Whitesboro Health And Rehabilitation Center

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 each resident with respect and dignity and care for each resident in a manner and in an environment that promoted maintenance or enhancement of his or her quality of life for 1 of 4 (Resident #1) residents reviewed for dignity.The facility failed to treat Resident #1 with dignity and promote enhancement of his quality of life when the resident was not provided

a privacy bag for his urinary catheter bag (collection bag for urine) on 09/10/2025.This failure could place residents at risk of not having their right to a dignified existence maintained.Findings included: Record

review of Resident #1's Face Sheet, dated 09/10/2025, reflected the resident was a [AGE] year-old male who admitted to the facility on [DATE REDACTED]. Resident #1 had diagnoses which included benign prostatic hyperplasia (flow of urine from the bladder is blocked) and cerebral infarction (blood flow to a part of the brain is blocked). Record review of Resident #1's Quarterly MDS (tool used to assess functional capabilities and health needs) Assessment, dated 08/19/2025, reflected moderately impaired cognition with a BIMS (tool used to assess cognition) score of 08. Section H (bowel and bladder) indicated Resident #1 had an indwelling urinary catheter. Record review of Resident #1's Comprehensive Care Plan, dated 07/23/2025, reflected Resident #1 had an indwelling catheter. One intervention was position catheter bag and tubing below the level of the bladder and in a privacy bag.During an observation and interview on 9/10/2025 at 8:40 AM, Resident #1 was sitting in his wheelchair in the hallway near the nurse's station talking to CNA B.

Resident #1's urinary catheter bag was hanging on his wheelchair and not in a privacy bag. Resident #1 stated it was usually covered. CNA B stated Resident #1 had probably lost the privacy bag. She stated it was supposed to be covered for the resident's dignity. CNA B stated she would get a privacy bag for the resident.During an interview on 09/10/2025 at 8:54 AM, LVN C stated Resident #1's urinary catheter bag should have been inside a privacy bag. She stated it was a dignity issue. During an interview on 09/10/2025 at 2:14 PM, the DON stated her expectation was for nursing staff to ensure urinary catheter bags were covered for the dignity of the residents. During an interview on 09/10/2025 at 3:20 PM, the ADON stated residents with a urinary catheter should have it in a privacy bag for the resident's dignity.The facility's policy Catheter Care, undated, did not address the use of a privacy bag.

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

Event ID:

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/10/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitesboro Health and Rehabilitation Center

1204 Sherman Dr Whitesboro, TX 76273

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 0558

Reasonably accommodate the needs and preferences of each resident.

Level of Harm - Minimal harm or potential for actual harm

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

observation, interview, and record review the facility failed to ensure residents had the right to reside and receive services in the facility with reasonable accommodation of resident needs and preferences except when to do so would endanger the health or safety of the resident or other residents for 1 of 10 (Resident #2) residents reviewed for reasonable accommodation of needs. The facility failed to ensure the call light system in Resident #2's room was in a position accessible to the resident on 09/10/2025.This failure could place the residents at risk of being unable to obtain assistance when needed and help in the event of an emergency.Findings included: Record review of Resident #2's Face Sheet, dated 09/10/2025, reflected the resident was a [AGE] year-old male who admitted to the facility on [DATE REDACTED]. Resident #2 had diagnoses which included dementia (decline in cognitive function that interferes with daily life) and unsteadiness on feet.Record review of Resident #2's Quarterly MDS Assessment, dated 08/20/2025, reflected severe cognitive impairment with a BIMS score of 03. Resident #2 required staff assistance for self-care needs.

Record review of Resident #2's Comprehensive Care Plan, dated 09/01/2025, reflected the resident was at risk for falls. One of the interventions was to ensure the call light was within reach and encourage the resident to use it for assistance as needed. During an observation and interview on 09/10/2025 at 9:40 AM, Resident #2 was lying in bed awake. Resident #2's call light cord was on the floor approximately two feet to

the right of the head of his bed. When he was asked if he used his call light, Resident #2 replied no. A further attempt to interview the resident was unsuccessful due to his cognitive status. CNA B came into the resident's room and stated the resident did not use the call light. He stated Resident #2 had poor vision and

the call light was normally clipped near the resident's pillow. CNA B placed the call light within the resident's reach. He stated it was important for the call light to be within the resident's reach so he could use it to call for help. During an interview on 09/10/2025 at 10:23 AM, LVN C stated Resident #2 did not use the call light and staff had to anticipate his needs. She stated staff tried to keep the call light clipped on Resident #2's bed. She stated it was important to ensure the call light was within the resident's reach because it was a safety issue. LVN C stated it was also Resident #2's right to have access to his call light. During an

interview on 09/10/2025 at 1:45 PM, the Administrator stated the facility did not have a policy specific to call light placement. He stated the expectation was for all residents to have access to their call lights. He stated

the nursing staff monitored call light placement during rounds, and all staff should ensure the call light is within reach before leaving a resident's room. He stated the call light should have been clipped within Resident #2's reach. During an interview on 09/10/2025 at 2:14 PM, the DON stated Resident #2's call light should have been within his reach so if he wanted to use it he could. During an interview on 09/10/2025 at 3:20 PM, the ADON stated all residents should have their call light in reach. He stated it was for the residents' safety and to ensure they could notify staff if they needed assistance of any kind.The facility did not provide a policy related to the use of call lights.

Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/10/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Whitesboro Health and Rehabilitation Center

1204 Sherman Dr Whitesboro, TX 76273

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)

Federal health inspectors cited Whitesboro Health and Rehabilitation Center in Whitesboro, TX for a deficiency under regulatory tag F-F0880 during a complaint investigation conducted on 2025-09-10.

Category: Infection Control Deficiencies

The facility was found deficient in the following area: Provide and implement an infection prevention and control program.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 3 deficiencies cited during this inspection of Whitesboro Health and Rehabilitation Center.

Correction Status: Deficient, Provider has no plan of correction.