Health inspection·December 22, 2023

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, interview, and record review, the facility failed to ensure medications were secured on 1 (Medication Cart 1) of 8 medication carts reviewed for pharmacy services. The facility did not ensure medication cart (Medication Cart 1) was secured and locked. This failure could place the residents at risk of gaining access to unlocked medications not prescribed to them. Findings included: During an observation on 12/21/2023 at 2:00 PM, LVN A left Med Cart 1 unsecured and out of LVN A's sight, on the front hallway by the resident's living room, while she walked away to the medication room. There were not any other staff in visual sight of the medication cart, and there were residents that were within 8 feet of the medication cart. The State Surveyor was unsure where the nurse went and took Medication Cart 1 to the Administrator. During an interview and observation on 12/21/2023 at 2:35 PM, The Administrator immediately locked Med Cart 1. He revealed that the facility policy and expectations were that all medications were to be locked when not in use or when the nurse walked away. He revealed that he was unsure whose cart it was, but that he would find out and correct the issue. He stated that it was the responsibility of the nurse who was assigned the medication cart to ensure that it was locked. During an interview on 12/21/2023 at 2:45 PM, LVN A said that she walked away to go into the medication room. She said that she had not realized that the medication cart was unlocked and that she knew that it was to be always locked, when not in use. She said that she should have locked the medication cart up before she left it unattended with residents around it. She said that this could cause a patient to get into it and take the medications. She stated that this failure could cause a resident who gained access to the medication to get sick. During an interview on 12/22/2023 at 10:45 AM, the DON said that her expectations were for medications to be locked up anytime a nurse walked away from a medication cart. She said that staff were all trained on medication expectations and know not to leave medications out or unattended. She stated she was responsible for the training on securing medication carts and that the LVN was up to date on her in-service. She had just completed a staff training on securing medication carts. A policy and procedure titled Security of Medication dated April 2007 revealed the following: (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: 676499 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 676499 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/22/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Springtown Park Rehabilitation and Care Center 201 Williams Ward Rd. Springtown, TX 76082 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)