Accel At Willow Bend

honored by staff and that staff were aware. In an interview on 08/21/25 at 2:35 PM with the MDS Coordinator, she stated she was aware that Resident #38 preferred the nurse to put the medications in the palm of her hand and she had updated the care plan after a medication aide had attempted to give Resident #38 her medication in a cup and Resident #38 refused her medications.

She reviewed Resident #38's care plan and stated she could see how the updated care plan on 08/14/25 could've been made to seem more like a behavioral concern of refusing medications rather than a preference due to the resident being legally blind and wanting the medication in her palm so she could feel the medication.

She stated person-centered care plans were important to ensure residents received their plan of care. In an interview on 08/21/2025 at 2:57 PM with ADON L, she stated Resident #38 was legally blind and during medication administration she liked to have the pills placed in the palm of her hand because it reassured Resident #38 because she knew what the pills felt like and could make out some colors. ADON L stated she was not sure if Resident #38's care plan was updated to reflect her preference and the MDS Coordinator was responsible for updating resident care plans. ADON L stated it was important to care plan Resident #38's medication administration preference so that other people were aware of her residents preferences and if a new staff member was going to work with the resident, they would be able to look at it and learn the resident too.In an interview on 08/21/25 at 4:43 PM with the Administrator, he stated that it was important to ensure a resident's care plan was as personalized as possible and would have expected Resident #66 and Resident #38's preferences to be care planned. He stated it was important for care plans to personalized so residents received the care they needed.

The Administrator stated the MDS Coordinator was responsible for updating resident care plans and they were reviewed and updated upon change of condition, admission, and quarterly.

Record review of the facility's care plan policy, titled Care Planning and dated revised 10/24/22 reflected: .To ensure that a comprehensive person-centered Care Plan is developed for each resident based on their individual assessed needs .

Each resident's Comprehensive Care Plan will describe the following: A.

Services that are to be furnished to attain or maintain the resident's highest practicable physical, mental and psychosocial well-being

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

The facility failed to complete Resident #3's comprehensive care plan in a timely manner after his comprehensive assessment was completed.

This deficient practice could place residents at risk of not receiving appropriate interventions to meet their current needs.

Record review of Resident #3's admission MDS Assessment, dated 7/31/25, reflected the resident was an [AGE] year-old male who was admitted to the facility on [DATE] . Resident #3 had the following diagnoses: Anxiety Disorder, Atrial Fibrillation (an irregular, often rapid heart rate that commonly causes poor blood circulation), Heart Failure, Diabetes and Asthma.

Section M reflected resident was developing a pressure ulcer.

Resident was admitted with the following medications: Antipsychotic, Anticoagulant (blood thinner), Antibiotic, Diuretic and Hypoglycemic (including insulin).

Section O reflected resident needed continuous oxygen.

Record review of Resident #3's Admit Baseline Care Plan reflected a completion date of 7/28/25.Record request for Resident #3's Comprehensive Care Plan on 8/21/25 at 2:04pm revealed he did not have one completed.Interview with the MDS Coordinator on 8/21/25 at 2:35pm revealed she was responsible for the completion of the Comprehensive Care Plan.

The MDS Coordinator stated the expectation was she completed the MDS first and the Comprehensive Care plan would have been completed within 14 calendar days after the resident admitted to the facility.

The MDS Coordinator stated she overlooked the care plan for Resident #3 and had not completed his comprehensive care plan yet.

The MDS Coordinator stated she would used the CAA, notes from physician, nurses' notes and physician orders to complete the Comprehensive Care Plan.

The MDS Coordinator stated psychotropic medications would be on the Comprehensive Care Plan, along with behavioral monitoring and monitoring of side effects.

The risk to the resident of not having a comprehensive care plan in a timely manner was staff would not know how to provide accurate care and interventions.

The MDS Coordinator completed the following trainings: RAI and Care Planning.

The MDS Coordinator also referred to regional resources and trainings when she had questions on completion of the Care Plans.

She stated the training for Care Planning was ongoing.

