Health inspection·May 22, 2025

F 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure that each resident received food that is palatable, attractive, and at a safe and appetizing temperature for 1 of 1 lunch meals tested for nutritive value, flavor, and appearance: Residents Affected - Some The facility failed to provide palatable food served at an appetizing temperature to residents, during lunch on 05/21/2025. This failure could affect the residents who ate food from the facility kitchen by placing them at risk of poor food intake and/or dissatisfaction of the meals served. The findings included: During an observation on 05/21/2025 at 10:30 AM, in the dining room, the daily menu was posted and revealed: Pork Steak w/gravy, Black-Eyed Peas, Cauliflower with cheese, Roll and Banana Cake. During an interview on 05/21/2025 at 10:46 AM LVN B stated she had received complaints from residents stating that the food was cold. During an observation and interview on 05/21/2025 at 11:50 AM [NAME] A stated he had taken the temperature of food when he had taken it out of the oven. [NAME] A stated he would take the temperature of the food before he served the food. [NAME] A took the temperature of the pork chop and the thermometer read 155 degrees. [NAME] A stated the pork chop was at the correct temperature, it was supposed to be held at least at 145 degrees. [NAME] A had uncovered the meat, the DM told him several times to cover the meat to keep it warm. [NAME] A had plated food and left them sitting on the counter for 2-3 minutes. During an observation and interview on 05/21/2025 at 12:05 PM Resident #9 stated, Look at my food. Resident #9 stated the food looked disgusting and he could not eat it. Resident #9 left his plate of food and went back to his room. During an observation and interview on 05/21/2025 at 12:40 PM the test tray was observed to have crumbles of meat on top of the vegetables with cheese, the roll was dark brown and black cu on the bottom and the gravy was very thin (looked like water). The cake was not iced and was not a solid piece. The DM stated she was embarrassed by the food service today. The DM stated she had only been the DM for a little over 3 weeks. The DM stated the test tray did not appear to be appetizing. The DM stated the chopped-up food that was on the vegetables was probably the mechanical soft meat and should not have been on the plate. The DM stated the gravy was too thin and did not think [NAME] A followed the recipe when he made the gravy. The DM stated the roll had been overcooked. The DM stated the (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: 675084 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 675084 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/22/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Trinity Nursing & Rehab of Granbury 600 Reunion Court Granbury, TX 76048 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)