Health inspection·December 4, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to the resident had a right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely for one (Resident#1) of four reviewed for environment. The facility failed to ensure Resident #1's sheets were clean and free of any stains. This failure could place residents at risk for a reduced quality of life and unsanitary and hazardous living conditions. Findings included: Record review of Resident #1's Face Sheet printed 12/04/2024, reflected a [AGE] year-old female who was admitted to the facility initially 06/02/2022 and readmitted on [DATE] and 12/11/2022 with diagnoses to include but not limited to Dementia, unspecified severity without behavioral disturbance, psychotic disturbance, mood disturbance (term used to describe a group of symptoms affecting memory, thinking and social abilities), high blood pressure and heart failure. Record review of Resident #1's quarterly l MDS, dated [DATE], reflected a BIMS score of 10 which indicated moderate cognitive impairment. Record review of Resident #1s care plan revised 06/15/2024reflected, Resident #1 at risk for impaired cognitive function/dementia or impaired thought processes regarding UNSPECIFIED DEMENTIA WITHOUT BEHAVIORAL DISTURBANCE. Intervention included: COMMUNICATION: Identify yourself at each interaction. Face when speaking and make eye contact. Reduce any distractions- turn off TV, radio, close door etc. Use simple, directive sentences. Provide with necessary cues- stop and return if agitated. Engage in simple, structured activities that avoid overly demanding tasks. Observation and interview on 12/04/2024 at 1:30PM with Resident #1 revealed the sheets on the bed were largely stained with a light brown substance that appeared to be food. Resident #1 stated she may have spilled something a few days ago and the sheets were not changed. Resident #1 stated she would have liked to have the sheets changed on the bed however staff had not done it yet. Resident #1 stated maintenance was supposed to change out her mattress today(12/04/2024) and had come in the room to look at the mattress but had not returned with the mattress yet. Interview on 12/04/2024 at 2:40PM with CNA A revealed she worked the hall for Resident #1's room however she did not change the sheets. CNA A stated she did not notice that the sheets needed to be (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 6 Event ID: 675579 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 675579 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/04/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Beacon Harbor Healthcare and Rehabilitation 6700 Heritage Parkway 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)