Health inspection·December 29, 2023

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 observations, interviews, and record reviews, the facility failed to develop and implement a baseline care plan that includes the instructions needed to provide effective and person-centered care of the resident that meet professional standards of quality care within 48 hours of admission for one (Resident #1) of two residents reviewed for baseline care plans, in that: The facility failed to develop a care plan within 48 hours of Resident #1's return from the emergency room that addressed Resident #1's wound care needs or address emergency management in the event of suture displacement. This failure could affect the resident's healthcare needs and risks the resident to suffer pain, loss of blood or infection. The findings included: Record review of Resident #1's face sheet from 12/22/2023 indicated a [AGE] year-old female, admitted to the facility on [DATE] with a primary diagnosis of Alzheimer's disease. Record review of Resident #1's MDS assessment dated [DATE] showed Resident#1 had a BIMS score of 4 indicating severe cognitive impairment. Record review of Resident Care Plan accessed 12/22/2023 revealed no care plan for wound maintenance. Record review of Resident #1's emergency room record from 12/17/2023 showed she arrived at an emergency room post fall at 1:34 PM and received x-rays and a cat scan with negative results. Resident #1 was given a local anesthesia, treated for a laceration to her head with 5 sutures, and discharged from the emergency room at 3:50 PM with instructions to keep the wound clean and dry, to watch for infection, and to give over the counter Tylenol and ibuprofen as needed for pain. During an observation of Resident #1 on 12/22/2023 at 2:10 PM she displayed an approximately a 1-inch by 2-inch patch of dried blood to her forehead. No sutures were visible. During an interview with the DON on 12/22/2023 at 2:30 PM she said there was no care plan in the chart for wound care, but there should have been a care plan in the chart. The DON said the MDS Coordinator usually created the care plans, but the charge nurses could make changes to the care plan. The DON said that a resident discharged from the emergency room should have had a care plan right away. (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 6 Event ID: 675672 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 675672 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/29/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at River Ridge 3922 W River Dr Corpus Christi, TX 78410 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)