I just bought the truck and I don’t know if it was neglected or not. The fact that it’s using so much oil has me leaning towards “neglected”.
Get a new valve cover gasket and take off one of the valve covers (whichever looks easier to remove) and take a picture of the valve train.
Then we'll have a better idea of what that engine looks on the inside - is there sludge or only varnish. You can also take off the valve cover after 4-5K miles with VRP and we can see if there any difference.
At 250K miles I bet your problem is not the PCV.