Health inspection·April 17, 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 provide housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior environment in 1 of 3 halls (Hall 1) observed for environmental conditions for Resident #1 and #2, in that: 1. The facility failed to prevent the temperature from being 86°F in Resident #1's room. 2. The facility failed to prevent the temperature from being 86°F in Resident #2's room The facility's failure placed the residents at risk for harm by a diminished quality of life and discomfort. The findings included: Resident #1 Record Review of the resident #1's Face Sheet dated 04/17/2024, revealed a [AGE] year-old male, admitted to the facility on [DATE], with a Diagnoses of Cerebral Infarction (stroke), diabetes, depression and hypertension (high blood pressure). Resident #1's MDS, dated [DATE], Section C revealed a BIMS score of 12 (moderately impaired). During an observation of temperature on 04/17/2024 at 2:56 PM of Resident #1's room revealed a temperature of 86°F. During an interview on 04/17/2023 at 10:53 AM, Resident #1 stated there had been a problem with the air conditioning on hall 100. He stated his room, when warm outside affected the temperature in his room, and had felt warm. He stated he had to get fans in his room but was only moving the warm air around. During an interview on 04/17/2024 at 4:20 PM, Resident #1's Representative stated she had thought it was really warm in the room while visiting. Resident #2 Record Review of the resident #2's Face Sheet dated 04/17/2024, revealed a 57 year. old male, admitted to the facility on [DATE], with a Diagnoses of Congestive heart Failure, open wounds, and skin Page 1 of 3 675769 675769 04/17/2024 Harmony Care at Stamford 1003 Columbia Stamford, TX 79553

F 0584 conditions. Level of Harm - Minimal harm or potential for actual harm Resident #14's MDS, dated [DATE], Section C revealed a BIMS score of 12 (moderately impaired). Residents Affected - Few During an observation of temperature on 04/17/2024 at 2:58 PM of Resident #2's room revealed a temperature of 86°F. During an interview on 04/17/2023 at 10:53 AM, Resident #2 stated it was hot in his room and had previously asked had told the staff several times if or when the A/C would be repaired. During an interview on 04 /17/2024 at 1:12 PM the facility Maintenance stated the temperatures should have been between 71°F and 77°F. He stated if the resident room temperatures go up to 79°F, he would open a window on hall 1 to help the cooler air flow circulate to/through that area from the cooler halls. The maintenance stated he felt there should have been temperature logs when the air conditioning failed to cool properly. He also stated he was recently hired and had not looked for any temperature logs. He stated the ADMN had told him that she was waiting on the approval for the repairs from corporate and did not know how long it would take to repair. The maintenance man stated he had been busy repairing other things in the facility and had not checked the room temperatures. During an interview on 04/17/2024 at 3:12 PM the ADMN stated the staff had not voiced any complaints from residents that it was hot in any rooms. She stated she had spoken to corporate, and he stated to her he was still getting quotes. The ADMN stated maintenance and housekeeping were the staff to monitor the air conditioning and temperatures for resident rooms. She stated the negative impact to residents would be, being uncomfortable and dehydration. The ADMN stated the failure would have been the pending quotes from corporate, with her expectations to improve the air conditioning and cooling system on hall 1 so that the residents would be comfortable. During an interview on 04/17/2024 at 3:29 PM the Corporate Owner stated with the fact that the facility is in a rural area it was harder and took longer to get parts for air conditioner this time of year. He stated the issues were waiting for all the parts to still come in. He stated he had made a promise to maintenance that it was supposed to had been installed previously and it did not happen. He stated he told him exactly when it would be arriving then it had not. The corporate owner stated the issue that they were having was getting ordered to correct part and then not receiving it at all. He stated it had not done the repairs because they were hoping the parts were in. He stated it would inconvenient residents to install window units for them in the meantime and they could move to a different room on another hall that had air conditioning. The corporate owner stated the monitoring of the temperatures in rooms should be the facility administrator. He stated there would be no negative impact to residents with 90°F weather outside and no a/c for them. He stated his expectations would be to have the air conditioner fixed and correct the problem with the facility administrator and maintenance man. Review of https://www.wunderground.com/history/weekly/us/tx/stamford/KABI/date/2024-4-17 on 04/17/2024 at 3:21 PM the temperature was 89°F outside. Record Review of facility Description of Work receipt dated 03/05/2024 revealed: Provided diagnosis of hall 100 RTU; found that (1) of (2) compressors is grounded and the second compressor circuit is low of refrigerant charge, due to an active refrigerant leak; given the severity 675769 Page 2 of 3 675769 04/17/2024 Harmony Care at Stamford 1003 Columbia Stamford, TX 79553

F 0584 of the issues facing this RTU it is recommended that it be replaced; Level of Harm - Minimal harm or potential for actual harm Record Review of facility policy Section IV: Emergency Preparedness and Planning dated August 2019 revealed: Residents Affected - Few C. Temperature Regulation 1. Temperature regulation for resident health, safety and comfort (between 71 and 81°F), as well as to protect supplies and subsistence needs, will be maintained by the alternate power source. 2. If unable to maintain safe temperatures throughout the entire facility, the residents and provisions are, in a safe and timely manner 675769 Page 3 of 3