Health inspection·June 20, 2023

F 0552 Ensure that residents are fully informed and understand their health status, care and treatments. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to inform and enable participation in treatment in a way she could understand for 1 of 13 residents (Resident #16) reviewed for care plans, in that: Residents Affected - Few Resident #16 did not have a comprehensive care plan completed to address her communication-barrier within 7 days after the completed of her comprehensive assessment. This failure placed residents at risk of not receiving services that could maintain the resident's highest practicable mental, and psychosocial well-being. Findings Included: Record review of Resident #16's face sheet, dated 06/20/2023, revealed a [AGE] year-old female resident who was admitted into the facility on [DATE] and was diagnosed with metabolic encephalopathy, overactive bladder and cognitive communication deficit. Record review of Resident #16's MDS, dated [DATE], revealed the resident had a BIMS score of 4 indicating the resident's cognition was severely impaired and was assessed to not need or want an interpreter to communicate with staff. In an interview with Resident #16 on 06/18/23 at 9:39AM, surveyor attempted to complete the interview in English but Resident #16 could not respond. With the use of a Vietnamese translator via phone, she stated she had no way to communicate with the staff and she felt like the nurses were rude to her. Record review of Resident #16's care plan, dated, dated 06/14/2023, revealed the care plan was not completed and did not address the communication-barrier the resident had. In an interview with RN B on 06/18/2023 at 11:00PM, she revealed she called Resident #16's family member sometimes to talk with the resident and see what she needs. She said Resident #16's Physician Assistant also speaks Vietnamese and is able to talk to her when she visits. In an interview with the family member of Resident #16 on 06/19/23 at 02:08 PM, she stated Resident #16's main complaint was that she often felt ignored by the staff even after pressing the call light and telling them what she needed. In an interview with CNA R on 06/20/2023 at 10:48 AM, she stated Resident #16 spoke Vietnamese and communicated with staff by pointing and making gestures to let them know when she wanted to use the (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 5 Event ID: 675080 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 675080 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Vosswood Nursing Center 815 S Voss Rd Houston, TX 77057 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)