Health inspection·November 6, 2025

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record review, the facility failed to provide the necessary services for residents who were unable to carry out activities of daily living to maintain good grooming and personal hygiene for 1 resident (Resident #3) of 6 residents reviewed for ADLs. The facility failed to ensure Resident #3 had his fingernails cleaned and trimmed on 11/06/25. This failure could place residents who were dependent on staff for ADL care at risk for loss of dignity, risk for infections, and a decreased quality of life. Record review of Resident #3's admission MDS assessment dated [DATE] reflected Resident #3 was an [AGE] year-old male admitted to the facility on [DATE]. His diagnoses included dehydration (occurs when the body loses more fluids than it takes in, leading to a depletion of water and electrolytes), coronary artery disease (a condition where the arteries that supply blood to the heart [coronary arteries] become narrowed or blocked), and benign prostatic hyperplasia (a non-cancerous enlargement of the prostate gland, a walnut-sized organ located below the bladder in men). Resident #3's had a BIMS score of 05 out of 15, which indicated severe cognitive impairment. The MDS assessment indicated Resident #3 required maximum assistance with personal hygiene. Record review of Resident #3's Care Plan dated 10/01/25, reflected the following: Focus: [Resident #3] has an ADL selfcare performance deficit. Goal: [Resident#3] will maintain current level of function . Personal hygiene. Interventions: Assist with personal hygiene as required . BATHING: Check nail length and trim and clean on bath day and as necessary. Report any changes to the nurse.Record review of Resident #3's Shower sheets on 11/06/2025 revealed Resident #3's last bed bath was on 11/04/2025, and shower was on 10/30/2025.An observation and interview on 11/06/25 at 09:01 AM revealed Resident #3 was lying in his bed. Resident #3's nails on both hands were approximately 0.4 cm in length extending from the tip of his fingers. The nails were discolored tan with brown matter underneath. Resident #3 stated he would like his fingernails trimmed and cleaned. In an interview on 10/06/25 at 10:27 AM, CNA B looked at Resident #3's fingernails and stated she would clean and trim them today after Resident #3's shower. CNA B stated that both CNAs and Nurses were responsible for nailcare. She said that if the resident has diabetes, then nurses trimmed their fingernails. She stated that if nails were long and dirty, residents may be at risk of infection. In an interview and observation on 11/06/25 at 10:33 AM, LVN C stated that both nurses and CNAs were responsible for doing nail care for the residents. He stated that fingernails should be trimmed and cleaned on shower days and as needed. He stated that Resident #3 had dirty, untrimmed nails, and will provide nail care to the Resident today. He stated that dirty nails could lead to a risk in infections. In an interview on 11/06/25 at 2:47 PM, the ADON stated nail care should be completed as needed and every time aides washed the residents' hands. The ADON stated nails should be observed daily. The ADON stated nurses were responsible for trimming the nails of residents who were diabetic, and CNAs could trim other residents' nails. The ADON stated she expected CNAs to offer to cut and clean nails if they were long and dirty. The ADON stated she 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 3 Event ID: 455895 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 455895 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/06/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Five Points at Lake Highlands Nursing and Rehab 9009 White Rock Tr Dallas, TX 75238 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)