Inspection·February 8, 2024

F 0565 Honor the resident's right to organize and participate in resident/family groups in the facility. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to provide a private meeting space for residents' monthly council meetings for 4 of 4 reviewed for resident council. Residents Affected - Some The facility failed to provide a private space for resident council meetings. This failure could place residents, who attended resident council meetings, at risk of not being able to voice concerns due to a lack of privacy. Findings included: Interview on 02/07/24 at 1:56 PM with the Activity Director revealed the resident council meeting would be held in the bird room which is the living/lounge room. She stated it was the best place with the most privacy. She stated she would keep a watch on the hall to make sure staff were aware of the meeting. Observation and interview on 02/07/24 beginning at 2:00 PM, during a confidential resident group meeting with four residents, revealed the meeting was held in the living/lounge room. There were no doors to close off the room. A sign was posted to indicate that a confidential meeting was being held. However, multiple staff and visitors walked through the hall to get to another hall and entering/exiting the elevators located across the living/lounge room. Also, the nurses' station was located next to the lounge room. During the confidential group meeting, three residents revealed the meeting was held each month in the dining area. While the meeting was being held, a confidential resident proceeded to state No privacy here while staff were exiting the elevator. The residents stated they were used to having staff around during their resident council meetings. Interview on 02/08/24 at 12:07 PM with the Activity Director revealed resident council meetings were held in the dining room area or at times in the living/lounge room. She stated after they completed an activity she would conduct a resident council meeting. She stated she would get more participation when residents were in the dining room. She stated normally four to five residents attended the resident council meetings monthly. She stated the facility did not have a private room area. However, since the census lowered in the last three weeks, they had rooms available. The Activity Director stated all the residents who participated in the resident council meetings monthly felt comfortable talking and there were no potential risks. Interview on 02/08/24 at 1:45 PM with the Administrator revealed the resident council meetings were always held in the dining room or in the bird room living/lounge room. She stated her expectations were for residents to be comfortable during meetings and if they wanted the meeting to be held in the dining room it should be respected. She stated she was not aware that the resident council (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 4 Event ID: 675238 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 675238 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Trinity Terrace 1600 Texas St Fort Worth, TX 76102 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)