Treasure Hills Healthcare And Rehabilitation Cente

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

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

volunteers, staff of other agencies serving the resident, resident representatives, families, friends, or other individuals. If there is an allegation or suspicion reviews, the facility will make a report to the appropriate agencies as designated by state and federal laws. Procedure:In response to allegations of abuse, neglect, exploitation, or mistreatment, the facility will:Ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source and misappropriation of resident property, are reported immediately but: Note later than two (2) hours after the allegation is made if the events that cause the allegation involves abuse or results in serious bodily injury. No later than twenty-four (24) hours if the events that cause the allegation does not involve abuse and does not result in serious bodily injury.

Event ID:

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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

08/21/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Treasure Hills Healthcare and Rehabilitation Cente

2204 Pease St Harlingen, TX 78550

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 0644 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

said she did not know the timeframes after the IDT meeting, she said the MDS nurse in charge of that. An

interview on 08/20/25 at 10:20 a.m., the Administrator said she had been present during Resident #1's initial Interdisciplinary Team meeting held on 01/09/25. She said she remembered the team had not requested a specialized mattress. She said what was requested was a specialized wheelchair, therapy (physical, occupational, and speech), and a provider to visit resident daily. She said it's the LIDDA caseworker responsibility to upload a resident's Individual Profile to LTC Simple portal after the Interdisciplinary Team meeting. She said since a specialized mattress had not been requested during the IDT meeting, she did not follow-up on it. The Administrator said she remembered she received an email from PASSR (state office) inquiring on a specialized mattress and she had forwarded it to the current MDS/RN B to handle it. She said the current MDS/RN B had responded to the email. The Administrator said MDS/RN B received an email back from PASSR (state office) advising them it had been resolved, she did not remember the date and did not provide a copy. The Administrator said the facility did not have access to the LIDDA's Individual Profiles and did not know the timeframes they had to submit to the Simple portal. She said what she suspected was that the LIDDA caseworker had included a request for a specialized mattress after the IDT meeting without the facility's knowledge. The Administrator said the facility did not have a PASSR policy but did provide their Behavioral Health Services policy. Record review

on 08/20/25 of Resident #1's LIDDA's Individual Profile-Nursing Facility dated 01/09/25 reflected:Adaptive Aids and Medical Supplies: Due to recent falls, team agreed to specialized mattress, bolsters and concave mattress to support her from falling off the bed. Record review on 08/20/25 of the facility's Behavioral Health Services policy, dated 08/2017 which reflected: It is the policy of this facility to provide resident with necessary behavioral health care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.

Behavioral health encompasses a resident's whole emotional and mental well0being, which includes the prevention and treatment of mental and substance use disorders, as well as psychosocial adjustment difficulty, or those with history of trauma and/or post-traumatic stress disorder. Procedure:8. The IDT will also review PASRR recommendations.

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

08/21/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Treasure Hills Healthcare and Rehabilitation Cente

2204 Pease St Harlingen, TX 78550

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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Based on observations, interviews, and record review, the facility failed to ensure drugs and biologicals were stored and labeled in accordance with currently accepted professional principles for 1 (Cart 1) of 5 medication carts. The facility failed to ensure that the nurses medication cart for 100 hall was secured by a lock when it was left unattended by RN A. These failures could place residents at risk of injury if medication left unsecured were consumed. Findings included: During an observation on 08/20/2025 from 02:40 PM revealed the A Wing Hall nurse's medication cart was left unlocked and unattended against the nurse's station. During the observation RN A approached the nurses' medication cart and notice that was unlocked and the RN A secured the cart by locking it. During an interview on 08/20/2025 at 02:42 PM with RN A revealed she was responsible for the nurse's medication cart that was left unlocked. She stated he was expected to lock the nurse's medication cart when she walked away from it. She stated if it was left unlocked then a resident could open a drawer and take anything that was not for them. She stated he had left the cart unlocked because she just went to another cart to use the computer. During an interview on 08/20/2025 at 04:18 PM with the DON revealed numerous staff, including her and the ADON, were responsible for ensuring medications carts were locked. The DON stated her expectation of staff when they walk away from the medication cart was to lock it. DON stated that the negative outcome for leaving the cart unlocked was that a resident or visitor could grab the medication from the cart, and it could harm them.

She stated she had provided in-services to the staff, and she visually monitored daily. Record review of undated facility policy Medication Access and Storage: revealed It is the policy of this facility to store all drugs and biological in locked compartments under proper temperature controls. The medication supply is accessible only to licensed nursing personnel, pharmacy personnel, or staff members lawfully authorized to administer medications

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If continuation sheet