Health inspection·January 2, 2026

F 0919 Make sure that a working call system is available in each resident's bathroom and bathing area. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record review, the facility failed to ensure resident rooms were adequately equipped to allow residents to call for staff assistance through a communication system which relays the call directly to a staff member or to a centralized staff work area for 2 of 10 residents (Residents #1 and #2) reviewed for resident call light system. 1. The facility failed to ensure Resident #1 had a call light. 2. The facility failed to ensure Resident #2's call light was placed within reach. These failures could place residents at risk of injuries and unmet needs.Findings included: 1. Review of Resident #1's quarterly MDS assessment dated [DATE] reflected the resident was a [AGE] year-old male admitted to the facility on [DATE]. His diagnoses included end stage renal disease (where the kidneys fail to function adequately), hemiplegia (paralysis of one side of the body), and aphasia (a language disorder that impairs the ability to speak, understand, read, and write). Resident #1 had a BIMS score of 12 which indicated his cognition was moderately impaired. The MDS further reflected the resident used a manual wheelchair for mobility and he required partial to moderate assistance with ADLs. Observation and interview on 01/02/26 at 9:52 AM of Resident #1 revealed he was in his room sitting in his wheelchair, and there was no cord attached to the call light system in his room. The resident said he was able to do a lot of things on his own, despite his right-side paralysis, and because he did not have a call light cord, he would yell out at staff if he needed something. Resident #1 stated he never said anything to the staff about his call light cord because he thought they already knew but would like to have access to his call light to alert staff if he needed something. Interview on 01/02/26 at 9:54 AM with CNA A revealed she had only been working with Resident #1 for about a month. The CNA said she did not realize the resident did not have a call light cord in his room, and Resident #1 usually yelled out if he needed something. Interview on 01/02/26 at 1:41 PM with LVN B revealed she was not aware Resident #1 did not have a call light cord in his room. The LVN said the resident usually went to the nurses' station when he needed something. LVN B said it was important for resident to have access to a call light in case of an emergency or they needed something. 2. Review of Resident #2's face sheet printed on 01/02/26 reflected the resident was a [AGE] year-old female admitted to the facility on [DATE]. Her diagnoses included encephalopathy (disease in which the functioning of the brain is affected by some agent or condition), sepsis (serious condition resulting from the presence of harmful microorganisms in the blood or other tissue), urinary tract infection, and weakness. Review of Resident #2's baseline care plan dated 12/30/26 reflected the resident was not cognitively impaired, had impaired functional abilities, and required assistance with ADL care and mobility. Observation and interview on 01/02/26 at 12:59 PM with Resident #2 revealed she was in her room sitting in her wheelchair to the left of her bed. There was a blue call light cord tied to the bed repositioning bar on the right side of the bed. Resident #2 said she could not reach her call light cord that was tied to the bed and if she needed something she would wait until staff went Residents Affected - Some (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 2 Event ID: 676358 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 676358 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/02/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Villages on MacArthur 3443 N MacArthur Blvd Irving, TX 75062 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)