Inspection·February 20, 2025

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure each resident / and or their representative were invited to attend/participate attend and IDT in the care plan meeting including both the comprehensive and quarterly review assessments for with the participation of the resident for 1 of 6 residents (Resident's #1) reviewed for care plan timing and revision. The facility failed to ensure representatives/residents were invited to attend comprehensive care meetings for Resident #1. The facility failed to document the reason for the representative/resident non-participation in the care plan meeting. This failure could place residents at risk of not being able to attain or maintain their highest practicable level of physical, mental, and psychosocial well-being. The findings included: In a record review of Resident #1's face sheet, dated 02/19/25, revealed the resident was a [AGE] year-old female, originally admitted to the facility on [DATE] and with the latest admission date of 09/19/24. The resident was discharged on 02/10/25 to the local hospital. Resident had diagnosis of atherosclerotic heart disease of native coronary artery without angina pectoris (blockage of the arteries of the heart), dysphagia (difficulty swallowing), and vascular dementia (brain damage caused from impaired blood flow). In a record review of Resident #1's last quarterly MDS, dated [DATE], revealed resident's BIMS score was 00 reflecting resident was not able to complete the interview and was not interview able. In an interview on 02/20/25 at 10:00 am, Resident #1's POA stated she had not been invited to a care plan meeting in a long time. In a record review of Resident #1's comprehensive care plan revealed it was dated as reviewed/revised on 01/07/25. The attendance document on the care plan was blank. In a record review on 02/20/25 at 11:00 am, Resident #1's progress notes revealed no documentation evidence that the resident had been invited to participate or attend a care plan conference. In an interview on 02/20/25 at 10:45 am, the Social Worker stated the facility reviewed Resident #1 (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: 455931 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 455931 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Advanced Rehabilitation and Healthcare of Vernon 4401 College Dr Vernon, TX 76384 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)