Interview with LVN E on 8/21/25 at 3:25pm revealed the MDS Nurse or Unit Manager created and updated care plans.

Nurses did not complete care plans.

Interview with the DON on 8/21/25 at 4:09 pm revealed the comprehensive care plan was due 21 days from admission.

The countdown started from the first day of admission and was calendar days.

The nurses were responsible for acute comprehensive care plans, but the CAA triggers were completed by the MDS nurse.

He stated Resident #3 should have had his comprehensive care plan completed already.

The risk of not having had the care plan done would be it could impede the resident's treatment. He was unsure of the reason the care plan had not been completed.

Interview with the Administrator on 8/21/25 at 4:49 pm revealed the expectation was the MDS nurse or nursing staff completed the care plans.

The risk to the resident of not having a completed care plan was a lot of things could have gotten messed up and affected the resident negatively.

Review of the facility's policy Person Centered Care Plans revised 6/25/22 reflected .Standard of Practice: Each resident will have a person-centered care plan developed and implemented to meet his or her other preferences and goals, and address the resident's medical, physical, mental and psychosocial needs.9.

Comprehensive Care Plan - must be developed within seven (7) days after completion of the comprehensive assessment, quarterly, annually and with any change of condition.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

The facility failed to ensure Resident #56 had his fingernails cleaned and trimmed on 8/19/25.

This failure could place residents who were dependent on staff for ADL care at risk for loss of dignity, risk for infections and a decreased quality of life.

Record review of Resident #56's Quarterly MDS assessment dated [DATE] reflected Resident #56 was a [AGE] year-old male admitted to the facility on [DATE] with diagnoses which included cerebrovascular accident (a condition that occurs when blood flow to the brain is blocked.

The blockage can lead to brain tissue death.), and elevated blood pressure. Resident #56's BIMS score of 14, indicated Resident #56' cognition was intact.

The MDS assessment indicated Resident #56 required maximal assistance with bathing.

Record review of Resident #56's Care Plan revised 07/02/25, reflected the following: Care area: Self-care deficit .

Goal: [Resident #56] will accept assistance with area of dressing, grooming hygiene and bathing over the next 90 days .

Interventions: . provide assistance with self-care as needed. In an observation and interview on 08/19/25 at 10:24 AM revealed Resident #56 was lying in his bed.

The nails on both his hands were approximately 0.3cm in length extending from the tip of his fingers.

The nails were discolored tan and had brownish colored residue on the underside. Resident #56 stated he did not like his nails long and dirty and he did not tell staff because they were busy. In an interview on 08/19/25 at 2:08 PM, LVN I stated CNAs and nurses were responsible to clean and cut the residents' nails. LVN I stated she did not notice Resident #56's nails.

She stated she would do it right then.

She stated the risk would be infection control and injury.

In an Interview on 08/20/25 at 3:42 PM, the DON stated nail care should be completed as needed and every time aides washed the residents' hands.

The DON stated nails should be observed daily.

The DON stated nurses were responsible for trimming the nails of residents who were diabetic, and CNAs could trim other residents' nails.

The DON stated he expected CNAs and nurses to offer to cut and clean nails if they were long and dirty.

The DON stated the ADONs would do the routine rounds to monitor.

The DON stated residents having long and dirty nails could be an infection control issue and skin break down if scratching.

Record review of the facility's policy ADLs/Bathing revised February 2020, did not address the concern of fingernails care.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

licensed nursing staff will provide resident with medications and treatments as ordered by his/her physician.Procedure.2.The licensed nurse clarifies and reconciles all orders that may lead to an administration error. 3.

The electronically entered order will be automatically transcribed onto the Medication admission Record (MAR) or Treatment Record.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

The facility failed to ensure CNA P provided appropriate perineal care for Resident #41 after an incontinent episode when she failed to clean the resident's labia on 08/19/25.

This failure could place residents at risk for the development and/or worsening of urinary tract infections.

