Health inspection·May 29, 2025

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 interviews and record reviews the facility failed to ensure the residents had the right to participate in his or her treatment which included the right to be informed in advance, by the physician or other practitioner or professional, of the risks and benefits of proposed care of treatment and treatment alternatives or treatment options and to choose the alternative or option he or she preferred, for 1 of 5 residents (Resident #14) reviewed. Residents Affected - Few The facility failed to obtain a signed informed consent based on information of the benefits, risks, and options available for Resident #14 prior to administering increased dose of Seroquel, a psychotropic medication, (a psychoactive drug taken to exert an effect on the chemical make-up of the brain and nervous system). This failure could place residents at risk of receiving medications without their prior knowledge or consent, or that of their responsible party or being aware of the benefits and risks of the medications prescribed. Findings included: Record review of Resident #14's face sheet, dated 01/22/2025, revealed a [AGE] year-old-female who was admitted to the facility on [DATE] with diagnoses to include psychotic disorders with delusions due to known physiological condition (a mental disorder characterized by a significant cognitive departure from reality), psychotic disorder with hallucinations due to a known physiological condition (refers to hallucinations and perceptual disturbances), depression (a mood disorder that causes a persistent feeling of sadness and loss of interest), muscle weakness, Alzheimer's (a chronic neurodegenerative condition that primarily affects memory, thinking, and behavior), dysuria (painful or difficult urination), and atrial fibrillation (irregular heart rhythm). Record review of quarterly MDS assessment (Minimum Data Set) dated 5/6/2024 revealed Resident #14 was understood and understands others. The MDS revealed Resident #14 had a Brief Interview for Mental Status (BIMS) score of 3 out of 15 which indicated the resident's cognition was severely impaired. Record Review of Section N0415 indicated Resident #14 was taking antidepressants, antipsychotics, and anticonvulsant medications. Record review of a care plan for Resident #14 dated 3/26/2025 revealed a focus area of Psychotropic Drug Use: Resident requires use of antipsychotic. Goal section of care plan revealed that Resident #14 will be free of drug related complications including movement disorder, discomfort, hypotension, gait disturbance, constipation cognitive behavioral impairment. Approach section of care plan stated observe target behaviors, notify physician of adverse reactions, educate (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 8 Event ID: 675326 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 675326 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Central Texas Nursing & Rehabilitation 1800 N Broadway St Ballinger, TX 76821 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)