Health inspection·July 21, 2025

F 0656 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few bed when he heard a popping sound on Resident # 1's left shoulder, and the Resident was crying. Nurse A stated she did not review the care plan to know how many staff were required currently to assist Resident # 1 during transfers. Nurse A stated she assessed Resident #1 and gave her pain medication. During an interview with CNA D on via telephone on 07/18/2025 at 11:47 am, he stated he walked into Resident # 1's room and remembered she was a 1 person assist from the last time he checked the POC. He stated, he did not check the portion of the POC that would have showed if she was a one or two person assist, so he did not request for assistance. CNA D said, Resident # 1 was begging to be put back into bed. CNA D told the Resident; the mechanical lift was not working because the battery was not charged. CNA D in attempting to pivot Resident #1 back to her bed, he heard a popping sound from the resident's left shoulder. During an interview with Resident #1 on 07/18/2025 at 3:23 pm over the phone, she stated CNA D was trying to put her in bed by himself without using a mechanical lift. She stated CNA D did not tell her that, the mechanical lift was not working because the battery was not charged. Resident #1 said, she asked CNA D; Would you please use the Hoyer Lift, he said no. I can pick you up by myself. Resident #1 said, when CNA D picked her up from under her arms, she heard a popping sound from her left shoulder and started crying. Resident # 1 said when the nurse arrived at her room about 20 minutes later, she told the nurse CNA D picked her up in the wrong way, and her left arm popped. Resident #1 said, the nurse gave her pain medication on that day. Resident # 1 said In the past, it's been two staff helping to transfer me. This one decided not to use the Hoyer lift on Tuesday night.During an interview with the ADON on 07/21/2025 at 10:11 am, she stated updating the care plan to reflect the needs of the residents was the responsibility of all nurse managers, but the MDS coordinator was predominately over the care Plan. The ADON stated she did not know why Resident # 1's care plan was not updated prior to the incident. During an interview with the Administrator on 07/21/2025, at 11:43 am, he stated: I did not realize there was a discrepancy between the care plan and the MDS. During an interview with the Administrator on 07/20/2025 at 1:57 pm, the Administrator stated the MDS, and the Care Plan information should match. He said on the MDS if there is a 7 day look back period for transfer and there are 2 days where the transfer level required a higher level of assistance for the rest for the week, that is what is going to be coded on the MDS. He said the MDS will capture the highest level of assistance, and the care plan will capture the lowest. That is why Resident # 1's care plan and MDS do not match. During an interview with the DON on 07/21/2025, she stated it was the responsibility of the Director of Nursing, Assistant Director of Nursing, wound care nurse and MDS nurses to update care plans. The DON stated it was updated quarterly or when an incident occurred. During an interview via telephone on 07/19/2025 at 11:31 am with the MDS coordinator, she said assessments were done quarterly-every 3 months. She stated if a resident's care changed to hospice care, a new assessment was completed, and the care plan would be updated. The MDS coordinator said, the care plan and MDS should match. The MDS which had what was charted, and the care plan had the same information. The MDS coordinator was not on site. The facility's MDS policy revised on 05/05 2023 revealed: -Complete a comprehensive significant assessment as soon as needed to provide appropriate care to the individual. -A significant correction is completed when the MDS or care plan does not suit Residents' needs.On 07/20/2025 at 10:39 am., an Immediate Jeopardy was identified. The Administrator was provided with the IJ template on 07/20/2025 at 10:39 am and Plan of Removal (POR) was requested at that time. The POR summited by the Administrator was accepted on 07/20/2025 at 10:17 am. The POR revealed: Immediate Jeopardy, Plan of Removal 07/21/2025 at 11:34 am.F656 Develop/Implement Comprehensive Care Plan The facility failed to develop and implement a comprehensive person-centered care plan for Resident#1, which included measurable objectives and timeframes (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676463 If continuation sheet Page 2 of 8 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 676463 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Crimson Heights Health & Wellness 19279 McKay Dr. Humble, TX 77338 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 - Immediate jeopardy to resident health or safety Residents Affected - Few to meet a resident's medical, nursing, mental and