Inspection·February 9, 2025

F 0622 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless the discharge was necessary for the resident's welfare and the resident's needs could not be met in the facility for 1 of 4 residents (Resident #1) reviewed for discharge requirements. The facility failed to ensure Resident #1 was readmitted to the facility, after being sent to the hospital for behaviors. This failure could place discharged residents and residents residing in the facility at risk of being discharged and not allowed to return to the facility causing a disruption in their care and/or services. Findings included: A record review of Resident #1's face sheet dated 01/21/2025 reflected a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #1's diagnosis was unspecified dementia(memory loss), blindness right eye(unable to see), hearing loss(unable to hear), and essential primary hypertension(high blood pressure). A record review of Resident #1's Initial MDS assessment, dated 01/20/2025, reflected the resident had a BIMS score of 0, which indicated severe cognitive impairment. A record review of Resident #1's care plan, dated 02/05/2025, reflected focus of discharge from the facility is not feasible as evidence by dementia. The goal reflected Resident #1 would be provided an opportunity to receive information on returning to the community. The intervention for Resident # 1 was to respect resident's rights to view nursing facility as his home Review of Resident #1's 30-day discharge letter dated 01/21/2025, revealed Resident #1 was given the 30-day discharge letter on the same date (01/21/2025) he was discharged to the hospital. The discharge letter was delivered to hospital ER on [DATE] with Resident #1. Review of Resident #1's Discharge Planning and Summary date 01/21/2025, revealed Resident #1 was sent to the hospital for behaviors. Attempted an interview on 02/09/2025 at 12:10 p.m. left message for the local ombudsman to return call. (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: 455601 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 455601 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Alvarado Meadows Nursing & Rehabilitation 101 N Parkway Alvarado, TX 76009 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)