Health inspection·November 8, 2024

F 0558 Reasonably accommodate the needs and preferences of each resident. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on Observations, Interviews, and Record review, the facility failed to ensure that residents had the right to reside and receive services in the facility with reasonable accommodation of resident needs and preferences except when to do so would endanger the health or safety of the resident or other residents for 1 of 3 residents (Resident #22) reviewed for reasonable accommodation of resident needs and preferences, in that: Residents Affected - Few The facility failed to ensure Resident #22's call light was within reach. This failure could place residents at risk of achieving independent functioning, dignity, and well-being. Findings include: Record review of Resident #22's face sheet dated 11/7/24 revealed a [AGE] year old female admitted to the facility on [DATE]. Resident #22 had diagnosis that included Amputation of Bilateral lower extremity (surgical removal of more than one limb), Major Depressive Disorder (a severe mood disorder that can affect a person's thoughts, feelings, and ability to perform daily activities), and Heart failure (occurs when the heart muscle doesn't pump blood as well as it should). Record review of Resident #22's admission MDS assessment, dated 9/21/24, reflected a BIMS score of 04 which suggested severe cognitive impairment. Record review of Resident 22's care plan, dated 6/20/24, reflected, the resident is at risk for falls, with intervention's, be sure to keep the call light within reach. Observation and interview on 11/07/24 in Resident #22s room at 10:15 AM revealed that the call light was on the floor. Resident #22 stated, she did not know how the call light got on the floor and prefers to scream Help . Interview on 11/07/24 at 9:50 AM, CNA A stated that she was the assigned nursing assistant for Resident #22. CNA A stated she did not know how Resident #22's call light ended up on the floor. CNA A also noted that if Resident #22 did not have access to the call light, Resident #22 might fall. During an interview with the DON on 11/08/24, at 11:15 AM, the DON stated the facility did not have a policy to address the use of call light but stated the importance of ensuring a call light is accessible to all residents, stating the lack of accessibility to a call light for any resident could lead to a potential fall if assistance was needed. The DON also mentioned charge nurses currently (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: 675372 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 675372 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/08/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA Bahia Nursing and Rehabilitation 225 E Ward St Goliad, TX 77963 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)