Health inspection·December 4, 2025

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete receive services. LVN M stated staff made rounds at least every two hours to ensure call devices were within reach. LVN M stated when she left a resident's room, she ensured the resident did not have additional needs and ensured the call device was within reach. LVN M stated the facility's policy was that call lights must be within reach of the resident. LVN M was provided with a photo of a call light during a surveyor's observation and identified the call light was positioned out of reach for the resident.In an interview on 10/03/2025 at 12:45 PM, The DON stated call lights were used so residents could communicate their needs to staff. The DON stated the call light must be accessible to the patient, defined as next to the patient, on the bed or wheelchair depending on the resident's current location. The DON stated all staff were responsible for ensuring call lights were within reach to include CNAs, nurses, housekeeping, dietary, and leadership. The DON stated staff were trained to ensure the call light was within reach before leaving the room. The DON reported that even if the resident's neighbor was the one receiving care, staff should review the environment of both residents to ensure accessibility to call devices. The DON was provided a photo of the call device and stated it was out of reach for the resident. The DON stated a resident without access to a call device could potentially fall trying to get it, infringes on resident's rights, and could need assistance. The DON stated the last call light in service was approximately one to two months ago. In an interview on 10/03/2025 at 04:05 PM, The Administrator reported the call device was used for residents to express their needs to staff and request assistance. The Administrator stated nursing staff and CNAs as responsible for responding to call lights. The Administrator stated all staff as responsible parties for ensuring residents' call lights was always within reach. The Administrator stated staff were trained to review the residents' environment, ask the residents if they needed any additional assistance before leaving the room. The Administrator reported that staff should be checking that the call device was within reach for both residents in the room. The Administrator recognized the delay of care with ADLs as a potential outcome for residents who do not have their call device within reach. The Administrator stated this could cause the residents to be anxious or result in a loss of balance for residents that attempted to reach the call device or self-ambulate. The Administrator was provided with a photo of the call device and confirmed it was out of reach for the resident. The Administrator reported the last in-service for call devices was conducted on 05/26/2025.Review of the facility's policy titled (undated) Hospital nursing policies and procedures section: C - Call Lights stated the staff will provide an environment that helps meet the parent's need. Procedure number 7 stated, when leaving the room, be sure the call light is placed within the patients reach. Event ID: Facility ID: 676393 If continuation sheet Page 2 of 20 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 12/04/2025 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 0641 Ensure each resident receives an accurate assessment. 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 that the assessment accurately reflected the resident's status for 1 (Resident #2) of 14 resident reviewed for accuracy of MDS assessment, in that:The facility failed to ensure that Resident #2's Significant Change Assessment reflected Resident #2 required total assistance of two persons with bed mobility. The facility failed to ensure that Resident #2's Significant Change Assessment documented in Active Diagnoses resident had two types of autoimmune skin diseases. This failure could place residents at risk of not receiving appropriate interventions or care to meet their current needs. Findings included:Closed record review of Resident #2's Face Sheet dated 10/03/25 revealed, initial admission date 02/19/25, and re-admission date of 07/01/25. Review of History & Physical, dated 06/10/25, for Resident #2 revealed a [AGE] year-old male with past medical history of diabetes mellitus (a condition where the body has high blood sugar (glucose) because it does not make enough insulin or cannot use it effectively), osteoarthritis (wear and tear disease where the protective cushion on the ends of your bones wears away overtime), rheumatoid arthritis (an autoimmune disease where your immune system mistakenly attacks the lining of your joints, causing them to become inflamed, painful, swollen and stiff), pemphigus vulgaris (an autoimmune disease where the body mistakenly attacks its own skin and mucous membranes, causing painful blisters to form on the skin and in the mouth, nose, throat, and eyes) and [NAME]-[NAME] Syndrome (a rare, serious, and life-threating reaction, often to a medication, that causes a painful, blistering rash and sores on the skin and mucous membranes, mouth, throat, eyes, genital). Skin superficial ulcer wound to neck, resident non-compliant with dermatologist appointment due to difficulty with arranging transportation to Drs. Clinics. General appearance - alert and oriented. Skin - coccyx wound. Multiple lesions, scabs, rash throughout the body due to history of [NAME]'s Syndrome and pemphigus Vulgaris. Activities of daily living- impaired by symptoms. Review of Significant Change MDS dated [DATE] for Resident #2 revealed, Section I - Active Diagnoses Stevent-[NAME] syndrome, reduced mobility.Review of Care Plan dated 09/22/25 for Resident #2 revealed: - Problem Start Date: 07/01/25. Edited 09/16/25. Chronic Pain R/T Stevens-Johnson Syndrome and Rheumatoid arthritis. Approaches: Administer Acetaminophen-codeine as ordered.During a telephone interview 10/01/25 at 2:46 PM, CNA A revealed he worked on 9/21/25 on the night shift and he was not given report about his assigned residents by the Nurse or CNAs at the start of shift and was just assigned to work in the 100-Hall. He said he was not given access to the Kiosk to check how much assistance the residents required with ADLS. He said he had provided care to Resident # in room [ROOM NUMBER], on that night. He said he had entered the room to check if the resident was incontinent. He said he did not know how many people needed to turn and reposition the resident in bed since he did not have access to the Kiosk. He said the resident could not assist with turning & repositioning in bed. He said he had turned and repositioned the resident to be able to change the soiled brief. During an interview and record review on 10/07/25 at 2:00 PM, LVN MDS Nurse E and RN MDS Nurse F revealed, Section I - Active Diagnoses [NAME]-[NAME] syndrome and did not document resident also had a diagnosis of pemphigus vulgaris.Review of Nursing Policies and Procedures dated 09/28/25 revealed, Subject: Minimum Data Set (MDS) Policy: A licensed nurse will conduct or coordinate each assessment with the interdisciplinary team. An MDS, which is a comprehensive, accurate, standardized reproducible assessment, will be completed for each resident, using the RAI process. Procedures: Review the resident's medical record. Review is to include, but not be limited to pre-admission, admission, and transfer notes; current plan of care, physician's orders, progress notes, history and physical; nursing, dietary, activity, social service, therapy notes and assessments; monthly summaries, medication Residents Affected - Some (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 3 of 20 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 12/04/2025 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 0641 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete administration records, treatment administration records, and resident and family interviews. Interview, observe and physically assess the resident to obtain validation of items identified on the medical record and to collect information for items where no documentation exists. Documentation of participation must include direct observation and communication with the residents, as well as communication with licensed and non-licensed direct care staff members on all shifts. Perform interviews and test of physical functioning as required by MDS RAI Manual. Be sure to speak to staff that have firsthand knowledge of the residents. Talk to staff from all shifts. Ask about the residents' performance on ADLs. GG