Inspection visit

Health inspectionFebruary 10, 2023

The Heights of AtascosaCMS #6761816 citations on this visit

6 citations recorded

Inspector’s narrative

What the inspector wrote

This survey cited 6 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.

F 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure Residents have the right to formulate an advance directive for 1 of 18 resident (Resident #46) reviewed for advanced directive in that: The facility failed to have the physician's license number recorded on the Out of Hospital Do Not Resuscitate (OOHDNR) order, which made the advanced directive invalid. This failure could affect any resident in the facility who had an OOHDNR in their chart and place them at risk of having cardiopulmonary resuscitation (CPR) performed against their wishes. Findings: Record review of Resident #46's face sheet dated [DATE] revealed an admission on [DATE] with diagnosis which include: Alzheimer's disease; Unspecified dementia, unspecified severity, without behavioral disturbance, mood disturbance and anxiety; and muscle weakness. Record review of Resident #46's Quarterly MDS review assessment revealed a BIMS of 15, which revealed the resident is cognitively intact. Record review of Resident #46's Care Plan, dated [DATE] revealed code status of DNR (no CPR). Record review of Resident #46's active Physician Order Summary Report revealed an active order for DNR as of [DATE]. Record review of Resident #46's OOH-DNR, dated [DATE], revealed the physician's medical license number was missing from the form. During an interview with the SW on [DATE] at 4:40 p.m., while reviewing Resident #46's OOH-DNR, the SW stated the physician's license number should be on there and it is not. SW the said she does review the facility OOH-DNR's usually and if EMS came to provide services to the Resident #46 and looked at the current OOH-DNR they might not accept it because it does not have the physician's license number on it. She further stated, it would be a rights violation because he would be considered full code and EMS would take measure to keep him alive when the DNR shows that is not what he wanted. During an interview with the Administrator on [DATE] at 4:47 p.m., the Administrator said Resident #46's OOH-DNR should have the physician's license number on it, in the designated place or it is not complete and valid. She explained the Residents should receive the care they want. (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 10 Event ID: 676181 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 676181 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of Atascosa 1855 W Goodwin Pleasanton, TX 78064 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)

F 0578 Level of Harm - Minimal harm or potential for actual harm Record review of the Texas Health and Human Services webpage titled, Out of Hospital Do Not Resuscitate Program, updated 12/2020, accessed [DATE] revealed, Out-of-Hospital Do-Not-Resuscitate Form section D requires the patient's attending physician to sign and date the form, print or type his/her name and give his/her license number. Residents Affected - Few Upon exit the Administrator provided a blank copy of an OOH- DNR in lieu of policy. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676181 If continuation sheet Page 2 of 10 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 676181 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of Atascosa 1855 W Goodwin Pleasanton, TX 78064 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)

