Health inspection·July 18, 2024

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview, and record review the facility failed to provide pharmaceutical services (including procedures that assist the accurate acquiring, receiving, dispensing ,and administering of all drugs and biologicals) to meet the needs of each resident for 1 of 3 residents(Resident #1) reviewed for pharmacy services. The facility failed to acquire and administer Resident #1's scheduled dose of Dexamethasone (a corticosteroid that prevents the release of substances in the body that cause inflammation.) on 7/7/2024 and 7/8/2024. This failure could place residents at risk for pain and poor quality of life. The findings were: Record review of Resident #1's face sheet, dated 7/17/2024 revealed a [AGE] year-old female with an admission date of 6/27/2024 and diagnoses which included neoplasm of cerebral meninges, ( A meningioma is a tumor that grows from the membranes that surround the brain and spinal cord, called the meninges. A meningioma is not a brain tumor, but it may press on the nearby brain, nerves and vessels. ) hyperlipidemia, (high cholesterol)unspecified dementia(Dementia is the loss of cognitive functioning thinking, remembering, and reasoning - to such an extent that it interferes with a person's daily life and activities.), anxiety disorder, hypertension (high blood pressure) and muscle weakness. Record review of Resident #1's MDS dated [DATE] revealed a BIMS score of 00 which indicated the resident was cognitively impaired. Record review of Resident #1's physician's orders from 6/27/2024 to 7/31/2024 revealed a physician order for Dexamethasone oral tablet 4mg give 1 tablet every six hours. The order start date was 6/27/2024. Record review of Resident #1's July 2024 MAR revealed Dexamethasone oral tablet 4mg give 1 tablet every six hours and was documented as not given due to medication unavailable on 7/7/2024 and 7/8/2024every 6 hours. (12:00 am,6:00 am,12:00pm,6:00 pm missing a total of 8 doses in 2 days) Record review of Resident #1's Nurse Practitioner notes dated 7/12/2024 at 11:00 am revealed: no signs of distress noted, family at bedside, patient follows commands but appears weak, family states patient was sitting up eating and talking this morning prior to PT. Patient typically becomes sleepier after therapy based on my encounters with her and family confirms. Discussed concerns with patient family member regarding dexamethasone. Patient seemed to decline after missing 2 days of by mouth (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: 676447 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 676447 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/18/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ignite Medical Resort San Antonio, LLC 6035 Eckhert Rd San Antonio, TX 78229 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)