Inspection·December 15, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some observed in Shower room [ROOM NUMBER] should have been thrown away immediately and not left on the sink. The risk to the residents who were showered in a dirty shower was possible exposure to bacteria that could have made them sick. During an anonymous group interview with 8 Residents on 12/15/25 at 10:32am revealed the residents believed the shower rooms were messy and at times when they were taken to the shower rooms the shower rooms had dirty towels on the floor from the previous resident who showered. One of the anonymous residents stated they had observed feces on the floor in the shower on one occasion when staff took them to the shower room. During an interview with CNA A on 12/15/25 at 10:42 am revealed she was responsible for cleaning the showers after showering residents in the shower rooms. If a resident had an accident and there was urine or feces in the shower, she would have picked it up immediately and wiped the shower down. She would have then notified housekeeping about the need to sanitize the shower. CNA A stated the risk to the residents of not cleaning the showers after every use was the resident could have gotten sick, an infection or slipped if there was urine on the floor. During an interview with CNA B on 12/15/25 at 11:34 am revealed she had used the Shower room [ROOM NUMBER] about 8am and had not observed it to be dirty. CNA B stated it was the responsibility of the CNA to clean up any accidents that happened during or after a shower. She stated once they cleaned up any feces or urine, they would call housekeeping to sanitize the shower room. The risk of bringing a resident in the shower room while it was dirty with feces would have been the resident could have gotten contaminated or an infection. During an interview with CNA C on 12/15/25 at 11:44 am revealed she frequently used Shower room [ROOM NUMBER] to shower residents. She stated after every shower she would situate the resident in a safe place and would go back to the shower room and would pick up trash and dirty linens. If she saw poop on the floor, she would clean it up immediately. CNA C stated she also checked the showers before the end of her shift to make sure they were clean because her main goal was infection control. CNA C stated a dirty floor, with poop, in a shower room could have exposed a resident to bacteria. During an interview with CNA D on 12/15/25 12:15pm revealed he worked in the section assigned to Shower room [ROOM NUMBER]. CNA D stated he had not noticed the dirty conditions of Shower room [ROOM NUMBER] because he used another shower room in the area. He stated if he had observed blood on the floor he would have cleaned it up as best as he could and called housekeeping for more in-depth cleaning. If he was showering a resident and there were bodily fluids like urine, feces or blood he would have cleaned it and would have asked housekeeping to disinfect the room. CNA D reported the person who gave the shower to a resident was responsible for cleaning up the shower room after. He stated if he entered a shower room and it had feces or blood he would clean and disinfect it before he brought the new resident into the shower room. CNA D stated there was a high risk to residents if there was feces or blood in the shower room because they could catch something because you never know what is in the stool or blood. During an interview with the DON on 12/15/25 at 4:05pm revealed housekeeping staff had been cleaning the shower rooms daily, but CNAs were responsible for cleaning up after themselves between showering residents. The DON stated housekeeping staff should have been keeping up with the shower rooms and should have been checking them throughout the day. The risk to the residents of not having had clean showers was infection. During an interview with the Administrator on 12/15/25 at 4:51pm revealed the expectation of the CNAs after using the shower rooms would have been they no wait to clean up the shower but cleaned it immediately. The Administrator stated if a CNA saw BM on the floor he would have expected them to clean it up and not leave it there. The CNAs were required to keep the showers sanitary and clean. Housekeeping was expected to do their daily rounds to ensure the shower rooms remain clean, but it was not housekeeping staff's responsibility to keep the showers clean after every shower. The risk to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675969 If continuation sheet Page 2 of 3 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 675969 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Settlers Ridge Care Center 1280 Settlers Ridge Rd Celina, TX 75009 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 0584 Level of Harm - Minimal harm or potential for actual harm the residents of not having clean showers was infections and negative effect on their sense of dignity. Requested the policy related to the cleanliness of the facility and/or the shower rooms on 12/15/25 at 5:00pm and was informed by the Administrator the facility did not have a policy related to cleanliness. The facility did not submit a policy on cleanliness of the facility or shower rooms by the date and time of exit. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675969 If continuation sheet Page 3 of 3