psychosocial needs.Identified resident is being transferred using 2-person mechanical lift transfer per updated resident's plan of care. Resident #1's care plan and care profile were updated to reflect 2-person mechanical lift transfer on 7/17/25 by the Director of Nursing/Designee. Investigator observed Resident #1 during a transfer with 2 staff. The facility record reviewed by the Investigator revealed, Certified Nursing Assistant D no longer employed at facility. Last day of employment was 7/17/25 due to violation of rules and policies. Mechanical lifts in the facility were examined for proper functioning and operation including batteries on 7/18/25 at 12:15 pm by the Maintenance Director/designee. Facility record reviewed by the Investigator revealed, Licensed nurses and certified nurse aides were re-educated by Rehab Director/Designee by 7/18/25 on the following: Identifying changes to resident's activities of daily living assistance required and reporting to nurse/nurse management to update the plan of care. Accessing point of care profile of the resident to confirm assistance needed for activities of daily living Facility records reviewed by the Investigator revealed Licensed Nurses and certified Nurse aides had 2-person competency checks completed by the director of Nursing/Designee by 7/19/25. Nursing Staff not receiving the education or completing the competency by 7/19/25 will receive prior to their next scheduled shift. The Administrator, Director of Nursing and Nurse Assessment Coordinators were reeducated by the Clinical Consultant on comprehensive person-centered care plans including that the care plan and MDS should reflect the residents current transfer status on 7/20/25. Change in status needs will be discussed three times a week during nurse aide meeting. The Director of Nursing/Designee during this meeting will review the identified resident's profile and care plan to validate changes in assistance have been updated. Completed MDS will be reviewed in clinical morning meeting to validate current transfer status is reflected in the care plan and care profile Monday - Friday by the Director of Nursing/Designee. The Director of Nursing/Designee will randomly observe 3 certified nursing assistants performing transfers three times weekly to validate transfers are following the residents' plan of care. Resident's will be reviewed quarterly following the MDS schedule and as needed with changes of condition daily during the clinical meeting review to validate current transfer status matches the care plan and care profile by the Director of Nursing/Designee. The administrator will validate reviews in clinical morning meeting and review transfer observations to validate appropriate actions are taken to safeguard the residents. This was verbalized during a morning meeting. The Administrator stated the medical director was notified of the immediate jeopardy on 7/20/2025 by the administrator.An Ad Hoc (A meeting called to address specific quality issues) Quality Assurance Performance Improvement meeting was held on 7/20/2025 regarding the contents of this plan. Monitoring of the Plan of Removal included: Following acceptance of the facility's plan of removal, the facility was monitored from 07/20/2025 at 10:39 am to 07/21/2025 at 11:34 am. The Investigator confirmed the facility implemented their plan of removal sufficiently from 07/20/2025 to 07/21/2025. Record review, Resident #1's care plan was updated to reflect 2 persons transfer with a mechanical lift on 07/17/2025 by the DON. CNA D was terminated on 07/17/2025 due to violation of rules and policies. Record review of facility's records revealed, nurses and certified nurse assistants were re-educated on:-Identifying changes to Residents'' activities of daily living assistance requirements and reporting to nursing management to update care plan.-Nurses and CNAs to identify point of care profile of the residents to confirm assistance is needed. Nursing staff had competency checks from 07/18/2025 to 07/19/2025 with signatures. Record Review of facility's record revealed: Change in status will be discussed 3 times a week during Nurse Aides meetings. The DON/designee during these meetings will review the identified Residents' profile and care plan to validate changes in assistance have been updated. Interview (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676463 If continuation sheet Page 3 of 8 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 676463 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Crimson Heights Health & Wellness 19279 McKay Dr. Humble, TX 77338 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 - Immediate jeopardy to resident health or safety with the facility Administrator on 07/21/2025 at 11:43 am, revealed the care plan was updated to reflect Resident # 1's current assistance needs. The Administrator, Regional Clinical Consultant, DON, ADON and the Medical Director, were informed the Immediate Jeopardy was removed on 07/21/2025 at 11:34 am. The facility remained out of compliance at a severity level of no actual harm with the potential for more than minimal harm that is not immediate jeopardy and a scope of isolated as the facility continued to monitor the implementation and effectiveness of their plan of removal. