Health inspection·February 6, 2025

F 0694 Provide for the safe, appropriate administration of IV fluids for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to ensure they followed professional standards of practice in accordance with physician orders and facility policy for care of PICC for 1 (Residents #1) of 2 residents reviewed for parenteral and intravenous care. Residents Affected - Some The facility failed to change Resident #1's PICC line dressing as ordered. This failure placed the residents at risk of complications with their PICC needed for infusion therapy. Findings included: Record review of Resident #1's face sheet dated 2/3/25 revealed a [AGE] year-old female who was admitted to the facility on [DATE] with diagnoses of repeated falls, metabolic encephalopathy (condition in which brain function is disturbed either temporarily or permanently due to different diseases or toxins in the body), and pneumonia. Record review of Resident #1's admission MDS assessment still in progress had a BIMS score of 12, indicting her cognition was moderately impaired. Record review of Resident #1's care plan dated 1/15/25 revealed a focus area for at risk for complications due to PICC line located in left upper arm with interventions of change dressing as ordered and as needed if soiled, wet, or lose. Record review of Resident #1's physician order dated 1/14/25 revealed Nurse to use Sterile Technique when changing PICC line dressing changes once a week per facility protocol. In an observation and interview on 2/4/25 at 8:50 am, Resident #1 was in bed, the PICC line dressing was dated 01/27/25 and remained intact. Resident #1 denied any discomfort or pain at the site. There were no signs of soiling or infection observed. In an observation and interview on 2/5/25 at 9:33 am, Resident #1 was in bed, the PICC line dressing was dated 01/27/25 and remained intact. Resident #1 denied any discomfort or pain at the site. There were no signs of soiling or infection observed. In an interview on 2/5/25 at 9:35 am, LVN C stated that Resident #1's PICC line dressing should have been changed on Monday or Tuesday, as the order required it to be changed every seven days. LVN C mentioned that anyone could have done it the previous day. LVN C stated the dressing was intact 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: 676457 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 676457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/06/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Bartlett Skilled Nursing and Assisted Living 221 Bartlett Drive El Paso, TX 79912 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)