Inspection·November 22, 2024

F 0677 -11/11/24- setup/clean-up assistance to complete activity Level of Harm - Minimal harm or potential for actual harm -11/12/24- setup/clean-up assistance to complete activity -11/13/24- oral hygiene not applicable Residents Affected - Some -11/15/24- independent-pt completed activity by themselves -11/16/24- no documentation Shower/bathe self: -11/08/24- shower not applicable -11/11/24- shower not applicable -11/12/24- shower not applicable -11/13/24- shower not applicable -11/15/24- dependent- required all effort by helper (staff) to complete activity In an interview on 11/21/24 at 1:55 PM, Patient #1 stated he admitted to the nursing facility for rehabilitation to regain his strength after a hospital stay. He stated he resided at the nursing facility for about 10 days and did not receive the best care. Patient #1 stated a staff wiped his lower legs and abdomen off with a wet wipe on one occasion; however, he never received a full shower or bed bath during his entire stay. He stated staff informed him that he would have to be transferred using a mechanical lift due to his large size for all care/treatment. Patient #1 stated he was very anxious about getting on the mechanical lift and may have refused it once. However, he later informed staff that he would get on it. Patient #1 stated even after agreeing to get on the mechanical lift, staff never attempted to transfer him for a shower or provide a bed bath. He stated not being bathed made him more concerned about the wounds on his body, although he was receiving wound care. Patient #1 stated he also was not provided toiletries or a setup for him to brush his teeth daily as he would have liked. Patient #1 stated that made him feel ashamed and unclean. He stated his friends would help as much as they could when they visited. In an interview on 11/21/24 at 03:02 PM, CNA A stated she worked at the facility for about one month. She stated she sometimes worked with Patient #1 and his shower days were every Monday, Wednesday, and Friday. CNA A stated she worked with Patient #1 on 11/15/24 and she initially stated she took the patient to the shower room to shower him. When asked if she used a mechanical lift to transfer the patient, she stated No, then said she must have given him a bed bath. CNA A stated she marked Patient #1's ADL task sheet in the electronic health record as not applicable for his shower and stated it was a mistake. CNA A stated Patient #1 was able to complete oral care independently, so she never assisted him with it. CNA A stated she recalled seeing a toothbrush, toothpaste, and basin in his room. CNA A stated staff would have to provide water for the basin if a patient was unable to get out of bed and she could not recall if she did so. CNA A stated Patient #1 never complained to her about not receiving a shower/bed bath or oral care. CNA A stated most day there were enough staff to accommodate all patients and denied concerns that any patients were being neglected. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676407 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 676407 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/22/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Purehealth Transitional Care at Thr Arlington 800 W. Randol Mill Road, 6th Floor Arlington, TX 76012 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 In an interview on 11/21/24 at 03:15 PM, the Interim DON stated staff were expected to provide all patients' showers or baths on scheduled days. The DON stated if a patient refused, the aides were supposed to notify the nurse so they could offer alternatives and ask about concerns. The Interim DON stated they would involve the family if refusals were persistent. The Interim DON stated staff were expected to document all encounters, whether the task was completed or refused. Residents Affected - Some In an interview on 11/22/24 at 10:58 AM, CNA B stated she worked at the facility for about 5 months. She stated she sometimes worked with Patient #1. CNA B stated Patient #1 required a 2-person assist with most care, but he was able to help some. CNA B stated she recalled giving the patient a bed bath one day but could not remember the date. She stated there was another day Patient #1 was due for a shower or bath, but the facility was short-staffed, and he was unable to get it during the morning shift. CNA B stated if they were unable to provide a shower due to being short-staffed, they would inform the oncoming staff so they could provide it. CNA B stated she could not recall if she informed the oncoming staff that Patient #1 did not receive a shower or bath on that day. CNA B stated it was important for patients to receive their showers or baths as scheduled to keep the body clean from bacteria and prevent odor. In an interview on 11/22/24 at 11:39 AM, the Administrator stated the expectation was for the staff to document each time a patient received a shower/bath. The Administrator stated a patient had the right to refuse showers or baths, but it also needed to be documented. She stated the facility did not use paper shower sheets and documented all ADL tasks in the electronic health record. The Administrator stated not providing hygiene care to patients could place them at risk for infections and further skin breakdown. In a further interview on 11/22/24 at 1:35 PM, the Interim DON stated the risk of not providing patients with proper ADL care could place them at risk of skin breakdown, dignity issues, and infection. Record review of the facility's policy titled Activities of Daily Living (ADLs), Supporting, revised 8/2024, reflected in part the following: Policy Statement: Residents will be provided with care, treatment and services as appropriate to maintain or improve their ability to carry out activities of daily living (ADLs). Residents who are unable to carry out activities of daily living independently will receive the services necessary to maintain good nutrition, grooming and personal and oral hygiene. . FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676407 If continuation sheet Page 3 of 3