Health inspection·June 14, 2024

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review the facility failed to ensure a resident who is unable to carry out activities of daily living receives the necessary services to maintain good personal and oral hygiene for 1 (Resident 1) of 10 residents reviewed for ADLs. Residents Affected - Few The facility failed to ensure Resident #1's dentures were cleaned regularly. The failure was identified as past non-compliance as the facility had instituted adequate corrective measures to prevent reoccurrence of the non-compliance. This failure could place residents at risk of poor hygiene and grooming, bad breath, mouth sores and thereby decrease their quality of life. Findings Included: Record review of Resident #1's face sheet, dated 6/13/24, revealed an [AGE] year-old female admitted to the facility on [DATE] with diagnoses that included, but were not limited to: respiratory failure with hypoxia (inadequate oxygen), mild protein-calorie malnutrition (lack of proper nutrition), muscle weakness, lack of coordination, communication deficit, aphasia following cerebral infarction (language disorder following ischemic stroke), dysphagia (difficulty swallowing), muscle wasting and atrophy, mood disorder, candidiasis (fungal infection), parkinsonism (tremors in hands, arms legs, muscle stiffness, slowness of movement, impaired balance), epilepsy (seizure disorder), speech and language deficits, cataract (clouding of the lens of the eye), osteoporosis (weak and brittle bones), pain, need for assistance with personal care, depressive episodes, difficulty walking, unsteadiness on feet, anxiety disorder, dementia (loss of cognitive functioning thinking, remembering and reasoning), hypertension (high blood pressure), heart failure, hemiplegia and hemiparesis (complete or severe paralysis on one side of the body). Record review of Resident #1's annual MDS, completed 4/12/24, documented a BIMS of 5 which indicated severely impaired cognition, usually understands and was understood. Record review of Resident #1's care plan, undated, documented the Resident #1 was at risk for an ADL Self Care Performance Deficit related to history of stroke with right hemiparesis, muscle weakness, difficulty walking, abnormalities of gait and mobility, ataxia (impaired coordination) - personal hygiene/oral care - requires ( 1 - 2 person assistance) staff participation with personal hygiene and oral care. During a confidential interview on 6/12/24 at 1:30 p.m., it was said that Resident #1 was not (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 3 Event ID: 675925 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 675925 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/14/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Mildred & Shirley L. Garrison Geriatric Educat 3710 4th St Lubbock, TX 79415 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)