Record review of Resident #41's Quarterly MDS assessment dated [DATE] reflected Resident #41 was an [AGE] year-old female admitted to the facility on [DATE] with diagnoses which included dementia (a group of conditions that cause a decline in cognitive abilities, such as memory, thinking, reasoning, and judgment), and elevated blood pressure. Resident #41's BIMS score of 03, indicated Resident #41's cognition was severely impaired.

The MDS assessment indicated Resident #41 was frequently incontinent of bowel and bladder.

Record review of Resident #41's Care Plan reviewed 07/14/25, reflected the following: Problem: At risk for problems with elimination.

Goal: Resident's elimination status will be maintained or improved over the next 90 days.

Interventions: . provide incontinent care after each incontinent episode .In an observation on 08/19/25 at 2:56 PM revealed CNA P entered Resident #41's room to provide incontinence care. CNA C washed her hands and put on gloves and unfastened the brief to reveal the resident had been incontinent of urine. CNA P pushed the soiled brief down between the resident's legs, toward her buttocks and cleaned her peri area (the area of skin between the anus and the external genitalia) from the front to back but did not separate the labia and clean down the middle. CNA C rolled the resident onto her side revealing the resident had soaked through her brief. CNA C continued to provide incontinence care, wiping the resident's buttocks from back to front and reapplied a clean brief.

She removed her gloves and washed her hands. An interview with CNA P on 08/19/25 at 3:02 PM revealed she failed to separate the resident's labia, and she wiped the resident's buttocks from back to front and by providing inappropriate incontinent care that could lead to an infection.

She stated she had been in training and knew the importance of properly cleaning a resident. In an interview on 08/20/25 at 03:42 PM, the DON stated when providing incontinent care, staff were to clean the peri area including the labia for female residents, then moving toward the buttocks and always clean from the front to back. He stated by not providing accurate incontinent care it placed residents at risk for urinary tract infections, skin breakdown and overall poor hygiene. He stated he would monitor by doing skills check on all CNAs periodically.

Record review of the facility's policy titled, Perineal Care/Incontinent Care, dated April 2012, reflected, .For female patient/resident: Separate the labia and wash downward (down the center of labia), then downward on each side of the labia using a different per wipe with each stroke.Clean outer hip of buttocks going upwards towards back .

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

water could cause tube to clog. He stated all nurses were skills checked prior to G-tube medications administration and were expected to follow the physician ordered flushes. He stated any time a nurse questioned an order it was their responsibility to clarify the order. He stated they would be doing follow up monitoring to ensure staff were following proper procedures.

Record review of the facility's policy, Irrigating a Feeding Tube, revised 04/22/2020, reflected, .Flush medication completely through the tube.

Irrigate routinely before, between, and after final medication .

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

2022 reflected: Purpose: 1.

The community will use psychotropic drug therapy when appropriate to enhance the quality of life, while maximizing functional potential and well-being of the patient/resident.

For drug therapy: Within the first year in which a resident is admitted on a psychotropic medication or after the facility has initiated a psychotropic medication: GDR attempts in two separate quarters with at least one month between the attempts.

The GDR must be attempted annually thereafter unless clinically contraindicated.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

Based on observation, interview, and record review the facility failed to label drugs and biologicals used in the facility in accordance with currently accepted professional principles, and include the appropriate accessory and cautionary instructions, and the expiration date when applicable for 2 (300 Hall Nurses Cart and 200 Hall Nurses Cart) of 4 medication carts reviewed for pharmacy services in that:

The facility failed to ensure: 1- 300 Hall Nurses Cart did not have:o 1 insulin pen for Resident #64 without an open date on 08/19/25. o 1 insulin pen for Resident #58 without an open date on 8/19/25. o 1 insulin pen for Resident #7 without an open date on 08/19/25. o 1 insulin pen for Resident #51 without an open date on 08/19/25. 2200 Hall Nurses Cart did not have: o 1 insulin pen for Resident #44 without an open date on 08/19/25.

These failures could affect residents resulting in diminished effectiveness and not receiving the therapeutic benefits of the medications.1-

Record review and observation on 08/20/25 at 8:56 AM of the 300 Hall Nurses Cart, with RN A revealed: - The pen of insulin Lispro 100 unit/ml for Resident #64 with no open date.

