Health inspection·December 30, 2025

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few daily to visit Resident#1 ADLs Mondays through Fridays. CNA A stated the hospice aides were supposed to do Resident#1 ADLs including showers and fingernails care. CNA A stated she saw HA B visiting Resident#1 this morning but did not know which kind of care was given to the Resident. CNA A asked Resident#1 if she had a shower or bed bath by HA B on 12/30/25; 12/29/25, 12/26/25 and 12/25/25 and the Resident replied no. CNA A asked Resident#1 when was the last time she received shower/bed bath and Resident#1 stated it had been weeks. CNA A stated it was the responsibility of the CNAs to make sure Resident#1 received proper care, and report to the nurses in charge if the residents refused the care. CNA A stated risk to residents loss of dignity, skin break down, scratching self, and development of infection. In a telephone interview on 12/30/25 at 12:53 p.m., CNA C stated she worked weekends, and she offered Resident#1 shower on Saturday 12/27/25, but Resident#1 refused, and she washed her waist down in the bathroom while helping her with incontinent care, and changed her clothes. She stated for residents on hospice services the CNAs only offer them shower/bed bath, because they are supposed to have shower during the hospice Aides visits on the weekdays (Monday through Friday). She stated she did not notify the charge nurse about the refusal of shower for Resident #1. In an interview over the phone on 12/30/25 at 02:12 p.m., HA B stated her last visit with Resident#1 last week was on 12/24/25 and there was another hospice Aide that visit the resident on 12/25/25, 12/26/25. HA B stated during her visits on 12/29/25 and 12/30 Resident#1 refused shower, and she only washed her down. When asked to be more specific, she repeated the same. She stated she did not notify the charge nurse about Resident#1 refusal of shower. HA B stated she cleaned Resident#1 fingernails during her visit on 12/29/25 but because Resident#1 scratch her skin her fingernails get dirty. HA B stated she logged her visit on the Resident's hospice file and did her document on an app on her phone. In an interview on 12/30/25 at 01:37 p.m., LPN D stated the Nurse in charge were responsible for ensuring the resident's showers and ADLs care were performed. He stated the HA B visit Resident#1 daily Monday through Friday for her ADLs care per hospice services including shower, nails care and changing bed lining. He stated HA B called him today to Resident#1 room to help her transfer the Resident#1 from bed to wheelchair, and he left the room after that. He stated he did not know that HA B did not give Resident#1 shower or bed bath. He stated the CNAs/Hospice Aides were supposed to let them know if a resident refused ADLs care or if they were unable to give the scheduled shower or bath. He stated the risk to residents skin break down, and development of infection. In an interview on 12/30/25 at 01:56 p.m., The DON stated she was unable to locate any refusal documentation of shower/bed bath or nails care for Resident#1. She stated residents on hospice services were supposed to get showers and nail care during the hospice Aides visit on the weekdays Mondays through Fridays. She stated HA B had a good relationship with Resident#1 and had been visiting and providing care for her for the last three years. She stated the CNAs were supposed to offer showers for the residents on hospice. She stated the hospice Aides were supposed to communicate to the charges nurses the care rendered to the residents and if there was any refusal of care. The DON stated it was the responsibility of the CNAs and the Charge nurse to make sure residents were kept cleaned, and well-groomed all the time. She stated they were talking with the hospice agency to implement a new system where any refusal had to be documented by the hospice Aides, Charge nurse, and the resident to see if the resident wished for a shower at a different time. She stated the hospice Aides were documenting the care in a separate system belonging to the hospice agency, and the facility was looking to have the documentation forwarded to the facility. She stated ultimately the Charge nurses need to be ensuring the care is provided. The DON stated the risk to residents not getting their showers and nails care was skin issues, hygiene, development of infection, and loss of dignity. In an interview on 12/30/25 at 2:26 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676248 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 676248 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Founders Plaza Nursing & Rehab 721 S Hwy 78 Wylie, TX 75098 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 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete p.m., The ED stated the hospice services were supposed to fulfill their contract and provide the services agreed upon to the residents. He stated the DON and the ADON were in servicing CNAs and charge nurses on better communication with the hospice staff, and to make sure the residents received their care daily. He stated he was in contact with the hospice service for the facility to start getting the documentation of the care provided by the hospice staff. Review of the facility policy titled Nursing Policies and Procedures Subject Hospice Care revised 5/5/2023 revealed .2. The Hospice retains primary responsibility for the provision of hospice care and services, based upon the resident's assessment, including but not limited to the following: .nursing (including assigning a hospice aide as needed to support the resident's on-going care) .8. The facility and hospice will have ongoing collaborative communication. Review of the facility policy titled Nursing Policies and Procedures Subject Activities of Daily Living , Optimal Function revised 5/5/2023 revealed Activities of daily living (ADLs), refer to tasks related to personal care including, grooming, dressing, oral hygiene, transfer, bed mobility, eating, bathing and communication system.The facility provides necessary care to all residents that are unable to carry out activities of daily living on their own to ensure they maintain proper nutrition, grooming, and hygiene. Event ID: Facility ID: 676248 If continuation sheet Page 3 of 3