F 0584
Level of Harm - Minimal harm
or potential for actual harm
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.
Based on observation, interviews and record review, the facility failed to provide a safe, clean, comfortable,
and homelike environment for 2 of 5 shower rooms (300 and 500 halls) reviewed for environment.
Residents Affected - Few
The facility failed to ensure the 300 and 500 hall shower rooms were clean and free of trash and soiled
towels.
These failures could place residents at risk of not having a safe, clean, sanitary, comfortable, and homelike
environment.
Findings included:
Observation on 04/19/2025 at 9:08 AM in the 500 Hall shower room revealed the following:
*a soiled washcloth on a shower rack and two soiled towels (one wet and one dry) on the shower floor,
*a gallon of liquid body soap in the shower area, and
* a long black duffel bag on the floor located between the toilet and the trash bin.
Observation on 04/19/2025 at 10:08 AM in the 300 Hall shower room revealed the following:
*two used gloves, one inside out on the floor, in the corner to the right of the sink.
*two used gloves and a hanger underneath the shower chair on the floor.
In an interview on 04/19/25 at 10:15 AM, CNA C stated she had worked at the facility for four months. She
stated CNAs were supposed to clean up behind themselves, but housekeeping was responsible for
cleaning the shower rooms. She stated the showers should be clean and free from any items that do not
belong in them. She stated the risk to residents were infection or injury.
In an interview on 04/19/25 at 12:24 PM, LVN D stated she had worked at the facility for five months. She
stated CNAs should be cleaning up after themselves, but it was the responsibility of the housekeeper to
ensure the shower rooms were clean and free from trash. She stated the risk to the resident could be
infection.
(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:
675112
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
675112
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
04/19/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Coral Rehabilitation and Nursing of Arlington
1112 Gibbins Rd
Arlington, TX 76011
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 0584
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
In an interview on 04/19/2025 at 12:52 PM, HK A stated she had worked at the facility for 23 years. She
stated she was responsible for cleaning residents' rooms, the facility offices, and shower rooms. She stated
the shower rooms were clean three times a day, in the morning, after lunch and before her shift ends. She
stated not having showers free from trash and items could cause infection and be harmful to the residents.
In an interview 04/19/2025 at 01:03 PM, HK B stated she had worked at the facility for 15 years. She stated
she was responsible for cleaning the shower rooms and the nurses' stations. She stated the shower rooms
were cleaned twice a day, once in the morning and in the evening. She stated the shower rooms should be
free of used gloves and soiled towels. She stated the gallon of body soap should not be on the shower floor.
She stated the risk to residents could be they fall on the towels or get their hands on the soap and used
gloves, causing them harm.
In an interview on 04/19/2025 at 01:35 PM, DON stated she had worked at the facility since October 2024.
She stated her responsibility was to oversee the nursing department. She stated both CNAs and
housekeepers were responsible for ensuring the shower rooms are clean and free from debris. She stated
the risk to residents would be infection.
In an interview on 04/19/2025 at 02:15 PM, ADM stated he had worked at the facility for 13 years. He stated
that before and after residents receive showers, CNAs should ensure showers were clean and that they
look proper and free of any clutter, items, and dirty laundry. He stated the risk to residents was infection.
Review of the facility's policy titled Quality of Life-Homelike Environment, revised date of August 2009,
reflected Residents are provided with a safe, clean, comfortable, and homelike environment and
encouraged to use their personal belongings to the extent possible. The facility staff and management shall
maximize, to the extent possible, the characteristics of the facility that reflect a personalized, homelike
setting. These characteristics include cleanliness and order.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
675112
If continuation sheet
Page 2 of 2