functional status. Interview with the resident's physician. Ask about medication and treatment orders. Discuss any negative outcomes identified during assessment. Interview with the resident's family. Ask them to clarify conflicting information and to provide historical information when the resident is not able to do so. Each assessment must represent an accurate picture of the resident's status during the observation periods of the MDS. When the MDS is completed, only those occurrences during the observation period will be captured on the assessment. Event ID: Facility ID: 676393 If continuation sheet Page 4 of 20 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 12/04/2025 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 observation, interview, and record review, the facility failed to develop and implement a person-centered comprehensive care plan to include measurable objectives and timeframes to attain or maintain the resident's highest practical physical, mental, and psychosocial well-being for 1 of 14 (Resident #2) residents reviewed for comprehensive care plans in that: The facility failed to revise or update Resident #2's care plan to reflect the need for two people for bed mobility due to pain caused by autoimmune skin disease. The facility failed to revise or update Resident #2's care plan to reflect physician's orders to treat autoimmune skin disease. This failure could place residents at risk of not receiving appropriate interventions or care to meet their current needs. The findings included:Closed record review of Resident #2's Face Sheet dated 10/03/25 revealed, initial admission date 02/19/25; and re-admission date 07/01/25. Review of History & Physical, dated 06/10/25, for Resident #2 revealed a [AGE] year-old male with past medical history of diabetes mellitus (a condition where the body has high blood sugar (glucose) because it does not make enough insulin or cannot use it effectively), osteoarthritis (wear and tear disease where the protective cushion on the ends of your bones wears away overtime), rheumatoid arthritis (an autoimmune disease where your immune system mistakenly attacks the lining of your joints, causing them to become inflamed, painful, swollen and stiff), pemphigus vulgaris (an autoimmune disease where the body mistakenly attacks its own skin and mucous membranes, causing painful blisters to form on the skin and in the mouth, nose, throat, and eyes) and [NAME]-[NAME] Syndrome (a rare, serious, and life-threating reaction, often to a medication, that causes a painful, blistering rash and sores on the skin and mucous membranes, mouth, throat, eyes, genital). Skin superficial ulcer wound to neck, resident non-compliant with dermatologist appointment due to difficulty with arranging transportation to Drs. Clinics. General appearance - alert and oriented. Skin - coccyx wound. Multiple lesions, scabs, rash throughout the body due to history of [NAME]'s Syndrome and pemphigus Vulgaris. Activities of daily living- impaired by symptoms. Review of Care Plan dated 09/22/25 for Resident #2 revealed: - Problem Start Date: 07/01/25. Edited 09/16/25. Chronic Pain R/T Stevens-Johnson Syndrome and Rheumatoid arthritis. Approaches: Administer Acetaminophen-codeine as ordered.- Problem Start Date: 05/30/25. Edited 09/16/25. Incontinent of Bowel & Bladder. Approach: Provide incontinent care after each incontinent episode.Problem Start Date: 5/30/25. Edited 09/22/25. ADLS Functional requires assistance with ADLS. Approaches: Bed Mobility total dependence with assistance of 1-2 staff. During a telephone interview 10/01/25 at 2:46 PM, CNA A revealed he worked on 9/21/25 on the night shift and he was not given report about his assigned residents by the Nurse or CNAs at the start of shift and was just assigned to work in the 100-Hall. He said he was not given access to the Kiosk to check how much assistance the residents required with ADLS. He said he had provided care to Resident # 2, on that night. He said he had entered the room to check if the resident was incontinent. He said he did not know how many people needed to turn and reposition the resident in bed since he did not have access to the Kiosk. He said the resident could not assist with turning & repositioning in bed. He said he had turned and repositioned the resident to be able to change the soiled brief. He said he had slipped his right hand under the resident's hip and the left hand under the shoulder to turn and reposition the resident on his own because he was the only CNA assigned to work in the 100-Hall. He said the resident would grimace and moan when he was moved in bed. During a telephone interview on 10/06/25 at 9:56 AM with Resident #2's family member revealed, Resident #2 said a young man that had been assigned to care for him during the night on 09/21/25 had moved him without assistance causing pain and discomfort. She said Resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 5 of 20 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 12/04/2025 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 #2 could not move in bed without assistance. Resident #2's family member said, The attendant was new, and he did not know what type of care (Resident #2) needed and the attendant did not speak Spanish so they could not communicate with each other. She said Resident #2 was alert and can tell you what happened on that day. The family member said, He is right here, let me ask him if he wants to talk to you so he can tell you what happened on that day. Interview with Resident #2 revealed he was alert, oriented to person, place and time. He said the young man who had cared for him at night on 09/21/25 was very rough when he moved him in bed to change the soiled brief without assistance causing a lot of pain and discomfort. During an interview on 10/06/25 at 1:19 PM with RN B Charge Nurse on the 6-2 shift on the 100-Hall revealed, Resident #2 was alert, oriented to person, place, time and situation. She said the resident had a skin condition that caused sores, pain and skin peeling all throughout his body that caused pain when he was touched to provide care. She said the resident needed to be always turned & repositioned with a sheet with the assistance of two people, to prevent direct contact with the skin. She said taking blood pressure on him caused a lot of pain. She said the resident always complained of pain, itching and burning sensations to the skin, especially when he was moved in bed. During an interview on 10/06/25 at 3:29 PM with CNA C assigned to the 100-Hall revealed, Resident #2 and he was alert, oriented to person, place and time. She said, The resident required total assistance with ADLs, and needed two-people for turning and repositioning because he had a skin condition all over his body that caused pain when they touched him to provide care. He had sores and skin peeling all over his body and they had to use a sheet to move him in bed because any movement caused pain. She said the resident always had a lot of pain when he was touched to provide any type of care. During an interview on 10/06/25 at 3:36 PM, with CNA D revealed, Resident #2 was alert, oriented to person, place, and time, required total care and always required two people to turn and reposition the resident in bed because the resident had a skin condition that caused pain with movement or when he was touched to provide care, because he had sores and skin peeling all over his body so they had to use a sheet to move him in bed because any movement caused pain. She said the resident had a lot of pain when he was touched to provide any type of care. He always complained of pain when he was touched or moved to provide care. She said the resident used the call-light for assistance with toileting. During an interview on 10/07/25 at 2:00 PM, LVN MDS Nurse E and RN MDS Nurse F revealed they gathered the information from the documentation in the resident's clinical record written by the nurses and the CNA documentation in the Kiosk. RN MDS F said, So according to the CNAs documentation, the resident did require two people for turning and repositioning most of the time. I did not talk to the nurses and the CNAs to determine if the resident required two people to for turning and repositioning in bed.During an interview and record review on 10/07/25 at 2:35 PM with RN MDS Nurse F in the presence of LVN MDS Nurse E and revealed, that according to the documentation done by the CNAs in the Kiosk documented Resident #2 required two-person assistance with bed mobility most of the time. RN MDS Nurse F said the resident had a skin