Health inspection·January 18, 2024

F 0657 Resident #54 Level of Harm - Potential for minimal harm Review of Resident #54's electronic face sheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of Alzheimer's disease (a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks). Residents Affected - Some Review of Resident #54's quarterly MDS assessment dated [DATE] revealed the resident had a BIMS of 15 which indicated no cognitive impairment. Review of Resident #54's care plan conference on 04/04/2023 revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident. Review of Resident #54's care plan conference on 01/11/2024 revealed no evidence of attendance by attending physician, nurse, and nurse aide with responsibility for the resident. During an interview on 01/16/2024 at 11:54 a.m., Resident #54 stated during her last care plan meeting there was not a nurse present. Resident #54 stated she felt the members would not be able to answer questions about her labs and medications without a nurse present. Resident #71 Review of Resident #71's electronic face sheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of Alzheimer's disease (a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks). Review of Resident #71's quarterly MDS assessment dated [DATE] revealed the resident had a BIMS of 11 which indicated moderate cognitive impairment. Review of Resident 71#'s care plan conference on 12/28/2023 revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident. Resident #81 Review of Resident #81's electronic face sheet revealed resident was [AGE] year-old male who was admitted to the facility on [DATE] with diagnosis of cerebral palsy (abnormal brain development or damage to the developing brain that affects a person's ability to control his or her muscles). Review of Resident #81's quarterly MDS assessment dated [DATE] revealed the resident had a BIMS of 09 which indicated moderate cognitive impairment. Review of Resident #81's care plan conference on 06/15/2023 and 12/14/2023 revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident. Resident #98 Review of Resident #98's electronic face sheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of Alzheimer's disease (a brain disorder that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 2 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 0657 slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks). Level of Harm - Potential for minimal harm Review of Resident #98's quarterly MDS assessment dated [DATE] revealed the resident had a BIMS of 04 which indicated severe cognitive impairment. Residents Affected - Some Review of Resident #98's care plan conference on 12/28/2023 revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident. During an interview on 01/17/2024 at 9:44 a.m., CNA C stated that she did not attend care plan meetings . During an interview on 01/17/2024 at 3:13 p.m., LVN D stated that he did not attend care plan meetings . During an interview on 01/18/2024 at 4:27 p.m., MDS Coordinator E stated that there were no physician and nurse aide signatures present on the care plan attendance on 04/04/2023, 06/15/2023,12/07/2023, 12/14/2023, 12/21/2023, 12/28/2023 and 1/11/2024. MDS Coordinator E stated that there were no nurse signatures present on care plan attendance on 01/11/2024. During an interview on 01/18/2024 at 4:44 p.m., the DON stated that it would be best if the direct care nurse and nurse aide be present during care plan meetings for continuity of care. She stated that her expectation would not be for physician to attend care plan meetings. She stated that the IDT may appear differently based on the needs of the residents in the facility and availability of the direct care staff. The DON stated no negative effects would occur to resident from nurse not attending care plan meetings. She stated that other staff members including therapy would be able to go over medications with residents. Review of facility policy titled Comprehensive Care Plans dated 07/2020 revealed: 4. The comprehensive care plan will be prepared by an interdisciplinary team, that includes, but is not limited to: a. The attending physician or non-physician practitioner designee involved in the resident's care, if the physician is unable to participate in the development of the care plan. b. A registered nurse with responsibility for the resident. c. A nurse aide with responsibility for the resident. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 3 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to ensure residents were provided respiratory care received care consistent with professional standards of practice for 2 of 2 residents (Resident #11 and Resident #42) reviewed for oxygen administration. Residents Affected - Few The facility failed to provide Oxygen (O2) in use sign on resident doorways for Resident #15 and #17. The facility failed to obtain a physician's order prior to administering oxygen for Resident #15. The facility failed to change the oxygen tubing every 7 days for Resident #15 and # 17. These failures could place residents who use O2 at risk for respiratory illnesses and at risk of injury from fire. Findings included: Resident #15 Review of Resident #15's electronic face sheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of urinary tract infection, sleep