Health inspection·February 5, 2026

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete activities, both up in geri-chairs with mechanical slings underneath them with loops that were faded in color. During an interview on 2/5/26 at 9:15 a.m., CNA B said when she transferred a resident using the lift, she would inspect the sling for any loose strings or fading. She said if the sling had any loose strings or fading, it could be unsafe to use, and a resident could fall and possibly get hurt . During an interview on 2/5/26 at 9:20 a.m., the DON said that residents could get hurt if they were transferred using a sling that was unsafe. She said she looked for faded colors and loose strings, rips, tears. She said they had just replaced the slings about 6 months ago and she does not n't know why they keep fading unless laundry is using bleach . During an interview on 2/5/26 at 9:30 a.m., the Laundry Aide said she had been employed at the facility here for 4 years. She said she did not use bleach on the lift slings and said they were washed in hot water and air dried. She said if she noticed any rips, tears, fading or loose strings, she would put that sling to the side show that sling to the administrator to possibly be removed from service. She said the CNAs were supposed to check them when they come get them and before they use them for transfers. During an interview on 2/5/26 at 9:35 a.m., the Administrator said the laundry supervisor was responsible for checking the slings and removing them from service. She said if an unsafe sling was used, a resident could fall and get hurt. Record review of a facility policy titled Lifting Machine, Using a Mechanical dated July 2017 read: .Make sure that all necessary equipment (slings, hooks, chains, straps and supports) is on hand and in good condition . and .examine all hooks, clips or fasteners . and .discard any work, frayed, or ripped slings . Record review of a facility form titled [Service Company C] Sling Log undated read: .Laundry Aide should inspect for rips, tears, frays, or discoloration after each laundering . Event ID: Facility ID: 676147 If continuation sheet Page 2 of 4 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 676147 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/05/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Stallings Court Nursing and Rehabilitation 4616 NE Stallings Dr Nacogdoches, TX 75965 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observations, interviews, and record reviews the facility failed to store, prepare, distribute, and serve food under sanitary conditions in 1 of 1 kitchen reviewed for kitchen sanitation.The facility failed to ensure the temperature for the dish machine was at the appropriate temperature of 120 degrees Fahrenheit during the wash cycle according to the manufacturer's guidelines to sanitize dishes appropriately on 02/04/2026.This failure could place residents who eat from the kitchen at risk of foodborne illnesses. Findings included :During an initial observation and interview on 02/04/2026 at 09:00 a.m., Dietary Aide A was running the dish machine after the breakfast meal. Dietary Aide A ran the machine and checked the Dish Machine gauge for required temperature of compliance with manufactures requirements of 120 degrees Fahrenheit during the wash cycle. After 4 attempts the temperature reached 100 degrees Fahrenheit. Dietary Aide A said the machine was tested early this morning and reached a temperature of 120 degrees Fahrenheit for wash cycle and tested for final rinse - 50 ppm (parts per million) hypochlorite (chlorine) on dish surface in final rinse. During an interview on 02/04/2026 at 9:15 a.m., the Dietary Manager said he had been the Dietary Manager for two years. He said he would contact the Maintenance Director to ensure the hot water heater was functioning as the morning load at the facility would pull the hot water supply down. The Dietary Manager said the facility would serve using disposable products until the dish machine had reached the required 120 degrees for sanitation. He said that if the dishes were not properly sanitized the residents could develop a food borne illness.During an interview on 02/04/2026 at 9:30 a.m., the Maintenance Director said he had adjusted the temperature on the hot water heater and the dish machine. He said that after laundry had been done this morning the heater was not keeping up with demand. He said he would recheck the hot water after two hours to see if the temperature was meeting requirements. During an observation on 02/04/2026 at 11:30 am the Dietary Aide ran the dish machine, and the Dish Machine meet the required temperature of compliance with manufactures requirements of 120 degrees Fahrenheit during the wash cycle and final rinse - 50 ppm (parts per million) hypochlorite (chlorine) on dish surface as required. During an interview on 2/4/2026 at 2:00 p.m., the Director of Health Care Operations said the dish machine should reach 120 degrees during operation to ensure sanitation and the sanitation should be 50-100 parts per million chlorine in the rinse cycle. She said the Dietary Aide would be in-serviced on proper sanitation procedures for dishwashing and to report when the machine was not reaching the required temperatures. The Director of Health Care Operations said the facility would remain on paper products until the water temperature reached the required temperatures for sanitation. She said if the dishes were not properly sanitized the residents could develop a food borne illness.During an interview and record review on 2/5/2026 at 11:00 a.m., the Administrator said the low temp dish machine should reach 120 degrees during operation. The Administrator said that the hot water heater was not functioning properly and had been adjusted to meet the required temperature. The Administrator said a new part was ordered to repair the hot water heater. The receipt for the part was reviewed with the Administrator. The Administrator said she was not aware of any problems with the hot water heater until 02/04/2026. She said that if the dishes were not properly sanitized the residents could develop a food borne illness.Record review of an undated dietary policy indicated:Ware washing Policy and ProcedurePolicy StatementWe prioritize the cleanliness and sanitation of all dishware, service ware, and utensils to uphold the highest health and safety standards.Procedures1.Training and Handling: Our Dietary Services staff undergo comprehensive training to proficiently operate dishwashing machinery and handle clean dishware, ensuring strict adherence to sanitary protocols.2.Machine Temperature Management: We (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676147 If continuation sheet Page 3 of 4 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 676147 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/05/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Stallings Court Nursing and Rehabilitation 4616 NE Stallings Dr Nacogdoches, TX 75965 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete regulate the temperature of dishwashing machine water according to the specifications provided by the manufacturer, whether utilizing high-temperature or low-temperature cleaning systems.3.Record Keeping: Meticulous logs are maintained to track either temperature or sanitizer concentration, depending on the type of machine, always guaranteeing compliance with sanitation standards.4.Drying and Storage: Cleaned dishware is air dried and stored appropriately to prevent any potential contamination prior to use, maintaining the integrity of our sanitary practices.Required Documentation:Dish Machine LogReferencesThis policy is aligned with: CMS Conditions of Participation: Food and Dietetic Services (A-0618, S482.28) CMS Manual System: Store, Prepare, Distribute, and Serve Food (F812, S483.60) Joint Commission Standards on Food and Nutrition AvailabilityRecord review of the manufacturer's instructions for Auto- Chlor Dishwasher operating requirements for low temp dish machine indicated the wash cycle is supposed to reach 120 degrees. Low Temperature Dishwasher (chemical sanitization): Wash - 120 degrees F; and Final Rinse - 50 ppm (parts per million) hypochlorite (chlorine) on dish surface in final rinse. The chemical solution must be maintained at the correct concentration, based on periodic testing, at least once per shift, and for the effective contact time according to manufacturer's guidelines. Event ID: Facility ID: 676147 If continuation sheet Page 4 of 4