F 0583 Keep residents' personal and medical records private and confidential. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure residents have a right to personal privacy for 1 of 6 resident (Resident #1) reviewed for privacy, in that: Residents Affected - Few LVN E did not completely close Resident #1's privacy curtain and window curtain while providing wound care for the resident. This deficient practice could place residents at-risk of loss of dignity due to lack of privacy. The findings include: Record review of Resident #1's face sheet, dated 02/09/2023, revealed an admission date of 07/06/2020, and a readmission date of 01/23/2023, with diagnoses which included: Congestive heart failure(condition in which the heart doesn't pump blood as efficiently as it should), Type 2 diabetes mellitus (blood glucose, also called blood sugar, is too high.), Chronic obstructive pulmonary disease(a chronic inflammatory lung disease that causes obstructed airflow from the lungs), Cirrhosis of liver(late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions), Chronic kidney disease (gradual loss of kidney function), Dementia (loss of cognitive functioning - thinking, remembering, and reasoning), Pain, Alzheimer's disease(brain disorder that causes problems with memory, thinking and behavior) Record review of Resident #1's Quarterly MDS, dated [DATE], revealed the resident had a BIMS score of 6, indicating severe impairment. Resident #1 required extensive assistance and was always incontinent of bowel and bladder and was coded for having 3 stage 3 pressure ulcers. Observation on 02/09/23 at 09:45 a.m. revealed LVN E provided wound care for Resident #1, LVN E did not pull the curtains completely around Resident #1's bed and did not close the window curtain completely to offer privacy to the resident during care. Resident #1's wounds were on the sacrum and coccyx area. During an interview with LVN E on 02/09/2023 at 10:02 a.m., LVN E confirmed the staff was supposed to provide complete privacy during care and close completely the privacy curtain and window curtain. She confirmed the end of bed was uncovered and confirmed the window curtain was partially opened. She stated the window curtain was broken and needed to be replaced. She confirmed receiving training about privacy during care. During an interview with the DON on 02/10/2023 at 1:20 p.m., the DON confirmed the curtains and window curtain should have been closed during care to provide privacy. The DON confirmed the staff received training on resident rights. The facility did annual skill checklists with the staff. The RN weekend supervisor did audits every weekend on different staff to check their knowledge and skills. Review of the facility's policy titled Standards for clinical procedures, dated 01/2022, revealed, Prior to the initiation of any clinical procedure: [ .] g. Pull the privacy curtain between the residents, even if the roommate is not present. Close the window blinds. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676181 If continuation sheet Page 3 of 10 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 676181 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of Atascosa 1855 W Goodwin Pleasanton, TX 78064 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)

F 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure MDS assessments accurately reflected the residents' medications ordered for 3 of 8 residents (Resident #35, #37, #62) whose records were reviewed for accuracy, in that Residents Affected - Some Resident #35's Quarterly MDS misidentified a medication as an anticoagulant instead of an anti-clotting agent; Resident #37's Annual MDS misidentified a medication as an anticoagulant instead of an anti-clotting agent; Resident #62's Quarterly MDS misidentified a medication as an anticoagulant instead of an anti-clotting agent; This deficient practice could affect residents who required an MDS assessment and could result in an inaccurate reflection of their care needs. The findings were: Record review of Resident #35's admission Record dated 02/09/23 revealed an [AGE] year-old female admitted to facility on 08/10/22. Resident #35's diagnoses included Type 2 diabetes mellitus with hyperglycemia (a chronic disease characterized by high levels of sugar in the blood), unspecified sequelae of cerebral infarction (unspecified residual effects of a stroke) and chronic kidney disease, Stage 3. Record review of Resident #35's Physician's Orders dated 02/09/23 revealed an order for Plavix Tablet 75 mg (Clopidogrel Bisulfate) to be given one time a day. Record review of Resident #35's Quarterly MDS dated [DATE] Section N0410 Medications Received revealed item E. Anticoagulant was marked as having been given for the last 7 days. The instructions for this section read, Indicate the number of DAYS the resident received the following medications by pharmacological classification, not how it is used, during the last 7 days or since admission/entry or reentry if less than 7 days. Record review of Resident #37's admission Record dated 02/09/23 revealed a [AGE] year-old female admitted to facility on 04/01/21. Resident #37's diagnoses included Type 2 diabetes mellitus with unspecified complications (a chronic disease characterized by high levels of sugar in the blood), hemiplegia and hemiparesis following cerebral infarction affecting right dominant side (muscle weakness or paralysis following a stroke) and dysphagia following cerebral infarction (swallowing difficulties after a stroke). Record review of Resident #37's Physician's Orders dated 02/09/23 revealed an order for Clopidogrel Bisulfate Tablet 75 mg with instructions to give 1 tablet by mouth one time a day for blood clot prevention related to cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676181 If continuation sheet Page 4 of 10 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 676181 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of Atascosa 1855 W Goodwin Pleasanton, TX 78064 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)