apnea, and asthma. Review of Resident #15's admission MDS assessment dated [DATE] revealed the resident had a BIMS of 15 which indicated no cognitive impairment and that she used oxygen while a resident. Record review of Resident #15's care plan dated 01/03/2024 revealed: Resident #15 had oxygen therapy. Record review of Resident #15's physician orders dated 01/18/2024 revealed no order for oxygen. During an observation on 01/17/2024 at 10:25 a.m., revealed an oxygen concentrator was by Resident #15's bed. There was no sign on the doorway to indicate oxygen in use . During an observation on 01/18/2024 at 10:00 a.m., revealed Resident #15's room had an oxygen concentrator with oxygen tubing connecting to CPAP machine. The tubing had one sticker with 1/9 date written on it and another sticker with 1/16 date written on it. There was no sign on the doorway to indicate oxygen in use. Resident #17 Record review of Resident #17's electronic face sheet revealed resident was a [AGE] year-old female who was admitted to the facility on [DATE] with diagnoses of unspecified psychosis and respiratory disorders. Record review of Resident #17's quarterly MDS assessment dated [DATE] revealed the resident had a BIMS of 08 which indicated moderate cognitive impairment. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 4 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0695 Level of Harm - Minimal harm or potential for actual harm Record review of Resident #17's care plan dated 01/22/2020 revealed: Administer oxygen per MD orders. Observe oxygen precautions. Record review of Resident #17's physician orders dated 06/23/2017 revealed: O2 @ 2 L/min via nasal cannula .as needed. Residents Affected - Few During an observation on 01/16/2024 at 11:19 a.m., revealed Resident #17 was lying in bed with oxygen being administered via nasal cannula from the oxygen concentrator. The oxygen tubing had sticker with 1/9 date on it. There was no sign on the doorway to indicate oxygen in use. During an observation on 01/18/2024 at 10:00 a.m., revealed an oxygen concentrator was in Resident #17's room and had tubing connected to humidification dated 1/9. There was no sign on the doorway to indicate oxygen in use. During an interview on 01/18/2024 at 9:17 a.m., RN B stated an oxygen order needed to be obtained prior to administering oxygen. During an interview on 01/18/2024 at 10:00 a.m., the DON stated she expected for oxygen tubing to be replaced weekly . She stated she felt oxygen tubing was not replaced when she saw two different dates on the same tubing. She stated she did not know what led to the failure for tubing to not be replaced or no oxygen in use signage outside of residents' rooms. She stated that not changing tubing could lead to infections. The DON stated that not having oxygen in use signage could put residents at risk of harm from emergency personnel not knowing what rooms oxygen had been in use. The DON stated there should be an order from the physician prior to oxygen being administered. She felt that the resident being in and out of the hospital lead to the failure of order not being transcribed correctly after readmission. Review of facility policy titled Oxygen Administration dated 2024 revealed: Oxygen is administered under orders of a physician, except in the case of an emergency .Oxygen warning signs must be placed on the door of the resident's room where oxygen is in use .Cleaning and care of equipment shall be in accordance with facility policies for such equipment .Possible risks and complications include, but are not limited to: a. Fire b. Respiratory infections related to contaminated humidification systems. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 5 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 observations, interviews, and record review, the facility failed to store medications used in the facility in the original containers or packaging and labeled in accordance with currently accepted professional principles for 1 of 2 (Medication Cart #1) medication carts reviewed for medication storage. The facility failed to keep each resident's medications in their original containers or packaging by placing medications in clear plastic cups then placing the cups in a medication drawer. This failure could result in drug diversion and accidental medication administration to the wrong resident. Findings included: During an observation on 01/17/2024 at 09:28 AM, revealed Medication Cart #1's top left drawer had 4 separate clear plastic 1 oz cups containing loose medications that were outside of their original containers. One medication cup had crushed medications mixed in a yellow substance and was not labeled. One medication cup was labeled with a resident's last name. There were 2 cups on the right that were not labeled. Upon discovery of the medication cups, RN B removed the 2 cups on the right and went down 100 hall. On 01/18/24 at 08:22 AM, a policy on preparing medications in advance by placing each resident's medication in a cup and placing the cup in the medication cart was requested from the DON. She stated the facility did not have a policy. The DON stated nurses should be following basic standards of care and they should not be setting up medications ahead of time. During an interview on 01/18/24 at 10:20 AM, RN