Inspection·March 8, 2024

F 0692 Provide enough food/fluids to maintain a resident's health. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to offer, based on resident's comprehensive assessment, a therapeutic diet when there was a nutritional problem, and the health care provider ordered a therapeutic diet for 2 of 5 residents (Residents #1 and #2) reviewed for therapeutic diets. Residents Affected - Some The facility to ensure Resident #1 and Resident #2 received fortified meal plan as ordered by their physician. This failure could place residents who are on a modified diet at risk of weight loss and decline in health status. Findings Included: Resident #1 Record review of Resident #1's face sheet dated on 03/08/2024 revealed he was an [AGE] year-old female who was admitted to the facility on [DATE] and readmitted on [DATE]. Her diagnoses included dementia (memory loss), hyperlipidemia (high level of fat in the blood), protein calorie malnutrition (inadequate intake of food such as protein, starch, and nutrients), muscle weakness, essential hypertension (high blood pressure), hypothyroidism (when the thyroid glands does not produce enough thyroid hormones), iron deficiency anemia (lack of sufficient healthy red blood cells in the blood), oropharyngeal phase (chewing and transferring of food through the oral cavity), abnormalities of gait(walking disorder), encounter for attention to gastrostomy (opening in the stomach), altered mental status (confusion, disorder), major depression (affects how you think, feel and behave), adult failure to thrive (decline in health and ability to gain weight), insomnia (sleep disorder), vitamin D deficiency (lack of vitamins), constipation (difficulty passing stool) and myocardial infarction (blockage of blood flow to the heart). Record review of Resident #1's quarterly MDS dated [DATE] revealed a BIMS score of 03 indicating she was severely impaired for cognitive skills for decision making. For swallowing and nutritional status, she was coded as having no swallowing problems or weight loss of more than 5%. For nutritional approaches the resident was feed via a feeding tube and was on a mechanical altered diet. Record review of Resident #1's care plan dated 2/20/2024 revealed the following: Focus: Resident has unplanned/unexpected weight loss. Goal: To have Resident regain lost weight. Intervention: Alert Dietitian if consumption is poor for more than 48 hours. Give supplement as ordered. (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: 675344 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 675344 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Paradigm at Sweeny 109 N McKinney Sweeny, TX 77480 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)