Health inspection·January 24, 2024

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Record review of Resident #1's care plan dated 01/10/2024 revealed Resident #1 had a focus area that indicated the following: Resident #1 was dependent on staff for meeting emotional, intellectual, physical, and social needs. An intervention was to confer with resident to assess comfort level and staff will offer one to one visit to resident. Record review of Resident #1's SBAR Communication Form dated 01/14/2024, reads in part that resident was observed with change in condition and signs observed were congestion and low oxygen saturation. Resident #1 with increased confusion and disorientation. Physician notified and ordered to send Resident #1 to the emergency room. Review of hospital report dated 01/14/2024, reads in part Resident #1 sent to hospital due to fever and shortness of breath. No injuries noted. Diagnosed with pneumonia, bronchitis, CHF, pulmonary embolism, COPD, pulmonary edema, sepsis. No concerns noted related to reported allegation. During an interview on 01/22/2024 at 2:57 p.m., Resident #4 said he and Resident #1 shared a room and were receiving services at the facility up until the time Resident #1 went to the hospital. Resident #4 said that the services were good. Resident #4 said he felt safe at the facility and he and Resident #1's needs were met. Resident #4 said Resident #1 was treated well by the staff at the facility. Resident #4 said Resident #1's his wife's health decline while in the hospital and she passed away at the hospital. Resident #4 said he had no complaints regarding the care and staff treatment provided at the facility. Record review of admission dated 1/24/2024 revealed Resident #2 was an [AGE] year-old female admitted to the facility on [DATE]. Resident #2's diagnoses included the following: dementia (loss of cognitive functioning to such an extent that it interferes with person's daily life and activities), pneumonia (infection that affects one or both lungs), depression (depressed mood or loss of pleasure or interest in activities for long periods of time), type 2 diabetes (disease that occurs when blood glucose is too high), anxiety disorder (persistent and excessive worry that interferes with daily activities), muscle weakness, and cerebral infarction (damage to tissues in the brain due to a loss of oxygen to the area). Record review of Resident #2's quarterly MDS assessment dated [DATE] revealed a BIMS score of 06 indicating severe cognitive impairment. Section on Functional Abilities and Goals revealed Resident #2 was independent with eating. Record review of Resident #2's care plan dated 11/08/2024 revealed Resident #2 had a focus area that indicated the following: Resident #2 requires assistance and motivation with feedings. Intervention for eating included assist of one staff member. Record review of Resident #2's assessment dated [DATE], revealed no injuries and no signs or symptoms of psychological distress. During an interview on 01/22/2024 at 12:10 p.m., CNA K said on 01/13/2024 she observed while bathing Resident #1 that CNA L used foul language referring to Resident #1 as a pinchi vieja (translation from Spanish to English: fucking old woman) and pinchi familia (translation from Spanish to English: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 2 of 7 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 01/24/2024 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some fucking family). CNA K said while Resident #1 was lying on a cushioned shower gurney, CNA L roughly pulled a pillow that was under the resident's head without first assisting the resident to lift her head. CNA K said Resident #1 did not hit her head but that the action was forceful and unprofessional. CNA K said that she took over physically bathing Resident #1 as it appeared CNA L was in a bad mood. CNA K said that the resident was not injured and did not show any emotional affects from the incident. CNA K said after the bathing incident she observed CNA L assisting Resident #2 to eat in the dining room. CNA K said that CNA L told Resident #2 to hurry up and eat. CNA K said she told CNA L that she would help feed Resident #2 instead, since CNA K's actions appeared to be rough. CNA K said that her error was that she did not report the incident to anyone immediately because she did not have the Administrator's phone number. CNA K said she should have contacted someone immediately but did not report the incidents to anyone until the next shift. CNA K said she told her manager Staffing Coordinator E about the incident. CNA K said that the Staffing Coordinator removed CNA L immediately from working with residents. CNA K said that she then spoke with the HR Coordinator about the incidents. CNA K said she knows she should have called the Administrator immediately regarding the incidents but did not know where to find the number. CNA K said she did not ask anyone for assistance to contact someone regarding the incidents. CNA K said she had the numbers for the Staffing Coordinator but figured she would let him know the next time she saw him in person. During an interview on 01/22/2024 at 12:59 p.m., the Regional Nurse Consultant (RNC) said facility staff are trained to report allegations of abuse or neglect immediately to the Administrator. The RNC said CNA K failed to report the allegation immediately and waited until the following day to report the allegation to the Staffing Coordinator. The RNC said the Staffing Coordinator suspended CNA L immediately pending investigation. The RNC said she and the Administrator did not learn of the incidents until 01/16/2024, at which time the Administrator self-reported the incidents and immediately began an investigation. The RNC said the Administrator's contact information was on the bulletin board in the hallway and by