Health inspection·November 9, 2023

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure that all allegations involving abuse, neglect, and misappropriation were reported immediately, but no later than 2 hours after the allegation is made to the State Survey Agency for 1 of 4 residents (Resident #2) reviewed for abuse. The facility did not report to the State Survey Agency (HHSC) one incident of abuse following the allegation of CNA A providing Resident #2 with illicit drugs. This failure could place residents at risk for abuse and could lead to a diminished quality of life and psychosocial harm. The findings included: Record review of Resident #2's face sheet, dated 11/8/23, revealed the resident was admitted on [DATE] with diagnoses that included: Quadriplegia (paralysis of all limbs), Hypokalemia (low potassium in the blood), Anxiety Disorder, and Depression. Record review of Resident #2's Care Plan, dated 8/31/23, revealed: Resident #2 had an ADL self-care performance deficit r/t quadriplegia. Record review of Resident #2's MDS assessment, dated 8/28/23 revealed, the resident had a BIMS score was a 15 (cognitively intact). The resident was dependent on staff for all ADLs. Record review of undated PD Form CIC-01 revealed: Type of Offense: Found prop narcotics, Case Number: PD23246977 . Record review of Report # PD23246977 - Offense/Incident Report, dated 11/3/23, revealed .I was dispatched to the above location for found property. [LVN B] stated that at the above date and time a nursing assistant discovered possible drugs in [Resident #2] locked box. The nursing assistant notified [LVN B] and [LVN B] called the police to get the suspected drugs out of facilities. Officers responded and talked to [LVN B] and to [Resident #2] . Since the items were inside of [Resident #2]'s property box they asked [Resident #2] for permission to get the items? [Resident #2] said no get a warrant. The officers explained that they could not get the items without a warrant and departed. [LVN B] told me that she could not have illegal drugs in the facility, so she opened the lock box and took the suspected drugs. [LVN B] notified police and I responded. I placed the items in the property room. Page 1 of 2 455742 455742 11/09/2023 The Lev at San Antonio 7703 Briaridge Drive San Antonio, TX 78230

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Record review of statement by LVN B , dated 11/2/23, revealed the following statement, .resident asked why was [CNA A] here today if she was giving me the drugs . Record review of statement by Administrator C, dated 11/2/23, revealed the following statement, .It was reported that resident [Resident #2 ] wished to report that the C.N.A. that let team know about the illegal substances was the person who gave them to him . ADON and Administrator entered resident room and this writer asked resident about C.N.A. giving him these items, asked if she supplied the items to him or if she physically helped him partake in the illegal substance, resident stated, half and half, asked which half did C.N.A. have a role in, resident stated well she did both . During observation and interview with Resident #2, on 11/8/23 at 3:02 PM, Resident #2 was lying in his bed, covered, face was clean and had no visible injuries. Resident #2 said He (Resident #2)) called state because he was caught with meth (Methamphetamine (meth) a synthetic stimulant that is addictive) he had. He added that he was paralyzed from the neck down and that somebody was giving it to him. Resident #2 said he gave CNA A a vape pen and then he and CNA A started trading things and she (CNA A) brought Resident #2 meth and started giving it to him. Resident #2 added that this was abuse and the facility should have reported it to HHSC within 24 hours. During interview on 11/8/23 at 3:45 PM, CNA A said Resident #2 made allegations against her, stating that she (CNA A) had brought drugs to him (Resident #2). During an interview on 11/9/23 at 11:32 am SW D said Resident #2 made an allegation that CNA A traded a vape pen for this substance. SW D added that she did not know what the substance was, but it was said to have been meth. During an interview on 11/9/23 at 11:53 am LVN B said she asked Resident #2 if Staff A brought the drugs in, and Resident #2 said that CNA A was giving it to him. During an interview on 11/9/23 at 1:31 pm Administrator C said Resident #2 said that CNA A gave him a vape pen in exchange for the drugs. Administrator C said that she did not self-report the allegation to HHSC, she added that once Resident #2 alleged that CNA A brought him the drugs, the allegation was considered abuse and should have been reported to HHSC. Record review of Intake Submission confirmation revealed the incident was reported to HHSC on 11/9/23. Record review of facility's undated policy titled Abuse, Neglect and Exploitation read: .Policy: It is the policy of this facility to provide protections for the health, welfare and rights of each resident .Vll. Reporting/Response A. The facility will have written procedures that include: 1. Reporting of all alleged violations to the Administrator, state agency, adult protective services and to all other required agencies (e.g., law enforcement when applicable) within specified timeframes: a. Immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury, or . 455742 Page 2 of 2