Health inspection·April 25, 2025

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. Based on observation, interview, and record review, the facility failed to assure drugs and biologicals were secured properly in 1 (400 hall medication cart) of 6 Medication carts reviewed for drug storage. The medication cart on 400 hall was unlocked and no staff in view of the cart. This failure could place residents at risk of having access to unauthorized medications and/or lead to possible harm or drug diversion. The findings included: Observation on 04/25/25 at 6:45 AM revealed the medication cart was unlocked and parked on the far end of 400 hall at the nursing station with the drawers facing the hallways towards the exit doors. Observed no staff in view of the medication cart. Observation on 04/25/25 at 6:59 AM revealed LVN-PRN came out of a residents room and opened the top drawer of the medication cart. Interview on 04/25/25 at 7:00 AM LVN -PRN stated the medication cart should be locked when you are not using it. LVN-PRN stated residents could overdose on medication or take medications that did not belong to them. Interview on 04/25/25 at 9:01 AM RN stated the medication cart should be locked when you step away from the cart. RN stated locking the cart was a safety precaution and could prevent residents from overdosing on medication. Interview on 04/25/25 at 9:24 AM MA stated when medication cart was not in view you must lock the cart and put the key in your pocket. MA stated this would stop residents from getting into the medication cart and taking the wrong medication. Interview on 04/25/25 at 9:39 AM DON stated the medication cart should be locked when staff are not using the cart. DON stated medications in the medication cart could alter the resident state of mind if the wrong medication was taken. Record review of facility policy titled, storage of Medications, revised 08/20 reflected, Medications and biologicals are stored safely, securely, and properly, following manufacturer's (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: 675817 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 675817 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE FT Worth Southwest Nursing Center 5300 Alta Mesa Blvd Fort Worth, TX 76133 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)