condition that caused pain when he was touched. RN MDS Nurse F said the care plan did not document the resident also had pemphigus vulgaris and skin peeling all throughout his body, skin sensitivity that caused pain when touched to provide care and sores on his skin throughout his body. He said the care plan did not document resident was on EBP precautions related to G-tube, history of MDROs, pressure ulcer and open skin sores related to skin condition. RN MDS Nurse F said the care plan did not document resident was treated with Prednisone and Silvadene for skin condition. Review of Nursing Policies and Procedures, dated revised 5/05/23 revealed, Subject: Care Plan Process, Person-Centered Care. Policy: The facility will develop and implement a comprehensive care plan for each resident that includes the instructions needed to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 6 of 20 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 12/04/2025 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 FORM CMS-2567 (02/99) Previous Versions Obsolete provide effective and person-centered care of the residents that meet professional standards of quality care. The services provided or arranged by the facility, as outlined by the comprehensive person-centered care plan, will meet professional standards of quality. Procedures: Following RAI Guidelines develop and implement a comprehensive person-centered care plan that includes measurable objectives and timeframe to meet a resident's medical, nursing, and metal and psychosocial needs that are identified in the comprehensive assessment. The person-centered care plan includes Date, problem, interventions, discipline specific services, and frequency. Resolution/Goal Analysis. Event ID: Facility ID: 676393 If continuation sheet Page 7 of 20 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 12/04/2025 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 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. 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 residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan for 1 (Resident #1) of 1 reviewed for quality of care.The facility failed to ensure that Resident #1 received an initial neurological check and continued neurological checks for 72 hours following an unwitnessed fall as per the facility's policy on fall management and and neurological checks, from 09/25/2025 to 09/27/2025. This failure could place residents at risk of head related injuries, decrease cognitive and functional abilities and not receiving the necessary care and services. Findings included:Record review of Resident #1's care plan, dated 09/16/2025, revealed Resident #1 has a history of falling related to age-related cognitive decline, unspecified dementia, unspecified severity, with other behavioral disturbance and has difficulty focusing attention/ understanding others due to age-related cognitive decline, unspecified dementia, unspecified severity, with other behavioral disturbance. Interventions included fall mat utilization (updated 09/24/2025), Keep personal items and frequently used items within reach (updated 09/02/2025; after 09/01/2025 fall incident), and provide proper, well maintained footwear (updated 09/02/2025; after 09/01/2025 fall incident).Record review of Resident #1's physical and health, dated 09/25/2025, revealed the resident was diagnosed with dementia (a degenerative disease that alters an individual's cognition and functional capabilities) with history of falls resulting in hospitalization and generalized weakness.Record review of Resident #1's MDS, dated [DATE], revealed a BIMS score of 99 (resident was unable to complete Brief Interview for Mental Status). Section GG -Functional Abilities (mobility) revealed Resident #1 required substantial/maximal assistance for rolling to sides, sit to lying, lying to sitting, sit to stand, and chair/bed-to-chair transfer; ambulation was scored an 88 signifying that attempts were not made due to the resident's medical condition or safety concerns.Record review of Resident #1's admission record, dated 10/01/2025, revealed a [AGE] year-old male admitted on [DATE] and readmitted on [DATE].Record review of neurological checks binder and progress notes on 10/03/2025 at 09:00 AM, revealed Resident #1 there were no documented neurological checks for a fall that occurred on 09/25/2025 at 02:30 AM.During an interview on 10/02/2025 at 10:18 AM, LVN M, stated she was completing a neurological check sheet for a resident who experienced an unwitnessed fall. She stated that after a fall, the nurse completed the head-to-toe assessment, neurological check, SBAR, contacted the physician, family, hospice (if applicable), notified the DON and the administrator immediately. She reported that if the resident was not sent out for further evaluation, staff was to check the resident every 15-30 minutes following the fall and enter progress notes.In an interview on 10/02/2025 at 11:03 PM, CNA O stated she was on a break on 09/25/2025 at 2:30AM and walked by the resident's room out of familiarity with resident's sleep patterns. She stated she saw the call light illuminated and located the resident halfway on his bed with blood all over his face. She stated the resident said, I was asleep, and I fell. She stated the mattress was halfway off the bed with half the mattress protruding towards the window with the resident half way on the bed. She stated the resident climbed back on to his bed hallway, after the experienced fall. She stated she tried to readjust the mattress from the window side, while the resident was halfway on the mattress. She stated the resident slid against her legs; She stated the resident did not accrue additional injuries from transition. She stated she called for the shift nurses (LVN J and RN L). She stated the nurses conducted their assessments, cleaned resident, notified family, physician, and requested 911. She stated the last time the resident was checked on was at 1 am and he was asleep. She identified RN L who reported the incident to The DON and The Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 8 of 20 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 12/04/2025 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 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Administrator. She stated how training and in-services were left at the nurse's station for third shift staff to read and sign or they were called in during the day for trainings. She stated the last in service was abuse, neglect and exploitation this week (09/30/2025 to 10/03/2025). She stated the steps for abuse and neglect reporting and identified shift nurse and The Administrator as key individuals to immediately report to. She stated the resident's injury was to the left side of his head, with no symptoms (nausea, headache, loss of consciousness, convulsions) present besides bleeding. She stated the resident denied being in pain, discomfort and did not want to go to the hospital.During an interview on 10/02/2025 at 11:24 PM, LVN J, stated the call light was illuminated on 09/25/2025 at 02:30 PM to Resident #1's room, and CNA O responded to call light. She stated CNA O had called out for assistance from room [ROOM NUMBER] where Resident #1 was assigned on the day of the incident. She stated she went to get the wound cart while RN L passed her to go tend to Resident #1. She stated the cut was less than an inch on the left side of his forehead and that he had a visible hematoma (swelling) the size of a golf ball. She stated Resident #1 had a history of falling She stated the resident moved a lot in his sleep She stated the resident was unaware what had happened and woke up upon hitting his head; She stated she was uncertain what Resident #1 hit his head on. She stated she printed the summary of health paperwork for the EMT to take with the resident to ensure continuous care for diagnosed conditions. She stated that RN L stayed with Resident #1 to complete vitals, assessment, and provide wound care. She stated Resident #1 did not lose consciousness during the assessment or before being transported to hospital. She stated that after a resident had fallen, she would report the incident to the physician, the resident's family, The DON, and The Administrator after assessing injuries. LVN J stated nursing staff were trained to complete neurological checks if it was unwitnessed fall. LVN J stated that the physician would order CT scans and x-rays for further evaluation. LVN J stated neurological checks were completed every 15 minutes for the first hour, every 30 minutes for the next