Health inspection·May 6, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Based on observation, interview, and record review the facility failed to ensure a safe and decent living environment for one (Dining Hall) of one dining halls reviewed for decent living environment. Residents Affected - Some The facility failed to ensure ten dinner trays from 05/05/25 were removed from the dining hall before breakfast on 05/06/25. This failure could place residents at risk for diminished quality of life due to the lack of a well-kept environment. Findings included: In an observation on 05/06/25 at 7:45 AM, reflected ten dinner trays with food and trash on the tables and on a cart in the dining hall. There were about 8 residents observed as they sat in the dining hall awaiting breakfast. In an interview on 05/06/25 at 8:30 AM, Resident #1 stated he saw the dinner trays still out from last night when he walked into the dining hall. He stated the dinner trays from the night before were left out every now and then. Resident #1 stated he did not like clutter and stated clutter brought critters to the place like bugs and anything crawling. Resident #1 stated he did not like critters. In an interview on 05/06/25 at 11:06 AM, Dietary Aide B stated the evening staff were responsible for ensuring the trays were put in the kitchen. He stated sometimes the caregivers returned trays to the dining hall after the kitchen staff left for the night. Dietary Aide B stated if that occurred it was the responsibility of the morning kitchen staff to clear the trays from the dining hall. Dietary Aide B stated the risks of trays left in the dining hall overnight were not having enough dishes and the old trays still in the dining hall when the residents arrived in the morning for breakfast. In an interview on 05/06/25 at 11:25 AM, the Interim Dietary Manager stated the morning staff was supposed to clean those trays before they started the breakfast line. The Interim Dietary Manager stated those trays should have been cleaned to prevent not having enough trays for breakfast, cross contamination, and a risk for pests. In an interview on 05/06/25 at 1:33 PM, the Administrator stated the risk of the older dinner trays in the dining hall was that a resident could eat the old food on the trays which could be spoiled or contaminated. Record review of the facility's policy, titled, Resident Rights, with a revision date of 04/2017, (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 5 Event ID: 676178 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 676178 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/06/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Duncanville Healthcare and Rehabilitation Center 419 S Cockrell Hill Rd Duncanville, TX 75116 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)