Health inspection·December 14, 2025

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete She stated, the only time I can remember refusing was when I was watching the Aggie game and it was the Friday after Thanksgiving. She stated they would take her to the shower room and give her a shower while she sat on bench. She said her shower schedule was Monday, Wednesday, Friday, but staff often gave her a bath off schedule. Resident #1 stated many times the staff would not even ask her if she wanted a bath and a family member would have to go get them to get it done. During an interview on 12/12/2025 at 10:45 am, the DON stated that Resident #1 refused a shower on 12/05/25. DON stated there was a late entry regarding the resident's refusal put in by the nurse on 12/11/2025. During an interview on 12/14/2025 at 6:32 pm, the ADM stated it was her expectation that showers be given per the shower schedule. She stated it is the responsibility of the charge nurses to make sure they are done, the aides need to let the nurses know if there are any refusals, so they can put in a progress note. She stated a possible negative effect of residents not getting showers will have a body odor and she wants her residents clean. During an interview on 12/14/2025 at 6:45 pm, the DON stated it was the responsibility of the nurse on the unit to make sure residents are getting showers and her expectation was that the CNA would give the shower, and the resident gets the shower and they have a shower schedule. She stated a possible negative. effect of someone not getting a shower is that the resident is not clean, but the resident has a right to refuse a shower, and the nurse needs to document when this happens. Review of facility policy Shower/Tub Bath dated revision October 2011 reflected: PurposeThe purposes of this procedure are to promote cleanliness, provide comfort to the resident and to observe the condition of the resident's skin. Documentation The following information should be recorded on the resident's ADL record and/or in the resident's medical record: 1. The date and time the shower/tub bath was performed.2. The name of the individual(s) who assisted the resident with the shower/tub bath.3. All assessment data (e.g., any reddened areas, sores, etc., on the resident's skin) obtained during the shower/tub bath.4. If the resident refused the shower/tub bath, the reason(s) why and the intervention taken. Reporting 1. Notify the supervisor if the resident refuses the shower/tub bath.2. Notify the physician of any skin areas that may need to be treated.3. Report other information in accordance with facility policy and professional standards of practice. Event ID: Facility ID: 676437 If continuation sheet Page 2 of 4 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 676437 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Accel at College Station 1500 Medical Avenue College Station, TX 77845 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 0757 Ensure each resident’s drug regimen must be free from unnecessary drugs. 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 residents were free from unnecessary drugs for one resident (Resident #1) of seven reviewed in that: The facility failed to follow Resident #1's Nephrologist's orders on 11/13/2025 to discontinue medications metformin, potassium citrate, prenatal vitamin, valsartan-hydrochlorothiazide. This failure affected Resident #1 and could have affected all residents receiving medication by placing them at risk of illness, toxicity, or other adverse reactions. Findings included: Review of Resident #1's face sheet dated 12/10/2025 revealed she was a [AGE] year-old female admitted on [DATE] with diagnosis that included: fracture of the right lower leg, asthma (breathing disorder), type 2 diabetes (blood sugar regulation disorder) and history of falling. Face sheet reflected Resident #1 was her own responsible party. Review of Resident #1's admission MDS dated [DATE] reflected a BIMS of 15, suggesting she was cognitively intact. Review of Resident #1's After Visit Summary from the Nephrologist office dated 11/13/2025, reflected: STOP taking these medications:Metformin 500 MG [blood sugar regulation medication]potassium citrate 1 meq [potassium supplement]prenatal vitamin 28 mg/800mcg valsartan-hydrochlorothiazide 320-12.5mg [blood pressure medication] Review of Resident #1's November 2025 MAR reflected she received the medications Metformin, potassium citrate, and valsartan-hydrochlorothiazide from 11/13 - 11/30. Review of Resident #1's December 2025 MAR reflected she received the medications Metformin, potassium citrate, and valsartan-hydrochlorothiazide on 12/1/2025 and 12/2/2025 until they were discontinued on 12/2/2025. Review of Resident #1's progress notes from 11/13/2025 to 11/26/2025 reflect no entries regarding the discontinuation of medications as ordered by Resident #1's Nephrologist. Review of Resident #1's progress notes dated 11/27/2025 reflected: Pt [FM2] stated pt had went to a Nephology visit on the 13th and the Nephrologist of the patient made orders to stop completely taking Metformin, [Potassium] Citrate, Prenatal Vitamins, and Valsartan-hydrochlorothiazide, and Neurontin, and Meloxiam and to gradually stop taking Protonix r/t Kidney function. MD Notified of [FM2] concerns orders pending. Review of Resident #1's progress notes dated 12/2/2025 reflected: Nephrology office did not call back. [FM2] stated she would email the orders indicating which meds the MD wanted DC'd. I discussed with [MD]. She gave orders to DC the Mobic, Gabapentin, Protonix and started Pepcid 20 mg daily. Orders updated.11/13/25 Office visit from Nephrologist indicated to DC the following meds: Prenatal vitamin Valsartan- HCTZ, Metformin, Potassium Citrate. Orders updated. During an interview on 12/11/2025 at 12:53 pm, Resident #1 stated a facility staff took her to her Nephrologist