scheduled pain medication; Special Treatments: occupational therapy; physical therapy. Review of Care Plan edited on 07/02/23 for Resident #30 revealed, Resident was at risk for falls R/T Parkinson's. Approaches: Toileting before/after meals and at bedtime. Keep personal items and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 20 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few frequently used items within reach. Observe frequently and place in supervised area when out of bed. Give resident verbal reminders not to ambulate/transfer without assistance. Keep the call light in reach. Provide resident environment free of clutter. Review of Physician's Orders Report dated 08/01/23 - 10/22/23 revealed for Resident #30 diclofenac sodium gel 1% 2 gm topically every 8 hours as needed for pain. Lt. ankle portable x-ray related to pain. Refer to Ortho for non-displaced FX at the junction of the distal shaft and lateral malleolus (a fracture shin bone where the bones remain aligned). Review of PRN (as needed) Medications Administration History dated 08/01/23 - 08/31/23 for Resident #30, revealed there was no documentation of the administration of the diclofenac gel by RN D on 08/13/23 when resident complained of pain to left ankle. Review of Licensed Nurse Administration History: 08/01/2023 - 08/31/23 for Resident #30, revealed RN D had not documented 08/13/23 when resident complained of pain to left ankle in the morning and evening shifts. Review of Resident Incident/Accident Investigation Worksheet dated 08/13/23 at 11:00 PM for Resident #30 revealed, Type of Incident/Accident: Unknown Cause. Location of Injury: Left ankle. Mental Status: Confused/Disoriented. Ambulatory Status before: Wheelchair. Describe exactly what happened - CNA reported left heel was swollen and complaining of pain. Assessment done; swelling present, no redness. Resident able to move ankle. Applied diclofenac 1% as PRN order. NP notified. X-ray to left heel. New order to transfer out to hospital for further evaluation. Resident came back from hospital 08/19/23. Review of Radiology Order dated 08/14/23 for Resident #30 revealed portable x-ray of left ankle. Interview on 10/22/23 at 11:16 AM, RN D revealed she was assigned to Resident #30 on Sunday 08/13/23 on the 6-2 and 2-10 shift when one of the CNAs had reported resident had a swollen left ankle but could not remember her name. RN D stated she assessed the resident and noted the left ankle was swollen and complained of pain with movement. RN D stated she had not documented in progress notes when CNA reported Resident#30 had a swollen left ankle and had not documented the level of pain in the progress notes or the Medication Administration Record on the 2-10 shift. RN D reported she had not documented on the Medication Administration Record that she applied diclofenac sodium gel topically to Resident # 30's left ankle for pain. RN D stated I was trained to document the pain level in nursing school. I was busy and forgot to chart. Interview and record review on 10/22/23 at 1:35 PM with DON confirmed that RN D had not documented on the Medication Administration Record for Resident #30 that she applied the diclofenac sodium gel 1% topically for pain on 8/13/23, when resident was having pain to the left heel. DON stated, nurses had been trained to immediately document after administering medications on the Medication and Treatment records. DON also confirmed RN D had not documented in the Progress Notes when she assessed Resident #30 on 08/13/23 for pain to the left heel. DON stated, the nurses needed to assess all residents for pain on every shift and document pain level on the Medication Administration Record and Progress Notes. Review of Policy Documentation Guidelines revised 07/01/2016 revealed Policy: Documentation guidelines pertinent to good clinical record practice will be followed by all individuals who document in the medical record. Guidelines: All entries should be based on the writer's first-hand knowledge. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 21 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0842 Level of Harm - Minimal harm or potential for actual harm Review of Pain Management revised on 07/01/2023 revealed, Policy: The intent of this policy is to ensure that residents receive treatment in accordance with professional standards, related to pain management. Procedures: Pharmacological interventions utilized will consider factors such as the causes, location, and severity of pain, the potential benefit, of medication. Ongoing evaluation of the resident's pain levels. