Health inspection·November 5, 2023

F 0804 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some to report if nothing had been done. Resident #5 stated the cold food had been served that way for a very long time and he was used to eating the food cold. During an interview on 11-05-2023 at 11:20 AM, RP for Resident #1 stated Resident #1 complained so many times about cold food being served. The cold food concerns was made to the ADM with nothing being done about it. There is no reason any residents should be eating cold foods and they would not want any of their family members eating cold food. During an interview on 11-05-2023 at 12:30 PM, Resident #4 stated the facility had been knowing they served cold food. Resident # 4 stated she don't make any reports about the cold food as nothing had been done. Resident #4 stated the food is not good when it is cold, and she just eat the cold food. During an interview on 11-05-2023 at 12:40 PM, Resident #7 stated that the food had always been given to her cold. Resident #7 stated she don't like cold food and she just eat anyway. Resident # 7 stopped answering the surveyor when trying to obtain information on whether she had reported the cold food to any staff. During an interview on 11-05-2023 at 12:44 PM, Resident #1 stated being served cold food was her concern. Resident #1 stated the food is not enjoyable when it is delivered, and she do not want to eat. Resident # 1 stated that she couldn't recall the nursing staff that she reported to when the food was cold and didn't want to eat. During an interview on 11-05-2023 at 12:55 PM, Resident #2 stated he is the resident council president and it had always been a problem with the facility serving cold food. Resident #2 stated it had been brought to the ADM and the kitchen manager's attention. Resident # 2 stated no one had done anything about it and the residents had been used to eating their food cold. Resident #2 stated residents stopped making concerns about it in the resident council meeting. Resident #2 stated, It's a shame that food is not desirable when food is brought to residents cold. Who wants to eat food that is supposed to be hot but cold. Resident #2 stated he is fortunate to order food from the outside of the facility, but other residents are not able to do that. Resident #2 stated, It was really sad that they could do people like that. Trays are cold because they are sitting in the hall waiting to be passed out to residents. Resident #2 stated he did not want the food tray that CNA B brought in because it was cold and not desired to be eaten that way. During an interview on 11-05-2023 at 1:05 PM, Resident #8 stated the food was always cold when served. Resident #8 could not recall how long the food had been served like that but stated It's been like that for a while. Resident #8 stated, food was not desirable cold and who want to eat cold food. Resident # 8 stated, She have family to bring her food but not all resident's families do that. Resident # 8 stated the ADM had been told about the cold food so many times and nothing had been done about it. During an interview on 11-05-2023 at 1:15 PM, CNA A stated that is known by the entire facility that the food is cold when being served to residents. CNA A stated that the cart the trays are being delivered on are not heat insulated to keep the food warm. CNA A stated when the kitchen staff delivered the trays to the halls a nursing staff checked the trays and signed off on them. CNA A stated no one was notified that the trays were on the halls because the nursing staff had returned to her job duties and the trays were just sitting there. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675431 If continuation sheet Page 2 of 4 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 675431 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Red Oak Health and Rehabilitation Center 101 Reese Dr Red Oak, TX 75154 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 0804 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an interview on 11-05-2023 at 1:35 PM, Resident #3 stated that the food he was eating was cold and he just dealt with it. Resident #3 stated, What else could he do. Resident #3 stated he had been dealing with the cold food for so long he had got used to it. Resident # 3 stated, he got to eat so he ate it cold. During an interview on 11-05-2023 at 1:45 PM, Dietary Aide A stated the facility had been knowing the food was delivered to the resident's cold. Dietary Aide A stated she was responsible for delivering the food carts to the halls. Dietary Aide A stated that when the cart is delivered it is checked and signed off by a nursing staff. Dietary Aide A stated the ADM and kitchen Manager had been told too many times about the trays just sitting on the halls when she had delivered them. Dietary Aide A stated the food was getting cold because the carts were not insulated with heat to keep warm. Dietary Aide A stated that food would be cold when the resident received their