appointment 11/13/2025 and afterwards she handed the paperwork to the staff. She stated she thought she was going to give it to the nurse, but she didn't watch to see if she did this. During an interview on 12/11/2025 at 1:53 pm, FM #3 stated Resident #1 had a visit with the Nephrologist on 11/13/2025 and was transported by the facility to the appointment. FM #3 stated they were on the phone with Resident #1 while at the appointment with the Nephrologist and heard him say he wanted medications discontinued to protect her kidneys. The stated Resident #1 told her she handed the after-visit summary paperwork to the facility staff on 11/13/2025 after the appointment and they were supposed to give it to the nurse. They started on 11/27/2025, when Resident #1 was brought back after Thanksgiving, they asked the nurse about why the resident was still taking the medications and why they were not discontinued back on 11/13/2025 and the nurse stated she would call the doctor. They stated they were very upset that the specialist had discontinued the medications two weeks prior and the facility was still giving them to the Resident #1. During an interview on 12/11/2025 at 4:25 pm, MD stated she did not remember staff calling her about discontinuing medications for Resident #1. She stated just because she cannot remember someone not calling - doesn't mean Residents Affected - Some (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676437 If continuation sheet Page 3 of 4 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 676437 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/14/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Accel at College Station 1500 Medical Avenue College Station, TX 77845 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 0757 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete they did not. She stated she does know if they had called her about discontinuing the meds from the nephrologist -her answer would be to discontinue the medications and follow orders of the specialist - she stated, I don't argue with a nephrologist. She wouldn't argue with a doctor that has been treating a patient long term. During an interview on 12/12/2025 at 12:30 pm, the DON stated Resident #1 was taken to the nephrologist by a family member. DON stated that when the resident returned to the facility there was no paperwork. DON stated there was a nursing progress note on 11/13/25 regarding the issues. DON stated when the facility transports a resident to an appointment the transportation staff gets all paperwork and returns it to the facility. The nurse on the unit is responsible for completing follow up. The expectation is for the nurse to follow up with the clinic regarding visits and continue to follow up until the visit information is obtained. If a family takes a resident to an appointment, the nurse is responsible for contacting the family to obtain visit information as well. During an interview on 12/14/2025 at 6:32 pm, the ADM stated her expectation was that the nurse would call the MDs office to see if there was a change of medication, they must have the documentation of a medication change, if there were no documents, staff must call to verify. She stated it is the responsibility of the staff that received the resident back into the facility and either hears from the family that there is documentation or if they hear from family they need to follow up with the MD immediately and verify if there are any changes from the doctor - if they did not get a response from the specialist, then they should have reached out to the facility MD. She further stated it was her expectation that communication to the nephrologist happened sooner as a possible negative effect would be lack of communication and lack of continuity of care. Also, a negative effect could be that the Resident #1 would not get the correct medication due to lack of communication. During an interview on 12/14/2025 at 6:45 pm, the DON stated the facility transported Resident #1 to her specialist appointment on 11/13/2025. She stated her expectation that the transportation aide should come back with paperwork and give it to the nurse on the unit. The nurse needs to review the documentation and if there are any changes then they needed to phone the PCP to get the orders updated. She stated the communication should have gone from the nurse to the specialist, if the specialist did not get back, she would not wait more than 24 hrs., she would let the facility MD know the same day that did not get any paperwork back from the specialist - she said MDs sometimes have access to information they do not. She stated the resident received medications that were supposed to be discontinued, because the nurse did not follow up with the specialist. She stated a possible negative effect of a resident receiving unnecessary medications - she said she could not answer that because Resident #1 was on the medication previously and she did not want to speculate what could have happened, she said there might have been special tests done at the specialist and they might have information she did not access to- but she stated if a resident is given medication that should have been discontinued, the resident could have an adverse reaction. Review of Facility Policy Administering Medications dated revised December 2012 reflected: Medications shall be administered in a safe and timely manner, and as prescribed. Policy Interpretation and Implementation1. Only persons licensed or permitted by this state to prepare, administer and document the administration of medications may do so.2. The Director of Nursing Services will supervise and direct all nursing personnel who administer medications and/or have related functions.3. Medications must be administered in accordance with the orders, including any required time frame. Event ID: Facility ID: 676437 If continuation sheet Page 4 of 4