Health inspection·March 21, 2025

F 0727 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to use the services of a registered nurse for at least 8 consecutive hours a day, 7 days a week for 1 of 1 facility reviewed for nursing services. The facility did not have RN coverage for 17 days on [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE] and [DATE]. This failure could place the residents at risk of not receiving needed care and services. The findings were: Review of the facility RN timesheets revealed there were no RN hours for Saturdays on [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE], [DATE] and [DATE]. Review of the facility RN timesheets revealed there were no RN hours for Sundays on [DATE], [DATE], 12/29/.24, [DATE], [DATE], [DATE], [DATE], and [DATE]. During interview with the DON on [DATE] at 2:26p.m, she said she had been employed in the facility since [DATE]. She stated to the best of her knowledge the facility doesn't have RN coverage especially on weekends. The DON explained the facility used to have a RN that came on weekend but not anymore. She stated she understood RN coverage as a person with broad responsibility that provides specialized nursing care that LVN cannot or not required or qualified to do. She came an example with a peripherally inserted central catheter (PICC line) which LVN are not qualified to do. The DON stated she was not aware of the specific days not covered in the facility. She explained the management was aware of the lack of RN coverage in the facility. This was because on one occasion, he asked if not having an RN coverage will affect her license as a RN/DON. She was assured by the management that her license will not be affected. The DON stated she is aware the facility does not have RN coverage in the required days including weekends. She indicated the facility has approved and placed an advertisement looking for weekend RN coverage and she will be interviewing candidates soon. In an interview with ADM on [DATE] at 2:49p.m, she is the Administrator and started working for the facility since [DATE]. The ADM explained the policy of the facility is to have RN coverage 8 hours a day, seven days a week. She knows there was some days the facility did not meet this requirement. She stated the purpose of RN coverage was to cover for any incident which the LVN cannot handle or not trained to provide service. The ADM noted the DON has covered some weekends. She said there was no negative effect because the facility has telehealth and can contact them if RN was needed. She stated the facility has not had incident requiring a RN on weekend recently. She monitors the RN (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: 675554 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 675554 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Grace Care Center of Nocona 306 Carolyn Rd Nocona, TX 76255 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)