two hours, every hour for the next two hours, and every shift for the next 72 hours after the fall.Records were requested from The DON on 10/03/2025 at 10:42 AM for the neurological checks for Resident #1 on 09/25/2025.The DON stated no neurological checks were documented for the incident on 09/25/2025 because the resident was sent out to the hospital.In an interview on 10/03/2025 at 12:30 PM with The DON, she stated she received a call from RN L at approximately 2:30AM that the resident had fallen from bed and had a laceration to the left side of his head. She stated RN L notified the PCP, family, and herself. She stated reported she notified The Administrator in the morning during regular business hours. She stated PCP requested the resident to be sent to local hospital. She stated neurological checks were performed in response to unwitnessed falls. She stated neurological checks were completed on the resident but were not documented because the resident was sent to the hospital; She stated there were progress notes and SBARs entered. DON reported the staff have been trained to conduct neurological checks upon locating the resident and per facility fall and neurological check policy. DON stated the staff did not adhere to the facility's policy for the resident's fall on 09/25/2025. DON identified potential outcomes to staff not adhering to their policy in conducting neurological checks could result in the resident experiencing, brain bleed, contusion, could be anything. DON reported for staff to continue neurological checks after hospital discharge they needed to obtain orders from the physicians. DON reported there was no in-service or training recently completed for neurological training. The DON reported neurological checks were not conducted upon the Resident #1's return from the hospital on [DATE].In an interview via telephone call on 10/03/2025 at 01:32 PM with RN L, he stated he had checked on Resident #1 earlier in the night of 09/25/2025 and at approximately 02:00 AM to 02:30 AM CNA O began her rounds. He stated the resident used (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 9 of 20 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 12/04/2025 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 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few his call device at approximately 02:00 AM to 02:30 AM and was observed halfway off the bed near the window side He stated the resident stated he was asleep, rolled in his sleep and fell to the floor. He stated he suspected Resident #1 fell on the corner of the cabinet in his room due to the 2.5-centimeter laceration to the left side of the resident's forehead. He stated he notified the PCP, The DON and family. He stated that the resident denied being in pain at the time of the incident and denied wanting to go to the hospital. He stated he completed a fall assessment, skin assessment, progress note, and hospital transfer note for the ambulance to take to the hospital. He stated he physically conducted the neurological check but did not document them on the facility provided sheet. He stated the neurological check sheet was not necessary to complete if the resident was sent out for further evaluation per facility policy. He stated that a resident who experienced an unwitnessed fall/direct head injury could have a neurological deficit, blown pupil, stroke, and encephalitis (swelling of the brain) if not identified during a neurological check. He stated potential outcomes for the diagnosis could result in pain to the resident, hospitalization, and even death. He stated any unwitnessed fall that occurred must have a neurological check completed.In an interview via telephone call on 10/03/2025 at 02:10PM with The PCP, he reported he was notified of both instances of the resident falling on 09/01/2025 and 09/25/2025 by nursing staff at the facility. He stated the resident's falls were attributed to non-compliance on the resident's behalf with instructions for care and required more redirection. He stated the resident was sent out to the hospital which provided more advanced evaluations, therefore nursing staff were not required to continue neurological checks. He stated that nurses needed physician orders to continue neurological checks upon hospital discharge. PCP stated he received a report from his colleague who was on call for the weekend of 09/25/2025. As per the PCP, Dr. [NAME] met with the resident's family at the hospital; family declined further neurological assessments and evaluations at the hospital. PCP reported no further intervention was necessary due to family's request.In an interview on 10/07/2025 at 11:00 AM with RN Clinical service Director reported neurological checks were to be completed when residents sustained an unwitnessed fall or witnessed if resident hit their head. RN Clinical service Director stated that neurological checks should be done for 72 hours following a fall. RN Clinical service Director reported the nurses should have continued neurological checks if the resident returned from the hospital in less than 72 hours from the fall. The RN Clinical service Director reported this was per facility policy.In an interview on 10/07/2025 at 11:10 AM with RN B stated that neurological checks were done to make sure that after a resident fell, they were cognitively intact. RN B continued stating the neurological checks were to make sure there were not any fractures, concussion, head aches or anything affecting the resident's neurological state. RN B stated neurological checks were to be done for 3 or 4 days after a fall either witnessed or unwitnessed, because the resident might complain later. RN B stated that the staff needed physician's orders if the resident returned from the hospital the same day. RN B stated she did not complete neurological checks for Resident #1 when he returned on 09/27/2025. RN B stated neurological checks were to be resumed with the physician's orders. RN B identified some risks of not continuing neurological checks would be concussions, headaches, and brain bleeding. RN B stated that the facility provided an in-service regarding neurological checks about 2 to 3 weeks ago.In a record review conducted on 10/03/2025 at 05:00 PM of the facility's nursing policies and procedures - subject: neurological checks under procedure 1: neurological checks are performed following an actual or suspected head injury or change in level of consciousness per physician ordered or frequency OR: initially then, every 15 minutes for 1 hour, then every 30 minutes for 2 hours, then every 1 hour for 2 hours, then every shift for 72 hours; and under procedure 3: documentation is completed on (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 10 of 20 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 12/04/2025 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 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete the neurological evaluation flow sheet, via the Glasgow Coma Scale. Secondary record review of PM of the facility's nursing policies and procedures - subject: fall management under procedure 7: neurological evaluations will be performed for a resident who sustains an unwitnessed fall, regardless of the resident's cognitive status at the time of the incident. The facility failed to follow their policy in continuing neurological checks for a resident who experienced and unwitnessed fall for the first 72 hours following the incident on 09/25/2025.Record review of Resident #1's electronic medical documentation completed by RN L revealed a progress note from 09/25/2025 with no mention of neurological checks conducted and an SBAR documentation with no mention of neurological assessment. Event ID: Facility ID: 676393 If continuation sheet Page 11 of 20 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 12/04/2025 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 interview and record review the facility failed to establish procedures for storing and disposing of drugs and biological in accordance with federal, state, and local laws. The facility failed to ensure medications pending return to the pharmacy were stored in a locked cabinet in the DON's office. This failure could place 68 residents living at the facility at risk of drug diversion. The findings included:During an observation on 10/01/25 at 9:26 AM revealed, the door to the DON's office was opened and unsupervised. There was an opened cardboard box that contained medication blister packets stored on the floor by a cabinet and several medication blister packets were visible from the entrance to DON's office. During