Health inspection·October 23, 2024

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record review, the facility failed to maintain an infection control program designed to provide a safe, comfortable, and sanitary environment to help prevent the development and transmission of communicable diseases for 31 of 31 residents reviewed for infection control (Residents #1#31). Residents Affected - Many 1. The facility failed to implement and maintain contact precautions and ensure staff utilized Personal Protective Equipment (PPE) appropriately to prevent cross contamination from residents (Resident #3, #4, #6, and #28) positive with COVID-19. 2. The facility failed to place readily visible signage on the door of Resident #1-#30 who was actively on contact precautions. 3. The DM and CNA A entered the room of a resident (Resident #6 and #28) who was on transmission-based precautions without proper PPE. 4. Housekeeper D entered the room of a resident (Resident #14 and #19) who was on transmission-based precautions without proper PPE. 5. The HA entered the room of a resident (Resident #30) who was on transmission-based precautions without proper PPE. 6. The HA provided a resident (Resident #4) who was on transmission-based precautions snacks without proper PPE. 7. Page 1 of 13 455936 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 The facility failed to implement and maintain contact precautions and prevent cross contamination for resident (Resident #31) by cohorting him with a positive resident (Resident #13) with COVID-19. Level of Harm - Minimal harm or potential for actual harm These failures could place residents at risk for spread of infection and cross contamination. Residents Affected - Many Findings included: Resident #1 Record Review of Resident #1's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: dementia (memory loss), pneumonia (lung infection) and muscle weakness. Record Review of Resident #1's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 14, indicating the resident was not cognitively impaired. Record review of Resident #1's care plan, dated 10/22/24, did not the residents positive status for COVID-19. Record review of Resident #1's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident #1's nursing progress notes entered by LVN D dated 10/21/24 at 5:10 PM indicated Resident #1 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #1 tested positive on 10/21/24 with the following symptoms: lethargy and weakness. Resident #2 Record Review of Resident #2's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: diabetes (blood sugar condition), reduced mobility, morbid obesity and major depressive disorder. Record Review of Resident #2's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 15, indicating the resident was not cognitively impaired. Record review of Resident #2's care plan, dated 10/14/24, reflected the following: A focused area, initiated on 11/09/20, Resident #2 was at risk for exposure to respiratory virus (COVID-19) due to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #2 was to minimize risk of potential exposure over through next review date. Record review of Resident #2's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. 455936 Page 2 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 Level of Harm - Minimal harm or potential for actual harm Record Review of Resident #2's nursing progress notes entered by LVN E dated 10/18/24 at 4:09 AM indicated Resident #2 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #2 tested positive on 10/16/24 with the following symptoms: congestion, chills and runny nose. Residents Affected - Many Resident #3 Record Review of Resident #3's face sheet revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: cognitive communication deficit (difficulty communicating), pneumonia (lung infection), anxiety disorder (increased worry) and muscle wasting atrophy (loss of muscle tissue). Record Review of Resident #3's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 14, indicating the resident was not cognitively impaired. Record review of Resident #3's care plan, dated 10/14/24, reflected the following: A focused area, initiated on 11/09/20, Resident #3 was at risk for exposure to respiratory virus (COVID-19) due to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #3 was to minimize risk of potential exposure over through next review date. Record review of Resident #3's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #3's nursing progress notes entered by the DON dated 10/16/24 at 7:58 PM indicated Resident #3 tested positive for COVID-19 on 10/16/24. Record review of the email sent by the DON on 10/29/24 at 10:00 AM revealed Resident #3 tested positive on 10/16/24 with the following symptoms: asymptomatic. Resident #4 Record Review of Resident #4's face sheet revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: schizophrenia (chronic mental illness), dementia (memory loss) and cognitive communication deficit (difficulty communicating). Record Review of Resident #4's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 10, indicating the resident was moderately cognitively impaired. Record review of Resident #4's care plan, dated 10/14/24, reflected the following: A focused area, initiated on 10/14/24, Resident #4 was COVID positive and had clinical concerns. The goal initiated on 10/15/24, was that Resident #4 would be monitored for secondary infections/virus. 