Inspection·October 14, 2023

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few room. The room divider curtain was not drawn. As surveyor stood in the hall outside of room [ROOM NUMBER], for approximately 5 minutes, CNA B was observed to be providing care to Resident #1, emptying a water basin, leaving the room to obtain incontinent supplies from the supply cart and returning to Resident #1, without closing the door. In an interview attempt on 10/14/23 at 4:10 pm, Resident #1 stated she was well but declined to further speak with surveyor. In an interview on 10/14/23 at 4:12 p.m., CNA B stated she was an agency aide, and it was her second time working in the facility. CNA B stated she had provided Resident #1 a bed bath and was finishing up when surveyor knocked on the open door of room [ROOM NUMBER]. CNA B stated when personal care was provided to residents, the curtain should be pulled to protect the resident. CNA B stated she did not pull Resident #1's curtains because they were stuck, she stated she did not close the door because Resident #1's roommate was in and out of the room. CNA B stated she received training from her staffing agency and had not been apart of any facility held in-services. CNA B stated providing personal care with the door and curtains open could expose the resident to people in the hallway. In an interview on 10/14/23 at 4:15 p.m., LVN C stated she was the nurse for the 600 hall. LVN C stated she was not aware Resident #1 received personal care with the curtains and door open. LVN B stated when a resident received care, the door and curtains should be pulled to protect the resident's privacy. LVN B stated it was the responsibility of the staff member providing care to protect the resident's privacy and not doing so could cause a resident to lose their sense of self and dignity. In an interview on 10/14/23 at 6:07 p.m., the ADON stated she was made aware of the surveyors' observation and stated CNA B should have staff should have knocked on the door introduced herself, obtained verbal consent for the care being provided, pulled the curtain for privacy, closed the door and provide the care. The ADON stated any nursing staff member who provided care were responsible for ensuring the privacy of the resident was protected. The ADON stated not ensuring the residents privacy was protected while they received care could cause emotional distress. The ADON stated they have begun to in-service all nursing staff on privacy and have placed CNA B on the do not return list, barring her from selecting shifts at the facility in the future. In an interview on 10/14/23 at 6:40 p.m., the RDCO stated nursing staff should be closing doors and privacy curtain and should be cognizant of the resident's privacy, as it was their responsibility. The RDCO stated not closing doors and privacy curtains could affect the resident's sense of dignity and would restrict their privacy. The RDCO stated she and the ADON have started to in service nursing staff on privacy and dignity and will conduct hall audits to ensure resident privacy was protected at all times in the future. In an interview on 10/14/23 at 7:00 p.m., the AADMIN stated it was expected for nursing staff to provide and respect the rights of any residents who receive care. the AADMIN stated staff are continually educated on resident rights and in services were started following this incident. The AADMIN stated hall sweeps would be conducted at random to ensure residents privacy was protected. Review of the facility's policy entitled Dignity, revised in February 2021, read in part: Policy Statement: Each resident shall be cared for in a manner that promotes enhances his or her of well-being, level of satisfaction with life, and feelings of self-worth and self-esteem. Policy Interpretation and Implementation: 1. Residents are treated with dignity and respect at all times .11. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675212 If continuation sheet Page 2 of 3 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 675212 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/14/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Homestead of Denison 1101 Reba McEntire LN Denison, TX 75020 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 0550 Staff will promote, maintain, and protect resident privacy, including bodily privacy during assistance with personal care and during treatment procedures . Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675212 If continuation sheet Page 3 of 3