Observation of the pen reflected it was used.

And instruction on the pen reflected to discard after 28 days of use. - The pen of insulin Novolog 100 unit/ml for Resident #58 with no open date.

Observation of the pen reflected it was used.

And instruction on the pen reflected to discard after 28 days of use.- The pen of insulin Lispro 100 unit/ml for Resident #7 with no open date.

Observation of the pen reflected it was used.

And instruction on the pen reflected to discard after 28 days of use.- The pen of insulin Lantus 100 unit/ml for Resident #51 with no open date.

Observation of the pen reflected it was used.

And instruction on the pen reflected to discard after 28 days of use Interview on 08/19/25 at 9:21 AM, RN A stated nurses were responsible to check the medication carts and the insulin pens for the open dates before giving insulin. He stated the nurse was supposed to label the pen with the open date when first opened. RN A stated the purpose of putting an open date was for expiration purposes because the insulin was only good for 28 days. He stated after 28 days the insulin would be ineffective. 2-

Record review and observation on 08/19/25 at 9:27 AM of the 200 Hall Nurses Cart, with LVN I revealed: The pen of insulin Lantus 100 unit/ml for Resident #67 with no open date.

Observation of the pen reflected it was used.

And instruction on the pen reflected to discard after 28 days of use.

Interview on 08/19/25 at 9:45 AM, LVN I stated nurses were responsible to check the medication carts and the insulin pens for the open dates before giving insulin.

She stated the insulin was good for 28 days only after opened, after 28 days the insulin should be discarded because its effectiveness decreased.

Interview on 08/20/25 at 3:42 PM, the DON stated the insulin flex pens and vials, once opened, needed to be dated because each insulin pen and vial had a specific day's shelf life and if not thrown out by that time the insulin could lose its effectiveness.

The DON stated the pharmacy consultant checked the carts monthly and he stated he would do random checks of the medication carts for monitoring.

Record review of the facility's policy titled Medication Storage, dated January 2024, reflected .

Insulin products should be stored in the refrigerator until opened.

Note the date on the label for insulin vials and pens when first used.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

tasks.

Review of the facility's policy Food Storage revised 4/8/25 reflected .Storeroom.airtight containers or bags are used for all opened packages of food.

All containers are accurately labeled with the item and date opened.Refrigerator.all foods are covered, labeled and dated.

Review of the Food and Drug Administration Food Code, dated 2022, reflected, .3-302.12 Food Storage Containers, Identified with Common Name of Food.

Except for containers holding food that can be readily and unmistakably recognized such as dry pasta, working containers holding food, or food ingredients that are removed from their original packages for use in the food establishment, such as cooking oils, flour, herbs, potato flakes, salt, spices, and sugar shall be identified with the common name of the food 3-305.11 Food Storage.(B) .refrigerated, ready-to eat time/temperature control for safety food prepared and packaged by a food processing plant shall be clearly marked, at the time the original container is opened in a food establishment and if the food is held for more than 24 hours, to indicate the date or day by which the food shall be consumed on the premises, sold, or discarded, based on the temperature and time combinations specified in (A) of this section and: (1) The day the original container is opened in the food establishment shall be counted as Day 1; and (2) The day or date marked by the food establishment may not exceed a manufacturer's use-by date if the manufacturer determined the use-by date based on food safety

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

The facility failed to ensure MA N disinfected the blood pressure cuff in between blood pressure checks for Residents #10, Resident #56, and Resident #61.

This failure could place residents at-risk of cross contamination which could result in infections or illness. 1.

Record review of Resident #10's Quarterly MDS assessment, dated 07/25/25, reflected Resident #10 was a [AGE] year-old male admitted to the facility on [DATE].

Diagnoses included elevated blood pressure, multidrug-resistant organism (microorganisms that are resistant to at least one class of antimicrobial agents, including antibiotics, and wound infection). Resident #3 had a BIMS of 3 which indicated Resident #10's cognition was severely impaired.

