Health inspection·January 8, 2026

F 0602 Protect each resident from the wrongful use of the resident's belongings or money. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure residents were free from misappropriation of property for one (Resident #1) of 10 residents reviewed for misappropriation of property. The facility failed to protect Resident #1 from misappropriation of property by one of their employees, Housekeeper A. On 12/18/2025 the Social Worker came to know that Housekeeper A used Resident #1's bank account for unauthorized transactions. As a result, Resident #1 lost approximately $300.00 from his personal bank account. This failure could place residents at risk of loss of lifelong earnings. Findings included: Record review of Resident #1's face sheet dated 01/08/2026 revealed Resident #1 was a [AGE] year-old male, with an original admission date of 07/15/2025. Diagnoses included: Radiculopathy lumbosacral region (pain in the lower back), paroxysmal atrial fibrillation (irregular heartbeat), cerebrovascular disease (blood flow to the brain affected), adult failure to thrive (overall decline in physical and cognitive function), chronic systolic (congestive) heart failure (the left ventricle of the heart can't pump blook efficiently), and dementia (decline in mental abilities). Record review of Resident #1's Quarterly MDS assessment dated [DATE] revealed he had a BIMS score of 12, which indicated moderate cognitive impairment. Resident #1 required supervision or partial/moderate assistance with ADLs. Record review of Resident #1's Care Plan dated 09/15/2025 reflected that he had impaired cognitive function/dementia or impaired thought processes related to dementia/memory deficit. Record review of Provider Investigation Report (PIR) (Form 3613-A of Texas Health and Human Services) dated 01/06/2026 reflected a screenshot of Resident #1's cell phone that reflected an electronic transfer of $300 from Resident #1's bank account to Housekeeper A's cell phone number. In an interview on 01/08/2026 at 9:11 AM, the Social Worker revealed someone had stolen money from Resident #1's bank account. She stated Resident #1 revealed an employee in activities assisted him with sending money to a family member. She stated she reviewed the transaction history with Resident #1 which reflected a $300 electronic transfer transaction to a telephone number and person with the same last name of Resident #1. She stated Resident #1 didn't recognize the name nor telephone number. She stated the telephone number was verified by Human Resources and the Administrator as Housekeeper A's telephone number. She stated an interview with Housekeeper A revealed she established an electronic transfer through Resident #1's bank account on his cell phone but denied sending money to her telephone number. She stated Housekeeper A was suspended during the investigation and terminated as a result. She stated Social Services employees, Activities employees, and the Business Office assisted residents with financial matters. In an interview on 01/08/2026 at 9:31 AM with the Activity Director, revealed Resident #1 and Housekeeper A were in the dining room when Resident #1 asked if Housekeeper A could assist him with his bank account. The Activity Director responded Housekeeper A could help him. She stated she was informed the next day Housekeeper A took $300 from Resident #1's bank account. She stated she was aware that only she and Activity Assistants were authorized to assist residents with financial Residents Affected - Few (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 455653 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 455653 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/08/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Skyline Nursing Center 3326 Burgoyne Dallas, TX 75233 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)