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 22 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections in 2 out of 6 residents reviewed for infection control. Residents Affected - Some The facility failed to ensure CNA F and CNA I maintained proper hand hygiene and use gloves while performing perineal care for Resident #30 and Resident #15. This failure could place other residents who receive perineal care at risk of cross-contamination. Findings included: Resident #30 Record review of Resident #30's face sheet undated revealed a [AGE] year-old female was admitted on [DATE]; re-admitted [DATE]. Record Review of Resident #30's History & Physical dated 08/21/2023 revealed history of left distal tibia (lower leg near the ankle) fracture, anxiety disorder, Parkinson's disease, Major Depressive disorder, muscle wasting and atrophy, unsteadiness on feet, and lack of coordination. Record review of Resident #30's annual MDS assessment dated [DATE] revealed resident had unclear speech; usually made her needs understood and can understands others. Section C documented Resident#30 had a BIMS score of 11 indicating her cognition was moderately impaired. Required extensive assistance with ADLs was two persons transfer during bed mobility, extensive assistance of one person with locomotion on unit, dressing, eating, toilet use, personal hygiene, and total assistance of one person with bathing. Resident #30 has functional limitation in range of motion to lower extremities, mobility device-wheelchair. In section H (Bladder and Bowel) documented Resident #30 was always incontinent of both urinary and bowel. Record review of Resident #30's care plan dated 07/27/21 revealed resident is incontinent of urinary and bowel with interventions of; resident will be checked at least every 2 hours for incontinent episodes and incontinent care will be provided after each incontinent episode. Observation on 10/18/23 at 10:43 AM with CNA F performed perineal care on Resident #30 who had a bowel movement and soiled her pants. During observation CNA F utilized one pair of gloves cleaned resident front pubic area wiping toward the back. CNA F turned resident towards the right side and finished cleaning the resident's buttocks and removed the brief. CNA F removed her right glove and continued with incontinent care, placing ungloved hand on resident upper thigh. CNA F placed a cleaned brief on the resident, removed the other glove and threw everything in the trash. CNA F finished changing resident and assisted resident into her wheelchair. CNA F left Resident#30's room and entered another resident room without using handsinitizer or washing her hands. Interview on 10/18/23 at 10:54 AM with CNA F called back for interview, stated she usually washes her hands when done with perineal care but forgot and applied hand sanitizer during the interview to correct the error. CNA F stated she was trained to always use gloves when providing perineal care, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 23 of 24 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 676393 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Las Ventanas DE Socorro 10064 Alameda Avenue Socorro, TX 79927 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 0880 Level of Harm - Minimal harm or potential for actual harm and to not touch residents with her bare hands. CNA F stated she forgot to get sufficient gloves to proper perform perineal care on the resident and did not know if she could leave the resident side to go get more gloves. CNA F stated that by not following proper hand hygiene, the resident can be placed at resident risk of cross contamination. Residents Affected - Some Resident #15 Record review of Resident #15's face sheet dated 10/20/2023 revealed a [AGE] year-old male with an admission date of 02/01/2019. Record review of Resident #15's History and Physical dated 05/19/2023 revealed a diagnosis of hemiplegia (paralysis) and hemiparesis (weakness) affecting left side, and a history of stroke. Record review of Resident #15's Quarterly MDS assessment dated [DATE] revealed a BIMS score of 13 indicating he was cognitively intact. Section G (functional abilities) indicated Resident #15 required total assistance with 2-person assistance for personal hygiene. During observation on 10/19/23 at 04:25 PM, CNA I changed Resident #15 soiled brief and when done wiping Resident # 15, CNA I removed dirty gloves and threw them in the trash bin. CNA I continued to work with the resident with bare hands without washing her hands. CNA I placed calamine cream in between Resident #15's thighs and continued to close resident's brief and put on resident's pants. When done assisted Resident #15 into wheelchair, CNA I went to wash her hands. CNA I stated she was trained to always wear gloves when providing care for residents and not to touch residents with her bare hand because it can cause cross contamination. Record review of facility policy titled Perineal Care/ incontinent care dated 7/1/2016 read in part don gloves, cleanse skin with incontinent wipe until skin is clear of fecal material, wash hands, don (put on) gloves, apply moisture barrier if needed. Reapply appropriate incontinence brief. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 24 of 24