Health inspection·May 8, 2025

F 0550 before entering and it bothered her that the Housekeeping Supervisor did not. Level of Harm - Minimal harm or potential for actual harm During an interview on 05/06/25 at 10:00 a.m. The Housekeeping Supervisor stated he usually knocks before entering resident's room. He stated he saw Resident #13's door open so he went in looking for the other housekeeper. He stated he just peeped in the bathroom. Residents Affected - Few During an interview with Director of Nursing (DON) on 05/07/25 at 2:05 p.m. DON reported prior to entering a resident's room, staff knock on the door, identify themselves, ask permission to enter, and explain the reason for entering. The DON stated that was the expectation for all staff who go into a resident's room. The DON stated that would include housekeeping staff. Review of facility policy titled Resident Rights/Dignity and Respect, dated 02/2020 stated Residents shall be examined and treated in a manner that maintains the privacy of their bodies. A closed door or drawn curtain shields the Resident from passers-by. People not involved in the care of the Resident shall not be present without the resident's consent while they are being examined or treated. Staff members shall knock before entering the Resident's room. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675004 If continuation sheet Page 2 of 5 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 675004 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/08/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McKinney Healthcare and Rehabilitation Center 253 Enterprise Dr McKinney, TX 75069 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 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure residents had the right to retain and use personal possessions for one (Resident #32) of five residents reviewed for personal property. The Activity Director utilized residents' personal inventories of crayons/markers for the purpose of group activities. This failure could place residents at risk of not being able to retain and use personal property. Findings included: Review of Resident #32's Face Sheet, dated 05/08/25, reflected she was a [AGE] year-old female, who admitted to the facility on [DATE], with diagnoses including Attention-Deficit/Hyperactivity Disorder (a type of brain difference that can make it hard to pay attention, finish tasks and sit still) and generalized anxiety disorder (severe, ongoing anxiety that interferes with daily activities). Observation of an interaction between Resident #32 and the Activity Director on 05/06/25 at 10:30AM revealed the Activity Director asked Resident #32 if he could borrow from her personal inventory of crayons/markers for resident activities. Resident #32 stated she was very particular about her crayons/markers and did not want them to return broken after being used by other residents. The Activity Director agreed that broken crayons/markers had been an issue at the facility, and he told Resident #32 to disregard the request. During an interview with Resident #32 on 05/06/25 at 10:36AM, she stated this was the first time the Activity Director had requested to utilize her personal belongings for resident activities. She stated she was not bothered by this request. During an interview with the Activity Director on 05/06/25 at 12:50PM, he stated he had been requesting and utilizing residents' personal inventories of crayons/markers for resident activities for the past week. He stated the facility's inventory of crayons/markers were smashed up and/or broken. The Activity Director stated he did not feel as though there was an issue or a risk in asking to utilize residents' personal belongings for wide-spread group activities. During an interview with the Director of Nursing on 05/07/25 at 2:00PM, she stated the expectation was for the Activity Director to utilize the facility's supplies for activities. She stated it was not appropriate for the Activity Director to request to utilize a resident's personal inventory of crayons/markers for a wide-spread group activity. The Director of Nursing stated the risk in doing so was that the request could be misconstrued as misappropriation of resident property. Review of the facility's Resident Rights policy, dated 07/2017, reflected, .As a resident of this nursing facility, you have the right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. You have the right to exercise your rights without interference, coercion, discrimination, or reprisal from the facility as a resident of the facility and as a citizen or resident of the United States . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675004 If continuation sheet Page 3 of 5 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 675004 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/08/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McKinney Healthcare and Rehabilitation Center 253 Enterprise Dr McKinney, TX 75069 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 0880 Provide and implement an infection prevention and control program. 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 maintain an infection control program designed to prevent the development and transmission of infection for one of five residents (Resident #61) observed for infection control. Residents Affected - Few A COTA failed to perform hand hygiene while providing incontinence care to Resident #61. The failures could place the residents at risk for infection. Findings include: Record review of Resident #61's face sheet dated 05/08/25 reflected a [AGE] year-old male. He was admitted to the facility 03/06/25. Admitting diagnoses included muscle weakness, hypertension (high blood pressure), hypothyroidism (Hypothyroidism happens when the thyroid gland doesn't make enough thyroid hormone), and cellulitis (is a bacterial infection of the skin and underlying tissues). Review of Resident #61's admission MDS record dated 03/10/25 reflected the resident had a BIMS (Brief Interview of Mental Status) score of 13, indicative of no cognitive impairment. He was always incontinent of bowel and occasionally incontinent of bowels. Review of Resident #61's care plan initiated 03/09/25 reflected Resident #61 required assistance with activities of daily living. Observation on 05/08/25 at 10:49 AM revealed the COTA providing incontinent care to Resident #61. A COTA was observed completing hand hygiene and gloved before care, then she informed the resident she was providing incontinent care. The COTA then positioned the resident and unfastened the brief and proceeded to clean Resident #61's front area, then positioned the resident on his side and cleaned his bottom area. Resident #61 was minimally soiled with urine. After cleaning the resident, the COTA proceeded to apply barrier cream and apply clean brief with the same gloves she used to clean the resident. The COTA did not complete any hand hygiene or change gloves after cleaning the resident. In an interview on 05/08/25 at 12:42 PM with the COTA she stated normally she did not provide incontinent care to the residents, but the resident was ready to get out of bed that was why she offered to assist the resident. She stated she failed to complete hand hygiene and change gloves after care because she was caught in the moment and forgot to complete hand hygiene and change gloves after cleaning the resident. The COTA stated she was expected to complete hand hygiene and change gloves after cleaning the resident before applying the clean brief to prevent cross contamination and for infection control. In an interview on 05/08/25 at 12:59 PM with the DON she stated the staff was expected to clean hands and change gloves after providing incontinent care the resident. After providing incontinent care the gloves were considered dirty and the staff was supposed to complete hand hygiene and change gloves before applying the barrier cream and clean brief. The DON stated the facility had completed basic infection control training with all staff to prevent cross contamination and for infection control. Review of the facility policy revised on 05/2007 and titled Hand Washing reflected, It is the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675004 If continuation sheet Page 4 of 5 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 675004 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/08/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McKinney Healthcare and Rehabilitation Center 253 Enterprise Dr McKinney, TX 75069 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few policy of this facility to cleanse hands to prevent transmission of possible infectious material and to provide clean, healthy environment for residents and staff. Review of the facility policy revised 09/2017 and titled Infection Prevention and Control Program reflected, a. The Infection Prevention and Control Program is a facility-wide effort involving all disciplines and individuals and is an integral part of the quality assurance and performance improvement program. b. The elements of the Infection Prevention and Control Program consist of coordination/oversight, policies/procedures, surveillance, data analysis, antibiotic stewardship, outbreak management, prevention of infection, and employee health and safety. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675004 If continuation sheet Page 5 of 5