Inspection·January 17, 2026

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some normal; and resident was able to answer simple questions. Record review of R#1's ER report dated [DATE] reflected resident presented to the ER for an altered mental state and seizure. At the ER the resident coded resulting in 5 minutes of CPR. Resident was transferred to ICU for further observation. Laboratory tests revealed resident had a UTI. ER diagnoses given to the resident were: cardiac arrest on [DATE], obstructive shock (blood clot) caused by massive pulmonary embolism (blockage in a lung artery). Resident was placed on a ventilator. Observation on [DATE] at 10:30 AM, Resident #1 was on a ventilator in an ICU bed, not alert or oriented. During an interview on [DATE] at 10:35 AM, the ICU Nurse stated the resident was admitted to the ICU for a seizure like activity, sepsis (unknown source), and cardiac arrest in the ER for respiratory failure. The ICU Nurse stated the admission was not for the resident's surgical tail bone wound. During an interview on [DATE] at 10:40 AM in the hospital, the RP stated: the family visited the resident daily while she was in the nursing home. The RP alleged the resident was not receiving proper incontinent care with feces and urine sometimes found around the tail bone surgical wound. The RP added that the resident also did not receive proper wound care around the surgical wound (tail bone on back). The RP stated he had photos that attested to the worsening of the resident's surgical wound [photos were sent to the surveyor and were considered as part of the evidence]. During an interview on [DATE] at 4:21 PM, LVN B (wound nurse stated) stated that she could not give an explanation why wound care was not documented in [DATE] with missed dates ([DATE], [DATE] and [DATE]) and [DATE]. LVN B stated she was present on [DATE], [DATE] and [DATE] working on the floors as a nurse and it should have been the back-up nurse to do the wound care as ordered by the physician on Resident #1. Regarding the missed wound care on [DATE], LVN stated she was present as a floor nurse and wound care was not done. LVN B stated she was working the halls as a nurse and did not do wound care on [DATE], and expected the back-up nurse to do the wound care for Resident #1 on [DATE]. LVN B stated she could not remember who the back-up nurse or nurses were on [DATE]. During a telephone interview on [DATE] at 4:55 PM, NP stated that Resident #1's wound to the surgical area had improved over time. The NP stated on [DATE] the wound measured 0.6 cm X 0.7 cm X 1.0 cm with underlying mining of 1.5 cm (edge of wound). The NP stated there was no infection in the wound and no signs of feces or urine being in the wound. NP stated she made weekly wound care to the residents, and the resident was not bed bound. The NP stated on [DATE], the surgical wound measured 0.8cm X 0.8 cm X 1.0 cm with no infection or signs of urine or feces being in the wound. NP stated Resident #1's surgical wound had improved and stabilized prior to her (Resident #1) going to the ER on [DATE]. The NP stated nurses needed to follow MD orders and there was no excuse for wound care not given on the days the nurses missed wound care in [DATE] and [DATE]. NP stated the missed days of wound care did not adversely affect Resident #1 surgical wound or worsen the surgical wound. During an interview on [DATE] at 9:25 AM, the DON stated: Resident #1 received incontinent care at least every shift as standard nursing practice. DON stated weekly skin assessments revealed no skin breakdown or infection due to incontinent care. The DON stated Resident #1 was treated for a surgical wound from the time of admission until discharged on [DATE] to ER. DON stated the surgical wound improved and stabilized. The DON stated on [DATE] the family requested an ER visit because the resident was having seizure-like symptoms. The DON stated vitals taken at time of transfer and were BP=127/89 (normal), pulse=106 (little elevated over 100 (resident was a smoker), respiration=23 (normal), 02 saturation =97 %, temp=98.2 (normal); glucose=247 (normal for DM). The DON stated the resident was not sent to the ER for any issues involving wound care. The DON added she only became aware of the missing wound days involving Resident #1 when presented the evidence by the surveyor. The DON stated she had no explanation for the missing wound days except that the resident's wound condition did (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455597 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 455597 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/17/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Memorial Medical Nursing Center 307 W Cypress St San Antonio, TX 78212 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 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete not worsen. During an interview on [DATE] at 10:16 AM, CNA C stated: she provided ADL services to Resident #1 when the resident was in the facility. CNA C stated ADLs included: transfer and mobility bed to W/C or W/C to toilet. CNA C stated the resident never complained to her about wound care or lack of any care. The CNA stated she bathed the resident and never saw any skin breakdown or any deterioration in the peri-area. During an interview on [DATE] at 10:50 AM, the Administrator stated: there was no neglect of Resident #1 around wound care. The Administrator stated nursing staffing needed to document wound care as ordered by the physician. The Administrator stated she had no explanation for the lack of documented wound care in the TAR three times in [DATE] and one time in [DATE]. The Administrator stated the resident was sent to the ER for seizure-like symptoms on [DATE] and not for any issue involving wound care. The Administrator stated the resident was mobile and assisted by CNAs with transfer and mobility from W/C to and from bed and W/C to toilet; resident was not bed bound. Record review of the facility's Wound Treatment Management dated the year 2024 read, .Wound treatment will be provided in accordance with physician's orders, including the cleansing method, type of dressing, and frequency of dressing change. Record review of facility's Pressure Injury Prevention and Management policy dated the year 2024 read, .This facility is committed to the prevention of avoidable pressure injuries.and to provide treatment and services to heal the pressure ulcer/injury. Event ID: Facility ID: 455597 If continuation sheet Page 3 of 3