Health inspection·December 15, 2023

F 0760 Ensure that residents are free from significant medication errors. 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 must ensure residents were free of any significant medication errors for one (Residents #1) of five residents reviewed for medications. Residents Affected - Some LVN A failed to correctly transcribe the physician order of methotrexate sodium (medication for rheumatoid arthritis) for Resident #1 on 11/02/23, resulting in the resident receiving more medication than ordered. This failure could place residents at risk for not receiving therapeutic effects of their medications to include a diminished health status. Findings included: Review of Resident #1's clinical electronic record revealed the resident was a 74-old female admitted to the facility on [DATE]. The resident's diagnoses included syncope (fainting), urinary tract infection, chronic pain, muscle spasm and rheumatoid arthritis (chronic inflammatory disorder affecting joints). Review of Resident #1's admission MDS, dated [DATE], revealed Resident #1 had a BIMS score of 15, indicating resident was cognitively intact. Review of Resident #1's care plan dated 11/01/23 revealed Problem: Resident at risk for pain related to rheumatoid arthritis. Meds as ordered. Review of Hospital B discharge medication list dated 10/31/23 revealed methotrexate 2.5mg tablet, dose 2.5 mg, take 2.5mg by mouth once every week (on the same day each week) patient takes seven 2.5mg tablets of this medication on Fridays. Review of physician order dated 11/02/23 ordered by MD C created by LVN A revealed methotrexate sodium tablet 2.5mg; amount: 3.5 tabs; oral, once a day at 9:00 AM for rheumatoid arthritis. Review of Resident #1's Provider Investigation Report dated 12/13/23, it was discovered that Resident #1's medication order was entered incorrectly in the electronic health record that resulted in a resident receiving a medication more times than was ordered by the physician. Review of Resident #1's MAR for November 2013 reflected Resident #1 received methotrexate sodium tablet; 2.5mg; amount to administer: 3.5 tabs oral, once a day for rheumatoid arthritis with a start date of 11/02/23 daily on 11/03/23 - 11/17/23. (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: 675136 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 675136 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Denton Rehabilitation and Nursing Center 3345 Medpark Dr. Denton, TX 76210 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)