Silver City Care Center

F 0657

R #8

Level of Harm - Minimal harm or potential for actual harm

E. Record review of R #8’s admission documents, no date, revealed she was admitted to the facility

on [DATE REDACTED].

Residents Affected - Some

F. Record review of R #8's physician's orders, multiple dates, revealed the following:

1. 1. An order dated 06/10/25, for trazodone (prescription antidepressant medication that belongs to the class

of drugs known as serotonin antagonist and reuptake inhibitors) 100 mg 1 tablet by mouth once a day for circadian rhythm disorder (a sleep disorder that occurs when your body's internal clock, known as the circadian rhythm, is out of sync with your environment or your desired schedule).

2. 2. An order dated 07/15/25, for mirtazapine (is an atypical tetracyclic antidepressant used primarily to treat

major depressive disorder) 15 mg give one tablet at bedtime for depression.

G. Record review of R #8’s care plan, dated 07/08/25, revealed the care plan did not contain any interventions or goals for trazadone or mirtazapine.

H. On 08/26/25 at 1:39 PM, during an interview, the DON confirmed R #8’s care plan did not have interventions or goals for R #8’s trazodone or mirtazapine. The DON stated her expectation is that there should be interventions and goals for all psychotropic medications.

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

Event ID:

Facility ID:

If continuation sheet

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

08/27/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Silver City Care Center

3514 Fowler Avenue Silver City, NM 88061

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 0677

Provide care and assistance to perform activities of daily living for any resident who is unable.

Level of Harm - Minimal harm or potential for actual harm

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

record review, interview, and observation the facility failed to provide activities of daily living (ADL; activities related to personal care such as bathing, showering, dressing, walking, toileting, and eating) assistance for 1 (R #1) of 1 (R #1) resident reviewed for ADL care when staff failed to cut R #1's fingernails. This deficient practice is likely to negatively affect the dignity and health of the residents. The findings are: A. Record

review of R #1's admission record, no date, revealed R #1 was admitted to the facility on [DATE REDACTED]. B. On 08/25/25 at 1:16 PM, during an observation, some of R #1's fingernails were overgrown, some were jagged and uneven from breaking off. C. On 08/25/25 at 1:16 PM, during an interview, R #1 stated staff had not offered to cut her fingernails. R #1 said she did not have any clippers to cut them herself. D. Record review R #1's Quarterly MDS dated [DATE REDACTED] revealed R #1 needs partial to moderate assistance with personal hygiene. E. On 08/25/25 at 2:25 PM, during an interview, CNA #8 confirmed R #1's fingernails were long and had not been cut.

Residents Affected - Few

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

Event ID:

Facility ID:

If continuation sheet

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

08/27/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Silver City Care Center

3514 Fowler Avenue Silver City, NM 88061

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 0687

Provide appropriate foot care.

Level of Harm - Minimal harm or potential for actual harm

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

observation, record review, and interview, the facility failed to provide foot care for 1 (R #1) of 1 (R #1) resident reviewed for foot care when staff failed to provide nail care for R #1's toenails or make an appointment to a podiatrist for foot care. This deficient practice could likely cause podiatric complications (foot and ankle health issues, often arising from underlying systemic diseases like diabetes or poor circulation, that can lead to problems such as ulcers, infections, nerve damage (neuropathy), and, in severe cases, amputation in residents with diabetes). The findings are: A. Record review of R #1's admission record, no date, revealed the following: 1. R #1 was admitted to the facility on [DATE REDACTED]. 2. R #1 has a diagnosis of type 2 diabetes mellitus (a chronic metabolic condition characterized by insulin resistance, where the body's cells don't respond to insulin properly, and a gradual decline in the pancreas's ability to produce enough insulin) without complications. B. On 08/25/25 at 1:16 PM, during an observation, R #1's toenails were overgrown, and her feet were callused (a thickened and hardened part of the skin or soft tissue). C. On 08/25/25 at 1:16 PM, during an interview, R #1 stated staff had not offered to cut her toenails and that she had not seen a podiatrist (a person who treats the feet and their ailments) since her admission. R #1 stated she had lost a toenail but that it was growing back. D. Record review of R #1's progress note, dated 07/11/25, revealed R #1 resident's nail fell off with no pain or blood. There was a recommendation from the provider to cleanse with wound cleanser pat dry apply triple antibiotic ointment, cover with dry gauze and secure with tape until healed. E. On 08/25/25 at 2:25 PM, during an interview, CNA #8 confirmed R #1's toenails were long and had not been cut. F. On 08/25/25 at 2:29 PM, during an interview, LPN #8 confirmed R #1 had a diagnosis of type 2 diabetes mellitus. LPN #8 stated that if a resident has a diagnosis of diabetes that a podiatrist will provide foot care for residents. LPN #8 stated the facility does not have a podiatrist that comes to the facility. G. On 08/25/25 at 3:31 PM, during an interview, RN #8 stated she had not seen R #1's toenails and that she had not made any referrals for R #1 to be seen by a podiatrist. RN #8 stated that residents' nails should be checked once a week. RN #8 confirmed R #1 is

a diabetic. RN #8 confirmed that R #1's toenails are long and callused. H. On 08/26/25 at 2:46 PM, during

an interview, the Schedular (staff who schedules appointments) stated he had scheduled an appointment last week for R #1 to see a podiatrist.

Residents Affected - Some

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

Event ID:

Facility ID:

If continuation sheet

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

08/27/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Silver City Care Center

3514 Fowler Avenue Silver City, NM 88061

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 0842 Level of Harm - Minimal harm or potential for actual harm

essential for life including blood pressure, heart rate, body temperature and respiratory rate) for August 2025 revealed the following:

1. 1. Staff did not document R #1’s blood pressure on August 6th, 7th, 14th, 15th, 16th, 17th, 19th,

20th, 21st, 22nd, 23rd and 24th.

Residents Affected - Some

2. 2. Staff did not document R #1’s heart rate on August 4th, 6th, 7th, 14th, 15th, 16th, 17th, 19th,

20th, 21st, 22nd, 23rd and 24th.

E. On 08/27/25 at 4:22 PM, during an interview with the DON, the following was confirmed:

3. 1. Staff should document the required vital signs when administering medications if the MAR has that

option.

4. 2. If staff do not have the option to document vital signs on the MAR they should document them in the vital

signs section of the resident’s medical record.

5. 3. Her expectation is that staff will document the vital signs in the medical record as indicated on the

physician’s orders.

R #8 F. Record review of R #8’s admission documents, no date, revealed she was admitted to the facility

on [DATE REDACTED] with a diagnosis of circadian rhythm sleep disorder.

G. Record review of R #8's MAR for the month of August 2025 revealed, mirtazapine 15 mg give one tablet at bedtime for depression.

H. Record review of a psychiatric provider progress note, dated 07/15/25, revealed mirtazapine was prescribed for circadian rhythm disorder (a sleep disorder that occurs when your body's internal clock, known as the circadian rhythm, is out of sync with your environment or your desired schedule).

I. On 08/26/25 at 1:39 PM, during an interview, the DON stated R #8’s prescription for mirtazapine is for circadian rhythm disorder and that depression is the indication. The DON stated that staff entered the order wrong.

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

Event ID:

Facility ID:

If continuation sheet