B stated the medication cups he took out of the cart were for Resident #60, Resident #2, and Resident #59. Resident #60's medication included Aspirin 81 mg, Ferrous Sulfate 325 mg (Iron supplement for anemia), Multivitamin with minerals, Seroquel 25 mg (an antipsychotic for schizoaffective disorder), Depakene 250 mg (anticonvulsant for seizures), Lovaza 1 gram (for high cholesterol), Namenda 10 mg (for Alzheimer's disease), Vitamin D3 1000 international units (supplement for anemia), and Buspar 5 mg (anxiety for schizoaffective disorder). Resident #2's medications included Amiodarone 400 mg (to treat an irregular heart beat), Klor-Con 20 mEq (a potassium supplement), Multivitamin with minerals, Zinc 50 mg (a supplement), Apixban 5 mg (to prevent blood clots), Carvedilol 12.5 mg (to treat heart failure), Depakote 500 mg (an anticonvulsant for bipolar disorder), Entresto 24-26 mg (to treat an irregular heart beat), Furosemide 40 mg (reduces the workload on the heart with heart failure), Metformin 500 mg (to control blood glucose), Vitamin C 500 mg (supplement), and Buspirone 5 mg (to treat anxiety). Resident #59's medications included: Aspirin 81 mg, Empagliflozin 25 mg (to control blood glucose), Losartan 25 mg (to treat high blood pressure), MagOx 400 mg (supplement), Metformin 1000 mg (to control blood glucose), Namenda 10 mg (to slow cognitive loss), and Gabapentin 600 mg (to treat nerve disease). RN B stated he prepared medication for Resident #59 and Resident #2 before he was aware the residents were still asleep. He stated Resident #60 was not in her room because she was in dining room for breakfast. RN B stated he hated to throw out medications because he was not sure where the medications would end up and that he had heard services that claim to incinerate medications did not and chemicals could end up in the water system. RN B stated he would not administer medications prepared by anyone else and that was the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 6 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 reason he did not administer the unlabeled cup containing crushed medications. RN B stated the cup must have been prepared by a night nurse but did not know which nurse. He stated the nurses only had keys to the medication cart they were assigned to. RN B stated consequences to residents was it could kill them, could cause med errors which would lead to notifying the prescriber, the family, and administration. During an interview on 01/18/24 at 10:43 AM, the DON stated she expected when the nurses were preparing medications, the medications were not prepared in advance then left in the cart unlabeled. She stated the effect on residents could be getting the medications mixed up with a resident receiving the wrong medications and that could be detrimental and even fatal. The DON explained medication administration training was included during orientation, refreshers via in-services and re-direction. Review of the facility policy titled Medication Administration revised February 2023, revealed a list of tasks to perform prior to preparing medication. The tasks included identifying the resident, explaining the purpose of the visit, obtaining vital signs if needed, and position resident for comfort and ease of administration. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 7 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 0805 Level of Harm - Minimal harm or potential for actual harm Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. Based on observation, interview, and record review, the facility failed to ensure food was prepared in a form designed to meet individual needs for 1 of 1 lunch meal reviewed. Residents Affected - Few The facility failed to ensure the recipe was followed for pureed meatloaf. This failure placed residents who received pureed diets at-risk of inadequate nutrition and weight loss. The findings included: During an observation and on 01/16/2024 at 11:10 AM, revealed [NAME] A placed 10 slices of bread with the crumbled meatloaf and chicken stock into a blender. Once completed, he then added thickener for a mashed potato consistency. No recipe was observed during the pureeing of meatloaf. During an interview on 01/16/2024 at 11:38 AM, [NAME] A stated he followed the standardized recipe. He stated he had followed the recipes for so long he had them memorized. The [NAME] stated he was not entirely sure if the recipe called for bread, but he had always used it for the consistency of the proper thickness in purees. He stated he was not sure if adding bread changed the nutritional value of the puree food. During an interview on 01/16/2024 at 11:42 AM, the DM stated she used bread as a thickener in her previous experience in pureeing food. She stated she felt it would not lessen the value of the nutrition but felt it would give it more nutrition. She stated she had not had time to look at the recipes because she had been at the facility for only a week. The DM stated if a resident was ordered a low carb diet, she would not want to add sugars or starches. She stated she did not know which residents were on a pureed diet or regular diets. During a follow up interview on 01/18/2024 at 11:03, the DM stated in the facility's policy and procedures the staff should follow the recipes for