F 0641 Level of Harm - Minimal harm or potential for actual harm Record review of Resident #37's Annual MDS dated [DATE] Section N0410 Medications Received revealed item E. Anticoagulant was marked as having been given for the last 7 days. The instructions for this section read, Indicate the number of DAYS the resident received the following medications by pharmacological classification, not how it is used, during the last 7 days or since admission/entry or reentry if less than 7 days. Residents Affected - Some Record review of Resident #62's admission Record dated 02/09/23 revealed an [AGE] year-old male admitted to facility on 10/06/21. Resident #62's diagnoses included Type 2 diabetes mellitus without complications (a chronic disease characterized by high levels of sugar in the blood), peripheral vascular disease (a slow and progressive circulation disorder and narrowing, blockage, or spasms in a blood vessel), and atherosclerotic heart disease of native coronary artery without angina pectoris (buildup of plaque inside the artery walls and a reduction of oxygen-rich blood supply to the heart muscle). Record review of Resident #62's Physician's Orders dated 02/09/23 revealed an order for Clopidogrel Bisulfate Tablet 75 mg with instructions to give 1 tablet by mouth one time a day for blood clot prevention/post angiogram. Record review of Resident #62's Quarterly MDS dated [DATE] Section N0410 Medications Received revealed item E. Anticoagulant was marked as having been given for the last 7 days. The instructions for this section read, Indicate the number of DAYS the resident received the following medications by pharmacological classification, not how it is used, during the last 7 days or since admission/entry or reentry if less than 7 days. On 02/09/23 at 12:22 p.m., an interview with MDS Coordinators RN H and LVN I, revealed they would research the coding on the identified residents medications. During an interview with the Regional MDS Coordinator, RN J, on 02/09/22 at 1:00, RN J stated she agreed the MDS forms had been incorrectly coded and MDS Coordinators RN H and LVN I had been inserviced on the medication issue identified. The Regional MDS Coordinator, RN J, said the MDS was coded that the residents received an anticoagulant the past 7 days and they did not. It should have been a 0. Review of instructions for MDS 3.0 RAI Manual v1.17 - Section N state: N0410E, Anticoagulant (e.g., warfarin, heparin, or low- molecular weight heparin): Record the number of days an anticoagulant medication was received by the resident at any time during the 7-day look-back period (or since admission/entry or reentry if less than 7 days). Do not code antiplatelet medications such as aspirin/extended release, dipyridamole, or clopidogrel here. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676181 If continuation sheet Page 5 of 10 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 676181 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of Atascosa 1855 W Goodwin Pleasanton, TX 78064 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)

F 0801 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Based on observation, interview, and record review, the facility failed to employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, taking into consideration resident assessments, individual plans of care and the number, acuity and diagnosis of the facility's resident population in accordance with the facility assessment requirement, for 1 of 1 kitchen staff (Dietary Manager) reviewed for qualifications, in that: The Dietary Manager did not have the appropriate license, certification, or qualifications to function as the food service supervisor. This failure could place all residents who consume food prepared from the kitchen at increased risk of food borne illness and not receiving adequate nutrition. Findings include: During an interview on 02/09/2023 at 11:15 a.m., the DM revealed she does not have the certification required for her current position. She explained she was enrolled in a certification program currently but has not yet finished. The DM said she would finish at the earliest in December 2023. During an interview on 02/09/2023 at 2:10 p.m., the Administrator explained the facility did not have a Certified Dietary Manager employed at this time and further stated the staff currently identified by kitchen staff as the current Dietary Manager was not certified. The Administrator said she thought there was a waiver for facilities in rural areas allowing more time for the Dietary Manager to obtain her certification as the DM is currently in school. During an interview on 02/10/23 at 9:51 a.m., the Dietician explained she spends approximately 24 hours a month working with the facility staff. Record review of employee files and licensure revealed the Dietary Manager was hired 2/06/2017 as an employee with the facility. Further review of the Dietary Manager's employee file revealed there was no dietary manager certification. Record review of the USDA Food Code 2017 indicated the following: Based on the risks inherent to the Food Operation, during inspections and upon request the Person in Charge shall demonstrate to the Regulatory Authority knowledge of food borne disease prevention application of the Hazard Analysis of foodborne disease prevention, application of the Hazard Analysis and Critical Control Point principles, and the requirements of this Code. The Person in Charge shall demonstrate this knowledge by: (A) Complying with this Code by having no violations of priority items during the current inspection; (B) Being a certified food protection manager who has shown proficiency of required information through passing a test that is part of an accredited program; Record review of documentation titled F tag Help - F801 Qualified Dietary Staff dated 02/10//22 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676181 If continuation sheet Page 6 of 10 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 676181 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of Atascosa 1855 W Goodwin Pleasanton, TX 78064 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)

