Health inspection·October 17, 2024

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 received services in the facility with reasonable accommodation of resident needs for two (Resident #1 and Resident #2) of four reviewed for resident call system, in that. Residents Affected - Few 1.Resident #1 and Resident #2's call lights were on the floor and not within reach on 10/10/2024. This failure could place the residents at risk of not receiving the care and services to maintain their highest level of well-being. Findings included: Record review of Resident #1's electronic face sheet, printed on 10/10/2024, revealed a [AGE] year-old female who was admitted to the facility 04/24/2024 with diagnoses that included but not limited to dementia (loss of cognitive function), glaucoma (a condition that damages the optic nerve, often due to increased eye pressure, leading to vision loss or blindness), high blood pressure. Record review of Resident #1's quarterly MDS, dated [DATE], revealed a BIMS score of 03, indicating the was severely cognitively impaired. Review of Section GG functional abilities and goals revealed substantial/ maximal assistance needed with eating, oral hygiene, toileting hygiene, shower, dressing, putting on/ taking off footwear and personal hygiene. Record review of Resident #1 s care plan, dated 05/03/2024, reflected, problems that included skin concerns, pain interference with day-to-day activities, communication issues, resident is able to understand others and able to communicate. Record review of Resident #2's electronic face sheet, printed on 10/11/2024, revealed a [AGE] year-old female who was admitted to the facility 01/03/2024 with diagnoses that included but not limited to dementia (loss of cognitive function), chronic kidney disease(involves gradual loss of kidney function), cellulitis of the lower limbs( bacterial skin infection), major depressive disorder(disorder that causes a persistent feeling of sadness and loss of interest) Record review of Resident #2's quarterly MDS, dated [DATE], revealed a BIMS score of 03, indicating the was severely cognitively impaired. Review of the MDS revealed section GG functional abilities and goals was not completed. Record review of Resident #2 s care plan, dated 04/26/2024, reflected, problems that included falls related to self-ambulating while unsteady with intervention to include place call light within (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 3 Event ID: 676112 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 676112 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Crestview Court 224 W Pleasant Run Rd Cedar Hill, TX 75104 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)