Inspection·March 12, 2024

F 0689 Level of Harm - Immediate jeopardy to resident health or safety Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record review, the facility failed to ensure each resident recieved adequate supervision for one resident (Resident#44) of 2 residents whose records were reviewed for elopements. Residents Affected - Few Resident #44 eloped from the facility undetected on 05/05/23. Resident #44 was able to remove her wanderguard bracelet and exit the facility on 06/24/23. Resident #44 eloped from the facility undetected after removing wanderguard bracelet for a second time 06/26/23. The non-compliance was identified at PNC (Past non-compliance). The Immediate Jeopardy (IJ) situation began on 06/26/23 and ended 06/27/23 The facility had corrected the noncompliance before the survey began. This failure could place the residents with exit seeking behaviors at risk for injury or death. Findings included : Record review of Resident #44's admission record dated 03/08/24 documented a [AGE] year-old female admitted to the facility on [DATE]. Diagnoses of Primary Osteoarthritis (common form of arthritis; wear and tear arthritis), other Specified Site, Difficulty in Walking, Not elsewhere Noted, Other Abnormalities of Gait, Unspecified Dementia, unspecified Severity, Without Behavioral Disturbance, Psychotic Disturbance (group of serious illnesses that affect the mind), Mood Disturbance, and Anxiety. Record review of Resident #44's MDS annual assessment dated [DATE] revealed a BIMS score of 11 indicating moderate cognitive impairment. Record review of the Provider Investigation Report revealed Resident #44 eloped on 05/05/23 at approximately 1:32 pm from the facility. Dietary Aide B witnessed Resident #44 walking on the sidewalk outside the facility and notified LVN G. LVN G redirected resident back to facility and assessed Resident #44. Record Review of Progress Note dated 06/27/23 revealed Resident #44 was discharged home with family. In an interview on 03/07/24 at 11:55 am LVN G said from what she could recall, on the day of[ Resident #44's] first elopement, Dietary Aide B notified her that Resident #44 was outside the facility. LVN G said she went outside and found Resident #44 walking in the parking lot. LVN G said R#44 was redirected into the facility with no incident. LVN G said that Resident #44 said that wanted to go (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: 675363 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 675363 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/12/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Nursing and Rehabilitation Center of Wesla 721 Airport Dr Weslaco, TX 78596 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)