pureeing food items. She stated bread should not have been added if the recipe did not call for it but that she had always added bread for thickness where she had previously worked. The DM also stated the added bread would most likely change the nutritional value and add more calories. The DM stated the staff should have followed the recipe and to not add or take away ingredients as it altered the nutritional value. The DM stated it was herself who monitored the puree and following recipes with staff having it available as they are being made. The DM stated the negative impact for resident if altering the recipe could have possibly made someone sick or have an altered nutritional value. She stated the failure occurred by not following the recipes that were available to them, with her expectations were for staff to follow the recipes, having them available at all times. During an interview on 01/18/2024 at 11:03 AM the ADMN stated he did not know what the policy and procedures were for pureed food. He stated the DM and Dietician should have monitored more closely. The ADMN stated those two staff are new to the facility. An attempted interview on 01/18/2024 at 4:33 PM was performed to the Dietician with no answer and no return phone call. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 8 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 0805 Record review of facility recipe titled Glazed Meatloaf (#55561) dated 09/2022 revealed: Level of Harm - Minimal harm or potential for actual harm .Step 2 Measure number of servings using the regular prepared recipe portion. Place in a blender or food processor Residents Affected - Few .If needed, gradually add thickener. Follow manufacturer instructions for amount of commercial thickener. Record review of facility Pureed Foods Guideline undated, revealed: . .4. If needed, gradually add thickener (ex: cream of rice or a commercial thickener-follow manufacturer instruction for amount of commercial thickener). During an interview on 1/18/2024 at 6:40 PM the ADMN stated there were no further policies to provide during facility exit conference. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 9 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 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 for 1 of 1 kitchen reviewed, in that: Residents Affected - Some The facility failed to ensure open items in the freezer, refrigerator, and dry food storage were dated and labeled and free from expired foods. These failures could place residents at risk for food borne illness and cross-contamination. Findings included: During an observation on 01/16/2024 at 10:19 AM, the pantry revealed: 1. one 5 lbs. opened container of creamy peanut butter with no open date. 2. one 3.55 lb. opened container of dry flakes of mashed potatoes with no open date. 3. one bag of opened small marshmallows with no open date. 4. two 2 lb. 11 oz packages of Light Tuna with no in date. 5. one 24 oz opened bag of Crispy Fried Onions with no open date. 6. one 42 oz opened container of Quaker Oats Oatmeal with no open date. During an observation on 01/16/2024 at 10:26 AM, freezer #1 of 4 contained: 1. one unopened plastic bag of okra not labeled or dated with the in date During an observation on 01/16/2024 at 10:28 AM, freezer #2 of 4 contained: 1. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 10 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 eight 2.5 lbs plastic containers of apple juice with no in date. Level of Harm - Minimal harm or potential for actual harm During an observation on 01/16/2024 at 10:29 AM, freezer #3 of 4 contained: 1. Residents Affected - Some two clear unopened bags of frozen corn tortillas not labeled and no in date 2. one clear opened bag of okra with no open date. 3. one qt. opened container of eggnog with no open date. During an observation on 01/16/2024 at 10:31 AM, freezer #4 of 4 contained: 1. one opened box of hamburger patties, exposed to elements, with no open date. 2. two large unknown portions of frozen meat not labeled and no in date. 3. one opened box of frozen sausage patties with no open date. During an observation on 01/16/2024 at 10:35 AM, refrigerator #1 of 3 contained: 1. one unopened clear plastic bag that contained a yellow substance was not labeled or dated. 2. one opened container of mustard with no open date. During an observation on 01/16/2024 at 10:37 AM refrigerator #2 of 3 contained: 1. one 5 lbs. opened plastic bag of mozzarella cheese with no open date. 2. two 2 lbs. bags of opened romaine lettuce with no open date. