Corinth Rehabilitation Suites On The Parkway

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

not dated, reflected: Policy.2. The Facility shall report immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not result in serious bodily injury to the administrator of the facility and to other officials (including to the State Survey Agency and adult protective services where state law provides for jurisdiction in long-term care facilities) in accordance with State law through established procedures. See Also Reporting Reasonable Suspicion of a Crime Policy.

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

09/11/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Corinth Rehabilitation Suites on the Parkway

3511 Corinth Parkway Corinth, TX 76208

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 0610 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

Anonymous Person said when they arrived the resident was alone in his room on the floor, and they assisted him off the floor. The Anonymous Person said they saw two staff members seated at the nurse's desk and was told the other staff were at lunch break.An interview was attempted with RN B on 09/11/25 at 2:50 PM. RN B did not return the call of the Surveyor. An interview on 09/11/25 at 3:20 PM with CNA C revealed she was working on the 10:00 PM - 6:00 AM shift on 08/10/25. She said she was not assigned to Resident #1. CNA C said she was on a different hall, and she saw LVN D pacing in the Hall looking for CNA

A and RN B. CNA C said CNA A and RN B were on break outside in their cars. CNA C said she saw the paramedics were in the facility and she did not know why. CNA C said CNA A told her that Resident #1 had fallen and called 911 for help. An interview on 09/11/25 at 3:45 PM with CNA A revealed she worked the 10:00 PM - 6:00 AM shift on 08/10/25. CNA A said she was assigned to Resident #1. CNA A said she went to Resident #1's room (unknown time) and asked if he needed anything and he said no. CNA A said she told RN B she was going on lunch break, but did not realize that RN B was going to lunch break at the same time. She said another staff member (unknown) on a different hall came out to her car while she was

on break. CNA A said the staff member wanted to know where she and RN B were. CNA A said she stopped her lunch break and went back into the facility. CNA A said the paramedics already had Resident #1 back in his electric wheelchair. CNA A said if both assigned staff members went to lunch break at the same time, residents were at risk for falls.A follow-up interview on 09/11/25 at 4:10 PM with the DON revealed she went and interviewed Resident #1. The DON said there was nothing that stood out with his fall

on 08/10/25. The DON said she spoke to staff, but did not contact EMS about the incident. The DON said

she spoke to staff but did not know both CNA A and RN B had gone on lunch break at the same time. The DON said the incident was not self-reported because she did not realize the staff assigned were not in the facility when he fell. The DON did say there were other staff in the building when he fell.An interview on 09/11/25 at 4:20 PM with the Administrator revealed she spoke to Resident #1 about his fall (08/10/25) on 09/11/25. She said the resident told her call light response time was slow. The Administrator said she spoke to RN B who said on 08/10/25 she was out on break when he fell. The Administrator said she did not realize that both CNA A and RN B were on break at the same time. The Administrator said she did not speak to EMS, but Resident #1 told her he called EMS because staff did not respond when he fell. The Administrator said if she had known that both staff were on break when he fell; she would have self-reported the incident as neglect.Review of the facility policy, Abuse, Neglect, Exploitation, or Mistreatment, not dated, reflected: Policy.3. The facility's Leadership will conduct a prompt investigation of any allegation received of suspected abuse, neglect or exploitation or mistreatment and will implement immediate action to safeguard resident.

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

09/11/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Corinth Rehabilitation Suites on the Parkway

3511 Corinth Parkway Corinth, TX 76208

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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

room on the floor, and they assisted him off the floor. The Anonymous Person said they saw two staff members seated at the nurse's desk and was told the other staff were at lunch break. An interview was attempted with RN B on 09/11/25 at 2:50 PM. RN B did not return the call of the Surveyor. An interview on 09/11/25 at 3:20 PM with CNA C revealed she was working on the 10:00 PM - 6:00 AM shift on 08/10/25.

She said she was not assigned to Resident #1. CNA C said she was on a different hall, and she saw LVN D pacing in the Hall looking for CNA A and RN B. CNA C said CNA A and RN B were on break outside in their cars. CNA C said she saw the paramedics were in the facility and she did not know why. CNA C said CNA A told her that Resident #1 had fallen and called 911 for help. An interview on 09/11/25 at 3:45 PM with CNA A revealed she worked the 10:00 PM - 6:00 AM shift on 08/10/25. CNA A said she was assigned to Resident #1. CNA A said she went to Resident #1's room (unknown time) and asked if he needed anything and he said no. CNA A said she told RN B she was going on lunch break, but did not realize that RN B was going to lunch break at the same time. She said another staff member (unknown) on a different hall came out to her car while she was on break. CNA A said the staff member wanted to know where she and RN B were. CNA A said she stopped her lunch break and went back into the facility. CNA A said the paramedics already had Resident #1 back in his electric wheelchair. CNA A said if both assigned staff members went to lunch break at the same time, residents were at risk for falls. A follow-up interview on 09/11/25 at 4:10 PM with the DON revealed she went and interviewed Resident #1. The DON said there was nothing that stood out with his fall on 08/10/25. The DON said she spoke to staff, but did not contact EMS about the incident. The DON said she spoke to staff but did not know both CNA A and RN B had gone

on lunch break at the same time. The DON said CNA A and RN B were not supposed to be at break at the same time. The DON said staff were supposed to communicate with each other regarding lunch breaks. An

interview on 09/11/25 at 4:20 PM with the Administrator revealed she spoke to Resident #1 about his fall (08/10/25) on 09/11/25. She said the resident told her call light response time was slow. The Administrator said she spoke to RN B who said on 08/10/25 she was out on break when he fell. The Administrator said

she did not realize that both CNA A and RN B were on break at the same time. The Administrator said she did not speak to EMS, but Resident #1 told her he called EMS because staff did not respond when he fell.

Review of the only facility policy made available for falls reflected: Fall Management, revised May 2023: POLICY:1. The facility will identify each patient/resident who is at risk for falls and will plan care and implement interventions to manage falls.5. Qualified staff evaluates patient/resident for injury from a fall, identify and treat for pain related to fall, and determine contributing causes, including ascertaining what the resident was trying to do before he or she fell, addresses the risk factors for the fall such as the resident's medical conditions(s), facility environment issues, or staffing issue; and determines interventions to prevent future falls and completes a Fall Investigation Worksheet.7. Neurological evaluations will be performed for a resident who sustains an unwitnessed fall, regardless of the resident's cognitive status at the time of the incident.8. The physician and family are promptly notified, and an incident report is completed.9. Post fall nursing documentation for 72 hours, every shift will be completed to monitor the development of late effect or complications of the fall.

Event ID:

Facility ID:

If continuation sheet