Health inspection·April 12, 2024

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review and interviews the facility failed to ensure 1 of 6 residents (Resident #1) received necessary treatment and services, consistent with professional standards of practice, to promote wound healing, prevent infection and prevent new ulcers from developing. Residents Affected - Few The facility failed to ensure Resident #1's four wound dressings were dated and initialed per facility policy. This deficient practice could affect residents who received pressure ulcer preventative treatments and place them at risk for skin breakdown, infection, pain, and a decline in health. The findings include: Record review of Resident #1's face sheet, dated 04/11/24, revealed an [AGE] year-old male, admitted to the facility on [DATE]. Diagnoses included Urinary Tract Infection (bladder infection), Type 2 Diabetes Mellitus with Hyperglycemia (high blood sugar), and Congestive Heart Failure (the heart cannot supply enough blood to meet your body's needs). Record review of Resident #1's Order Summary Report, dated 04/11/24, revealed a physician order: Treatment to skin tears to bilateral elbows and shoulders - Cleanse with normal saline and 4x4 and pat dry, apply dressing daily and PRN, one time a day for wound healing. Record review of Resident #1's Care Plan, dated as revised on 04/07/24, revealed the care plan: Focus: Resident has current skin conditions: 1. Abrasions to rear bilateral shoulders. 2. Skin tears to bilateral elbows. Interventions: 1. Perform treatments per MD orders. 2. Monitor areas for increased breakdown. In an observation and skin assessment of Resident #1, on 04/11/24 at 1:25 pm, with the ADON and CNA A, revealed Resident #1 had bandages on his right and left elbows and on his right and left rear shoulders. The bandages were not dated or initialed. The resident was not interviewable. In an interview on 04/12/24 at 9:10 am, the DON said Resident #1's four wound dressings should have been dated and initialed by the nurse performing the wound care per facility policy. She did not know why the dressings were not dated or initialed, stating she would have to in-service her nurses. The DON said a potential negative outcome would be you wouldn't know when it was last changed and who changed it. Record review of the facility policy Skin Management: Prevention and Treatment of Wounds, effective (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: 675751 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 675751 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/12/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Focused Care at Odessa 2443 W 16th St Odessa, TX 79763 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)