Health inspection·July 24, 2025

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, and record review, the facility failed to ensure in accordance with professional standards and practices, the medical records on each resident were accurately documented for 1 of 7 residents (Resident #1) reviewed for accurate medical records. The facility failed to ensure LVN A accurately documented on Resident #1's medical record the time of physician notification in the progress note dated 7/15/25. This failure could place residents at risk of emergency situations not being accurately documented, leading to confusion on what occurred when.Findings included:Record review of the face sheet dated 7/24/25 indicated Resident #1 was a [AGE] year-old female admitted to the facility on [DATE] with diagnoses including syncope and collapse (fainting, or sudden temporary loss of consciousness), congestive heart failure (a chronic condition in which the heart does not pump blood as well as it should), hypertension (elevated blood pressure), and pulmonary hypertension (a type of high blood pressure that affects the arteries in the lungs and heart). Record review of the admission MDS dated [DATE] indicated Resident #1 understood others and was understood by others. The MDS indicated Resident #1 had a BIMS of 15 and was cognitively intact. The MDS indicated Resident #1 used a walker for mobility. The MDS indicated Resident #1 required partial assistance with indoor mobility and transfers. Record review of the care plan last revised 6/30/25 indicated Resident #1 was at risk for falls related to muscle weakness, unsteady gait, and syncope (fainting). Record review of the incident report dated 7/15/25 written by LVN A indicated Resident #1 was found lying in the floor. The incident report indicated Resident #1 had ambulated to her personal bathroom without her assistive device and fallen to the floor. The incident report indicated Resident #1 was non-responsive to verbal or physical stimulation. The incident report indicated Resident #1's physician was contacted by the facility at 11:00 p.m. and gave an order to send her to the emergency room. Record review of the progress note dated 7/15/25 written by LVN A indicated Resident #1 was found on the floor. The progress note indicated Resident #1 had a decreased blood pressure and decreased pulse. The progress note indicated Resident #1's physician was notified at 10:30 p.m. Record review of the Call for Service Report dated 7/22/25 from EMS indicated on 7/15/25 EMS received a call from the facility at 11:02 p.m. The Call for Service report indicated EMS was on the scene at the facility at 11:07 p.m. on 7/15/25. During an interview on 7/23/25 at 4:40 p.m. CNA B said she was working the night shift on 7/15/25 and was the staff member who found Resident #1 lying in the floor. CNA B said she found Resident #1 in the floor just a little before 11:00 p.m. CNA B said she made sure Resident #1 was breathing and then ran to get the nurse. CNA B said she had come on shift at 10:00 p.m., got report from the previous CNA, gathered her supplies, and started making rounds. CNA B said while making her first round was when she found Resident #1. During an interview on 7/23/25 at 4:43 p.m. LVN A said she was working on 7/15/25 when Resident #1 was found in the floor. LVN A said it was a few minutes before 11:00 p.m. when she was notified of Resident #1 being in the (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: 676049 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 676049 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/24/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Legend Healthcare and Rehabilitation - Paris 520 SE 8th St Paris, TX 75460 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)