Memorial Medical Nursing Center

for daily decision-making skills.

Record review of Resident #7's comprehensive care plan with revision date 12/3/24 revealed the resident had heart failure and required respiratory therapy with interventions including oxygen as ordered and respiratory therapy as ordered.

During an interview on 11/13/25 at 7:46 a.m. the Administrator stated the residents in the facility had been assessed to determine if they could self-medicate and stated there were no residents in the facility who could self-medicate.

The Administrator stated, in reference to Resident #4 having self-administered the breathing treatment with the Ipratropium-Albuterol Inhalation Solution, it was her expectation for nursing to assess the resident before and after the treatment to check for effectiveness.

The Administrator stated treatments with Ipratropium-Albuterol Inhalation Solution could increase heart rate and can cause an abnormality which would need to be reported to the physician.During an observation and interview on 11/13/25 at 8:09 a.m. with the Administrator, Resident #7 was observed sitting up in bed and a small jar of medicated mentholated ointment and the same product in a roll-on stick was seen at the bedside. Resident #7 stated she used the ointment in the jar to rub on her feet and the roll-on stick for when she experienced cold symptoms. Resident #7 stated she had not used the roll-on stick in a while because she was not experiencing any cold symptoms.

The Administrator instructed an unidentified staff to remove the bedside medications.

Record review of the facility document titled Storage of Medications dated 2018 revealed in part, .The facility shall store all drugs and biologicals in a safe, secure, and orderly manner.2.

The nursing staff shall be responsible for maintaining medication storage.8.

Drugs shall be stored in an orderly manner in cabinets, drawers, carts, or automatic dispensing systems.10.

Only persons authorized to prepare and administer medications shall have access to the medication room, including any keys.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

11/14/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Memorial Medical Nursing Center

307 W Cypress St San Antonio, TX 78212

SUMMARY STATEMENT OF DEFICIENCIES

During an interview on 11/14/25 at 10:56 a.m., the Administrator, who is also an RN, stated it was best practice for Resident #5's nursing admission assessment to be completed at the time of admission and no later than 72 hours.

The Administrator stated at the time of Resident #5's admission on [DATE], the admitting nurse had to leave the floor due to a family emergency and the Administrator and the ADON took over.

The Administrator stated she verified the physician orders and input the resident's medications into the electronic record.

The Administrator stated the nursing admission assessment for Resident #5 was not in the electronic record and could not be found.

The Administrator stated there was a problem with not having a complete nursing assessment because the assessment was used to develop the resident's care plan.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

11/14/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Memorial Medical Nursing Center

307 W Cypress St San Antonio, TX 78212

SUMMARY STATEMENT OF DEFICIENCIES

Summary Report dated 12/12/25 revealed the following:- Ipratropium-Albuterol Inhalation Solution 0.5-2.5 (3) MG/3ML, 3ml inhale orally three times a day for SOB with order date 10/19/25 and no end date.On 11/12/25 at 10:01 a.m., Resident #4 was observed sitting up in bed and a nebulizer machine was on the resident's nightstand on the left of the bed.

The nebulizer mask and tube were resting on the nightstand, not properly stored in a bag. Resident #4 stated she had a breathing treatment earlier in the morning but needed another breathing treatment because she had a history of asthma and knew she needed another breathing treatment. Resident #4 took an ampule of Ipratropium-Albuterol Inhalation Solution that was on the nightstand and placed the nebulizer mask on her face to give herself a breathing treatment.

During an interview on 11/12/25 at 3:23 p.m., RN B stated Resident #4 received nebulizer breathing treatments and had given the resident the Ipratropium-Albuterol Inhalation Solution and should not have because the resident was not to self-medicate but got busy with a request for narcotics and pain medication for another resident. RN B stated, when the nebulizer mask and tubing were not in use they were supposed to be stored in a bag because spores were everywhere, and it was a break in infection control which could result in the resident getting sick. RN B stated, the nebulizer mask and tubing were changed out every Sunday or as needed.During an observation and interview with the Administrator on 11/13/25 at 8:19 a.m. revealed Resident #4's nebulizer machine on the nightstand to the left of the bed had the nebulizer mask and tubing on the counter and not stored in a bag.

The Administrator stated it was her expectation for the nebulizer mask and tubing, when not in use, should be stored in a plastic bag to prevent cross contamination which could result in the resident developing an infection.

The Administrator stated, since the nebulizer mask and the tubing were not stored properly, they would have to be discarded.

Facility ID: