Health inspection·August 5, 2025

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, interviews, and record review, the facility failed to ensure that residents received treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices for 1 of 6 residents (Resident #1) reviewed for quality of care, in that:The facility failed to conduct weekly skin assessments for Resident #1 on 7/10/25 and 07/17/25. These failures placed residents at risk of physical harm, pain, and a decreased quality of life. Findings included: Record review of Resident #1's admission record, dated 08/05/2025, reflected a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #1 had diagnoses which included: seizures (sudden, temporary disruption of the brain's normal electrical activity, resulting in changes in behavior, movement, feelings, or consciousness), lack of Coordination (having difficulty controlling your movements and making them work together smoothly), protein calorie malnutrition (not getting enough food or the right food to maintain a healthy body), and unspecified dementia severe without behavioral disturbance, psychotic disturbance, mood disturbance and anxiety (memory loss and thinking difficulties). Record review of Resident #1's Quarterly MDS assessment, dated 05/01/2025, reflected the resident had a BIMS score of 15, which indicated cognitively intact. Resident #1 required setup or clean assistance in the areas of toileting hygiene, shower/bathe self, lower body dressing, putting on/taking off footwear, and person hygiene. Record review of Resident #1's care plan, dated 08/05/2025, reflected Resident #1 was care planned for potential for pressure ulcer development r/t required assist with bed mobility with an intervention of follow facility policies/protocols of prevention/treatment of skin breakdown. Review of Resident #1's weekly skin assessment in the EMR on 08/05/2025, reflected Resident #1 did not have a weekly skin assessment 07/10/25 & 07/17/25. During an interview and observation Resident #1 on 08/05/2025 at 11:30am., Resident #1 stated he could not remember if he had his weekly skin assessment on 07/10/25 & 07/17/25. Resident #1 stated he did not have any current skin issues. Resident #1 did not have any visible bruising or skin issues. During an interview with LVN A on 08/05/2025 at 1:15 PM, LVN A stated the purpose of a weekly skin assessment was to identify any new skin issues and monitor current skin issues. LVN A stated that the weekly skin assessment was completed on the same day of the week each week by the charge nurse. LVN A stated that 6/2 charge nurse was responsible for the 100 and 200 halls and 2/10 charge nurse was responsible for the 300 and 400 halls. LVN A stated that she was not sure what nurse was worked on 07/10/25 & 07/17/25. LVN A stated if a resident's weekly skin assessment was not completed then the resident could have a skin issues go untreated. During an interview with the DON on 08/05/2025 at 2:55 PM, the DON stated the purpose of a skin assessment was to identity and address any new skin concerns. The DON stated all residents were supposed to receive weekly skin assessments. The DON stated it was the charge nurse's responsibility to complete the weekly skin assessments. The DON was not aware that Resident #1 had not had a skin assessment on 07/10/25 & 07/17/25. The DON stated that if a resident did Residents Affected - Few (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: 675903 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 675903 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mexia Ltc Nursing and Rehab 601 Terrace LN Mexia, TX 76667 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)