an observation on 10/01/25 at 10:12 AM revealed, the DON was not in the office while the Housekeeper was vacuuming the office and the opened cardboard box that contained medication blister packets was still stored on the floor in the DON's office. During an observation on 10/01/25 at 10:14 AM revealed, the Corporate Clinical Service director was working in DON's office and the opened cardboard box that contained medication blister packets was still stored on the floor in the DON's office. During an observation and interview on 10/01/25 at 12:38 PM, with DON confirmed there were two cardboard boxes that contained medications stored on the floor in her office. She said the boxes contained medications that were pending return to the pharmacy for credit. She said, One of those boxes was stored in the office when I started working here in March 2025. I do not know how often medications are returned to the pharmacy for credit. I know that medications should not be left unattended when stored in my office because someone can come in my office and take the medications. The DON said the risk of leaving medications in her office unattended could result in residents and/or other unauthorized individuals taking the prescribed medications from her office. During an interview on 10/02/25 at 10:30 AM revealed, the DON's office door was still open, and no one was in the office. It was observed that the two white cardboard boxes that contained medications were still on the floor. The top box was still opened, and the several blister medication packets were visible from the entrance to DON's office. During an interview on 10/02/25 at 12:06 PM revealed, the DON's office door was wide open and unsupervised. It was observed that the two opened white cardboard boxes that contained medications were still on the floor. The top box was still opened, and the several blister medication packets were visible from the entrance to DON's office. During an observation and interview on 10/02/25 at 12:32 PM, with the Administrator, confirmed there were two white cardboard boxes stored on the floor by the cabinet in the DON's office that contained medications. He confirmed the top cardboard box was opened. He demonstrated to the state surveyor that the second box was not sealed and contained medication. He said, The door to the DON's office should be kept locked if medications are not stored in a locked cabinet. He said, Let me close the door and go tell the DON. He said the risk of leaving the door open and unsupervised could result in someone coming into the office and taking the medications. The DON's office was located by the living room and next to the central nurse's station. During an interview on 10/02/25 at 12:40 PM, the Administrator revealed medications pending return to the pharmacy for credit should be stored in the medication room. He said, Medications pending return to the pharmacy should be placed in the locked plastic containers that are kept in the medication room. The large plastic containers are locked, and they have an opening where the staff can drop the mediations containers into the locked containers. During an interview on 10/06/25 at 12:47 PM with RN G revealed, medications pending return to the pharmacy for credit were dropped into a locked container stored in the medication room pick-up from the provider pharmacy. She said she usually worked on the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 12 of 20 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 12/04/2025 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 FORM CMS-2567 (02/99) Previous Versions Obsolete weekends and did not know when the last time was return medication were picked up by the pharmacy. During an interview on 10/06/25 at 12:49 PM, with LVN Charge Nurse H on the 300-Hall revealed, medications pending return to the pharmacy for credit were dropped into a locked container stored in the medication room pending pick-up from the provider pharmacy. She said she did not know who called the pharmacy to pick up the medication containers to return the medications to the pharmacy. During an interview on 10/06/25 at 2:51 PM with the DON revealed, she calls the pharmacy after she and the ADON went through the locked medication containers stored in the medication to determine which medications could be returned to the pharmacy for credit. She said they listed the medications on the Medications Return Logs before the medications were returned to the pharmacy for credit. She said after the medications were listed on the Medication Return Logs the medications were placed in locked plastic containers and kept in the medication room until the pharmacy sent someone to pick up the container to return to the provider pharmacy. She said the pharmacy did not have a set date or time to pick up the locked medication containers since they had to send someone from out of town to pick up the returned medications. She said certain medications such as controlled substances and opened medication containers could not be returned to the pharmacy. The state surveyor asked the DON to provide copies of documentation given to the facility when locked medication containers that contained returned drugs were picked up by the pharmacy transporter. During a telephone interview on 10/06/25 at 1:03 PM, the Inventory Consultant Pharmacist at the provider pharmacy revealed, discontinued medications and/or medications with changes in medication orders were listed on the Medication Return Logs and must be signed by the facility's pharmacy consultant before faxing the form to the provider pharmacy to plan for picking up at the nursing home. The state surveyor requested a copy of the last Medication Return Logs completed by the nursing facility. The DON said there had been no pickups of medication for credit for 2025.Review of the Medication Return Log sheets pending pick up by the Pharmacy were dated 06/09/25 through 08/28/25. Review of the Pharmcy Pick-Up slip from the Provider Pharmacy were dated 12/12/24. Review of facility's Pharmacy Policy and Procedure, dated 4/17/204, revealed, Subject: Medication Returns to the LTC Provider Pharmacy. Policy: The Facility may return certain unused products for return and credit to the LTC Provider Pharmacy under specific conditions, based on LTC Provider Pharmacy policies and State and Federal Law. Procedures: When medication is discontinued or a resident is discharged , facility staff should refer to the LTC Provider Pharmacy policies regarding medication return eligibility and the process to be followed for returns. A medication return form must be completed when the medications are returned to the pharmacy to document the chain of custody of the returned medications. Facility should segregate and securely store the medications to be returned to Pharmacy until they are picked up by the Pharmacy. Event ID: Facility ID: 676393 If continuation sheet Page 13 of 20 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 12/04/2025 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 - Some 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 on each resident that were complete and accurately documented, in accordance with accepted professional standards and practices, for 1 of 14 residents (Resident #2) reviewed for clinical records with transfer assistance. The facility failed to give access to the contracted agency CNA to document in the residents' electronic record the care provided to assigned residents in the 100-Hall. This failure place residents at risk of having incomplete and accurate clinical records. Findings included:Closed record review of Resident #2's Face Sheet dated 10/03/25 revealed, initial admission date 02/19/25; and re-admission date 07/01/25. Review of History & Physical, dated 06/10/25, for Resident #2 revealed a [AGE] year-old male with past medical history of diabetes mellitus (a condition where the body has high blood sugar (glucose) because it does not make enough insulin or cannot use it effectively), osteoarthritis (wear and tear disease where the protective cushion on the ends of your bones wears away overtime), rheumatoid arthritis (an autoimmune disease where your immune system mistakenly attacks the lining of your joints, causing them to become inflamed, painful, swollen and stiff), pemphigus vulgaris (an autoimmune disease where the body mistakenly attacks its own skin and mucous membranes, causing painful blisters to form on the skin and in the mouth, nose, throat, and eyes) and [NAME]-[NAME] Syndrome (a rare, serious, and life-threating reaction, often to a medication, that causes