Health inspection·October 31, 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 interview and record review, the facility failed to develop and implement a baseline care plan for each resident that includes the instructions needed to provide effective and person-centered care of the resident that meet professional standards of quality care for 1 of 5 Residents (Resident #1) reviewed. The facility failed to complete a baseline care plan within 48 hours of admission for Resident #1. This failure could place all newly admitted patients at risk for lack of care, needs not being met, and goals not targeted towards the individual needs of the resident. Findings Included: Record review of Resident #1's face sheet, undated, revealed an [AGE] year-old female admitted to the facility on [DATE]. Resident #1's diagnoses included but are not limited to Systemic Lupus (autoimmune disease), Rheumatoid Arthritis (chronic inflammatory disorder that can affect more than just your joints), and Diabetes Mellitus (body has high sugar levels for prolonged periods of time) with unspecified complications. Record review of Resident #1's care plans, undated, showed a care plan beginning on 10/31/23. Further review revealed no baseline care plan completed. Record review of care plan assessments completed for Resident #1 since admission did not show a baseline care plan. An interview with ADON on 10/31/23 at 1:39 PM revealed that everyone does the care plans, but MDS C was who was in charge of the assessments and submitting the care plans. MDS C scheduled the meetings. ADON stated that baseline must be done withing 24 hours of admission and the admission nurse oversees completing the baseline care plans. ADON stated a negative outcome can be quality of care. In an interview with MDS C on 10/31/23 at 1:42 PM revealed that she (MDS C) oversees the MDS assessments and care plans. MDS C stated that the baseline care plan had to be completed within 24 hours and they were part of the admission process. Entry MDS was done and sent in, then they had 14 days to complete the MDS assessment and then 7 days after that to finish the care plan. They had a regional nurse above them that reviews the assessments and care plans all the time; above her there was a whole team of people who were constantly auditing them. MDS C stated that the regional nurse comes in one to two times a quarter and she was always in their charts. They sent a report once a week and her (Resident #1) care plan was not triggered. MDS C stated she did it today. MDS C confirmed the care (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: 675973 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 675973 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/31/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McLean Care Center 605 W Seventh St McLean, TX 79057 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)