Record review of Resident #56's Quarterly MDS assessment dated [DATE] reflected Resident #56 was a [AGE] year-old male admitted to the facility on [DATE] with diagnoses included cerebrovascular accident (a condition that occurs when blood flow to the brain is blocked.

The blockage can lead to brain tissue death.), and elevated blood pressure. Resident #56's BIMS score of 14, indicated Resident #56' cognition was intact.

Record review of Resident #61's Quarterly MDS assessment, dated 06/16/25, reflected Resident #61 was a [AGE] year-old female admitted to the facility on [DATE] with diagnoses included elevated blood pressure and type 2 diabetes mellitus. Resident #61's BIMS score of 11, indicated Resident #61's cognition was moderately impaired.

Observation on 08/20/25 at 7:58 AM revealed MA N performing morning medication pass, during which time she checked the blood pressure on Resident #10. MA N did not sanitize the blood pressure cuff before and after using it on Resident #10 and continued to the next resident without sanitizing the blood pressure cuff. MA N then checked Resident #56's blood pressure. MA N did not sanitize the blood pressure cuff before using it on Resident #56.

She continued to the next resident without sanitizing the blood pressure cuff. MA N then checked Resident #61's blood pressure. MA N did not sanitize the blood pressure cuff before using it on Resident #61.

Interview on 08/20/25 at 8:40 AM, MA N stated reusable equipment, like blood pressure cuffs, should be sanitized before and after use on each resident in order to keep germs from spreading.

She stated she forgot to sanitize the blood pressure cuff between residents' use.In an interview with the DON on 08/20/25 at 3/42 PM, he stated his expectation was for staff to sanitize the blood pressure cuff after each use. He stated to ensure staff were knowledgeable in the sanitation of the blood pressure cuff the facility would do skills competency checks and he stated he would make daily rounds and watched care and medication administration.

Record review of the facility's policy titled Disinfecting and Sterilizing Resident Care Equipment, revised March 2025, reflected .

Non-critical items are those that either do not ordinarily touch the residents or touch only intact skin.

Such items include . blood pressure cuffs . it is imperative that these items are clean.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Accel at Willow Bend

2620 Communications Parkway Plano, TX 75093

SUMMARY STATEMENT OF DEFICIENCIES

Observation on 08/19/25 at 9:32 AM revealed CNA H exited Resident #4's room with his breakfast tray. In an observation and interview on 08/19/25 at 9:34 AM revealed Resident #4 was laying in bed and his call light was on the floor next to his bed. Resident #4 stated that he needed his call light and was not sure where it was located. In an observation and interview on 08/19/25 at 9:43 AM with CNA H, she stated she had picked up Resident #4's tray and did not notice that the call light was on the floor before she left his room with his breakfast tray. CNA H picked up the call light and clipped it to Resident #4 blanket within reach. CNA H stated she should have checked before leaving Resident #4 room and ensured his call light was within reach.

She stated that it was important to ensure a resident's call light was within reach because the resident may need to ask for help. In an interview on 08/19/25 at 1:04 PM with LVN I, she stated CNA H should have ensured Resident #4's call light was within reach before leaving his room. LVN I stated it was important to ensure resident call lights were always within reach so the residents could call for assistance. In an interview on 08/21/2025 at 2:57 PM with ADON L, she stated Resident #4's call light was supposed to always be within reach residents.

She stated before staff left the resident's room, they should have ensured the call light was within reach.

She stated it was important for resident call lights to be within reach because that was how they called for help; it was their life line.In an interview on 08/21/25 at 12:38 PM with the DON, he stated his expectation was for staff to ensure resident call lights were within reach before leaving the room. He stated having the call light within reach of the resident was important for residents to be able to call for assistance if there was an emergency.Record review of facility policy titled call lights answering with reviewed date of 01/19/2023 reflected: Purpose: Policy: .The staff will provide an environment that helps meet the resident's needs by answering call lights appropriately. when leaving the room, be sure the call light is placed within the resident's reach .

Facility ID: