Health inspection·April 17, 2024

F 0660 Plan the resident's discharge to meet the resident's goals and needs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to develop and implement an effective discharge process that focuses on the resident's discharge goals and effectively transition them to post discharge care for 1 of 1 (Resident #1) resident reviewed for an effective discharge process. Residents Affected - Few The facility failed to ensure Resident #1 was not discharged pending a discharge appeal. This failure could place residents who discharge at risk of improper discharge, unmet needs, and harm. The findings included: Record review of Resident #1's undated face sheet indicated Resident #1 was an a 44 year- old male admitted to the facility on [DATE] with diagnoses which included but not limited to osteomyelitis of vertebra, sacral and sacrococcygeal region (develop from direct open spinal trauma, infections in surrounding areas and from bacteria that spreads to a vertebra from the blood), pressure ulcer(localized skin and soft tissue injuries that form as a result of prolonged pressure and shear, usually exerted over bony prominences). Review of the admission MDS dated [DATE] revealed a BIMS score of 15 which indicated the resident was cognitively intact. Review of Section Q participation in assessment and goal setting revealed plans to discharge to community. Review of Resident #1's care plan revised 4/2/2024 revealed Resident #1 required assistance with ADL's. The Care plan did not address discharge planning. Review of the facility provided Notice of Medicare non coverage for Resident #1 revealed Medicare skilled services would end on 4-8-2024. The Notice stated you have the right to an immediate independent medical review(appeal) of the decision to end Medicare coverage of these services. Your services will continue during the appeal. Interview on 04/17/2024 at 10:00 a.m., with Resident #1's family member revealed Resident #1 was discharged home even though an appeal was completed. The family member stated Resident #1 was discharged home without the results of the appeal and without home health services. Interview with the Social Worker 04/17/2024 at 12:35 PM, revealed Resident #1 was given a notice of discharge by human resources. She stated prior to discharge she tried to find a nursing home and set up DME for the resident. The Social worker stated she documented all her attempts to find a (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: 455748 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 455748 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ashford Hall 2021 Shoaf Dr Irving, TX 75061 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)