Health inspection·November 12, 2024

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to ensure that drugs and biologicals were stored in locked compartments for 1 of 4 medication carts observed for compliance. Medication cart #1 was left outside of room [ROOM NUMBER] unlocked and unattended by RN A. This failure could place residents at risk of access and ingestion of non-narcotic medications. This failure had the potential to affect 5 residents in this hall. Findings were: During an observation on 11/7/2024, at 8:39 a.m., Medication cart #1 unlocked on hall 400 without a supervised staff in view of the cart. The cart was unlocked for 5 minutes until RN A was questioned about the unlocked cart. During an interview on 11/7/2024 at 10:45 a.m., RN A verbalized the unlocked cart was her cart. She verbalized she must have forgot to lock the cart after giving her last medication. RN A stated it was proper process to lock the cart when the cart was not in view or when not being used. She also stated a resident could have accessed the medications in the drawers that were accessible. RN A stated all narcotics were locked in a double locked drawer and were not accessible. RN A stated she should have taken the medication cart back to the nurses station with her. During an interview on 11/7/2024 at 9:12 a.m., the Director of Nursing (DON) stated medication carts should be locked when licensed personnel walk away from the cart. The DON stated a resident could have opened the cart and taken a medication that was not theirs. All carts were to be within the line of sight of the staff member utilizing the cart or locked this prevents residents from obtaining access to improper medication. During an interview on 11/12/2024 at 2:50 p.m., the Administrator stated the expectation for all staff using medication carts was that they are locked when not in use and to follow the medication administration policy. The policy was in place to ensure the residents were kept safe. The unlocked cart could have allowed a resident access to the medications in the cart other than narcotics because they were locked in a drawer. A review of the Administering Medication policy dated 07/08/2024 number 19 revealed During administration of medications, the medication cart is kept closed and locked when out of sight of the (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: 675494 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 675494 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/12/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lone Star Ranch Rehabilitaion and Healthcare Cente 316 General Cavazos Blvd Kingsville, TX 78363 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)