Health inspection·July 11, 2023

F 0921 Level of Harm - Minimal harm or potential for actual harm Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Based on observation, interview, and record review the facility failed to provide a safe, functional, sanitary, and comfortable environment for one of one laundry room viewed for environment. Residents Affected - Few The facility failed to ensure the laundry room was clean and free from debris. This failure could result in unsafe and unsanitary environment. Findings included: An observation on 07/10/23 at 11:11 AM of the laundry room revealed the dirty side of the laundry room; to have two large bins that were full of trash bags of linens. There were five more trash bags of laundry on top of those two bins. Next to the bins there was a mesh bag of laundry that was open, a plastic laundry basket with dirty clothes, and a closed trash bag of clothes on the floor. Going further in, there was a double sink overflowing with at least five dirty pillows and two that appeared to have fallen over the sink and were laying on the floor. To the left of the sink (facing sink) were two large plastic trash bins full of linens. Blankets not in a trash bag was seen hanging over each trash bin. A plastic bag (one on each trash bin) of more linens on top of the two trash bins with a pile of dirty blankets reaching up to approximately 6ft high against the wall and falling over onto the pillows in the double sink. At the feet of the trash bin on the left, on the floor, was a pile of what appeared to be four dirty blankets. As you walk through the dirty side of the laundry room, there were small amount of room to walk through due to laundry on both sides of the walkway. At the end of the dirty side, on the floor, there were two trash bags full of cleaning cloths and pads for housekeeping, one linen bag full, and a laundry basket full. On top of the two washers, there were ten pillows, 2 large boxes of unused gloves, two plastic cleaning gloves, what appeared to be a trash bag, and a stack of papers. In front of the washers there was, a large, opened trash bin full of dirty blankets, with blankets hanging over the trash bin as well as a box of linens not opened yet in the middle of the floor. In an interview on 07/10/23 at 10:20 AM the laundry manager stated that right now he was currently trying to get caught up due to water leak a few weeks ago. He stated, the stains set in and he had to order more linens. He stated, it is not normal for laundry to be stacked up it is due to back up for several reasons. In an interview on 07/10/23 at 1:30 PM the laundry manager stated, they have run out of room to store linen due to being behind. Once we get caught up then we can get more into the linen closets and free up space. The laundry manager stated that the pile of blankets were 6 feet tall because I am 6 foot 3. The laundry staff and manager are responsible for organization and cleanliness of laundry (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: 676394 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 676394 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/11/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Woodlands Place Rehabilitation Suites 5600 Woodlands Trail Denison, TX 75020 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)