Health inspection·December 13, 2023

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights, that include measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment for one of eight residents (Resident #79) reviewed for comprehensive care plans. The facility failed to ensure Resident #79's pressure ulcer care was reflected in his comprehensive care plan. This failure could place residents at risk of not receiving necessary care and services. The findings were: Record review of the admission record for Resident #79 reflected the resident was admitted to the facility on [DATE] and re-admitted on [DATE], was a[AGE] year-old male with diagnosis which included diabetes (high blood sugar levels), dysphagia (difficulty in swallowing), cellulitis of left toe(bacterial infection), acquired absence of left great toe and dementia (decline in cognitive abilities.) Record review of the quarterly MDS dated [DATE] for Resident #79 reflected Resident #79 had severe cognitive impairment and one stage 3 pressure ulcer that was present upon admission/entry or reentry. Record review of the care plans for Resident #79 last revised on 12/12/23 reflected there was no evidence a care plan to address Resident #79's stage 3 pressure ulcer care was included. Record review of the MARs dated 12/01/23 for Resident #79 reflected an order for Santyl External Ointment 250 unit/gm, apply to sacrum topically one time a day for stage 3, cleanse with wound cleanser, pat dry with clean gauze, apply Santyl, cover with bordered gauze, daily. Interview on 12/13/23 at 10:40 am with MDS Coordinator A revealed Resident #79 had a stage 3 pressure ulcer to the sacrum when Resident #79 was re-admitted on [DATE] from the hospital. MDS Coordinator A said the care plan should have been updated at that time to develop his care area for the pressure ulcer. MDS Coordinator A stated the pressure ulcer was reflected in the quarterly MDS dated [DATE], and she had overlooked developing a care plan for Resident #79's pressure ulcer. MDS Coordinator A said she and the nurses were responsible to update and develop new care plans for residents. (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: 675415 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 675415 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/13/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Las Palmas Nursing and Rehabilitation Cent 1301 E Quebec Ave McAllen, TX 78503 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)