Health inspection·March 28, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to treat residents with respect and dignity for 1 of three (Resident #1) residents reviewed for dignity in that: Facility staff stood over Resident #1 while assisting the resident with her meal in the dining area. This failure could affect residents who require assistance with activities of daily living and placed them at risk for psychosocial harm due to a diminished quality of life. The findings were: Review of Resident #1's electronic face Sheet printed 3/28/24 reflected a [AGE] year-old-female initially admitted on [DATE] with diagnoses including but not limited to the following: dysphagia (difficulty swallowing), dementia (impaired ability to remember, think, or make decisions that interferes with doing everyday activities). Review of Resident #1's Quarterly MDS, dated [DATE] reflected Resident #1 was rarely/never understood. Review of Section GG of Resident #1's MDs revealed partial/ moderate assistance eating. Review of Resident #1's Care Plan revised 11/17/2023 reflected the following problems: The resident has potential for altered nutritional status regarding Dementia. Regular diet 5/8/23- Change diet to Mechanical soft consistency ,11/16/23- Nectar consistency liquid, Date Initiated: 03/26/2021 Revision on: 11/17/2023. Review of the facility provided list on 03/28/2024 of residents who required full assistance with feeding revealed the list included Resident #1. Observation on 03/28/24 at 12:12 PM in the dining hall revealed Charge Nurse A was observed standing over Resident #1 and assisting her with feeding her the meal by placing food in her mouth with a utensil. There was a vacant chair observed next to the resident. In an interview on 03/28/24 at 12:20 PM Charge Nurse A revealed she was assisting Resident #1 with feeding temporarily until the other caregiver returned. Charge Nurse A stated staff typically sit down and assist the resident throughout their entire meal however she was only assisting until the other staff member returned. The Charge Nurse stated standing over the resident and feeding her could Page 1 of 2 676390 676390 03/28/2024 Lexington Medical Lodge 2000 West Audie Murphy Pkway Farmersville, TX 75442

F 0550 be a dignity issue however she was only helping out until the other caregiver returned. Level of Harm - Minimal harm or potential for actual harm In an interview with the Director of Nursing on 03/28/24 at 3:36PM revealed if staff were assisting with feeding during meals then they should be sitting down and helping the resident until the meal is completed. The Director of Nursing stated Resident #1 did require full assistance with eating. The Director of Nursing stated if a staff is standing over a resident while assisting during meals then the resident rights could be violated. Residents Affected - Few Record review of the policy Operational/resident care policies undated revealed The facility protects and promotes the rights of each resident admitted in order to provide a dignified existence, self-determination and communication with and access to persons and services inside and outside the facility. The facility will protect and promote the rights of each resident. 676390 Page 2 of 2