Health inspection·June 5, 2024

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, observations, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the residents' rights, which included measurable objectives and time limits to meet a resident's medical, nursing, and mental, and psychosocial needs for 1 of 6 residents (Resident #1) reviewed for care plans. Resident #1's comprehensive care plan dated 05/02/2024, inaccurately reflected the resident was receiving a regular texture diet. These deficient practices could place residents at risk for not receiving proper care and services due to inaccurate care plans. The findings were: A record review of Resident #1's face sheet reflected Resident #1 was an [AGE] year-old female who was admitted to the facility on [DATE] with diagnoses of dysphagia (swallowing difficulties), Cognitive communication deficit (difficulty paying attention to a conversation, staying on topic, remembering information and following instructions), Obesity (abnormal or excessive fat accumulation that presents a risk to health), and metabolic encephalopathy (a problem in the brain cause by a chemical imbalance in the blood). A record review of Resident #1's Quarterly MDS assessment, dated 04/26/2024, reflected Resident #1's BIMS score was 15 which indicated resident is cognitively intact. Resident #1's Quarterly MDS also reflected that Resident #1 was receiving a mechanically altered diet. A record review of Resident #1's Care Plan, dated 05/02/2024, reflected that Resident #1 was on regular texture diet. A record review of Resident #1's Physician Order, dated 06/05/2024, reflected Resident #1's mechanical soft texture diet start date was 09/22/2022 and was still a current order. A record review of Resident #1's Dietary Profile, dated 04/26/2024, reflected Resident #1's current texture of food was mechanical soft. In an interview with Resident #1 on 06/05/2024 at 11:10 am, Resident #1 stated she received a mechanical soft diet. Page 1 of 2 675311 675311 06/05/2024 Fairview Healthcare Residence 601 E Reunion St Fairfield, TX 75840

F 0656 Level of Harm - Minimal harm or potential for actual harm An observation of Resident #1 on 06/05/2024 at 12:05pm, reflected Resident #1 was receiving a mechanical soft diet. In an interview with CNA A on 06/05/2024 at 11:15 am, CNA A stated that Resident #1 received a mechanical soft diet. Residents Affected - Few In an interview with the DON on 06/05/2024 at 1:50pm, the DON stated that the MDS Coordinator was responsible for completing the care plan. The DON stated that the facility has been sharing an MDS Coordinator with their sister facility since March. The DON stated that she was aware that Resident #1 was receiving a mechanical soft diet but was not aware that Resident #1's care plan was inaccurate. The DON stated that if the care plan was inaccurate then that could cause a resident not to receive proper care. In an interview with the ADM on 06/05/2024 at 2:10pm, the ADM stated that it was the MDS Coordinator's responsibility for completing an accurate care plan for the resident in the facility. The ADM stated he was not aware that Resident #1's care plan did not reflect her mechanical soft diet. The ADM stated if the care plan was inaccurate then the resident could choke or not get the proper care needed. Review of the facility's Care Plan, Comprehensive Person Centered policy, date March 2022, revealed A comprehensive, person-centered care plan that includes measurable objectives and timetables to meet the resident's physical, psychosocial, and functional needs is developed and implemented for each resident. 7. The comprehensive, person-centered care plan: a. includes measurable objectives and timeframes; b. describes the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being d. builds on the resident's strengths; and e. reflects currently recognized standards of practice for problems areas and conditions . 675311 Page 2 of 2