Health inspection·December 20, 2023

F 0565 Honor the resident's right to organize and participate in resident/family groups in the facility. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to provide a private meeting space for the residents' monthly council meetings for 9 of 9 confidential residents reviewed for resident council. Residents Affected - Some The facility failed to provide a private space for resident council meetings. This failure could place residents, who attended resident council meetings, at risk of not being able to voice concerns due to a lack of privacy. Findings included: Observation and interview on 12/19/23 beginning at 10:00 AM, during a confidential resident group meeting with 9 residents, revealed the meeting was held in the dining room. There were no doors or solid walls to separate the dining hall from the open nurses' station or the hallway between the two areas. There were no signs posted to indicate that a confidential meeting was being held; however, multiple staff walked through the space to get from one hall to the next hall. The Surveyor asked the Administrator if they had a private space for the meeting to be held due to the openness and proximity to the nurse's station. The Administrator stated they did not have another space on that floor. The Administrator stated they could move the resident council meeting to another location in the building. During the confidential group meeting, 5 of the 9 residents revealed the meeting was held each month in the dining area. One of the residents didn't respond to the question, three of the residents stated that they had only attended this meeting. They all agreed that there was no privacy and staff could overhear them. During the meeting a CNA finished clearing the breakfast dishes from the tables in the dining area. After she finished the meeting was resumed. The CNA went into the hallway, and overheard the question regarding confidentiality. She stated that the residents can meet over there, pointing to the other side of the hallway to another non private area. The residents didn't know they had the right to private meeting. Interview on 12/18/23 at 2:35 PM with the Activity Director revealed she had been employed at the facility for a few months. She stated she was responsible for organizing the resident council meetings. She stated resident council meetings were held in the dining room on the last week of every month. The Activity Director stated the resident council meetings were always held in the dining area even before her arrival. She stated she knew the meetings were confidential and had to be held in a private space; however, they did not have a private space big enough for the residents who were in wheelchairs. She stated that she has the signs but didn't get a chance to put them out for today's meetings. Interview on 12/20/23 at 3:45 PM with the Administrator revealed the resident council meetings were Page 1 of 4 676453 676453 12/20/2023 Simpson Place 3922 Simpson Street Dallas, TX 75246

F 0565 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some always held in the dining room. He stated they have always met there. He stated that there was no other spaces on that floor that offer privacy. He stated that there was other space in the building where they can meet. He stated that there were empty rooms on the floor and other places in the building where they can meet. He stated he had not had any residents complain to him about resident council meetings not being in a private area. The Administrator stated his expectation was for the meetings to be held in a private space for the residents to voice their concerns openly. He stated that he had not thought about the lack of privacy until now. He stated that he will have the Activities Director schedule the meetings in the meeting room downstairs and make sure the proper signage is in place. Record review of the resident council minutes for September, October and November 2023 revealed no requests for a private area. Record review of the facility's Resident Council policy, no revision date, revealed in part the following: Section labeled, Procedure 4th bullet point. The facility is responsible for providing a adequate space that residents may gather in confidence. A Do Not Disturb, Meeting in Progress sign should be posted. 676453 Page 2 of 4 676453 12/20/2023 Simpson Place 3922 Simpson Street Dallas, TX 75246

F 0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview and record review, the facility failed to maintain an effective pest control program so that the facility was free of pests for one (Hall 600) of one hall and one kitchen reviewed for pest control program. Residents Affected - Some The facility had live common house flies, gnats, and roaches in areas of the facility including resident rooms, and the kitchen area. This failure could place residents at risk for spread of infection, cross contamination, and decreased quality of life. Findings include: Observation on 12/18/23 at 9:30 AM revealed a large live roach was observed crawling on the wall behind the automated dishwasher system, in the kitchen. Several live black gnats were observed under the three compartment sink in the dishwashing area. Observation on 12/18/23 at 12:45 PM revealed 2 live house flies and 2 black gnats on a stuffed animal laying on the belly of Resident #26, on the 600 hall Resident #26 was non-interviewable. An interview on 12/18/23 at 12:48 PM with Resident #20 revealed that the resident had seen a live roach in her room on the evening of 12/17/23. She stated that she had told staff about it and that she had filed a grievance earlier in the last month or so. In a confidential group interview on 12/19/23 at 9:56 AM a.m., 8 residents revealed there was a fly/gnat and roach problem. They stated that pest control does come to the facility but that they still see small roaches, house flies and gnats in their rooms and other areas of the facility. Observation and interview on 12/19/23 at 11:32 AM with the DM revealed that 6 live black gnats were observed in the janitor closet in the kitchen area. The DM stated that she had never noticed the little black gnats before but would report it in the pest sighting log. Observation and interview on 12/19/23 at 11:34 AM with the DM revealed that three more live black gnats were observed flying around or landed on the three compartment sink and the covered trash can next to the handwashing sink in the dishwashing area. The DM stated that she saw that this (live black gnats) could be a problem and that having live flying insects in the kitchen could be a source of cross contamination and possibly expose residents to food borne illnesses. An interview on 12/19/23 at 11:54 AM with the DM revealed that the DM reported to the surveyor that they had personally informed the Maintenance Manager about the gnat problem in the kitchen. An interview on 12/19/23 at 12:11 PM with Resident #20 revealed that she had seen two more live roaches near her closet on the morning of 12/19/23 and that the live roaches had crawled under her closet door before she could get to them. An interview on 12/19/23 at 3:43 PM with Maintenance Manager revealed that pest control came out to the facility around every week. He stated that he reviews the pest sighting log and calls pest control for extra visits and that there were several sightings of house flies, gnats, and roaches in the 676453 Page 3 of 4 676453 12/20/2023 Simpson Place 3922 Simpson Street Dallas, TX 75246

F 0925 last several weeks that had been reported. Level of Harm - Minimal harm or potential for actual harm Review of the Grievance Logs for the facility from 09/01/23 to 12/18/23 revealed that on 10/02/23, 10/12/23 and 11/06/23 residents filed complaints of seeing roaches in their rooms. Residents Affected - Some Record review of the pest control provider service information dated 11/02/23 through 12/15/23 revealed the following regarding the technician comments, There were entries for all pests including gnats, flies and roaches. On 12/11/23 was the last visit from the pest control provider, after the surveyor's intervention, checked specifically for flies and gnats for fruit flies/gnats dusted drains and sprayed Review of he pest control logs revealed that pest control was visiting the facility on average every 10 days. Record review of the facility's policy dated 08/2020, and titled Pest control reflected to ensure the facility is free of insects, rodents, and other pests that could compromise the health, safety, and comfort of the residents, facility staff, and visitors .the facility maintains an ongoing pest control program to ensure the building and grounds are kept free of insects, rodents, and other pests .windows are screened at all times .garbage and trash is not permitted to accumulate in any part of the facility .the facility staff will report to the housekeeping supervisor any sign of rodents or insects .the housekeeping supervisor will take immediate action to remove any pests from the facility 676453 Page 4 of 4