Health inspection·February 26, 2026

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few days afterward. She noted that, although no further incidents occurred, she did not feel safe remaining in the same room with her previous roommate. Resident #1 expressed that she felt more comfortable after moving to her current room.During a telephone interview on 02/26/26 at 1:34 PM, the FM reported that Resident #1 disclosed the incident to her the day after it occurred, during a visit. The FM stated she had reported the incident to a staff member working on the floor on the same day but was unable to recall the staff member's name or role within the facility. She further indicated that the ADM recently discussed the incident with her and instructed her to report any complaints, preferably directly to the administrator rather than to other staff members on the floor. The FM expressed that this approach was new to her, as she previously believed she could report concerns to any staff member. She noted that no injuries or visible harm resulted from the incident and expressed satisfaction that the facility took steps to relocate Resident #1 away from the alleged perpetrator. She added, however, it would have been better if the roommate was removed from the room rather than Resident #1 moving to a different room. The FM stated she was generally satisfied with the care and services provided to Resident #1 at the facility thus far.During an interview on 02/26/26 at 11:10 AM CNA A stated that approximately few weeks prior, while changing Resident #1, the resident indicated that her roommate had hit her at some point in the past. CNA A stated that she did not inquire about the specific timing of the incident, nor did she ask the resident for more details. She said that she initially took the report lightly, as Resident #1 was discussing other topics and laughed it off. She stated that Resident #1 reported to her that she had previously reported the incident to other staff members at the time that had occurred, though she did not disclose their names. CNA A explained she had chosen to not to report the incident to AC because of Resident #1's statement that she reported about the incident to other CNAs, also it was in the past, and the resident did not appear to be upset about it at the time. CNA A recognized the ADM as the AC and acknowledged that she later received a one-on-one in-service from the AC. She stated she understood that her failure to report the allegation was a mistake. CNA A stated she learned that any allegation of abuse, regardless of when it occurred, should be reported to the AC.During an interview on 02/26/26 at 2:30 PM, the DON reported that she learned of the allegation through the SW. The DON stated, the LPC had informed the SW that, on 02/17/26, during a session with Resident #1, the resident disclosed that her roommate had assaulted her approximately two weeks earlier by smacking her in the face. However, upon further inquiry by the ADM, Resident #1 clarified that her roommate had hit her on the thigh and not on the face, several weeks prior. The DON said, since the roommate did not want to move out of the room, they asked if she wanted to move rooms, Resident #1 expressed a desire to do so and was promptly relocated. The DON stated Resident #1 reported feeling safe at the facility and was satisfied with the room change. The DON said when the roommate was interviewed, she denied ever hitting Resident #1, stating that although they had disagreements, she had never physically assaulted her. She said, both residents were under psychiatric care, with no prior documentation of such incidents in their sessions. The DON stated, the psychiatric team continued to monitor and followed up with both residents and during a follow-up psychiatric assessment on 02/19/26, Resident #1 was specifically asked about the alleged assault. The DON said, Resident #1 did not confirm any physical aggression and instead focused on property disputes and reported feeling happier and safer in her new room. The DON said on 02/17/26 the FM of Resident #1 was contacted and informed of the incident and room change. The FM acknowledged that Resident #1 had previously mentioned being hit in the face but explained she did not report it because she was not hurt. The FM was advised of the importance of reporting such incidents promptly and verbally committed to doing so in the future, even for minor concerns. The DON stated, staff (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676438 If continuation sheet Page 2 of 3 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 676438 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Killeen Nursing & Rehabilitation 5000 Thayer Dr Killeen, TX 76549 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete questionnaires completed after the incident revealed that CNA A had briefly mentioned that Resident #1 had reported the incident weeks earlier to her, noting it as a distant past event. The DON stated that CNA A said she did not report this incident to anyone in the facility as the incident had happened in the past. A one-on-one in-service was conducted with CNA A emphasizing the necessity of reporting all potential abuse, regardless of timing, to ensure proper documentation and investigation per facility policy. The DON stated she performed a comprehensive skin assessment on both residents, confirming no abnormalities from baseline. The DON said she conducted resident safety surveys to all residents in the 800 hall, including Resident #1, which showed no concerning trends. Additionally, staff training sessions on abuse, neglect, reporting procedures, and de-escalation techniques for residents with behavioral issues were implemented to improve staff awareness and response. When the investigator clarified that the FM was instructed by the ADM to report incidents directly to the administrator rather than to floor staff, the DON stated that this was inappropriate. She emphasized that residents and their families had the right to report concerns to any staff member, and it was the staff member's responsibility to escalate and report such complaints to the appropriate authority.An interview with ADM on 02/26/26 at 2:30pm was unsuccessful as she was on leave and was not accessible via mobile phone.Record review of in-service dated 02/17/26 reflected in-service was conducted with all staff over topic of Reporting abuse and neglect when anyone reports abuse or neglect regardless of time frame. All incidents should be reported to abuse coordinator. De-escalation techniques for residents with behaviors. It was also revealed that CNA A received a separate 1:1 in-service on the same subject on 02/17/26, from the AC.Record review of facility policy Abuse, Neglect, Exploitation and Misappropriation prevention program revised in April 2021 reflected: Reporting Allegations to the Administrator and Authorities:If resident abuse, neglect, exploitation, misappropriation of resident property or injury of unknown source is suspected, the suspicion must be reported immediately to the administrator and to other officials according to state law and HHSC reporting guidelines. 3.Immediately is defined as:n. within two hours of an allegation involving abuse or result in serious bodily injury; orb. within 24 hours of an allegation that does not involve abuse or result in serious bodily injury. Event ID: Facility ID: 676438 If continuation sheet Page 3 of 3