Health inspection·December 15, 2023

F 0908 Keep all essential equipment working safely. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review the facility failed to maintain mechanical and electrical equipment in a safe Residents Affected - Some operating condition for 7 (Resident #1, #2, #3, #4, #5, #6, and #7) of 7 rooms affected by mechanical failure. 1. The facility failed to repair heating to resident's room to properly maintain safe and comfortable temperature for residents in their rooms. This failure could place residents at risk of cold room temperatures. Findings included: In an observation and interview on 12/13/23 at 1:40 pm, Resident #1 stated the facility informed him that the heating unit for his room was out and the facility offered for him to relocate to another room in the facility that had heating. Resident #1 stated he thought the room temperature was fine and declined to move. An observation of the room temperature at time of survey was comfortable at 74 degrees. In an observation and interview on 12/13/23 at 1:55 pm, Resident #2 stated she was informed of the problem with the heating and the facility offered to move her to another room. Resident #2 stated she was fine and comfortable and declined to be relocated. An observation of Resident #2's room by the surveyor revealed that the room temperature was comfortable at 73 degrees. In an observation and interview on 12/13/23 at 2:05 pm, Resident #3 stated she does not get cold and declined to relocate to another Page 1 of 3 676053 676053 12/15/2023 Merkel Nursing Center 1704 N 1st Merkel, TX 79536

F 0908 room. An observation by the surveyor revealed that the room was comfortable at 73 degrees. Level of Harm - Minimal harm or potential for actual harm In an observation and interview on 12/13/23 at 2:21 pm, Resident #4 stated the facility has offered her to relocate but she felt fine Residents Affected - Some and comfortable. An observation by the surveyor revealed that the room was comfortable at 73 degrees. In an observation and interview on 12/13/23 at 2:38 pm, Resident #5 was not interview able. Resident #5's son was in the room. The son stated that he was informed of the heating problem by the facility Administrator over a week ago. Resident #5's son stated the room has been comfortable and did not see any need to move at this time. In an observation and interview on 12/13/23 at 2:43 pm, Resident #6 stated she felt fine and was comfortable. Resident stated she was visited by daughter each day. The resident does not recall being asked to move or that the heat was out. An observation by the surveyor revealed that the room was comfortable at 74 degrees. In an observation and interview on 12/13/23 at 2:55 pm, Resident #7 stated he was fine, and his room was comfortable, and he does not get cold at night. He stated he was asked if he wanted to move but declined. He has no problem with temperature. An observation by the surveyor revealed that the room was comfortable at 73 degrees. In an interview on 12/13/23 at 3:05 pm LVN A stated, she asks residents throughout the shift if they are ok or cold. She stated the facility has offered to move them into other single rooms temporarily, but the residents have declined. She stated it has not gotten cold in the rooms at this time, that it does feel fine, and that the heat from the hallway keeps them comfortable. In an interview on 12/13/23 at 3:10 pm CNA B stated, they have been monitoring and asking residents if the rooms are comfortable. She stated they can be moved if they get cold. CNA B stated the residents stated they were fine. In an interview on 12/13/23 at 3:15 pm CNA C stated, they were keeping track of temperatures in the rooms and asking residents if 676053 Page 2 of 3 676053 12/15/2023 Merkel Nursing Center 1704 N 1st Merkel, TX 79536

F 0908 they are cold, we have extra blankets and can move them really easily if they want to move. Level of Harm - Minimal harm or potential for actual harm In an interview on 12/13/23 at 3:30 pm, the Maintenance Director stated the heat loss only affected Resident #'s 1,2, 3, 4, 5, 6, and 7. Residents Affected - Some The MD stated the facility has offered residents affected by heating loss to be moved to other rooms, but the residents felt comfortable and refused. The MD stated he has been checking the temperatures every hour to see if they are maintaining a temperature at 72 or over and documenting results. The MD stated the heating unit that is down provided heating and cooling for 9 rooms. 7 of the 9 rooms affected have residents and 2 are not being used. Record review of temperature log, temperatures of rooms affected by mechanical failure are taken once per hour. In an interview on 12/13/23 at 3:48 pm, the Administrator stated the heat affecting that section of the facility has been out for over a week. The Administrator stated they have empty rooms available and offered all 7-residents affected by heat loss to move but they declined. The Administrator stated the resident's rooms were checked for temperature throughout the day by the MD and nurses at night, to ensure the residents were comfortable. The Administrator stated the families of the residents were aware of the heating unit being down and that the facility has rooms they can relocate residents to if or when they wish. The Administrator stated the heating unit was non-repairable and needed to be replaced. At time of the survey, the Administrator stated that a new unit had not been installed. Record review of facility's Emergency Preparedness Plan did not include a risk assessment for heating or cooling loss due to equipment failure. Interview on 12/13/23 at 4:45 pm, the Administrator stated he has ordered a new heating and cooling unit. 676053 Page 3 of 3