Health inspection·May 12, 2022

F 0758 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure that unnecessary antipsychotic medications were not administered without an adequate rational for use and the facility failed to reevaluate the use of a PRN psychotropic drug for 1 of 6 resident's reviewed (Resident #9). - Resident #9 had a PRN order for Xanax (an anti-anxiety medication) for more than 14 days without physician documentation re-evaluating the medication' to continue its use beyond the 14 days. - The facility failed to attempt a routine gradual dose reduction (GDR) for Resident #9's PRN Xanax, Sertraline and Trazadone. These failures could affect 14 residents receiving psychoactive medications by placing them at risk for adverse side effects due to unnecessary drugs. The findings were: A record review of Resident #9's face sheet dated 5/12/22 revealed a [AGE] year-old female admitted to the facility on [DATE]. Her diagnoses included recurrent mild major depressive disorder, and anxiety disorderunspecified. Record review of Resident #9 ' s Comprehensive Minimum Data Set assessment, dated 2/22/22, revealed Resident #9: -had moderate impaired cognitive status; -had trouble staying asleep or going asleep; -was sleeping too much and feeling tired or having little energy nearly every day; -had no hallucinations or delusions; -had no abnormal social behaviors and antianxiety medication once; -used an antidepressant medication 7 out of 7 days; -received no antipsychotic medications in the last seven days; and (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: 676336 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 676336 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/12/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Continuing Care at Eagles Trace 14703 Eagle Vista Drive Bldg 601b Houston, TX 77077 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)