F 0801 Level of Harm - Minimal harm or potential for actual harm revealed the following documentation, . Staffing. If a qualified dietitian or other clinically qualified nutrition professional is not employed full-time, the facility must designate a person to serve as the Director of food and nutrition services who is a a. Certified dietary manager, or Residents Affected - Few b. Certified food service manager; or c. Has similar national certification for food service management and safety from a national certifying body; or d. Has an associates or higher degree in food service management or in hospitality, if the course study includes food service or restaurant management, from an accredited institution of higher learning; and III. In states that have establish standards for food service managers or dietary managers, meets state requirements for food service managers or dietary managers. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676181 If continuation sheet Page 7 of 10 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 676181 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of Atascosa 1855 W Goodwin Pleasanton, TX 78064 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)

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation, interview and record review the facility failed to store, prepare, distribute and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen and 2 of 3 standard size refrigerators reviewed for sanitation and storage, in that: 1. The facility failed to properly store food in the walk-in dry food storage area. 2. The facility failed to properly store food in the large commercial style refrigerator. 3. The facility failed to properly store drinks/food in 1 of 2 standard size refrigerators observed on the hallways accessible to staff and Residents. These deficient practices could place residents who eat food from the kitchen at-risk of foodborne illness. Findings include: Observation on 02/07/2023 at 9:50 a.m. of the dry food storage area, with the [NAME] at 9:50 a.m. revealed a 5- pound container of peanut butter partially used with no open date. Observation on 02/09/2023 at 10:55 a.m. of the commercial style refrigerator, with the Dietary Manager revealed a plastic storage bag sealed containing another opened plastic manufacturer bag that contained 6 boiled eggs dated 1/26 on the outside of the plastic storage bag with black writing. Observation on 2/07/2023 at 12:16 p.m. of CNA D serving Resident #41 cranberry juice from an unlabeled pitcher, (there was not item name on the pitcher), after telling him there was no more apple juice. Observation on 02/07/2023 at 12:20 p.m., 4 unlabeled half gallon pitchers in the standard size refrigerator on hall 100. Observation on 02/07/2022 at 12:25 p.m. 4 unlabeled half gallon pitchers in the standard size refrigerator on hall 300 labeled with item name and date on each pitcher. During an interview on 02/07/2023 at 9:50 a.m. with the cook, she stated the peanut butter container should be labeled with the date it is received and the date it is opened according to the rules. Since the peanut butter was not labeled with the date it was opened and some was used out of the container then we don't know if it is fresh and we always want the residents to get fresh food. During an interview on 02/07/2023 at 12:21 p.m. CNA D said, I thought the pitcher was orange juices there is no label with the name on it so I couldn't tell. I told the resident there was no more apple juice they look the same. She said the pitchers just have dates on them and no names when the orange juice settles at the bottom it can be hard to tell and then pulled the cranberry and tea pitchers to the front of the others and said they can look alike as well. CNA D said it is important to serve the residents what they want. During an interview with the DM on 02/09/2023 at 2:00 p.m. the DM said the food items and drink (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676181 If continuation sheet Page 8 of 10 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 676181 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of Atascosa 1855 W Goodwin Pleasanton, TX 78064 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)

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some items like the pitchers are supposed to be labeled with the name and date by dietary and or nursing if needed. The DM said the peanut butter according to policy should have been labeled with an open date and was not. She said they have a new staff member that might have forgotten. She said all food items should be labeled according to facility policy. During an interview on 02/10/2023 at 2:18 p.m. the DON said any food items or drinks should be labeled with the name and date by dietary and if needed nursing, we take a team approach. During an interview on 02/10/2023 at 9:21 a.m. with Resident #41, he said he does not drink tea or orange juice so his only choices are cranberry and apple. Resident #41 said, if they don't have what I want there is nothing I can do. Record review of the facility's policy titled, Food Storage, dated 2018, revealed, 1. Refrigerators: (d) Date, label and tightly seal all refrigerated food using clean, nonabsorbent, covered containers that are approved for food storage. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676181 If continuation sheet Page 9 of 10 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 676181 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/10/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Heights of Atascosa 1855 W Goodwin Pleasanton, TX 78064 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)

