Health inspection·February 19, 2025

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to ensure the resident had the right to be treated with respect and dignity for 1 of 4 residents (Resident #1) reviewed for dignity. The facility failed to ensure staff properly fed Resident #1 breakfast, while she was lying in bed. This deficient practice could place the resident at risk of not feeling as if they were being treated with dignity and respect while being fed. Findings include: Record review of Resident #1's face sheet, dated 02/19/25, revealed a 62 -year-old female who was admitted to the facility on [DATE]. Resident #1's relevant diagnoses included Cerebrovascular Disease (cognitive impairment), and contracture of muscle (shorten muscles). Record review of Resident #1's Minimum Data Set, dated [DATE] revealed she had a BIMS score of 12, which indicated cognitively intact and for ADL care it stated, For feeding, the resident required a one-person physical assist. Record review of Resident #1's Care plan, dated 01/25/25, revealed The resident requires extensive assistance by (1) staff to eat. Use plate guard with meals. In an observation on 02/18/25 at 08:20 AM, CNA S was observed standing up while feeding Resident #1 breakfast while the resident was lying in bed. CNA S was observed to be positioned higher than the resident and was not at eye level. In an interview on 02/18/25 at 08:22 AM, CNA S stated they were supposed to sit down and feed the residents at eye level. CNA S then proceeded to grab a chair and placed it alongside the resident to continue feeding the resident her breakfast. She stated it was a dignity concern. In an interview on 02/18/25 at 11:00 AM, the DON stated she spoke with CNA S about standing up while feeding Resident #1 her breakfast. She stated CNA S advised her because she was short and was close to eye level with the resident, she did not feel she needed to sit down to feed the resident. The DON stated staff were required to sit down, eye to eye with the residents while feeding them because it was a dignity concern. Record review of the facility's policy on Dignity, dated February 2021, revealed Each resident Page 1 of 4 675109 675109 02/19/2025 Richardson Nursing and Rehabilitation 1111 Rockingham Dr Richardson, TX 75080

F 0550 shall be cared for in a manner that promotes and enhances his or her sense of well-being, level of satisfaction with life, and feelings of self-worth and self-esteem. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 675109 Page 2 of 4 675109 02/19/2025 Richardson Nursing and Rehabilitation 1111 Rockingham Dr Richardson, TX 75080

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **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 a safe, clean, comfortable, and homelike environment including but not limited to receiving treatment and supports for daily living safely for 4 of 6 resident rooms (room [ROOM NUMBER], #2, #3, and #4) and all the facility hall floors reviewed for environment. 1. The facility failed to ensure resident rooms #1, #2, #3, and #4 were thoroughly cleaned and sanitized. 2. The facility failed to ensure the facility hallway floors were cleaned and sanitized. These deficient practices could place residents at risk of living in an unclean and unsanitary environment which could lead to a decreased quality of life. Findings include: An observation on 02/18/25 at 08:19 AM of the facility hallways revealed large dark stains on the carpet areas and dark brown and black stains on the tiles, especially along the edges of the floor, near the walls. An observation on 02/18/25 at 08:20 AM of resident room [ROOM NUMBER] reflected the bathroom floor had dirty clothes on the floor under the sink. The bathroom floor had black stains under the sink and along the corners of the floor. The room floor had black stains all over it. An observation on 02/18/25 at 08:25 AM of resident room [ROOM NUMBER] reflected the floor had brown stains under a sink in the resident's room and along the corners of the floor. An observation on 02/18/25 at 08:33 AM of resident room [ROOM NUMBER] reflected white shredded papers and dirt between the resident bed and nightstand. The bathroom floor had black and brown stains, especially around the toilet and corners of the floor. The air condition unit had vents filled with black and brown debris. An observation on 02/18/25 at 08:33 AM of resident room [ROOM NUMBER] reflected the bathroom floor had back and brown stains, especially around the toilet and corners of the floor. The air condition unit had vents filled with black and brown debris and there was no filter observed. The resident's room floor had dark stains under the air condition unit and large [NAME] stains along the front of the bathroom door. In an interview on 02/19/25 at 12:00 PM, the Administrator was shown pictures of the concerns observed in the facility hallways and resident rooms #1, #2, #3, and #4. He stated the floors were old and their floor cleaning machine had broken down and was just recently repaired. He stated he agreed there was still an opportunity for them to do a better job cleaning. He stated the facility was scheduled for a revamp. He stated they planned to reconstruct one side of the facility and once they were done, they would move the residents to the newly rebuilt area and then work on the other side. He stated the project was scheduled to take 9 months. He stated this was the resident's home and it should be clean. 675109 Page 3 of 4 675109 02/19/2025 Richardson Nursing and Rehabilitation 1111 Rockingham Dr Richardson, TX 75080

F 0584 Level of Harm - Minimal harm or potential for actual harm In an interview on 02/19/25 at 02:00 PM, the Housekeeping Supervisor was shown the pictures of the concerns observed in the facility hallways and resident rooms #1, #2, #3, and #4. He stated the floors were old and not really stained. He was advised the floors observed were stained and were observed to be built up dirt that required extensive cleaning. He stated the risk for the residents was the facility was their home, and they should be in a safe and clean place. Residents Affected - Some Record review of the facility's policy on Homelike Environment (February 2021) reflected Residents are provided with a safe, clean, comfortable and homelike environment and encouraged to use their personal belongings to the extent possible . 2. The facility staff and management maximize, to the extent possible, the characteristics of the facility that reflect a personalized, homelike setting. These characteristics include: a. clean, sanitary and orderly environment 675109 Page 4 of 4