Health inspection·August 11, 2023

F 0565 Honor the resident's right to organize and participate in resident/family groups in the facility. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review the facility failed to provide a private meeting space for residents' monthly council meetings for 11 of 11 confidential residents reviewed for resident council. Residents Affected - Some The facility failed to provide a private space for resident council meetings. This failure could place residents, who attended resident council meetings, at risk of not being able to voice concerns due to a lack of privacy. Findings included: Observation and interview on 08/10/23 beginning at 11:00 AM, during a confidential resident group meeting with 11 residents, revealed the meeting was held in the dining room. There were doors that closed off the space with signs posted to indicate that a confidential meeting was being held; however, multiple staff and residents walked through the space to get from one hall to the next while the meeting was in progress. Also, the Social Worker's office was located inside the dining area, and she was inside during the meeting. During the confidential group meeting, all eleven residents revealed the meeting was held each month in the dining area. Six of the eleven residents in attendance stated they were uncomfortable expressing their concerns because they were afraid that staff would overhear them. A confidential resident proceeded to yell towards the Social Worker's office door and stated he knew that she was listening and would tell what was being discussed. The residents stated they had expressed their concerns for privacy to the Former Activity Director and to the new Activity Staff, but nothing had been done about it. Interview on 08/11/23 at 2:30 PM with the Activity Staff revealed she had recently started helping in the activity department after the Former Activity Director retired. She stated she was responsible for assisting the residents with organizing the resident council meetings and that they were always held in the dining area. She stated she knew the meetings were confidential and had to be held in a private space. The Activity Staff stated the doors were always closed and signs put up to alert staff that a confidential meeting was being held but some staff, especially new ones, would still walk through the doors. The Activity Staff stated she would redirect them when possible. She also stated the Social Worker would sometimes be in her office during the meetings. She stated the residents had complained to her about the staff walking through their meeting, and she was working on an in-service to educate staff further. The Activity Staff stated the risk of not holding resident council meetings in a private space was the residents not feeling comfortable talking about their concerns and fearing that staff would hear them. Interview on 08/11/23 at 3:45 PM with the Administrator revealed the resident council meetings were (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 2 Event ID: 675817 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 675817 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/11/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE FT Worth Southwest Nursing Center 5300 Alta Mesa Blvd Fort Worth, TX 76133 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)