food. Dietary Aide A stated many food trays had been returned back to the kitchen unwanted due to being too cold to eat. Dietary Aide A stated that it was not a kitchen issue the food temperatures are taken before plates are sent out of the kitchen. The kitchen manager knew the food was cold and it had been brought to his attention by residents and staff. Dietary Aide A stated management is well aware of the food being cold and nothing had been done about it. Dietary Aide A stated there were no microwaves in the kitchen to reheat any food. During an interview on 11-05-2023 at 1:56 PM, Kitchen [NAME] A stated that the food in the kitchen was not coming out cold. The food temperatures are checked before food is sent out to residents. Kitchen [NAME] A stated the plates are being prepared on a heated hot plate, but the food cart is not insulated for the food to stay warm. Kitchen [NAME] A stated that the Kitchen manager was well aware the food was getting cold on the floor waiting to be passed out to residents. Kitchen A stated They would not want to eat cold food so why let the resident's food sit and get cold? Kitchen [NAME] A stated the food trays are sent out on a cart that is not insulated which caused the food to get cold while sitting on the halls waiting to be passed out. During an interview on 11-05-2023 at 2:00 PM, Dietary Aide B stated that the facility had known that the food was sitting on the halls getting cold while waiting to be passed to residents. The Kitchen Manager was well aware of the cold food. Dietary Aide B stated she assisted Kitchen [NAME] A in preparing the trays and temperature checks completed before sending the trays out to the floor to be delivered. During an interview on 11-05-2023 at 2:15 PM, The Kitchen Manager stated his kitchen had no issue with food coming out cold. Kitchen [NAME] A checked temperatures before food was sent out to the floor. The Kitchen Manager stated no one had mentioned to him anything about cold food and he don't' feel his kitchen was responsible for food getting cold while sitting and waiting to be passed out. During an interview on 11-05-2023 at 3:19 PM, The ADM stated no one had told him anything about cold food. The ADM stated he observed the lids not securing the plated properly on 11-1-2023 at lunchtime and had ordered insulated carts and metal plates to keep the plates warm while being delivered to the residents. The ADM stated the carts now are not insulated and this could cause food to become cold while delivered to residents. ADM stated is he had been told about cold food he would had the problem fixed. During an interview on 11-05-2023 at 3:34 PM, CNA B stated residents had mentioned to her that the food was cold and they send it back to the kitchen. CNA A stated sometimes staff don't know food trays are on the halls and no one is notifying the staff that the trays are there. Once the trays are (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675431 If continuation sheet Page 3 of 4 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 675431 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/05/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Red Oak Health and Rehabilitation Center 101 Reese Dr Red Oak, TX 75154 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 0804 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some seen staff immediately start passing the trays out to residents. The food is cold because there are no insulated carts that the food are being kept in. CNA B stated she reported cold food to the kitchen staff. During an interview on 11-05-2023 at 3:56 PM, CNA C stated that Resident #2 refused his food when it was cold and she returned to the kitchen every time. CNA C stated it was known the food was being served cold. The food is sitting on the floor waiting for staff to pass out to residents. Once the kitchen staff brought it to the floor the nurse checked and signed off on it. The nursing staff who sign off return to their duties and no one is assigned to pass out the trays. CNA C reported a cold food complaint to the kitchen manager. During an interview with LVN A on 11-05-2023 at 4:20 PM, LVN A stated she checked trays and signed off. Once she signed off on she returned to her normal nursing duties without assigning staff to pass trays. LVN A stated it is known the food cart is not insulated which is causing the food to get cold when the food is not passed out timely. Review of grievances dated August, September, and October 2023 reflected no related grievances. Review of Resident Council dated August, September, and October 2023 reflected no related complaints on cold food. Review of facility policy dated revised December 2009 and titled Resident Nutrition Services reflected the following: Each resident shall receive the correct diet, with preferences accommodated as feasible, and shall receive prompt meal service and appropriate feeding assistance. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675431 If continuation sheet Page 4 of 4