455936 Page 3 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Record review of Resident #4's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #4's nursing progress notes entered by LVN E dated 10/18/24 at 4:12 AM indicated Resident #4 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #4 tested positive on 10/14/24 with the following symptoms: lethargy and dizziness. Resident #5 Record Review of Resident #5's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: traumatic brain injury, anxiety (increased worry) and bipolar disorder (mental illness that causes mood swings). Record Review of Resident #5's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 09, indicating the resident was moderately cognitively impaired. Record review of Resident #5's care plan, dated 8/14/24, reflected the following: A focused area, initiated on 1/2/23, Resident #5 was COVID positive and had clinical concerns. The goal initiated on 10/15/24, was that Resident #5 would be monitored for secondary infections/virus. Record review of Resident #5's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Record Review of Resident #5's nursing progress notes entered by the DON dated 10/14/24 at 6:33 PM indicated Resident #1 tested positive for COVID-19 on 10/14/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #5 tested positive on 10/14/24 with the following symptoms: congestion cough and SOB. Resident #6 Record Review of Resident #6's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted [DATE], with the following diagnoses: need for assistance with personal care, muscle wasting atrophy (loss of muscle tissue), and lack of coordination. Record Review of Resident #6's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 15, indicating the resident was not cognitively impaired. Record review of Resident #6's care plan, dated 08/24/24, reflected the following: A focused area, initiated on 10/21/24, Resident #6 was COVID positive and had clinical concerns. 455936 Page 4 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 The goal initiated on 10/15/24, was that Resident #6 would be monitored for secondary infections/virus. Level of Harm - Minimal harm or potential for actual harm Record review of Resident #6's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Residents Affected - Many Record Review of Resident #6's nursing progress notes entered by the DON dated 10/14/24 at 5:36 PM indicated Resident #6 tested positive for COVID-19 on 10/14/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #6 tested positive on 10/14/24 with the following symptoms: congestion, sneezing and runny nose. Resident #7 Record Review of Resident #7's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: dementia (memory loss), major depressive disorder, and schizophrenia (chronic mental illness). Record Review of Resident #7's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 14, indicating the resident was not cognitively impaired. Record review of Resident #7's care plan, dated 9/05/24, reflected the following: A focused area, initiated on 12/14/21, Resident #7 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #7 was to increase knowledge deficit related to infection control practices and/ or minimizing risks related to virus through next review date. Record review of Resident #7's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #7's nursing progress notes entered by the DON dated 10/16/24 at 10:16 AM indicated Resident #7 tested positive for COVID-19 on 10/16/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #7 tested positive on 10/16/24 with the following symptoms: fatigue. Resident #8 Record Review of Resident #8's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was admitted to the facility on [DATE], with the following diagnoses: malignant neoplasm of the brain (cancer growth in the brain), diabetes (blood sugar condition) and dementia (memory loss). Record Review of Resident #8's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 00, indicating the resident was severely cognitively impaired. Record review of Resident #8's care plan, dated 10/2/24, did not address the residents positive 455936 Page 5 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 status of COVID-19. Level of Harm - Minimal harm or potential for actual harm Record review of Resident #8's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/20/2024. Residents Affected - Many Record Review of Resident #8's nursing progress notes entered by the DON dated 10/20/24 at 12:24 PM indicated Resident #8 tested positive for COVID-19 on 10/20/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #8 tested positive on 10/20/24 with the following symptoms: asymptomatic. Resident #9 Record Review of Resident #9's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: dementia (memory loss), muscle weakness. And cognitive communication deficit (difficulty communicating). Record Review of Resident #9's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 13, indicating the resident was not cognitively impaired. Record review of Resident #9's care plan, dated 9/18/24, reflected the following: A focused area, initiated on 11/09/20, Resident #9 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #9 was to minimize risk of potential exposure over through next review date. Record review of Resident #9's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #9's nursing progress notes entered by the DON dated 10/16/24 at 11:21 AM indicated Resident #1 tested positive for COVID-19 on 10/16/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #9 tested positive on 10/16/24 with the following symptoms: congestion and runny nose. Resident #10 Record Review of Resident #10's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was admitted to the facility on [DATE], with the following diagnoses: heart failure, muscle weakness, anxiety (increased worry) and lack of coordination. Record Review of Resident #10's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 15, indicating the resident was not cognitively impaired. Record review of Resident #10's care plan, dated 9/11/24, reflected the following: 455936 Page 6 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many A focused area, initiated on 5/24/22, Resident #10 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 5/24/22, was that Resident #10 would remain free from virus through next review date. Record review of Resident #10's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident #10's nursing progress notes entered by LVN D dated 10/21/24 at 3:09 PM indicated Resident #10 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #10 tested positive on 10/21/24 with the following symptoms: congestion and runny nose. Resident #11 Record Review of Resident #11's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE] with the following diagnoses: epilepsy (seizure disorder), morbid obesity and lack of coordination. Record Review of Resident #11's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 15, indicating the resident was slightly, cognitively impaired. Record review of Resident #11's care plan, dated 0/7/24 reflected the following: A focused area, initiated on 