Health inspection·March 29, 2025

F 0812 recall the last day there was an incident of running out of hot water, and there had been no incidents today . Level of Harm - Minimal harm or potential for actual harm During an interview on 3/29/25 at 3:00 p.m., the ADM said the facility had an incident of running out of hot water in January of 2025 and the Maintenance Supervisor repaired the water heater. She said the washing machines could not be run while the dish machine was being ran or they would use all the hot water. She said she in-serviced kitchen staff regarding infection control, dishwashing, and required temperatures for sanitizing dishes. She said she already in-serviced kitchen staff again today and instructed them to re-wash all dishes and to use the 3-compartment-sink, which used lower temperature and chemical sanitization, if the water temperature was below 120°F . Residents Affected - Some During an interview on 3/29/25 at 3:45 p.m., the Housekeeping Supervisor said the issue of running out of hot water was first identified in January of 2025. He said the Maintenance Supervisor ordered the parts and made the repairs and there had been no incidents of running out of hot water since. He said the problem only affected the kitchen and laundry room, which had separate hot water tanks from the rest of the facility. He said the washing machines used too much hot water and there was none left in reserve for washing dishes. He said he in-serviced laundry staff not to run washing machines during meal service or when the kitchen was washing dishes. He said the ADM in-serviced kitchen staff to monitor the water temperatures and report any incidents concerning the hot water to supervisors . During observations on 3/29/25 at 4:25 p.m., the Dishwasher was wearing a hairnet and washing a load of dishes in the dish machine; the temperature gauge on the dish machine indicated the water temperature was 121°F. During a telephone interview on 3/29/25 at 4:30 p.m., the Maintenance Supervisor said he was unaware of any problems with the hot water at the facility. He said the facility began running out of hot water in the kitchen in January 2025. He said there were error codes displayed on the water heater that indicated the blower motor and a gas valve were faulty. He said he ordered the parts and repaired the unit and there had not been any more incidents reported to him. He said laundry staff were supposed to shut off laundry machines and not run them when dishes were being washed because the laundry machines used around 100 gallons of water and would use all of the hot water reserves. He said the issue only affected the kitchen and laundry room because the rest of the building had separate water heaters. He said he checked the water temperatures in resident rooms daily and kept a temperature check log and had not identified any concerns . Review of receipt from local a local plumbing company dated 1/9/24 revealed a ball valve was replaced in the boiler room kitchen. Review of DAILY WATER TEMP LOG for April 2024 through March 2025 revealed all daily water temperature checks in resident rooms and care areas fell within the 100°F to 110°F temperature. Review of in-service dated January 2025 titled Dish Machine and Ware Washing. Review of in-service dated 1/27/25 titled Laundry Wash Cycles and Time. Review of in-service dated 3/29/25 titled Infection Control and Regulations. Review of policy titled Ware Washing last revised on 5/2018 indicated the following: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675424 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 675424 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Advanced Rehabilitation and Healthcare of Athens 121 Commons Drive Athens, TX 75751 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 0812 .Improper temperatures and/or sanitizer strength will be reported to the person in charge immediately and manual ware washing and/or paper products will be implemented until the problem is corrected . Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675424 If continuation sheet Page 3 of 3