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 11 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 During an observation on 01/16/2024 at 10:37 AM Refrigerator #3 of 3 contained: Level of Harm - Minimal harm or potential for actual harm 1. one 5 lbs. opened plastic bag of mozzarella cheese with no open date. Residents Affected - Some 2. two 2 lbs. bags of opened romaine lettuce with no open date. During an interview on 01/18/2024 at 11:03 the DM stated that the facility's policy and procedures for when a truck delivered food to the facility was for the staff to have properly placed the in date and labeled the received food product. She stated if the food products were taken out of the boxes, the staff should have labeled the food item with the product name and the in dates should be written on them. The DM stated it was herself who should have been monitoring. She stated the negative impact to residents could have been contamination to food or possibility of pests in the dry goods and could have made the residents sick. The DM stated the failure occurred with staff not following the policy and procedures and with the previous DM not overseeing the product status. She stated her expectations were for everyone should have followed the policy and procedures. During an interview on 01/18/2024 at 11:10, the ADMN stated the kitchen policy and procedures for storage and labeling should have been done by kitchen staff in a timely manner if not immediately. He stated if the food package was opened, the food product should have been dated with the open date, and if out of the box the product should have been labeled. The ADMN stated the DM should have monitored as well as himself. He stated the negative impact to residents was becoming sick with an allergic reaction or gastrointestinal problems. He stated the failures occurred because the staff were not reviewing or checking what was labeled and dated. The ADMN's expectations were for staff to check the products daily as well as when the products came in. Record Review of the DM's training documents revealed Learn2Serve Texas Food Manager Certification Program dated 09/18/2022 with the expiration date to expire 5 years from the effective date. Record Review of the [NAME] A's training documents revealed ServSafe Food Handler dated 01/26/2022 with the expiration date to expire 01/26/2024. Record review of facility policy titled Food Receiving and Storage dated 07/2014 revealed: Policy: Foods shall be received and stored in a manner that complies with safe food handling practices . .6. Dry foods that are stored in bins will be removed from original packaging, labeled, and dated (use by date). Such foods will be rotated using a first in - first out system. 7. All foods stored in the refrigerator or freezer will be covered, label ed and dated (use by date). 8. All foods stored in the refrigerator or freezer will be covered, label ed and dated (use by date). (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 12 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 FORM CMS-2567 (02/99) Previous Versions Obsolete Review of Texas food Establishment Rules accessed https://www.fda.gov/media/164194/download 08/16/2023 revealed in annex 3 page 17: the manufacturer's use-by date is its recommendation for using the product while its quality is at its best. Although it is a guide for quality, it could be based on food safety reasons. It is recommended that food establishments consider the manufacturer ' s information as good guidance to follow to maintain the quality (taste, smell, and appearance) and salability of the product. If the product becomes inferior quality-wise due to time in storage, it is possible that safety concerns are not far behind. Event ID: Facility ID: 676416 If continuation sheet Page 13 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 0919 Make sure that a working call system is available in each resident's bathroom and bathing area. 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 adequately provide a communication system that would relay a call directly to staff or a centralized staff work are for 2(Resident #2 and Resident #59) of 3 residents reviewed for resident call system. Residents Affected - Some The facility failed to provide a working communication system, that was easily at reach, that would allow residents the ability to safely call for staff for assistance. This failure could place residents at risk of not having a means of directly contacting caregivers in an emergency or when they need support for daily living. The findings included: Record review of Resident #2's face sheet dated [DATE] revealed [AGE] year-old male admitted on [DATE] with original admission date of [DATE] with the following diagnosis paraplegia, reduced mobility, and muscle wasting. Record review of Resident #2's Annual MDS dated [DATE] revealed Section C- Cognitive Patterns Resident #2 has BIIMS score of 12 (meaning moderate cognitive impairment);.Section GG-Functional Abilities and Goals revealed- Resident #2 used wheelchair for mobility, has lower extremity limited range of motion. During an observation and interview on [DATE] at 12:11 PM revealed Resident # 2 was in his room in his wheelchair watching television. Resident #2's call light was lying in floor behind Resident #2. Resident #2 stated his call light did not work, that he was given a toy to squeeze to get staff's attention. The call lights were observed to not be working, both call lights had been pushed and the lights in the hallway did not light up. Resident # 2's squeaky toy was on a table located out of reach of Resident #2. Resident #2 was not able to move his wheelchair by himself to get the toy. Record review of Resident #59's face sheet dated [DATE] revealed [AGE] year-old female admitted on [DATE] with original admission date of [DATE] with the following diagnosis heart failure, need for assistance with personal care and repeated falls. Record review of Resident #59's Annual MDS dated [DATE] revealed Section C- Cognitive Patterns, Resident #59 