Inspection·July 29, 2023

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, interview, and record reviews the facility failed to ensure drugs and biologicals used in the facility were labeled in accordance with currently accepted professional principles and included the appropriate accessory and cautionary instructions, and the expiration date when applicable and the facility failed to store all drugs and biologicals in locked compartments under proper temperature controls and permitted only authorized personnel to have access to the keys for 1 of 2 medication carts (300 Hall Medication Cart) reviewed for medication storage. The facility failed to ensure the medication cart on the 300 Hall did not contain loose pills. This failure could place residents at risk for drug diversion, drug overdose and accidental or intentional missed doses or administration of medications to the wrong resident. Findings include: During an observation on 7/29/23 at 8:25 AM, revealed the 300 Hall medication cart had a cup with 5 medications in it. MA A stated the pills were for Resident #1 and she identified the pills. The following loose pills identified in the cup included: 1 capsule Erivedge 150mg for metastatic basal cell carcinoma 1 tab Vitamin B12 1000 mcg for B12 deficiency 1 cap Dicyclomine 10mg for irritable bowel syndrome ½ tab Metoprolol Tartrate 12.5 mg for high blood pressure and 1 cap Hydralazine 50mg for high blood pressure. During an observation on 7/29/23 at 9:02 AM of the 300 Hall medication cart revealed the cup of medication for Resident #1 was still located in cart. During an interview on 7/29/23 at 8:25 AM, MA A stated the pills in the cup were for Resident #1 and he was not in his room when she went to give him his medication. MA A stated that leaving the pills in the medication cart could result in her forgetting to give them to the resident. During an interview on 7/29/23 at 9:02 AM, MA A stated Resident #1 was not in his room when she (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: 676347 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 676347 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/29/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Amarillo Center for Skilled Care 6641 W Amarillo Blvd Amarillo, TX 79106 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)