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to maintain an Infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable disease and infection for 1 of 6 residents (Resident #52) reviewed for infection control, in that: Residents Affected - Few CNA F did not wash or sanitize her hands or change her gloves during incontinent care for Resident #52 These deficient practices could place residents at-risk for infection due to improper care practices. The findings include: Record review of Resident #52's face sheet, dated 02/09/2023, revealed an admission date of 11/09/2022, with diagnoses which included: Hypertension (High blood pressure) , Pain, Type 2 diabetes mellitus(blood glucose, also called blood sugar, is too high), Hyperlipidemia( too much lipids (fat) in the blood), Intellectual disability(generalized neuro developmental disorder characterized by significantly impaired intellectual and adaptive functioning) Record review of Resident #52's Quarterly MDS, dated [DATE], revealed the resident was non verbal, had memory problems and severe cognitive impairment. Resident #52 required extensive assistance and, was always incontinent of bladder and bowel. Observation on 02/09/2023 at 10:45 a.m. revealed during incontinent care, after cleaning Resident #52's buttocks , CNA F did not change her pair of gloves and did not sanitize her hands. CNA F, then, applied a clean brief to the resident and fastened it. During an interview with CNA F on 02/09/2023 at 10:59 a.m., the CNA F verbally confirmed not changing her gloves or washing or sanitizing her hands. She confirmed receiving infection control in service multiple times in the last year. She forgot to change her gloves and wash her hands. During an interview with the DON on 02/10/2023 at 1:20 p.m., the DON verbally confirmed the staff needed to change their gloves and sanitize their hands to prevent cross contamination. The staff was trained multiple times a year on infection control and they did return demonstration with skill checks. The RN weekend supervisor did audits every weekend on different staff members to check their knowledge and skills. Review of CNA F's CNA/caregiver competency checklist, dated 08/26/2022 revealed CNA F received proficiency for perineal care and infection control. Review of the facility's policy, titled Handwashing/hand hygiene , dated 08/2015, revealed Use an alcohol-based rub [ .] for the following situation [ .] h. before moving from a contaminated body site to a clean body site during resident care; [ .] j. after contact with blood or bodily fluids FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676181 If continuation sheet Page 10 of 10

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Citations

6 citations recorded^*CMS

What do CMS severity letters mean?

Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.

General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.

Each letter combines severity with scope: how many residents the deficiency affected.

0641GeneralS&S Epotential for harm
F641 - Accuracy of Assessments
Ensure each resident receives an accurate assessment.
0801GeneralS&S Dpotential for harm
F801 - Staffing
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
0812GeneralS&S Epotential for harm
F812 - Food safety requirements
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
0880GeneralS&S Dpotential for harm
F880 - Infection Control
Provide and implement an infection prevention and control program.
0578GeneralS&S Dpotential for harm
F578 - The right to request, refuse, and/or discontinue treatment, to participate in or
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
0583GeneralS&S Dpotential for harm
F583 - Privacy and Confidentiality
Keep residents' personal and medical records private and confidential.

FAQ · About this visit

Common questions about this visit

What happened during the February 10, 2023 survey of The Heights of Atascosa?

This was a inspection survey of The Heights of Atascosa on February 10, 2023. The surveyor cited 6 deficiencies, recorded on the federal Form 2567 statement of deficiencies.

Were any deficiencies cited at The Heights of Atascosa on February 10, 2023?

Yes, 6 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Ensure each resident receives an accurate assessment."

What type of survey was this?

This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.

SourceView on CMS Care Compare

Next steps

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Data from CMS Care Compare public records. Dataset last refreshed June 22, 2026. If you believe any information is inaccurate, report it here.

Health inspection·February 10, 2023