has BIMS score of 15 (meaning cognitively intact). Section GG-Functional Abilities and Goals revealed Resident #59 used wheelchair for mobility. During an observation and interview on [DATE] at 12:18 PM Resident #59 stated the call light was not working, and she was given a toy that squeaked to use if she needed help. Resident #59 stated she was not able to find her call light and would yell if she needed to get help. The squeaky toy was observed to be on floor under her bed. Record review of Resident #62's face sheet dated [DATE] revealed [AGE] year-old male admitted on [DATE] with the following diagnosis dementia and anxiety and heart disease. Record review of Resident #62's Quarterly MDS dated [DATE] revealed Section C- Cognitive Patterns, Resident #62 has BIIMS score of 15 (meaning cognitively intact ). (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 14 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 0919 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an interview and observation on [DATE] at 03:10 PM Resident #62 stated the call lights were not working and he was given a blue toy to squeeze when he needed assistance. The blue toy was on table within reach of Resident #62. During an interview and observation on [DATE] at 12:41 PM TNA G stated the call lights on the 100 hall were not working. TNA G stated a staff bought squeaky toys and bells for residents to use. TNA G stated the aides were checking residents more frequently due to the call lights not working. TNA G was observed walking up and down hall checking on residents. During an interview on [DATE] at 3:45 PM CNA H stated the call lights were not working on the 100 hall. CNA H stated some of the residents were given bells and some were given squeaky toys. CNA H was observed on the 100 hall checking on residents During an interview on [DATE] at 02:50 PM LVN F said the call lights have been out for almost a week. LVN F said residents were given a noise maker. LVN F stated she heard the noise makers in her office. LVN F stated staff were making more frequent rounds to check on residents. LVN F stated the noise makers should have been in reach. During an interview on [DATE] at 02:58 PM RN B stated the call lights had been out for a few days, and residents were given a squeaky toy. RN B stated staff were making more frequent rounds. RN B stated the toys should have been within reach. RN B stated at the beginning of shift he would tell the aides assigned to the hall that call lights were not working so they would need to listen for the squeaky toys and make more frequent rounds. During an interview on [DATE] at 03:18 PM the DON stated her expectation was that call lights or the squeaky toy should have been in reach of the residents. The DON stated she notified staff via their personal electronic devices and again at the beginning of their shift. The DON stated staff had increased their rounds for residents. The DON stated there had been no negative effects on residents because of the call system not working. The DON stated there had been no falls on the 100 hall. During an interview on [DATE] at 2:43 PM the ADMN stated call lights had not been working on the 100 hall for almost a week. The ADMN stated some of the call lights were fixed yesterday and the other rooms were waiting on a part to come in. The ADMN stated the parts had been ordered, hoping they will in less than a week . The ADMN stated residents were given noise makers, the CNAs were asked to monitor residents more frequently, and to ensure that the noise makers . The ADMN stated staff were informed by telling staff as they came on shift and by verbal in-services. The ADMN stated there were no negative affects to residents, he was not aware of any incidents due to not having call lights. The ADMN stated the residents should have a noise maker in their room and it should have been within reach. The ADMN stated noise makers should not be on floor or on a table that was far away. The ADMN stated residents not having noise maker in reach could have not allowed them to request the help they needed. The ADMN stated what led to failure was residents had thrown them down, slipped out of their hand or staff forgot to put them in reach. Record review of facility policy titled Call Lights: Accessibility and Timely Response dated 2023 revealed Staff will observe that the call light is within reach of resident and secured, as needed. The call system should be accessible to residents while in their bed or other sleeping accommodations within the resident's room . Staff will report problems with a call light or the call system immediately to the supervisor and /or maintenance director and will provide immediate or alternative solutions until the problem can be remedied. (Examples include replace call light, provide a bell or (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 15 of 16 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 676416 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brightpointe at Lytle Lake 1201 Clarks Dr Abilene, TX 79602 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 0919 whistle, increase frequency of rounding, etc.) Level of Harm - Minimal harm or potential for actual harm ? Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676416 If continuation sheet Page 16 of 16