Flatonia Healthcare Center

F 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few

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

notified at 6:28 p.m. The ADM was provided with the IJ template on 08/30/25 at 6:28 p.m.The following Plan of Removal submitted by the facility was accepted on 09/01/25 at 8:05 am. PLAN OF REMOVALPlan of RemovalOn 08/30/2025, an Immediate Jeopardy was identified at the facility due to a resident-to-resident abuse allegation.Action StepsThe following immediate actions were implemented Resident #1 was placed under 1:1 supervision immediately. Resident's care plan updated to reflect changes in monitoring. The 1:1 will remain in place until the IDT will be held on 9/2/2025, including physician, psychiatric input determines that it is safe to discontinue the cadence of supervision. If this is not deemed attainable, the facility will explore opportunities for discharging resident to an alternate setting. IDT meeting will be held weekly to discuss resident #1. Resident #1 was seen by psych services on 8/18, 8/26 and will continue with weekly visits until behaviors are improved.Residents 2 and 3 were assessed by DON for evidence of injury.Resident #2 was seen by the psych NP via telemedicine for evaluation of impact. A trauma informed assessment was completed on residents 1, 2 and 3. Care Plans updated for resident 1, 2, and 3. No negative outcomes found in resident assessment. Nursing Administration conducted resident record review, resident interviews to determine that no other residents were affected by the deficient practice. Direct care staff are trained on resident care plans through a combination of orientation, ongoing in-service education, and real-time instruction from licensed nursing staff. During orientation, staff receives instruction on individualized resident needs, the purpose of the care plan, and how their daily assignments connect to the plan of care. Supervisors and charge nurses review care plan updates with staff as changes occur, and education is reinforced during shift huddles, staff inservicing, etc. This ensures staff understand their role in implementing interventions outlined in each resident's care plan. Each incident was reported to HHSC via self-report email template. The incident for 8/11 was emailed on 8/30 @ 10:25PM. The incident for 8/15 was emailed 8/31 at 7:57am. The return emails from HHSC sending us the intake number has not been received yet. It typically takes 24-48 hours from time of submission.Start Date: 08/30/2025Completion Date:8/30/2025Responsible: Director of Nursing (DON), AdministratorFollowing the notification of immediacy, the Administrator and Director of Nursing received immediate elaborate retraining on abuse reporting requirements, the facility's abuse policy, and leadership responsibilities in responding to allegations. To validate that the retraining was effective and sustained, the Regional [TRUNCATED]

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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

09/02/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Flatonia Healthcare Center

624 N Converse St Flatonia, TX 78941

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)

Federal health inspectors cited Oak Manor Nursing Center in Flatonia, TX for a deficiency under regulatory tag F-F0684 during a complaint investigation conducted on 2025-09-02.

Category: Quality of Life and Care Deficiencies

The facility was found deficient in the following area: Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 2 deficiencies cited during this inspection of Oak Manor Nursing Center.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-03.