Inspection·July 17, 2025

F 0644 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to coordinate assessments with the PASRR program, including incorporating the recommendations from the PASRR level II determination and the PASRR evaluation report into a resident's care planning for two (Resident #1 and Resident #2) of seventeen residents positive for PASRR. The facility failed to ensure the service request form was sent to the state PASRR unit, within 30 days of the IDT meeting, to assist Resident #1 and Resident #2 with receiving services identified in the meeting plan. This failure could affect PASRR positive residents by placing them at risk of their specialized needs not being met. Findings included: 1.Review of Resident #1's Resident Face Sheet dated 7/16/25, reflected he was a [AGE] year-old female who admitted to the facility 10/8/24. She was diagnosed with bipolar disorder (a mental health condition characterized by extreme shifts in mood, energy, and activity levels, alternating between periods of mania or hypomania and depression), anxiety disorder (a group of mental health conditions characterized by excessive, persistent, and uncontrollable feelings of worry, fear, and unease), severe intellectual disabilities (a condition that limits intelligence and disrupts abilities necessary for living independently). Review of Resident #1's care plan dated 10/9/24 reflected he required total care, and 1-2 person assists with all ADLs including bed mobility, transfers, dressing, eating, toileting, hygiene, and bathing. Record review of Resident #1 PASRR evaluation revealed: Positive pasarr evaluation done on 10/21/24 from tropical. PASRR comprehensive service plan form done on 4/29/25 revealed initial spt meeting took place at mesa hill for [NAME], services agreed to ILST, HC and habilitative physical and occupational therapy. No needs identify for behavioral supports, employment assistance supported employment, day habilitation. 2. Review of Resident #2's Resident Face Sheet dated 7/17/25, reflected he was a [AGE] year-old female who admitted to the facility 3/11/24. She was diagnosed with bipolar disorder (a mental health condition characterized by extreme shifts in mood, energy, and activity levels, alternating between periods of mania or hypomania and depression), severe intellectual disabilities (a condition that limits intelligence and disrupts abilities necessary for living independently). Review of Resident #2's care plan dated 3/11/24 reflected he required total care and 1-2 person assists with all ADLs including bed mobility, transfers, dressing, eating, toileting, hygiene, and bathing. Record Review of Resident #2 PASRR evaluation revealed: Pasarr evaluation was done on 4/11/24. The outcome resident had a negative pasrr evaluation. On 6/26/24. Resident was positive pasrr evaluation. The initial meeting was 7/9/24 and the recommendation was ILST OT PT and ST. During an observation on 7/16/25 at 3:00 p.m. Resident #1 was not able to communicate. During an observation on 7/16/25 at 3:05 p.m. Resident #2 was not able to communicate. During an interview on 7/16/25 at 3:20 p.m. MDS Nurse A said she was responsible for submitting PASRR specialized services through the Simple Online Portal, but that she was not working in the facility when Resident #1 and Resident #2 were admitted to the facility. MDS Nurse A said that there was a 30 days' time frame for (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: 455423 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 455423 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/17/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mesa Hills Post Acute 901 Wildrose LN Brownsville, TX 78520 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)