Health inspection·July 6, 2024

F 0655 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review, the facility failed to develop and implement a baseline care plan for each resident that included the instructions needed to provide effective and person-centered care for 1 of 3 residents reviewed for baseline care plans. (Resident #1) The facility failed to develop a baseline care plan that addressed Resident #1's use of a fall mat at bedside and bed in the lowest position. This failure could place residents at risk of not receiving care and services to meet their needs. Findings Record review of the face sheet dated 07/05/2024 indicated Resident #1 was a [AGE] year-old female admitted to the facility on [DATE] with diagnoses including acute osteomyelitis (bone infection) of the right ankle and foot, muscle wasting, cognitive communication deficit, lack of coordination, hypertension (high blood pressure), pressure ulcers of the sacral area (a wound near the lower back and spine). Record review of the admission MDS assessment dated [DATE] indicated Resident #1 was sometimes understood by others and sometimes understood others. The MDS indicated Resident #1 had a BIMS of 04 and was severely cognitively impaired. The MDS indicated Resident #1 was dependent with toileting, lower body dressing, and putting on and taking off footwear, required maximum assistance with bathing, and moderate assistance with upper body dressing. In section GG0120 Mobility devices the MDS indicated in the last 7 days Resident #1 used a walker and a wheelchair. Record review of the Order Summary Report dated 07/06/2024 indicated Resident #1 had an active order with a start date of 06/25/2024 for fall mat at bedside and bed to be in lowest position. Record review of the baseline care plan signed 06/25/2024 revealed it did not address the use of a fall mat at bedside and bed in the lowest position. Record review of an undated comprehensive care plan indicated Resident #1 was at increased risk for falls with the following interventions: Anticipate needs, provide prompt assistance. Assure lighting is adequate and areas are free of clutter. (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 2 Event ID: 675398 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 675398 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/06/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care of Center 501 Timpson Center, TX 75935 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)