Park View Care Center

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

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

police on 12/19/25 which she then explained Resident #1 had voiced not feeling safe and his want to relocate therefore the facility would be supporting and honoring his wishes . The Administrator stated she understood not allowing Resident #1 to readmit to the facility placed him at risk for an improper discharge.

According to the Administrator Resident #1 did not have a proper discharge and he was not going to be allowed to return to the facility. Record review of facility policy dated 12/06/16 titled Discharge Planning did not address allowing residents to return after a hospital visit and reflected: Anticipated Outcome: The resident will receive medically related social services means services provided by the facility's staff to assist residents in maintaining or improving their ability to manage their everyday physical, mental, and psychosocial needs. Including discharge planning services (e.g., helping to place a resident on a waiting list for community congregate living, arranging intake for home care services for residents returning home, assisting with transfer arrangements to other facilities).Fundamental InformationSocial Service must develop and implement an effective discharge planning process that focuses on the resident's discharge goals, the preparation of residents to be active partners and effectively transition them to post-discharge care, and the reduction of factors leading to preventable readmissions. The facility's discharge planning process must be consistent with the discharge rights of a resident.Document, completed on a timely basis based on the resident's needs, and included in the clinical record, the evaluation of the resident's discharge needs and discharge plan.The results of the evaluation must be discussed with the resident or resident's representative.All relevant resident information must be incorporated into the discharge plan to facilitate its implementation and to avoid unnecessary delays in the discharge or transfer.Discharge SummaryPost-discharge plan of care that is developed with the participation of the resident and, with the resident's consent, the resident representative(s), which will assist the resident to adjust to his or her new living environment.The post-discharge plan of care must indicate where the individual plans to reside, any arrangements that have been made for the resident's follow up care and any post-discharge medical and non-medical services.

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

12/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Park View Care Center

3301 View St Fort Worth, TX 76103

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 0656

highest practicable physical, mental, and psychosocial well-being.

Level of Harm - Minimal harm or potential for actual harm 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

12/22/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Park View Care Center

3301 View St Fort Worth, TX 76103

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 0914

Provide bedrooms that don't allow residents to see each other when privacy is needed.

Level of Harm - Minimal harm or potential for actual harm

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

observations, interviews, and record review, the facility failed to ensure full visual privacy for each resident

in 6 rooms of 30 rooms (Rooms # 12, # 15, #23, # 71, #72 and #77) reviewed for privacy. The facility failed to maintain functional window blinds to provide privacy for the residents of Rooms #12, # 15, #23, # 71, #72 and #77. This failure could place residents at risk for exposure and decreased sense of dignity. Findings included:Observation on 12/22/25 at 9:45 AM in room [ROOM NUMBER] revealed the window blinds had 8 slats that were broken, allowing visualization of the bed from outside the facility. Observation on 12/22/25 at 9:53 AM in room [ROOM NUMBER] revealed the window blinds had 4 slats that were broken, allowing visualization of the bed from outside the facility.Observation and interview on 12/22/25 at 10:00 AM in Room # 77 revealed the window blinds had 12 slats that were broken, allowing visualization of the bed from outside the facility. The resident stated the blinds had been broken a long time, stating the needed to be replaced for privacy. Observation on 12/22/25 at 10:25 AM in room [ROOM NUMBER] revealed the window blinds had 10 broken slats, allowing visualization of the bed from outside the facility. Observation and

interview on 12/22/25 at 10:30 AM in room [ROOM NUMBER] revealed the window blinds had 7 broken slats, allowing visualization of the bed from outside the facility. The resident did not like the broken blinds, stating it let people see in. Observation on 12/22/25 at 11:00 AM in room [ROOM NUMBER] revealed the window blinds had 12 broken slats, allowing visualization of the bed from outside the facility. In an interview

on 12/22/25 at 11:54 AM, MA-C stated any repairs needed to the resident rooms were entered into the Maintenance Logbook, located at each nurses' station, for maintenance to address. She was unaware of any blinds in need of replacement. In an interview on 12/22/25 at 11:58 AM, LVN-D stated anything that needed to be fixed in the resident rooms was written in the Maintenance Logbook or told directly to the Maintenance Director. She was unaware of any blinds that needed to be replaced. Record review on 12/22/25 at 12:00 PM of Maintenance Logbooks for all three stations, revealed no requests for blind repair/replacement. In an interview on 12/22/25 at 5:00 PM, the Maintenance Director stated he was responsible for making repairs to the physical plant. He stated staff had been educated on the process of entering any repair requests in the logbook. He stated he checks the books the first thing in the morning, and then several times throughout the day. He stated he tries to make a sweep of all the rooms once a month, looking for things that need to be addressed, but he relies heavily on the staff to alert him about repairs needed. He was unaware there were blinds that needed replacement, he stated he has replacements in stock and would get them replaced. Record review of the facility's policy Homelike Environment, dated 04/24/25, reflected: .A homelike environment is essential for promoting the comfort, dignity, and quality of life of residents. 2. Privacy and Dignity: Ensure that residents have privacy and that their dignity is maintained at all times. This includes respecting their personal space and providing private areas for personal care and family visits.

Residents Affected - Some

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

Event ID:

Facility ID:

If continuation sheet