Health inspection·March 5, 2025

F 0655 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to develop and implement a baseline care plan for each resident that included instructions needed to provide effective and person-centered care for the resident that met professional standards of care within 48 hours of the resident's admission for one (Resident #144) of five residents reviewed for baseline care plans. The facility failed to complete a baseline care plan for Resident #144. This failure could place newly admitted residents at risk of not receiving effective and person-centered care and services. Findings included: Review of Resident #144's Face Sheet, dated 03/03/25, reflected she was a [AGE] year-old female who admitted to the facility on [DATE], with diagnoses including aftercare following joint replacement surgery (a period of pain management, physical therapy, wound care, and gradually returning to normal activities), type 2 diabetes mellitus (a chronic condition where the body either doesn't produce enough insulin, or the cells become resistant to the effects of insulin, leading to high blood glucose (sugar) levels), and heart failure (a chronic condition that occurs when the heart can't pump enough blood to meet the body's needs). Review of Resident #144's electronic medical records on 03/03/25 reflected a baseline care plan had been initiated on 02/25/25 by LVN F, but the baseline care plan was never completed. During an interview with LVN F on 03/03/25 at 12:54PM, he stated baseline care plans were required to be completed within 48 hours of a resident's admission. He stated he was responsible for completing Resident #144's baseline care plan. He said although he initiated the baseline care plan in the facility's electronic charting system, he forgot to complete the document. During an interview with the Director of Nursing on 03/05/25 at 12:00PM, he stated baseline care plans were required to be completed within 48 hours of a resident's admission. He stated there was not an inherent risk to residents if baseline care plans were not completed within this required timeframe, as facility staff communicated closely regarding resident care and ensured all care needs were still met. Review of the facility's Care Plans - Baseline policy, dated 03/2022, reflected, .A baseline plan of care to meet the resident's immediate health and safety needs is developed for each resident (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 8 Event ID: 676387 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 676387 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Highland Meadows 1870 John King Blvd Rockwall, TX 75032 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)