a painful, blistering rash and sores on the skin and mucous membranes, mouth, throat, eyes, genital). Skin superficial ulcer wound to neck, resident non-compliant with dermatologist appointment due to difficulty with arranging transportation to Drs. Clinics. General appearance - alert and oriented. Skin - coccyx wound. Multiple lesions, scabs, rash throughout the body due to history of [NAME]'s Syndrome and pemphigus Vulgaris. Activities of daily living- impaired by symptoms. Review of Significant Change MDS dated [DATE] for Resident #2 revealed, a BIMs Score of 7 (severely cognitively impaired), clear speech, able to make self-understood; preferred language was Spanish. functional limitation in range of motion to upper and lower extremities; Section GG0130 - Functional Abilities -OBRA/Interim: Toileting hygiene, upper/lower body dressing, and personal hygiene-dependent; Section GG0170 Mobility substantial/maximal assistance with Roll left and right; incontinent of bowel and bladder; Section I - Active Diagnoses Stevent-[NAME] syndrome, reduced mobility; Section J0100 Pain Management in the last 5 days - 0 had not received PRN pain medications; has not received non-mediation interventions for pain. J0200 Should Pain Assessment Interview be conducted? Yes. Section: J0300 Pain Presence Code: 1 Yes. J410 Pain Frequency Code: 4 Almost constantly. Section: J0510 Pain Effect on Sleep Code: 2 occasionally hard to sleep; Section: J0600 Pain intensity - Code: 9 in a scale form 00-10 pain scale. 10 being the worst pain. Section: K0520 Feeding tube on admission. Section: M1040 D. Open lesion(s) other than ulcers, rashes, cuts. Section: M1200 Skin Condition: Application of ointments/medications other than to feet. Section: Section V0200 A. CAA (Care Assessment Area Assessment Summary revealed Cognitive Loss/Dementia, ADL Functional, Urinary Incontinence, Feeding Tube, Pressure Ulcer, and Pain. Review of Care Plan revised 09/22/25 for Resident #2 revealed, -Problem Start Date: 09/22/25 Psychosocial Well-Being.- Problem Start Date: 07/01/25. Edited 09/16/25. Chronic Pain R/T Stevens-Johnson Syndrome and Rheumatoid arthritis. Approaches: Administer Acetaminophen-codeine as ordered.- Problem Start Date: 05/30/25. Edited 09/16/25. Incontinent of Bowel & Bladder. Approach: Provide incontinent care after each incontinent episode.- Problem Start Date: 05/30/25. Edited 09/16/25. The resident has a pressure ulcer to sacrum 7 Left heel R/T reduced mobility and Stevens-Johnson Syndrome. Approaches: Conduct a systemic skin inspection weekly. Wound (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 14 of 20 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 12/04/2025 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 - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Care Nurse to assess the pressure ulcer for location, stage, size, presence/absence of granulation issue and epithelization weekly and as needed.- Problem Start Date: 5/30/25. Edited 09/22/25. ADLS Functional requires assistance with ADLS. Approaches: Bed Mobility total dependence with assistance of 1-2 staff. Review of facility's CNA/Nurses assignment Sheet dated 09/21/25 revealed Contracted agency CNA was not listed on the assignment sheet. During a telephone interview 10/01/25 at 2:46 PM, with Agency CNA A agency revealed, he worked on the 10-6 shift on 09/21/25. He said he was not given access to the Kiosk to document the care that he had provided to the residents assigned to him on the 100-Hall on that day. During a telephone interview on 10/06/25 at 9:21 AM, Agency CNA A said, I was not granted access to the Kiosk so I could not document in the resident's electronic record the care that was provided to my assigned residents in the 100-Hall. He said no one assisted him in charting in the Kiosk at the end of the shift at the end of the night shift on 09/22/25. During an interview on 10/02/25 at 4:02 PM, the Administrator revealed it was the first time CNA A had worked at the facility. He said agency personnel were given access to document in the Kiosk prior to reporting to work so they could document the care that was provided during their shift. He said he had followed up with the DON today at 4:16 PM, and she did not know that CNA A had been scheduled to work on the day. So, he did not have access on 09/21/25 to document the care provided in the Kiosk for the residents in the 100-Hall. During an interview on 10/02/25 at 11:33 PM, with CNA I on the 10-6 shift revealed, she worked with the agency CNA A on 09/21/25 and he was assigned to work in the 100-Hall. She said CNA A was not given access to document the care provided to the residents during the night shift in the Kiosk. She said CNA A was not provided with any instructions on how to document the resident's care in the electronic record. She said, I offered to enter his resident's information in the Kiosk at the end of the shift in the morning on 09/22/25 and is why the documentation was showing under her name. She said, I would ask him the questions on the Point of Care Report and entered his responses under in the Kiosk and that was the reason the documentation was showing my name. During an interview on 10/02/25 at 11:25 PM, with LVN J on the 10-6 shift revealed, she worked with CAN I on 09/21/25 and said she was not sure if he had access to document in the Kiosk electronic record on that day. Review of Point of Care History reported provided by the DON on 10/03/25 at 8:52 AM, dated 9/21/25 9/22/25 for ADL documentation for Resident #2 revealed CNA I documented in the Kiosk on 09/22/25 at 00:22:44 (12: 22 a.m.) for CNA A. During an interview and record review on 10/07/25 with the DON revealed, CNA A picked up a shift at the last minute. She said, He showed up to work at the start of the shift on 09/21/25 and they had allowed him to stay and work. She said he was assigned to work on the 100-Hall. She said CNA A had not been granted access to document the care in the Kiosk, because she was not aware that CNA A had been scheduled to work on 09/21/25 in the night shift. She said, That is why CNA I documented for him on 09/22/25 at the end of the shift. During a telephone interview on 10/03/25 at 11:20 AM with, the contracted nursing agency employee who was responsible for scheduling staff to work at the nursing facility said, agency staff were given access by the contracted facilities to chart in the residents' electronic record before the start of shift. She said she was not aware of any concerns of access not provided to agency staff to document care provided to the residents at the nursing facility. Review of Nursing Agency contract signed 09/24/29 revealed, Responsibilities: Personnel have been advised to fully document services provided in accordance with Client's policies and procedures, current applicable standards of healthcare practices, and applicable federal, state, and local laws, rules and regulations. Event ID: Facility ID: 676393 If continuation sheet Page 15 of 20 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 12/04/2025 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 for one of fourteen residents (Resident #2) reviewed for Enhanced Barrier Precautions. The facility failed to implement their policy on Enhanced Barrier Precautions for Resident #2 who had wounds, indwelling medical devices and was incontinent of bowel and bladder. This failure could place residents at risk for healthcare associated cross-contamination and at risk of the transmission of multi-drug-resistant organisms (MDROs). The findings included:Closed record Review of Resident #2's Face Sheet dated 10/03/25 revealed, initial admission date 02/19/25; and re-admission date 07/01/25. Review of History & Physical, dated 06/10/25, for Resident #2 revealed a [AGE] year-old male with past medical history of pemphigus vulgaris (an autoimmune disease where the body mistakenly attacks its own skin and mucous membranes, causing painful blisters to form on the skin and in the mouth, nose, throat, and eyes) and [NAME]-[NAME] Syndrome (a rare, serious, and life-threating reaction, often to a medication, that causes a painful, blistering rash and sores on the skin and mucous membranes, mouth, throat, eyes, genital). Skin superficial ulcer wound to neck, resident non-compliant with dermatologist appointment due to difficulty with arranging transportation to Drs. Clinics. General appearance - alert and oriented. Skin - coccyx wound. Multiple lesions, scabs, rash throughout the body due to history of [NAME]'s Syndrome and pemphigus Vulgaris. Activities of daily living- impaired by symptoms. PEG tube feedings (Is a feeding tube that goes directly from the outside of the body, through the skin of the belly, and into the stomach). Review of Significant Change MDS dated [DATE] for Resident #2 revealed, a Section I - Active Diagnoses Multidrug-Resistant Organism (MDRO), Septicemia, Gastrostomy status, Stevent-[NAME] syndrome, Feeding tube on admission. Section: M0300 one stage 2 pressure ulcer present upon admission. Section: M1040 D. Open lesion(s) other than ulcers, rashes, cuts. Section: Section V0200 A. CAA (Care Assessment Area Assessment Summary revealed ADL Functional, Urinary Incontinence, Feeding Tube, Pressure Ulcer, and Pain. Review of Care Plan revised 09/22/25 for Resident #2 revealed, - Problem Start Date: 07/01/25. Edited 09/16/25. Chronic Pain R/T Stevens-Johnson Syndrome and Rheumatoid arthritis. Approaches: Administer Acetaminophen-codeine as ordered.