Health inspection·April 16, 2025

F 0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Level of Harm - Actual harm Residents Affected - Few **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, and record reviews the facility failed to ensure the residents had the right to be free from abuse for 1 of 6 residents (CR#1) reviewed for abuse. The facility failed to ensure CR#1 was free from abuse when CNA A physically abused CR #1 on 04/24/24 and threatened CR #1's roommate. The noncompliance was identified as PNC. The noncompliance began on 04/24/24 and ended on 04/24/24. The facility had corrected the noncompliance before the survey began. This failure could place residents at risk of being abused. Findings included: Record review of CR #1's admission record dated 04/15/25 revealed a-95-year- old female admitted to the facility admitted to the facility on [DATE] with diagnoses that included Essential hypertension (High blood pressure), chronic kidney disease, heart failure, chronic obstructive pulmonary disease, anxiety disorder, dementia, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety. Record review of CR #1's comprehensive care plan dated 03/17/23 with a revision date of 02/24/24 indicated she had no history of physical aggression and depended on staff for ADL care, meeting her emotional, Intellectual, physical, and social needs. Record review of CR #1's quarterly MDS assessment dated [DATE] reflected a BIMS score of 00, which indicated she had severely impaired cognition. Record review of intake incident dated 04/24/24 revealed resident's roommate called out for the nurse and reported that CR #1 had been abused by the CNA A. She stated the curtain was closed, but she could hear the abuse. Record review of a Nurse's notes dated 04/24/24 revealed in part Resident's roommate called this nurse into the room and stated that resident had just been abused. Resident was noted to be holding her wrist. When nurse moved her hand away, there was a significant amount of bruising to front and back of wrist. Roommate reports she didn't see what happened, but she could hear it. She stated she could hear the CNA hurting the resident. She states she threatened her as well, telling her not to use her call light again. Resident Unable to give description of event. (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 3 Event ID: 675323 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 675323 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Baywind Village Skilled Nursing & Rehab 411 Alabama Ave League City, TX 77573 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)