Health inspection·September 8, 2022

F 0655 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** . Residents Affected - Some 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 of the resident that met professional standards of care within 48 hours of the resident's admission for two (Resident #15 and Resident #145) of four residents reviewed for base line care plans. The facility failed to complete Resident #15 and Resident #145 baseline care plan within 48 hours of admission that included the minimum required healthcare information of initial goals based on admission orders, physician orders, dietary orders, therapy services, and social services. This failure placed residents at risk of not receiving effective and person-centered care. Findings included: Review of Resident #15's undated Face Sheet, reflected she was a [AGE] year-old female admitted to the facility on [DATE] . Her diagnoses included unspecified fracture of lower end of right femur( thigh ) pain in right leg, history of falling, muscle weakness, difficulty in walking, hypertension, and nausea with vomiting. Review of Resident #15's Initial Care Plan, dated 06/28/22 reflected Resident #15 had the potential for infection. The care plan did not address physician orders, dietary orders, therapy services, and social services. Review of Resident #145's undated Face Sheet, reflected she was a [AGE] year-old female admitted to the facility on [DATE]. Her diagnosis included encounter for other orthopedic aftercare, displaced fracture of the right thigh, pain in right hip, history of falls, muscle weakness, difficult in walking, hypertension, and diabetes due to underlying condition with hyperglycemia, excess of glucose in the bloodstream. Review of Resident #145's Initial Care Plan, dated 08/30/22 reflected Resident #145 was a fall risk. The care plan did not address physician orders, dietary orders, therapy services, and social services In an interview on 09/08/2022 at approximately 1:00 pm with the DON, she stated care plans are initiated and completed by the charge nurse upon a resident's admission into the facility and she tracked for completion. The DON did not state how she tracked care plans. The DON stated she became aware (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: 676483 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 676483 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/08/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ventana by Buckner 8301 N. Central Expressway Dallas, TX 75201 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)