Health inspection·June 17, 2025

F 0558 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few year-old female who admitted to the facility on [DATE]. Resident #11 had diagnoses which included Alzheimer's disease (loss of memory and cognitive ability that interferes with daily life) and muscle wasting and atrophy (loss of skeletal muscle mass). Record review of Resident #11's Quarterly MDS Assessment, dated 04/05/2025, reflected a BIMS Assessment was not appropriate because the resident was rarely/never understood. The staff assessment reflected severely impaired cognition with daily decision making. Section G (functional status) indicated Resident #11 required extensive assistance with acts of daily living. Record review of Resident #11's Comprehensive Care Plan, dated 05/29/2025, reflected Resident #11 had the potential for impaired visual function related to vision deficit. One intervention was to keep the call light in reach when Resident #11 was in her room or bathroom. During an observation on 06/17/2025 at 9:13 AM, Resident #11 was lying in bed asleep. The call light was wrapped around the call light fixture on the wall and not within the resident's reach. Resident #12 Record review of Resident #12's Face Sheet, dated 06/17/2025, reflected the resident was a [AGE] year-old male who admitted to the facility on [DATE]. Resident #12 had diagnoses which included cerebral infarction (stroke: interruption of blood flow to the brain) and hemiparesis (weakness on one side of the body) affecting the left non-dominant side. Record review of Resident #12's Quarterly MDS Assessment, dated 05/30/2025, reflected moderately impaired cognition with a BIMS score of 08. Section GG (functional abilities) indicated Resident #12 required substantial assistance with self-care needs. Record review of Resident #12's Comprehensive Care Plan, dated 05/13/2025, reflected Resident #12 was at risk for falls related to gait/balance problems and paralysis. One intervention was ensure the resident's call light was within reach and encourage the resident to use it for assistance as needed. During an observation and interview on 06/19/2025 at 9:17 AM, Resident #12 was lying in bed. The call light was in the top drawer of the nightstand next to the resident's bed and not within the resident's reach . Resident #12 stated he used the call light at times but staff didn't always answer it. During an interview on 06/17/2025 at 9:35 AM, the CNA stated at the beginning of each shift she rounded on all her residents. She stated she always checked to be sure the call lights were in reach and it was a miss on her part. She stated it was important for the residents to be able to reach staff if they needed a drink or snack, needed changed, or needed to be repositioned in bed. The CNA stated it was important to monitor residents' call lights to ensure they were within reach. She stated if a resident could not reach their call light, staff would not know they needed help. During an interview on 06/17/2025 at 1:15 PM, the ADON stated she expected all staff to monitor call light placement during rounds. She stated it was important for residents to have the call light in reach so they could tell staff what they needed. During an interview on 06/17/2025 at 1:40 PM, the RN stated residents' call lights should always be (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675402 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 675402 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rockwall Nursing Care Center 206 Storrs Rockwall, TX 75087 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 0558 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few within reach so anytime the resident had a need they could reach staff. She stated if the resident could not reach their call light, staff would not be able to respond right away. She stated a resident might fall trying to get to their call light. During an interview on 06/17/2025 at 2:51 PM, the Administrator stated it was important to ensure residents' call lights were in reach. He stated sometimes staff moved a call light when providing care and forgot to put it back. He stated CNAs should regularly round and correct that. He stated if a resident did not have their call light, there could be a delay in providing assistance to the resident. The facility did not have a policy specifically related to call lights. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675402 If continuation sheet Page 3 of 3