- Problem Start Date: 07/01/25. Edited 09/16/25. Requires feeding tube R/T Dysphagia. Approaches:- Problem Start Date: 05/30/25. Edited 09/16/25. Incontinent of Bowel & Bladder. Approach: Provide incontinent care after each incontinent episode.- Problem Start Date: 05/30/25. Edited 09/16/25. The resident has a pressure ulcer to sacrum 7 Left heel R/T reduced mobility and Stevens-Johnson Syndrome. Approaches: Conduct a systemic skin inspection weekly. Wound Care Nurse to assess the pressure ulcer for location, stage, size, presence/absence of granulation issue and epithelization weekly and as needed.Review of Physician Order Report dated 07/01/25 - 09/22/25, for Resident #2 revealed required Enhanced Barrier Precautions for wounds. During a telephone interview 10/01/25 at 2:46 PM with CNA A revealed he had worked on 9/21/25 on the night shift and he was not given report about his assigned residents by the Nurse or CNAs at the start of shift and was just assigned to work in the 100-Hall. He said he was not provided with an orientation prior to providing care to the residents on that day. He said he had provided care to Resident #2, on that night. He said he had entered the room to check if the resident was incontinent. He said the resident could not assist with turning & repositioning in bed and he had turned and repositioned the resident on that day on his own to provide incontinent care. He said he did not know which residents were on Enhanced Barrier Precautions, so he had not used PPE when providing direct care to the residents on Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 16 of 20 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 12/04/2025 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 Residents Affected - Few that day. He said he had not seen postings by the entrance to the residents' rooms, that indicated which residents were on Enhanced Barrier Precautions. He said PPE was not available in the 100-Hall on that day when he had worked at the nursing facility. He said the risk of not using PPE when residents were on Enhanced Barrier Precautions could result in cross contamination of uniforms and spread of infection. During an interview on 10/06/25 at 1:19 PM with RN Charge Nurse B on the 6-2 shift on the 100-Hall revealed, Resident #2 had a skin condition that caused painful sores and skin peeling all throughout his body. She said Resident #2 was on Enhanced Barrier Precautions because of the skin sores, pressure ulcer and G-tube. She said the facility only posted the small CDC Pocket Guide by the entrance to the resident rooms. She said they had been trained to use EBP for residents with indwelling medical devices, wounds, or those who are colonized by or infected with a multidrug-resistant organism (MDRO). She said the staff should use EBP when dressing or bathing, transferring, changing linens, assisting with toileting, accessing indwelling medical devices, providing wound care, and other high-contact resident care activities. During an observation and interview on 10/06/25 at 1:24 PM, with RN Charge Nurse B on the 6-2 shift in the 100-Hall revealed Resident in room [ROOM NUMBER]-A had a G-tube; Resident in room [ROOM NUMBER] had a G-tube and Resident #3 had a UTI. Rounds made with RN Charge Nurse B revealed there was no PPE readily available for staff to use in the 100-Hall. She said PPE should always be readily accessible for staff to use as needed to prevent cross-contamination and spread of infections. During an interview on 10/06/25 at 1:29 PM with CNA K assigned to the 100-Hall in the morning shift revealed, there were no residents at this time on any type of isolation. The state surveyor asked the CNA where they kept the PPE in the 100-Hall. She said, We do not have any PPE in the 100-Hall because we currently do not have any residents on any type of isolation. The CNA could not explain to the state surveyor what Enhanced Barrier Precautions were and what they needed to do. She said, We just use gloves when providing care to the residents. She said she did not remember being trained on Enhanced Barrier Precautions. She said she had not noticed the CDC pocket guide posted by the entrance to the resident rooms. During an interview on 10/06/25 at 1:38 PM with LVN Charge Nurse H assigned to the 300-Hall revealed, the facility posted a copy of the Enhanced Barrier Precautions CDC Pocket Guide by the entrance to the resident rooms. She said EBP were followed by the staff when residents have indwelling medical devices, wounds, or those who are colonized by or infected with a multidrug-resistant organism (MDRO). She said when a resident is on EBP, the staff should use an isolation gown, gloves and goggles as needed when dressing or bathing, transferring, changing linens, assisting with toileting, accessing medical devices, providing wound care, and other high-contact resident care activities. She said we usually keep a plastic container with PPE by the Kiosk, but it is not there today. She said that failure to use PPE when residents are on EBP could result in cross-contamination and the spread of infection. During an observation and interview on 10/05/25 at 3:35 PM with CNA C working on the 100-Hall in the evening shift revealed, she did not know why residents were placed on Enhanced Barrier Precautions. She said we only use gloves when direct care is provided to the residents. She said, We do not have any PPE such as gowns, masks, or goggles in the 100-Hall since we do not have any residents on isolation. She said, Central Supply Clerk keeps PPE in the small supply room in the hallway by the 100-Hall. Let me take you to the small supply room to show you the plastic container where they keep the PPE to use as needed. The CNA demonstrated to the state surveyor the drawers labeled Gowns and Gloves were empty. She said, We always have PPE in the container. I don't know why there is no PPE in the small supply room. During an interview on 10/06/25 at 3:36 PM with CNA D revealed, the facility placed residents on EBP when the resident had a urinary infection, skin infection, or COVID. She said, I know that we are supposed to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 17 of 20 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 12/04/2025 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 Residents Affected - Few use gowns, mask, and gloves when providing direct care. She said she could not remember if they had been trained on EBP. She said sometimes PPE was not readily available to use in the Resident Halls as needed. She said Resident [NAME] initially was in isolation for a urinary tract infection and was on antibiotics. She said after he had completed the antibiotic he was taken off isolation and they only used gloves when direct care was provided. She said the resident had a G-tube and a pressure ulcer on the buttocks. She said failure to have PPE could result in cross contamination and spread of infection. During an interview on 10/06/2025 at 3:50 PM with CNA Q in the 300-Hall revealed, contact precautions were in place when the resident had infections and EBP were for residents with foleys and g tubes. She stated that people on isolation have both signs because extra precautions were needed for them. She stated that sometimes there weren't any gowns available and that she had gone into the rooms without a gown only with gloves because that was all that was available. She stated that she had told the DON and ADON when this would happen, but it would take them a while to restock, and she could not keep residents waiting. She could not recall the last in-service regarding PPE, contact precautions and EBP. During an interview on 10/06/2025 at 3:57 PM with CNA R revealed, she did not