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676463 If continuation sheet Page 4 of 8 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 676463 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Crimson Heights Health & Wellness 19279 McKay Dr. Humble, TX 77338 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure each resident received supervision and assistive devices to prevent accident for Resident #1. On 07/15/2025, CNA D transferred Resident #1 unassisted using a stand and pivot method instead of a mechanical lift (a device used to aid in the transfer and movement of individuals especially those with mobility limitation) device as required by her care plan dated 12/06/2024. During the transfer there was audible pop from Resident #1's left shoulder. Resident #1 had pain and sustained a fracture. An immediate jeopardy (IJ) was identified on 07/18/2025. The IJ template was provided to the facility on [DATE] at 05:34 pm. While the IJ was removed on 07/20/2025, the facility remained out of compliance at a scope of isolated with a severity level of potential for more than minimal harm that is not immediate jeopardy due to the facility's need to evaluate the effectiveness of the corrective systems that were put into place. This failure placed dependent residents at risk of experiencing pain, injuries, bruises, and fractures from possible accidents which could result in a diminished quality of life and hospitalization. Findings include: Record review of Resident #1's face sheet revealed, a [AGE] year-old female who was admitted to the facility on [DATE]. The resident's diagnoses included: Personal history of traumatic brain injury (Primary, Admission), Pain disorder with related psychological factors, Acute pain due to trauma, Pain disorder exclusively related to unsteadiness on feet, Cognitive communication deficit, Need for assistance with personal care, other abnormalities of gait and mobility, Idiopathic gout (A digestive disease-heart burn), right ankle and foot, Muscle weakness (generalized), Conversion disorder with seizures or convulsions (Violent , uncontrollable shaking of the body). Record review of Resident # 1's MDS dated , 06/06/2025, revealed section C0500-BIMS codes as an 11 which indicated moderate cognition impairment. Section G-transfer revealed Resident # 1 depended totally on staff to move to or from between surfaces; bed, chair, wheelchair and standing, with two plus persons' physical assist. Record review of Resident #1's care plan, dated 12/06/2024, revealed the Resident required a mechanical lift with 2 staff for transfer. Further review revealed resident was at risk for falls related to unsteady gait. Record review of Resident # 1's nurses notes, dated 07/15/2025, revealed Nurse A notified Resident # 1 primary Physician of the popping sound. The Dr. ordered a STAT x-ray to the left shoulder and upper arm. Nurse # 1 said she ordered the STAT x-ray with a local X-ray company. The x-ray revealed a left shoulder mild displaced fracture of the proximal humerus (a break in the upper arm bone near the shoulder joint) surgical neck. Nurse A stated, the Dr. gave orders for Resident# 1 to be sent out to the hospital for further evaluation and a higher level of care. Resident was sent out by the night nurse. The Hospital x-ray revealed the same proximal humerus fracture. Observation of the mechanical lift storage room on 07/18/2025, at 10:25 am revealed there were three mechanical lifts and a battery charging unit that could hold three mechanical lift batteries. Two of the mechanical lifts had fully charged batteries while the third battery was on the battery charging unit. During an interview with Nurse A on 07/18/2025 at 11:07 am , said, she was at the nursing station documenting around shift change when CNA D came and asked her to come with him. Resident # 1 was still sitting in her wheelchair. CNA D said during the transfer, he attempted to pivot Resident #1 back into her bed when he heard a popping sound on Resident # 1's left shoulder, and the Resident was crying. Nurse A stated she did not review the care plan to know how many staff were required currently to assist Resident # 1 during transfers. Nurse A stated she assessed Resident #1 and gave her pain medication. During an interview with CNA D via telephone on 07/18/2025 at 11:47 am, he stated he walked into Resident # 1's room and remembered Resident #1 was a 1 person assist from (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676463 If continuation sheet Page 5 of 8 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 