Health inspection·December 20, 2025

F 0655 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to develop a baseline care plan that included the instructions needed to provide effective and person-centered care of the residents, for one (Resident #1) of five residents reviewed for base line care plans for newly admitted residents. 1) The facility did not develop a baseline care plan that addressed Resident #1's diabetes mellitus when he was admitted on [DATE]. This failure could place residents at risk of not having their needs met and increase the risk of adverse events regarding diabetes mellitus exacerbation or complications. The findings included: Record review of Resident #1's admission record dated 12/19/2025 revealed Resident #1 was initially admitted on [DATE] and readmitted [DATE]. Resident #1 discharged home with home health services on 09/22/2025. Resident #1 was admitted to the facility with multiple diagnoses including type 2 diabetes mellitus with diabetic chronic kidney disease, and heart disease. Record review of Resident #1's discharge MDS dated [DATE] revealed Resident #1 had a BIMS score of 12-Moderate cognition impairment and needed partial/moderate assistance with ADLs and was coded for type 2 diabetes with diabetic peripheral angiopathy without gangrene (narrowing of arteries in the legs due to diabetes but without tissue death). Record review of Resident #1's NURSING: Baseline Care Plan assessment admission date 09/18/2025 revealed #18 was not check marked for Resident has Diabetes Mellitus. Record review of Resident #1's Care Plan Report date initiated 09/18/2025 revealed it did not include a care plan for diabetes mellitus. During an interview on 12/19/2025 at 3:37PM the MDS Coordinator stated while she reviewed the baseline care plan assessment, box number 18 was not checked marked. The MDS Coordinator stated number 18 was entitled resident has diabetes mellitus. The MDS Coordinator stated if Resident #1 had diabetes mellitus the baseline care plan would be reflective of the admitting diagnosis. The MDS Coordinator stated Resident #1 was admitted to the facility on [DATE] for respite care and discharged on 09/22/2025. The MDS Coordinator stated LVN A failed to check mark number 18 by mistake. The MDS Coordinator stated there was no negative outcome due to Resident #1's baseline care plan lacking his admitting diagnosis of diabetes mellitus. The MDS Coordinator stated while she reviewed Resident #1's baseline care line, Resident #1's diagnosis of diabetes mellitus should have been within his baseline care plan. The MDS Coordinator stated baseline care plans are important because they outline the individualized plan of care, but reiterated there was no negative outcome from the missed baseline care assessment of diabetes mellitus for Resident #1. The MDS Coordinator stated the usual procedure for admission/readmissions begins when the admitting nurse facilitates the admission baseline care plan assessment, which will then be reviewed by the RN which used to be the previous DON. The MDS Coordinator stated that going forward she will be more diligent while reviewing baseline care plans as well as comprehensive care plans. During an interview on 12/20/2025 at 10:32AM LVN A stated Resident #1 was admitted on [DATE] for a 5-day respite stay. LVN A stated she was Resident #1's admitting nurse and recalled Resident #1 had diabetes mellitus. LVN A stated while (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: 455687 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 455687 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Alameda Oaks Nursing Center 1101 S Alameda Corpus Christi, TX 78404 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)