Health inspection·April 9, 2025

F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to develop and implement a person-centered comprehensive care plan to include measureable objectives and timeframes to attain or maintain the resident's highest practical physical, mental and psychosocial well-being for 1 of 5 residents (Resident #8) reviewed for comprehensive care plans in that: The facility failed to revise or update Resident #8's care plan to reflect the habitual losing or misplacing of items and accusing others of theft. This failure could affect the resident by placing him at risk for not receiving appropriate interventions to meet his current needs. The findings included: Record review of Resident #8 ' s face sheet dated 04/09/25 revealed an [AGE] year-old male with an original admission date of 02/28/23, and a current admission date of 05/20/23. Diagnoses for Resident #8 revealed Dementia (a decline in cognitive function) and Anxiety (feelings of worry, fear, and apprehension). Record review of Resident #8 ' s Quarterly MDS assessment dated [DATE] revealed a BIMS score of 10, which indicated moderately impaired cognition. Record review of Resident #8 ' s care plan initiated 03/15/23 revealed no care plan for misplacing items, losing items, and/or accusing others of theft of items. In an interview with CNA-D on 4/8/25 at 2:56 PM, she stated the CNAs used the care plans to know what the residents ' needs were and how to meet them, but they were not the ones who updated them. She stated she thought the nurses did that. In an interview with Resident #8 on 04/09/25 at 10:35 AM, he stated that he had 40 dollars in his wallet on his bed and 60 dollars in an envelope in his drawer. He stated that when he realized it was missing on 03/08/25, he reported it. He stated he was not exactly sure what happened to the money, and he initially stated he thought the nurse took it but then stated he had been suspicious of the CNA who worked his hall and the CNA who worked the other hall. He stated they were mother and daughter, and he thought they were in on it together. Resident #8 also stated he had property that went missing previously, and he usually found it, but he never found this missing money. Resident #8 stated he locked everything up now and kept the keys on him. (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 4 Event ID: 676391 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 676391 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Windsor Calallen 4162 Wildcat Dr Corpus Christi, TX 78410 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)