Health inspection·March 26, 2024

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure a comprehensive plan was reviewed and revised by an interdisciplinary team composed of individuals who have knowledge of the resident and his/her needs, that includes but is not limited the attending physician, a registered nurse with responsibility for the resident, a nurse aide with responsibility for the resident, and a member of food and nutrition services staff, for one of three residents (Resident #1) reviewed for comprehensive resident centered care plans. The facility failed to ensure all members of the interdisciplinary team were present for the care plan. The failure placed the residents at risk for unmet care needs and a decreased quality of life. Findings included: Record review of Resident #1's electronic face sheet, printed 3/26/2024, revealed a [AGE] year-old male was admitted to the facility on [DATE] and re admitted on [DATE] and 03/20/24 with diagnoses that included but not limited to pressure ulcer (areas of skin damage caused by a lack of blood flow), anxiety ( feeling of fear, dread, and uneasiness), heart failure(condition that develops when your heart doesn't pump enough blood for your body's needs). Record review of the quarterly MDS assessment dated [DATE] revealed Resident #1 had a BIMS score of 15 which indicated the resident was cognitively intact. In an interview on 03/26/24 at 12:00 PM, Resident #1 revealed she had a care plan meeting upon returning from the hospital on 3/21/24 and stated she had concerns about her care she wanted to address during the care plan meeting however no members of the interdisciplinary team showed up except the Social Worker. Resident #1 stated she felt the care plan should have been rescheduled to allow time for the other members of the interdisciplinary team to be present. The resident stated no other members from the interdisciplinary team had come to speak with her about her care following the meeting. Resident #1 stated she had not addressed her concerns because she was hoping the department heads would come to her room however no one had done so. Record review of the care conference report for Resident #1 revealed a post admission care plan dated 3/20/2024 with the Social Worker, and Director of Nursing which indicated they were the only staff who attended the meeting. Page 1 of 2 676039 676039 03/26/2024 The Parks at Garland Healthcare and Rehab 3737 N Garland Avenue Garland, TX 75044

F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Interview on 3/26/24 at 1:36PM with the Director of Nursing revealed the Social Worker was responsible for scheduling the care plan meetings and would let the members of the interdisciplinary team know about the meeting. The Director of Nursing stated all members of the interdisciplinary team should be present during the care plan meetings to ensure the resident was able to ask questions and be a part of their care. The Director of Nursing stated all department head were aware that they were expected to attend the care plan meetings and let the social worker if they were not able to attend. The Director of Nursing stated the risk of the interdisciplinary team not being at the care plan meeting would be the resident would not be fully informed about their care. Interview on 03/26/24 at 1:49 with the Social Worker revealed Resident #1 had a care plan meeting after returning from the hospital. The Social Worker stated she notified all members of the interdisciplinary team which included all department heads. The Social Worker stated she had 48 hours to complete the post admission care plan once a resident returned from the hospital. The Social Worker stated the interdisciplinary team should have let her know if they would not be able to attend the meeting however that did not happen. The Social Worker stated if the members of the interdisciplinary team were not able to attend the care plan meeting her expectation was that they would see the resident later and complete their portion of the care plan however she was not sure if the resident was seen. The Social Worker stated the risk of not having the interdisciplinary team at the meeting would be the resident wound not be able to ask them questions about their care. Review of the facility policy Care plan revised 02/2024 revealed The resident/representative's right to participate in the development and implementation of his or her plan of care includes the right to, participate in the planning process, identify individuals to be included in the planning process, request meetings, request revisions to the plan of care, participate in establishing his or her goals and expected outcomes of care, participate in the type, amount, frequency and duration of care, receive the services and/or items included in the care plan, be informed, in advance, of changes to the plan of care. 676039 Page 2 of 2