5/03/23, Resident #11 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 5/03/23, was that Resident #11 would increase knowledge deficit related to infection control practices and/or minimize risk to virus through next review date. Record review of Resident #11's Order Summary Report, dated 10/29/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/18/2024. Record Review of Resident #11's nursing progress notes entered by the DON dated 10/18/24 at 4:16 PM indicated Resident #11 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #11 tested positive on 10/18/24 with the following symptoms: weakness. Resident #12 Record Review of Resident #12's face sheet, dated 10/23/24 revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: muscle weakness, COVID-19 and schizophrenia (chronic mental disorder). Record Review of Resident #12's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 00, indicating the resident was severely cognitively impaired. 455936 Page 7 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 Record review of Resident #12's care plan, dated 9/5/24, reflected the following: Level of Harm - Minimal harm or potential for actual harm A focused area, initiated on 10/29/20, Resident #12 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 10/29/20, was that Resident #12 was to minimize risk of potential exposure over through next review date. Residents Affected - Many Record review of Resident #12's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/18/2024. Record Review of Resident #12's nursing progress notes entered by the DON dated 10/18/24 at 5:10 PM indicated Resident #12 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #12 tested positive on 10/18/24 with the following symptoms: asymptomatic. Resident #13 Record Review of Resident #13's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted on [DATE], with the following diagnoses: anxiety (increased worry), pneumonia (lung infection), and schizophrenia (chronic mental illness). Record Review of Resident #13's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 13, indicating the resident was not cognitively impaired. Record review of Resident #13's care plan, dated 10/2/24, reflected the following: A focused area, initiated on 10/12/22, Resident #13 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 10/12/22, was that Resident #13 would remain free from virus through next review date. Record review of Resident #13's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident #13's nursing progress notes entered by LVN D dated 10/21/24 at 3:08 PM indicated Resident #13 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #13 tested positive on 10/21/24 with the following symptoms: runny nose and weakness. Resident #14 Record Review of Resident #1's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was admitted to the facility on [DATE], with the following diagnoses: dementia (memory loss), muscle weakness and muscle wasting atrophy (loss of muscle tissue). Record Review of Resident #14's Comprehensive MDS assessment dated [DATE], revealed under Section 455936 Page 8 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 C, Cognitive Patterns, a BIMS score of 11, indicating the resident was moderately cognitively impaired. Level of Harm - Minimal harm or potential for actual harm Record review of Resident #14's care plan, dated 10/23/24, reflected the following: Residents Affected - Many A focused area, initiated on 10/16/24, Resident #14 was COVID positive and had clinical concerns. The goal initiated on 10/16/24, was that Resident #4 would be monitored for secondary infections/virus. Record review of Resident #14's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/16/2024. Record Review of Resident #14's nursing progress notes entered by the DON dated 10/16/24 at 5:10 PM indicated Resident #14 tested positive for COVID-19 on 10/16/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #14 tested positive on 10/16/24 with the following symptoms: congestion, chills and runny nose. Resident #15 Record Review of Resident #15's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was admitted to the facility on [DATE], with the following diagnoses: dementia (memory loss), anxiety (increased worry), and cognitive communication deficit (difficulty communicating). Record Review of Resident #15's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 14, indicating the resident was not cognitively impaired. Record review of Resident #15's care plan, dated 8/7/24, reflected the following: A focused area, initiated on 6/7/23, Resident #15 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 6/07/23, was that Resident #15 would increase knowledge deficit related to infection control practices and/or minimize risk related to virus through next review date. Record review of Resident #15's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Record Review of Resident #15's nursing progress notes entered by the DON dated 10/14/24 at 6:35 PM indicated Resident #15 tested positive for COVID-19 on 10/14/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #15 tested positive on 10/14/24 with the following symptoms: congestion and Runny nose. Resident #16 Record Review of Resident #16's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was initially admitted to the facility on [DATE] and readmitted [DATE], with the following diagnoses: 455936 Page 9 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 muscle weakness, COVID-19 and dementia (memory loss). Level of Harm - Minimal harm or potential for actual harm Record Review of Resident #16's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 09, indicating the resident was moderately cognitively impaired. Residents Affected - Many Record review of Resident #16's care plan, dated 10/22/24, reflected the following: A focused area, initiated on 2/15/23, Resident #16 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 2/15/23, was that Resident #16 was to minimize risk of potential exposure over through next review date. Record review of Resident #16's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/18/2024. Record Review of Resident #16's nursing progress notes entered by LVN E dated 10/18/24 at 4:21 AM indicated Resident #16 tested positive for COVID-19 on 10/18/24. Record review of the