Health inspection·February 20, 2025

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure residents had the right to reside and receive services in the facility with reasonable accommodation of resident needs and preferences except when to do so would endanger the health or safety of the resident or other residents for 1 of 1 residents (Resident #3) reviewed for accommodation of needs. Residents Affected - Few The facility failed to ensure Resident #3 had access to his call light. This failure could place residents at risk of not being able to call for help when needed. Findings included: Record review of Resident# 3's Quarterly MDS Assessment, dated 01/13/25, reflected a [AGE] year-old male who was admitted to the facility on [DATE] and a readmission on [DATE]. Resident #3 had diagnoses which included fractures, anemia (low blood levels) and hypertension (high blood pressure) . The resident's cognition was severely impaired with a BIMS score of 3. His Functional Status assessment reflected he needed substantial assistance with all his activities of daily living. Record review of Resident #3's care plan, dated 01/08/25, reflected Focus: [Resident #3] has hip fracture due to fall. Goal: The Surgical incision will heal without signs and symptoms of infection or breakdown by review date. Interventions: Anticipate and meet needs. Be sure call light is within reach and respond promptly to all requests for assistance. Observation on 02/19/25 at 1:00 PM revealed Resident #3 lying on his bed, and his call light cord was clipped on the ceiling suspended curtain away from the resident. Observation and interview on 02/19/25 at 2:25 PM revealed Resident #3 was lying on his bed, and his call light was clipped on the curtain. Resident #3 said he did not realize the call light was not within reach. He said he knew how to use the call light and had not called for help. Observation and interview on 02/19/25 at 2:34 PM with CNA B revealed she was assigned to Resident #3. She stated the last time she was in the room was when she was dressing him, and he did not want to get up in his chair. She stated she preferred to remain in bed, but she could not tell at what time. She said when she left him, the call light was within reach. CNA B stated she could not tell how it got clipped to the curtain. She put the call light within reach. She stated she was supposed to be checking whether the call light was within reach while doing her rounds. CNA B stated Resident #3 knew how to use the call light though he hardly called because he used a urinal. CNA B stated failure to have the call light within reach was a resident would not be able to call in case he needed (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: 675759 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 675759 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Stonegate Nursing and Rehabilitation 4201 Stonegate Blvd Fort Worth, TX 76109 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)