the front reception desk. Observation on 01/22/2024 at 1:30 p.m., revealed posting of the Administrator's name and number which included information of her being the Abuse Coordinator was found posted by the bulletin board entering the 300-hall. The same information was found posted by the front reception desk. During an interview on 01/22/2024 at 4:10 p.m., CNA L said at no time did she abuse anyone or speak to any of the residents using foul or aggressive language. CNA L said she and CNA K assisted Resident #1 during bathing and denied any incident involving Resident #1. CNA L denied speaking aggressively towards Resident #2. CNA L said she was suspended by the Staffing Coordinator and had not returned to work pending the investigation. During an interview on 01/24/2024 at 1:15 p.m., Resident #2 said she had no concerns regarding the services provided or staff communication with her. Resident #2 said no staff had yelled at her or made her feel upset with what they were saying. Resident #2 said there had been no incidents involving her and any staff at the facility. Resident #2 said she felt safe at the facility and all her needs were being met. Resident #2 said she had been at the facility in the past and liked the services, so she came back. Resident #2 said all staff treat her well and she had no concerns. During an interview on 01/24/2024 at 11:22 a.m., the Administrator said all staff at the facility are trained on reporting abuse, neglect, and exploitation during orientation and annually. The Administrator said she was out of town on 1/13/2024 but available by phone in case there are any allegations reported. The Administrator said she was not notified of the allegations that allegedly occurred on 01/13/2024 until 01/16/2024. The Administrator said she was notified of the allegation by the HR (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 3 of 7 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 01/24/2024 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Coordinator on 01/16/2024 at which time she reported the allegation to the State. The Administrator said that the HR Coordinator was made aware of the allegations on 01/15/2024 during the evening. The Administrator said that the HR Coordinator said that since she was going to see the Administrator the following day that she waited to report the allegation. The Administrator said that CNA K reported the allegations to the Staffing Coordinator on 01/15/2024, who then called the HR Coordinator to inform her that he was suspending CNA L immediately due to the allegations. The Administrator said there was a breakdown in the reporting process and the facility immediately began 100% staff training on reporting abuse, neglect, and exploitation. The Administrator said her contact number was located in the hallway bulletin board and posted by the front desk that had been posted since she started at the facility on 01/02/2024. The Administrator said after reporting the allegations, they conducted a safe survey and looked for symptoms or signs of depression in residents with communication challenges. The Administrator said the decision was made to terminate CNA L. The Administrator said the decision was also made to terminate CNA K for failure to report the allegations immediately and failing to protect the residents by allowing CNA L to continue being around other residents. During an interview on 01/24/2024 at 11:43 a.m., the Staffing Coordinator said he was contacted by CNA K on 01/15/2024 at around 5:30 p.m. The Staffing Coordinator said CNA K reported that CNA L was very rough with Resident #1 during a shower and pulled a pillow away from the resident roughly. The Staffing Coordinator said CNA K also reported that CNA L was using bad language around the resident. The Staffing Coordinator said that CNA K also reported that CNA L was speaking roughly to Resident #2 during dinner. The Staffing Coordinator said he asked CNA K why she had not called him immediately and she told him that she wanted to talk to him face-to-face. The Staffing Coordinator said CNA L was working at the time he received the information, and he called the HR Coordinator to told her what was reported and that he was suspending CNA L from work until talking to the Administrator the next day. The Staffing Coordinator said he spoke with the Administrator the next day (01/16/2024) and was informed that he should have called the Administrator immediately. The Staffing Coordinator said when he spoke with the HR Coordinator who was not at the facility at the time, she told him they would talk to the Administrator the following morning. Review of facility provided policy titled Abuse, Neglect, Exploitation, or Mistreatment undated, reads in part, The facility shall report immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not result in serious bodily injury to the administrator of the facility and to other officials (including to the Stat Survey Agency and adult protective services where state law provides for jurisdiction in long-term care facilities) in accordance with State law through established procedures. