Health inspection·July 6, 2023

F 0577 Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. Level of Harm - Potential for minimal harm Based on observation, interview, and record review, the facility failed to maintain the availability of the most recent survey results for 1 of 1 facility reviewed for rights to survey results, in that: Residents Affected - Many The facility failed to retain the previous survey results within the survey binder for residents to review. This failure could affect residents who resided in the facility and could result in a lack of awareness for visitors, family and residents regarding the survey results and the plan of corrections submitted by the facility. The findings included: Observation on 07/05/2023 at 10:06 AM revealed the state survey book did not contain information related to the annual certification on 03/09/2023. Interview on 07/05/2023 at 11:20 AM, the Administrator stated he was aware of the most recent state survey results not being in the state survey binder and stated he forget to add the results to the binder after the inspection was completed. The Administrator stated he was the staff member responsible for facility postings and updating the state survey binder. The Administrator stated he understood the risk to residents was that the residents, their families, or visitors would not know of historic inspection results for the facility. Record review of ASPEN Central Office reflected the most recent annual recertification and re-licensure inspection took place on 03/09/2023. Record review of facility policy, titled Resident Rights, undated, reflected in part that residents had the right to be informed of his or her rights. The facility must not prohibit or in any way discourage a resident from communicating with federal, state or local officials. Page 1 of 2 675205 675205 07/06/2023 The Atrium Rehabilitation Center 7602 Louis Pasteur St San Antonio, TX 78229

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure, in accordance with State and Federal laws, all drugs and biologicals were stored in locked compartments under proper temperature controls, and permitted only authorized personnel to have access in 2 of 3 medication rooms. The facility failed to separate expired medications from the remaining medications in 2 of 3 medication rooms. This failure could place residents at risk of receiving expired medications resulting in diminished clinical results. The findings included: Observation on 07/05/2023 at 12:54 PM revealed: four bottles of sixty-count vitamin D3 supplements expired on 05/23; two bottles of one hundred-count acetaminophen expiring on 06/23; and one bottle of one hundred-count [NAME]-Vite dietary supplement expired on 04/23 within the over-the-counter storage closet. Observation on 07/05/2023 at 12:59 PM revealed six units of influenza vaccination with a disposal date of 06/29/2023 within the cold storage refrigerator. Interview on 07/05/2023 at 1:09 PM, the Assistant Director of Nursing stated she was not aware of the expired medications in the over-the-counter storage room or the cold storage refrigerator and stated the storage room or refrigerator were not audited on a recurring basis. The Assistant Director of Nursing stated the over-the-counter and cold storage medications were to be checked by any staff member who opened the storage closet or refrigerator. The Assistant Director of Nursing stated she was not sure who the last person was that opened the over-the-counter storage closet or cold storage refrigerator and stated access to the room and refrigerator was not tracked. The Assistant Director of Nursing stated herself, the Director of Nursing, and any charge nurses had keys to the over-the-counter storage closet and cold storage refrigerator. The Assistant Director of Nursing stated the facility policy regarding storage of medications was to separate and dispose of expired medications immediately upon inspection and stated a risk associated with not separating and destroying expired medications would be that residents may be administered expired medications and receive insufficient results. Interview on 07/06/2023 at 10:42 AM, the Administrator stated it was his expectation that medications be routinely evaluated and inspected to remove expired medications as it could be accidentally provided to residents and not provide intended results. Record Review of the facility medication storage policy, titled Medication Administration, undated, reflected a purpose statement of medications are stored and administered in an accurate, safe, timely and sanitary manner. 675205 Page 2 of 2