Meridian Care Of Hebbronville

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

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

residents and staff. The DON stated she believed the reason Resident #1 was not allowed back in the facility was because there was not a physician to oversee his care. In an interview with the ADM at 10:59 AM on 10/29/25, the ADM stated Resident #1 was discharged from the facility on 04/11/25 because she was concerned about the safety of other residents and her staff. The ADM stated she understood that Resident #1 won his appeal on his discharge from the facility. The ADM stated the MD did not want Resident #1 back in the facility and he refused to treat him. The ADM stated there were no other doctors in

the area that could treat Resident #1 in the facility, so they were unable to readmit him. The ADM stated she spoke to Resident #1 on the phone after the appeal decision, but she told him he could not come back because the MD refused to treat him. The ADM stated she sent the response to the Hearings Officer on 08/08/25 that stated that there were no doctors at the facility to treat Resident #1 so they could not readmit him. The ADM stated she had not heard anything since then from the Hearings Officer. The ADM stated she did not attempt to find a new doctor that could treat Resident #1 at the facility. A policy was requested from

the ADM on 10/28/25 outlining the proper procedures for a discharge but none was provided. The ADM did provide a signed admission agreement by Resident #1, but it did not list the specific information that was required during the appeal process of a discharge.

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

10/29/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Meridian Care of Hebbronville

606 W Gruy Hebbronville, TX 78361

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 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review, the facility failed to ensure that one of five residents (Resident #1) reviewed for transfer or discharge had the required contents in the written notice. The facility discharged Resident #1

on 4/11/25 without including a specific location where Resident #1 was going after discharge. This failure could put residents at risk for inappropriate discharge from the facility.The findings included:Record review of Resident #1's face sheet dated 10/28/25 revealed a [AGE] year-old male with an admission date of 04/17/23 and a discharge date of 04/11/25. Resident #1's pertinent diagnosis included bipolar disorder (a chronic mental health condition characterized by extreme mood swings between highs and lows). Record

review of Resident #1's Quarterly MDS assessment dated [DATE REDACTED] revealed a BIMS score of 14 which indicated his cognition was intact. Record review of Resident #1's comprehensive care plan dated 04/11/25 revealed the focuses [Resident #1] demonstrates verbally abusive behaviors daily toward staff and residents, 4/11/25 = UPDATE: Resident continues to be verbally abusive towards staff/residents calling them names, cursing at them, and I have a cognitive impairment due to: Bipolar Disorder. Record review of discharge notice given to Resident #1 dated 04/11/25 revealed Location of discharge: Facility of choice and if you select no location the facility social worker will assist you with locating an appropriate placement. In

an interview with the DON at 10:01 AM on 10/29/25, the DON stated she was at the facility when Resident #1 was discharged but did not take part in creating the discharge notice. The DON stated it was not 100% clear on the discharge notice where Resident #1 was being discharged to go. The DON stated it was important to put a specific location on the discharge notice to ensure residents had a safe place to go after leaving the facility. In an interview with the ADM at 10:59 AM on 10/29/25, the ADM stated she filled out the discharge notice but received assistance from her regional team. The ADM stated it was not 100% clear on

the discharge notice where Resident #1 was being sent. The ADM stated Resident #1's home address was written at the top of the discharge notice, and that was the location he was being sent to. The ADM stated it was important to be clear with the discharge notice to ensure residents had a safe place to go after leaving

the facility. A policy was requested from the ADM on 10/28/25 outlining the proper procedures for a discharge but none was provided. The ADM did provide a signed admission agreement by Resident #1, but

it did not list the specific information that was required to be on a discharge notice.

Event ID:

Facility ID:

If continuation sheet