676463 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Crimson Heights Health & Wellness 19279 McKay Dr. Humble, TX 77338 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few the last time he looked at the POC. He did not check the portion of the POC on the day of the incident that would have showed if she was a one or two person assist, so he did not request for assistance. CNA D said, Resident # 1 was begging to be put back into bed. CNA D told the resident the mechanical lift was not working because the battery was not charged. CNA D in attempting to pivot Resident #1 back to bed, he heard a popping sound from Resident #1's left shoulder. During an interview with Resident #1 on 07/18/2025 at 3:23 pm over the phone, she stated CNA D was trying to put her in bed by himself without using a mechanical lift. She stated CNA D did not tell her that, the Mechanical lift was not working because the battery was not charged. Resident #1 said, she asked CNA D, Would you please use the mechanical Lift, he said, no. I can pick you up by myself. Resident #1 said, when CNA D picked her up from under her arms, she heard a popping sound from her left shoulder and started crying. Resident # 1 said when the nurse arrived at her room about 20 minutes later, she told the nurse CNA D picked her up in the wrong way, and her left arm popped. Resident #1 said, the nurse gave her pain medication on that day. Resident # 1 said; In the past, it's been two staff helping to transfer me. This one decided not to use the mechanical lift on Tuesday night. During an interview with the DON on 07/18/2925 at 12:49 pm, she said transfers were covered during orientation, which include the use of gait belt and mechanical lift. The DON stated inappropriate transfers, could cause injury, bruising, skin tears, a fall, a fracture, dislocation and abrasions. The DON stated, delayed treatment could cause further injury or harm to the resident. The DON stated she was notified of Resident # 1's incident. The DON stated, the CNAs had a profile on the computer where they documented and saw what assistance was needed by the residents. During an interview with the Administrator on 07/18/2025 at 2:37 pm, he stated CNA D disclosed what happened to the DON. The Administrator stated CNA D was terminated on 07/17/2025 for completing an improper transfer with Resident #1. The Administrator stated an inappropriate transfer, could lead to injuries of the Resident or the staff. He said it was inappropriate transfer that led to Resident # 1's left shoulder fracture. Fracture. During an interview with the Maintenance Director on 07/18/2025 at 3:05 pm, he stated staff told him the mechanical lift battery charger was not working. He stated he got a new battery, and it started working. He stated that was roughly about 3 months ago. Record review of facility's residents' rights policy revised on 06/09 2023 revealed: The facility must provide equal access to quality care regardless of diagnosis, and severity of condition. A record review of the facility's mechanical lift policy, revised on 05/05/2023, revealed: Mechanical lifts may be used for enhanced safety of patients, residents in situations including but not limited to:-Lifting from the floor-Bed to chair-Lateral transfer-Toileting and bathing-Repositioning.-Sitting or lying-to stand Prior to initiating the use of a mechanical lift for a patient or resident: Determine how many caregivers are necessary to safely lift the patient or Resident. In most cases and for safety, a minimum of 2 caregivers is recommended. Evaluate the resident's medical stability. On 07/18/2025 at 05:34 pm., an Immediate Jeopardy was identified. The Administrator was provided with the IJ template on 07/18/2025 at 05:34 pm, and a Plan of Removal (POR) was requested at that time. The POR summited by the Administrator was accepted on 07/19/2025 at 07: 29 am. The POR revealed: Crimson Heights Health and Wellness, Immediate Jeopardy, Plan of Removal, 07/20/2025 at 09:37 am.F689 Free of Accident Hazards/Supervision/Devices. The facility failed to safely transfer Resident #1 when CNA D performed a two person transfer alone using a stand and pivot method instead of a full Hoyer lift when resident persistently asked to be put in bed. Identified resident is being transferred using 2-person Hoyer transfer per updated resident's plan of care. Resident #1's care plan and care profile were updated to reflect 2 person Hoyer transfer on 7/17/25 by the Director of Nursing/Designee. Certified Nursing Assistant D no longer employed at (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676463 If continuation sheet Page 6 of 8 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 676463 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Crimson Heights Health & Wellness 19279 McKay Dr. Humble, TX 77338 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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few