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 4 of 7 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 01/24/2024 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation, interview, and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for professional standards for food service safety. -The facility kitchen was observed on 01/24/2024 with 1 bag of frozen French fries located in the walk-in freezer that was removed from the original package, dated 1/21/24 and was not sealed. -The facility kitchen was observed on 01/24/2024 with 1 bag of tater tots located in the walk-in freezer was found out of original package, was not sealed, or labeled. -Cook O was observed on 01/24/2024 with - with a beard and was not wearing a beard net while preparing food in the kitchen. These failures could place residents at risk of food-borne illness. Findings included: Observation on 1/24/2024 at 9:30 a.m., of the walk-in freezer revealed a gallon sized zipper storage bag of frozen French fries removed from the original package and that was open. The bag was labeled 01/21. Observation on 01/24/2024 at 9:30 a.m., of walk-in freezer revealed a gallon sized zipper storage bag of tater tots removed from the original package that was open and not labeled or dated. Observation on 01/24/2024 at 2:05 p.m., revealed [NAME] O with a beard. [NAME] O was preparing food and was not wearing a beard net. The DM observed [NAME] O and immediately told [NAME] O to put on a beard net. During an interview on 01/24/2024 at 2:15 p.m., the DM said she observed [NAME] O without a beard net and immediately redirected him. The DM said signs with those specific instructions are posted in the kitchen and there was no excuse for any staff to be without a hair or beard net. The DM said the risk of not wearing the appropriate hair or beard net was contamination of the food. The DM said she was aware that open packages were found in the freezer. The DM said that all food items must be sealed storage bag if removed from original package and must be labeled with the date the items were stored. The DM said the risk of open packages in the freezer was freezer burn and spoilage of food. Review of facility policy Food Safety in Receiving and Storage dated 2020, reads in part, food will be received and stored by methods to minimize contamination and bacterial growth. Place food that is repackaged in a leak-proof, non-absorbent, sanitary container with a tight-fitting lid. Label both the container and its lid with the common name of the contents, the date it was transferred to the new container and the discard date. Review of facility nutrition policy Dress Code dated 2020, reads in part, Dietary staff involved in food production adheres to the department dress code that includes: 6. Appropriate hair restraints (such as hats, hair covers or nets, beard restraints) while involved in food production activities. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 5 of 7 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 01/24/2024 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 0812 Review of Food Code 2022 revealed: Level of Harm - Minimal harm or potential for actual harm 2-402 Hair Restraints. FOOD EMPLOYEES shall wear hair restraints such as hats, hair coverings or nets, beard restraints, and clothing that covers body hair, that are designed and worn to effectively keep their hair from contacting exposed FOOD; clean EQUIPMENT, UTENSILS, and LINENS; and unwrapped SINGLE-SERVICE and SINGLE-USE ARTICLES. Residents Affected - Some 3-202.15 Package Integrity. FOOD packages shall be in good condition and protect the integrity of the contents so that the FOOD is not exposed to ADULTERATION or potential contaminants. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 6 of 7 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 01/24/2024 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 0850 Hire a qualified full-time social worker in a facility with more than 120 beds. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review the facility failed to ensure they employed a qualified social worker on a full-time basis for eight of eight weeks reviewed. Residents Affected - Some The facility, licensed for 126 beds, failed to have a full time Social Worker for eight weeks, from 11/27/2023 to 01/24/2024. This failure could place residents at risk of unmet psychosocial needs and poor quality of life. Findings included: Record review of the Facility Summary Report revealed the facility was licensed for 126 bed capacity. Record review of Employee Job History revealed SW P last date worked was 11/26/2023. During an interview on 01/24/2024 at 10:47 a.m., the Administrator said she started working at the facility on 01/02/2024. The Administrator said the facility does not currently have a Social Worker (SW). The Administrator said the former SW last worked at the facility on 11/26/2023. The Administrator said that a Social Services Contingency Plan was put into effect. The Administrator said she was the grievance officer, the MDS nurses are helping with discharges, and nursing was handling assessments while night nurses are doing interviews and PASSR service screening and the DON was helping with abuse and neglect investigations as needed with psychosocial well-being documentation and follow through. The Administrator said she was a Social Worker by education and training. The Administrator said the Social Worker position had been posted on a job search site since 11/27/2023. Review of Job posting on internet job site revealed Social Worker position for the facility. Start date of posting was 11/27/2023. Review of facility Social Services Contingency Plan, undated, reads in part, The facility has assigned back up for the Social Worker in their absence: 1. Nursing Assessment Coordinator, 2. Clinical Liaison, 3. Receptionist, 4. Director of Nursing, and 5. Other interdisciplinary team members as deemed necessary. Daily responsibilities were assigned to specific department positions. Review of facility provided policy titled Social Services Policies and Procedures dated 2023, reads in part, the facility has a Director of Social Services who is responsible for the provision of medically related social services. The goal of Social Services is to assist each patient/resident to attain or maintain their highest practicable physical, mental, and psychosocial well-being. Facilities with more than 120 beds will have a qualified full-time Social Worker who fulfills the Director of Social Services role. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 7 of 7