Winnfield Nursing And Rehabilitation Center, Llc

F 0627 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

discharge documentation, such as the basis for discharge, referrals, medication reconciliation, instructions for discharge, or coordination of care, was documented by the facility in Resident #1's record.An interview with S1 Administrator on 09/03/2025 at 9:25 a.m. confirmed that S6 SSD was responsible for discharge planning and documentation. In an interview on 09/03/2025 at 2:52 p.m., S2 DON stated Social Services was responsible for initiating the Discharge Summary and completing their part. S2 DON stated the nurse had a part to complete, also. S2 DON acknowledged Resident #1's medical record did not contain the reason for her discharge, nor any documentation that written instructions were given to or discussed with

the resident regarding her medications at discharge. Resident #R1Review of Resident #Resident R1's medical

record revealed an admit date of 03/18/2025 and a discharge date of 06/10/2025. Resident #Resident R1's diagnoses included Alzheimer's disease, Paroxysmal Atrial Fibrillation, Atherosclerotic Heart Disease, and Hemiplegia and Hemiparesis following Cerebral Infarction.Review of Resident #Resident R1's 5 day MDS with an ARD of 03/25/2025 revealed a BIMS score of 15, which indicated intact cognition.Review of Resident #Resident R1's medical record revealed no documentation stating why the resident was discharged . Further review revealed no documentation of the medications provided to the resident at discharge or any instructions given to the resident.Review of Resident #Resident R1's progress notes revealed the following:6/10/2025 at 12:23 p.m. Nurses Note by S8 LPN: Note Text: 12:20 p.m. Resident is discharged out of facility with medications.6/10/2025 at 10:54 a.m. Discharge Summary by S6 SSD: Resident sitting up in wheelchair waiting for family to arrive so that he can discharge home with fiancee. He is alert and oriented to self. His speech is clear. His hearing is adequate. He understands and is understood. No behaviors noted nor observed. He has a diagnosis of Alzheimer's Disease, Cerebral Infarction, HTN, and Type 2 Diabetes. He is incontinent of bowel and bladder. He is aware of activities and will attend those that interest him. Resident's main mode of transportation is wheelchair. Resident has to be encouraged to socialize with other residents.

He prefers to stay in room and isolate to his room. His family is active in his care and attentive to his needs.

He is capable of voicing his preference regarding his care. He is a full code, no living will, no POA, non-smoker, and not at risk for elopement. Resident discharges home 6/10/25. LTPCS will evaluate resident

on 6/23/25 to see what services that he can receive at home.In an interview on 09/03/2025 at 2:45 p.m., S3 LPN stated Resident #Resident R1 was here for short term therapy after having a stroke. S3 LPN stated Resident #Resident R1 wanted to go home after receiving therapy.In an interview on 09/03/2025 at 2:52 p.m., S2 DON stated Social Services was responsible for initiating the Discharge Summary and completing their part. S2 DON stated the nurse had a part to complete, also. S2 DON acknowledged Resident #Resident R1's medical record did not contain the reason for his discharge nor any documentation that written instructions were given to or discussed with the resident regarding his medications at discharge.

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Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

09/03/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Winnfield Nursing and Rehabilitation Center, LLC

915 1st Street Winnfield, LA 71483

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)

F 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Resident's main mode of transportation is wheelchair. Resident has to be encouraged to socialize with other residents. He prefers to stay in room and isolate to his room. His family is active in his care and attentive to his needs. He is capable of voicing his preference regarding his care. He is a full code, no living will, no POA, non-smoker, and not at risk for elopement. Resident discharges home 6/10/25. LTPCS will evaluate resident on 6/23/25 to see what services that he can receive at home.06/10/2025 at 12:23 p.m.: Nurses Note by S8 LPN: Note Text: 12:20 p.m. Resident is discharged out of facility with medications.Review of Resident #Resident R1's medical record revealed no documentation stating why Resident #Resident R1 was discharged , no documentation of the medications provided to Resident #Resident R1 at discharge, or any instructions given to the resident. Review of Resident #Resident R1's Discharge Summary/Instructions form dated 06/10/2025 revealed no documentation of Resident #Resident R1's diagnoses, course of illness/treatment, or therapy received and no medication reconciliation or summary of Resident #Resident R1's status at the time of discharge. The Discharge Summary was not signed by Resident #Resident R1.Interview with S2 DON on 09/03/2025 at 2:52 p.m. revealed Social Services was responsible for initiating the Discharge Summary and completing their part of the form and the nurse also had a part to complete. S2 DON confirmed Resident #Resident R1's Discharge Summary and medical record did not contain a list of medications provided to Resident #Resident R1 or documentation of written or verbal instructions provided to or discussed with Resident #Resident R1 regarding his medications at discharge. S2 DON acknowledged Resident #Resident R1's Discharge Summary did not contain a recapitulation of Resident #Resident R1's stay or Resident #Resident R1's status at time of discharge and should have.

Event ID:

Facility ID:

If continuation sheet