facility. Last day of employment was 7/17/25 due to violation of rules and policies. An audit was completed by the Director of Nursing/designee validating residents transfer status, including residents that require 2 person Hoyer lift with current orders, profiles, and care plans by 7/19/25. No discrepancies identified. Mechanical lifts in the facility were examined for proper functioning and operation including batteries on 7/18/25 at 12:15 pm by the Maintenance Director/designee. Licensed nurses and certified nurse aides were re-educated by Rehab Director/Designee on 7/18/25 on the following: Identifying changes to resident's activities of daily living assistance required and reporting to nurse/nurse management to update the plan of care. Accessing point of care profile of the resident to confirm assistance needed for activities of daily living Licensed Nurses and certified nurse aides will have 2-person competency checks completed by the Director of Nursing/Designee by 7/19/25. This was verified by the investigator. Nursing Staff not receiving the education or completing the competency by 7/19/25 will receive prior to their next scheduled shift. The Director of Nursing/Designee will randomly observe 3 certified nursing assistants performing transfers three times weekly to validate transfers are following the Resident's plan of care. This was verified by the investigator. Residents' will be reviewed quarterly following the MDS schedule and as needed with changes of condition daily during the clinical meeting review to validate accurate transfer status is included in the care plan and care by the Director of Nursing/Designee. New admissions and re-admissions will be reviewed daily in clinical morning meeting to validate transfer status included in the care plan and care profile is accurate. The weekend supervisor will validate care plans and care profile accuracy of transfer status on the weekend. There were no new admissions for the Investigator to observe. The Administrator will validate reviews in clinical morning meeting and review transfer observations to validate appropriate actions are taken to safeguard the residents. The Administrator verbalized this statement to the Investigator The medical director was notified of the immediate jeopardy on 7/18/2025 by the administrator.An Ad Hoc (A meeting called to address a specific issue) Quality Assurance Performance Improvement meeting was held on 7/18/2025 regarding the contents of this plan. Monitoring of the plan of removal included: Following acceptance of the facility's plan of removal, the facility was monitored from 07/18/2025 from 05:34 pm to 07/20/2025 at 09: 37 am. The Investigator confirmed the facility implemented their plan of removal sufficiently from 7/17/2025 to 07/20/2025 to remove IJ by: Record review of the facility completed reeducation from 07/17/2025 to 07/19/2025 on all-certified nurse assistants, completed by the ADON. The perpetrator, CNA D was terminated on 07/17/2025 due to violation of rules and policies. Resident # 1's care plan was updated to reflect 2-person mechanical lift transfer. Nurses and certified nurse assistants had two competency checks from 07/18/2025 to 07/19/2025 Observation of two CNAs on 07/18/2025 at 10:04 am, revealed they completed successful mechanical lift transfers from bed to wheelchair and wheelchair to bed. Observation of the storage room on 07/18/2025 at 10: 25 am revealed 3 mechanical lifts, and 2 of them had a fully charged battery. The third mechanical lift's battery was in the battery charging station. Observation on 07/18/2025 at 12:15 am, revealed all mechanical lift devices in the facility were examined for proper functioning and operation, including batteries and 07/18/2025 by Maintenance Director. Interviews were conducted with CNAs and nurses from 07/18/2025 at 10:04 am to 07/19/2025 at 10:57 pm ; CNA A,CNA C,CNA E, LVN A, CNA F, CNA F, LVN B, CNA G, LVN C, CNA H, CNA B, LVN D, RN A, CNA I, and CNA J, revealed they were reeducated on the use of mechanical lift and gait belt. The Administrator, DON, ADON, and Regional Clinical Consultant, Medical Director were informed, the Immediate Jeopardy was removed on 07/20/2025 at 09:37 am. The facility remained out of compliance at a severity level of no actual harm with the potential for more than minimal harm that is not immediate jeopardy and a scope of (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676463 If continuation sheet Page 7 of 8 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 676463 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Crimson Heights Health & Wellness 19279 McKay Dr. Humble, TX 77338 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 0689 isolated as the facility continued to monitor the implementation and effectiveness of their plan of removal. Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676463 If continuation sheet Page 8 of 8