email sent by the DON on 10/29/24 at 10:00 AM revealed Resident #16 tested positive on 10/17/24 with the following symptoms: asymptomatic. Resident #17 Record Review of Resident #17's face sheet, dated 10/23/24, revealed a [AGE] year-old female that was admitted to the facility on [DATE], with the following diagnoses: dementia (memory loss), anxiety (increased worry), diabetes (blood sugar deficit) and lack of coordination. Record Review of Resident #17's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 3, indicating the resident was severely cognitively impaired. Record review of Resident #17's care plan, dated 08/21/24, reflected the following: A focused area, initiated on 10/15/23, Resident #17 was at risk for exposure to respiratory virus (COVID-19). The goal initiated on 10/15/23, was that Resident #17 would remain free from virus through next review date. Record review of Resident #17's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/18/2024. Record Review of Resident #17's nursing progress notes entered by the DON dated 10/18/24 at 4:20 PM indicated Resident #1 tested positive for COVID-19 on 10/18/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #17 tested positive on 10/18/24 with the following symptoms: asymptomatic. Resident #18 455936 Page 10 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Record Review of Resident #18's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was admitted to the facility on [DATE], with the following diagnoses: lack of coordination, schizophrenia (chronic mental disorder), and dementia (memory loss). Record Review of Resident #18's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 07, indicating the resident was severely cognitively impaired. Record review of Resident #18's care plan, dated 9/25/24, reflected the following: A focused area, initiated on 06/07/23, Resident #18 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 06/07/23, was that Resident #18 would remain free from virus through next review date. Record review of Resident #18's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Record Review of Resident #18's nursing progress notes entered by LVN D dated 10/15/24 at 5:57 PM indicated Resident #18 tested positive for COVID-19 on 10/15/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #18 tested positive on 10/14/24 with the following symptoms: congestion and runny nose. Resident #19 Record Review of Resident #19's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was admitted to the facility on [DATE], with the following diagnoses: dementia (memory loss), muscle wasting and atrophy (loss of muscle tissue), and muscle weakness. Record Review of Resident #19's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 08, indicating the resident was moderately cognitively impaired. Record review of Resident #19's care plan, dated 08/07/24, did not address the residents positive COVID-19 status. Record review of Resident #19's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident #19's nursing progress notes entered by LVN D dated 10/21/24 at 5:10 PM indicated Resident #19 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #19 tested positive on 10/21/24 with the following symptoms: runny nose, congestion and weakness. Resident #20 Record Review of Resident #20's face sheet, dated 10/23/24, revealed a [AGE] year-old female that 455936 Page 11 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many was initially admitted to the facility on [DATE] and readmitted [DATE], with the following diagnoses: cerebral infarction (dying brain tissue that occurs due to blocked or reduced blood flow), muscle wasting atrophy (loss of muscle tissue), , abnormal weight loss and lack of coordination. Record Review of Resident #20's Comprehensive MDS assessment dated [DATE], revealed under Section C, no data was entered. Record review of Resident #20's care plan, dated 09/11/24, reflected the following: A focused area, initiated on 11/09/20, Resident #20 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #20 was to minimize risk of potential exposure over through next review date Record review of Resident #20's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/21/2024. Record Review of Resident 20's nursing progress notes entered by LVN D dated 10/21/24 at 3:17 PM indicated Resident #20 tested positive for COVID-19 on 10/21/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident #20 tested positive on 10/21/24 with the following symptoms: asymptomatic. Resident #21 Record Review of Resident #21's face sheet, dated 10/23/24, revealed a [AGE] year-old male that was initially admitted to the facility on [DATE] and readmitted [DATE], with the following diagnoses: diabetes (blood sugar deficit), dementia (memory loss) and lack of coordination. Record Review of Resident #21's Comprehensive MDS assessment dated [DATE], revealed under Section C, Cognitive Patterns, a BIMS score of 11, indicating the resident was moderately cognitively impaired. Record review of Resident #21's care plan, dated 09/5/24, reflected the following: A focused area, initiated on 11/09/20, Resident #21 was at risk for exposure to respiratory virus (COVID-19) die to worldwide pandemic and local state and community cases identified. The goal initiated on 11/09/20, was that Resident #21 would increase knowledge deficit related to infection control practices and/or minimize risks related to virus through next review date. Record review of Resident #21's Order Summary Report, dated 10/23/24, reflected the resident was to be assessed for s/s of COVID-19, isolate immediately and proceed with further precautions.; Ordered 10/14/2024. Record Review of Resident #21's nursing progress notes entered by LVN D dated 10/14/24 at 5:46 PM indicated Resident #21 tested positive for COVID-19 on 10/14/24. Record review of the facility list (untitled/undated) of COVID-19 residents/staff revealed Resident 455936 Page 12 of 13 455936 10/23/2024 Focused Care at Lamesa 1201 N 15th St Lamesa, TX 79331

F 0880 #21 tested positive on 10/14/24 with the following symptoms: congestion and runny nose. Level of Harm - Minimal harm or potential for actual harm Resident #22 Record Review of Resident #22's face sheet, dated 10/23/24, revealed a 68-[NAME][TRUNCATED] Residents Affected - Many 455936 Page 13 of 13