Health inspection·November 26, 2024

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some effort and is there to support resident by holding limbs and lifting resident) on staff for person hygiene areas such as, washing face and shaving. Record review of Resident #5's Care Plan dated 8/12/20, reflected resident should be provided with simple choices with ADL care and encourage participation; resident is a 1 person assist and should be bathed MWF per residents' preference. Record review of shower/bath documentation for the months of October 2024 and November 2024, show Resident #3 & Resident #5 have received their showers/bed baths on the 2pm - 10pm shift. It did not show any refusal of services. In an interview on 11/25/2024 at 1:37pm Resident #1 stated residents were not being showered and had been told that there weren't enough staff. He stated, residents that got showers on the 2pm - 10pm shift have it bad. He stated some residents have gone weeks without a shower or bed bath. He stated CNAs will mark it down like they've given showers when they haven't. He stated a lot of residents that cannot talk for themselves hardly gets there showers. He stated he is independent and can shower himself. In an interview on 11/26/2024 at 9:46am Resident #2 stated she had her showers. She stated she is very outspoken and demand her showers even though she is Bed B. However, she stated there are not a lot of people on Bed B that get their showers. She stated residents that have an Intellectual Disability (below average intelligence) and can't speak for themselves, they are not getting their showers as they should. The Bed B showers are given on the 2pm-10pm shift. Staff are always saying they are short of hand and unable to give showers, which is not true. She stated the staff are just not doing their jobs and the charge nurses aren't making them or holding them accountable. In an interview on 11/26/2024 at 11:21am Resident#3 stated staff are not available for showers on the 2pm - 10pm shift, which is when he is scheduled for showers. Resident #3 stated he does not need anyone to wash him up while in the shower; however, because his legs are unsteady, there must be a staff member available just in case the need for assistance arises (he falls). Resident #3 stated he is always told there are no staff available. He stated he is Bed B and his showers are on the 2pm -10pm shift. He stated a lot of times there are only two people working, the CMA and CNA and there aren't a lot of workers to give showers. He also stated the last time he had a shower was two weeks ago. He stated he just does a wash-up in the bathroom sink. In an interview on 11/26/2024 at 11:30am Resident #4 stated he gets his shower because he is Bed A and the 6am-2pm shift staff gets him his. He stated his roommate, Resident #3, complains about getting his shower all the time. His roommate is Bed B and there is hardly any staff available to give him his showers or they just won't. In an interview on 11/26/2024 at 11:35am CNA A stated she would shower a Bed B resident if she had a shower refusal from a resident in Bed A. She stated she has heard complaints from a lot of residents on Bed B about not getting their showers on the 2p - 10p shift. In an interview on 11/26/24 at 11:45am with Resident #5, she stated she has not received a bed bath in over 2 weeks and can't remember the last time she's had a shower. She stated she has continuously asked about a shower and has been told that the facility is shorthanded or there isn't anyone to help her . A review of the shower sheets indicated the resident had a shower; however, the resident denied this. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455490 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 455490 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Lakes at Texas City 424 N Tarpey Rd Texas City, TX 77591 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 0677 Level of Harm - Minimal harm or potential for actual harm In an interview on 11/26/24 at 11:55am with Resident #6, she stated she does not have any issues. She stated she gets her showers because she is Bed A. She stated her roommate, Resident #5, hasn't had a shower in over a month. She stated on one occasion she witnessed Resident #6 asking CNA staff for a shower and being told there isn't enough staff and there isn't a shower tech available cause the last one either quit or got fired. Residents Affected - Some In an interview on 11/26/24 at 3:45pm with CNA B she stated she typically works the 10p-6a shift. She stated she believes the residents are not getting their showers on 2p-10p shift because Bed B residents are always complaining about not getting it when she works. When asked if she had spoken with a charge nurse or the DON about the complaints, she stated she had not. She stated she worked the 2p-10p shift on overtime only and didn't want to cause any problems. She stated when she viewed the ADL's it appeared that residents on Bed B had their showers, but there are a lot of complaints. In an interview on 11/26/24 at 6:00pm with the DON, she stated showers for some beds (Bed A) are completed on the 6 am-2pm shift and other beds (Bed B) 2pm-10pm shift. She stated in the past there were some complaints, but recently she has not received any complaints. She stated not having a shower or bed bath in days, weeks or months is not accepted. Based on the task completed in Task Section of Point Click Care (the computer documentation for staff to use indicating if residents were given a shower, refused a shower and if the CAN noticed any issues with resident skin or any other changes in condition), it appears Resident#3 and Resident#5 received their showers and/or bed baths during the week. A resident should receive their ADL's when scheduled per week. It is unacceptable for a resident not to either be given a bed bath or offered one. In an interview on 11/26/24 at 7:00pm with Administrator she stated all residents should have their bed bath and showers or other ADL's completed by staff as scheduled. It is unacceptable when they don't. She stated she has not been informed that staff on certain shifts are not giving showers. She stated it is unacceptable and if she had known this issue would have been addressed. She stated the quality-of-life policy addresses the facility's position on self-esteem. Review of the Quality-of-Life Policy dated 1/10/2022, #reflected, The facility will create and sustain an environment that humanizes and promotes each resident's well-being and feeling of self-worth and self-esteem. On 11/26/2024, reviewed facility grievances for the past 3 months and no formal complaints related to ADL care. Review of the Bathing Policy dated 3/1/14 and reviewed 2/10/2020 reflected, purpose is to cleanse skin, prevent infection and promote circulation 2 times or more weekly or as patient requires. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455490 If continuation sheet Page 3 of 3