Inspection·January 8, 2025

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record reviews, the facility failed to immediately consult with the resident's physician when there was a need to alter treatment significantly and a decision to discharge the resident from the facility to the hospital for 1 (Resident #1) of 3 residents reviewed for notification of changes. The facility failed to notify Resident #1's physician when Resident #1 was transferred and discharged to the hospital on [DATE]. This failure could place residents at risk of not having their change of condition communicated to their physician, delay of treatment, and a decline in the residents' health and well-being. The findings included: Record review of Resident #1's Facesheet, dated 01/01/2025, revealed Resident #1 was an [AGE] year-old female, with an admission date into the facility of 12/10/2024. Diagnoses included Unspecified systolic (congestive) heart failure (refers to a diagnosis of heart failure where the problem lies with the heart's ability to contract and pump blood effectively), Type II diabetes mellitus without complications (disease that occurs when the body does not use insulin properly, resulting in high blood sugar levels), Anemia with chronic kidney disease (occurs when the kidneys cannot produce enough erythropoietin (EPO), a hormone that signals the body to make red blood cells), and Essential (primary) hypertension (type of high blood pressure that develops gradually over time and no clear cause). Record review of Resident #1's admission Minimum Data Set (MDS), dated [DATE], revealed Resident #1's BIMS score was 14, which indicated intact cognitive response. Record review of Resident #1's Progress Notes, dated 12/25/2024 at 10:44 p.m., documented by LVN B, revealed Resident #1, was sent to ER per resident request and family member request. Resident B/P continues to be high 199/80 with wrist cuff. Resident's B/P was 186/112 at 8:00 p.m., resident did not want to go to the ER at that time because she had been up and moving around, after the recheck, she called her family member and family member called the nurse home and told the nurse to send the resident to the ER, so the nurse went to the resident's room and told the resident her family member wanted her to go to the ER. During an interview on 01/01/2025 at 12:20 p.m., Resident #1's family member said Resident #1 called her and reported her blood pressure was high and Resident #1 needed to go to the emergency room. Resident #1's family member said she called the facility and spoke with LVN B and requested Resident #1 be sent to the ER. (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: 676046 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 676046 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/08/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Care Nursing & Rehabilitation 200 County Rd 616 Brownwood, TX 76802 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)