Health inspection·November 21, 2025

F 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to ensure that residents fed by enteral means received the appropriate treatment to prevent complications of enteral feeding including aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers for 1 of 9 residents (Resident #1) reviewed for enteral feed care. The facility failed to ensure Resident #1's tube feeding was paused when the head of his bed was lowered for incontinence care. This failure could place residents at risk for aspiration of their feeding solution. Findings included:Record review of Resident #1's quarterly MDS assessment, dated 08/04/25, revealed he was an [AGE] year-old male admitted to the facility on [DATE] with diagnoses which included stroke affecting his right side, and ability to swallow and to speak, required the placement of a feeding tube. His Functional Ability assessment revealed he was completely reliant on staff for his ADLs. Record review of Resident #1's care plan, dated 5/21/25, revealed he had a feeding tube and received continuous feeding via pump. Observation on 10/07/25 at 10:15 Resident #1 was in his bed with the head of the bed elevated about 30 degrees. Feeding pump was infusing at 70 ml/hr. Resident in no obvious distress. Observation on 10/07/25 at 10:22 AM revealed CNA A and CNA B providing Resident #1 incontinence care. CNA A lowered Resident #1's head to turn him for incontinence care. CNA A did not call a nurse in to pause Resident #1's feeding pump, nor did she pause it herself. The pump was infusing at 70 ml/hr. Incontinent care was completed, and the resident's head was raised again while the pump continued to infuse. In an interview on 10/07/25 at 9:12 AM, Resident #1's Family Member stated she monitored the resident's bed via electronic monitoring, and she expressed concerns about the resident's care, including staff not pausing his feeding pump when they lower the head of the bed. She stated she had brought her concerns to the Administrator and Resident #1's care seemed to have improved some since then. She stated the resident had not aspirated (inhaling stomach contents into the lungs) that she knew of. In an interview on 10/07/25 at 12:00 PM, the ADON stated any resident on a feeding pump was to have the pump paused by a nurse prior to having the head of their bed lowered, and the nurse was to restart the pump once the head of the bed was raised again. She stated leaving the pump running with the head flat could cause the resident to aspirate their enteral feed. The ADON stated after Resident #1's Family Member had spoken to the previous Administrator on 9/24/25, the DON had initiated an in-service on Enteral Feeding care, so staff should know about pausing the feeding pump. The ADON stated she would initiate another in-service immediately since the DON was not working. In an interview on 10/07/25 at 1:30 PM, CNA C stated she was just in-serviced by the ADON about the care of residents with feeding tubes. She stated she knew to have the nurse pause the pump before lowering the head of the bed and re-start it after she was done with care. She knew the risk of lowering the head of the bed with the pump infusing was aspiration. In an interview on 10/07/25 at 1:34 PM, CNA D stated residents with a feeding pump infusing (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: 676067 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 676067 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mira Vista Court 7021 Bryant Irvin Rd Fort Worth, TX 76132 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)