wear the PPE unless the residents were on isolation because those residents were contagious, so it was protection for her from the resident as well as protecting the resident from any new infections. She stated that she did not wear PPE when she went into rooms with residents with foleys and would only wear gloves when foleys were emptied. She could not tell the difference between residents needing enhanced barrier precautions and residents on isolation/ contact precautions. She stated that she was just PRN, and she did not remember the last time there was a training over this, she stated that the facility did give training, but she just could not remember the last one. During an interview on 10/06/25 at 4:10 PM, with RN ADON/Infection Control Preventionist revealed, all department heads except for the Administrator and DON completed hourly Angel Rounds on their designated Resident Halls. She said she randomly checked during rounds nursing staff were following EBP and using gloves when providing direct care to the residents. She said Central Supply placed plastic containers with PPE by Kiosk in each unit. She said, I check every day in the morning to make sure PPE is always available on the Resident Units to use as needed to prevent cross contamination and the spread of infection. She said, We post a sign on the door to the resident's room when a resident needs to be on EBP. She said, When a resident is on EBP, we place cardboard boxes in the resident's room for them to dispose the contaminated PPE prior to leaving the resident's room. She said she had started working as the ADON on September 28, 2025, and did not know if the staff had been trained in EBP. During an interview on 10/07/25 at 10:14 AM with the DON revealed she had started working at the facility on March12, 2025 and did not know when the staff had been trained on EBP. She said the administrator was out and would not be returning to work this week. The DON said, I am acting administrator until the administrator returns. She said, The Infection Control Preventionist and I are responsible for checking direct care staff are following EBP to prevent cross contamination and the spread of infection. During an interview on 10/07/25 at 11:27 AM with the Central Supply worker revealed, she was responsible for stocking PPE on the Resident Halls and in the small supply room by the 100-Hall. She said PPE was placed in plastic containers by the entrance to the resident rooms if the residents were placed on any type of isolation. She said she kept a plastic container with isolation gowns, gloves, masks, and gloves by the Kiosk in all resident units by the Kiosk for the direct care staff to use when direct care was provided to the residents. She said she checked the PPE levels at start of shift and twice before the end of the day on all Resident Halls and the small supply room by the 100-Hall to ensure PPE was always available for the direct care staff to use as needed. During an observation (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 18 of 20 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 12/04/2025 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 Residents Affected - Few on 10/07/25 at 11:32 AM with the Central Supply worker revealed, the plastic container in the 300-Hall by the Kiosk contained masks and isolation bags and the gown drawer was empty. She said, We usually keep the isolation gowns in the plastic container by the Kiosk. I will put gowns in the container as soon as possible. During an observation on 10/07/25 at 11:34 AM with the Central Supply worker revealed, the plastic container by the Kiosk in the 200-Hall contained isolation gowns, masks, goggles, and isolation bags. She said, We don't have anyone on isolation at this time. During an observation on 10/07/25 at 11:35 AM with the DON and Central Supply worker revealed, the plastic container stored in the locked supply room by the 100-Hall revealed the gown and mask drawer were empty. Central Supply Clerk said, I check the PPE levels twice a day. I did not restock the PPE this morning in the small supply room because I have been busy. The DON said that failure to have PPE readily available for direct care staff to use could result in cross contamination and spread of infection. During an interview on 10/07/25 at 11:40 AM with the DON revealed she and ADON made rounds several times during the day. She said I check for hand sanitizer and PPE to ensure these items are readily available in the Resident Halls for the staff to use as needed. She said, Today, I did not check the mini supply room by the 100-Hall today to see if PPE was available in the plastic container. She said we have not provided any training on EBP since I started working here in March 2025 and do not know when the last time the staff were trained on EBP. The state surveyor requested to see the in-service training binder for 2025. The DON said, EBP pocket guides are posted by the entrance of each resident rooms, and they know they need to gown up and put on gloves when they enter the room to provide any type of care to the residents. We do this to protect the residents from infections. That is all that we do. She said Central Supply usually checks that PPE is available in Resident Halls. The DON said, She is fairly new as well and is trying to learn what she needs to do. The DON said the failure to use EBP put the residents and staff at risk of cross contamination and spread of infections. Review of the facility's Infection Prevention and Control Policies and Procedures provided by the DON on 10/07/25 revised on May 15, 2023, revealed the following:Subject: Transmission Based/Standard Precautions, and Enhanced Barrier PrecautionsPolicy: Health Care workers will implement Universal/Standard Precautions whenever there is occupational exposure to blood and body fluids. The type of PPE and precautions implemented depends on the potential for exposure, route of transmission, and infectious organism/pathogen.Health Care will implement enhanced barrier precautions according to policy with additional measure to protect resident and staff from Multidrug-resistant Organisms (MDROs) MDROs refers to microorganisms predominantly bacteria that are resistant to one or more classes of antimicrobial agents.Procedures:Enhanced Barrier Precautions (EBP) documented in part:Enhanced Barrier Precautions expand the use of PPE (gowns and gloves) during high-contact resident care activities that provide opportunities for transfer of MDROs to staff hands and clothing.EBP will be implemented for ALL residents with the following:1) Infection or colonization with MDRO when Contact Precautions do not otherwise apply2) Wounds and/or indwelling medical devices (central lines, urinary catheter, feeding tube, tracheostomy/ventilator) regardless of MDRO colonization statusEBP will be implemented during the following high-contact resident care activities: dressing, bathing/showering, transfers, providing hygiene, changing Linens, changing briefs or assisting with toilet, device care or use: central lines, urinary catheter, feeding tube, tracheostomy/ventilator.A. EBP requires the following PPE: Gloves, Gowns, Face Protection if performing activity with risk of splash or spray. All PPE is donned and doffed with appropriate hand hygiene and disposable after individual use or when visibly soiled.B. EBP does not require any room restrictionsThe facility will post clear signage on the door or wall outside of the room indicating the type of precautions and required PPE (gowns and gloves). The (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676393 If continuation sheet Page 19 of 20 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 12/04/2025 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 Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete facility will post signage that clearly indicates the high-contact resident care activities that require the use of gown and gloves. The facility will provide gowns and gloves immediately outside of the resident's room and position a trash can inside the resident room and near the exit for discarding PPE after removal, prior to exit of the room or before providing care for another resident in the same room. The facility will provide education to the facility staff on the implementation and procedure of EBP. The facility will perform periodic monitoring and assessment of the EBP procedures to determine additional training and education. The facility will provide education on EBP to residents and visitors. Event ID: Facility ID: 676393 If continuation sheet Page 20 of 20