Las Ventanas De Socorro

Inspectors wroteBased on observation, interview, and record review the facility failed to provide proper treatment and care to maintain mobility and good foot health in accordance with professional standards of practice, including to prevent complications from the resident's medical conditions and if necessary, assist the resident in making appointments with a qualified person, and arranging for transportation to and from such appointments for 1 (Resident #5) 7 reviewed for foot care. The facility failed to provide access to podiatrist for Resident #5. This deficient practice placed residents at risk of poor foot hygiene and decline in residents' physical condition. Record review of resident #5 face sheet date 5/15/2026 revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Residents' diagnosis included severe weakness and weight loss (failure to thrive, cachexia, muscle wasting. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure the assessment accurately reflected the residents' status for 2 (Resident #70 and Resident #79) of 10 residents reviewed for assessment accuracy. The facility failed to accurately reflect Resident #70's ability to hear on his MDS.The facility to reflect Resident #79's surgical wound care and external Fixator on her MDS.This failure placed residents at risk for not receiving care specific to their condition.

Inspectors wroteBased on interview and record review, the facility failed to develop and implement a comprehensive person-centered care plan that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment for two (Resident #26 and Resident #79) of 9 residents reviewed for care plans. The facility failed to include Resident #26's wound care for her right lower leg wound on her care plan. The facility failed to include Resident #79's wound care and external fixator on her care plan. These failures could affect residents requiring wound care by placing them at risk for not receiving care and services to meet their needs.

Inspectors wroteBased on observations, interview, and record review, the facility failed to ensure a resident who was unable to carry out activities of daily living received the necessary services to maintain good nutrition, grooming, and personal and oral hygiene for 3 of 5 residents (Resident #4, Resident #7, and Resident #11) reviewed for ADL care. The facility failed to ensure Resident #4 and Resident #7 was groomed for facial hair on 2/15/2026. The facility failed to ensure Resident #11 had trimmed and clean nails on 02/15/2026. This failure could place residents who required assistance with ADLs at risk for unmet care needs.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the resident's environment was as free from accident hazards as possible for 2 of 8 residents (Resident # 24 and Resident # 29) reviewed for accidents. The facility failed to properly dispose of a shaving razor in sharps container for Resident # 24 and # 29. This deficient practice could place residents at risk of injury and contribute to avoidable accidents.

Inspectors wroteBased on observation, interviews, and record review the facility failed to ensure that a resident who needed respiratory care was provided such care, consistent with professional standards of practice for 3 (Resident #23, Resident #62, and Resident #67) of 12 residents observed for oxygen management. The facility failed to clean the oxygen concentrator air filter for Resident #23 and Resident #67 while the oxygen was in use; concentrators were observed with air filters with dust, and lint collected on them on. The facility failed to ensure Resident #62's nasal canula was properly stored while oxygen was not in use. This failure could place residents on oxygen therapy at risk of receiving incorrect or inadequate oxygen support and decline in health.

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen.-The facility failed to maintain safe consumable produce as evident by 4 visibly molded tomatoes, observed on 02/15/2026.-The facility failed to properly seal carrots to limit exposure, observed on 02/15/2026.-The facility failed to properly label prepared food being stored in the walk-in refrigerator/freezer/cart shelves with prepared and use by dates, observed on 02/15/2026.-The facility failed to dispose of 23 pudding sherbert nectars that were created on 2/8/2026 and had a use by date on 2/10/2026, observed on 02/15/2026.-The facility failed to accurately complete temperature logs as evidenced by afternoon logs being signed as completed on the morning of 2/15/2026.-The facility failed [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain all mechanical, electrical, and patient care equipment in safe operating condition for 1 of 5 steam table wells reviewed. The facility failed to ensure the furthest right steam table well was not used to hold food for breakfast and lunch due to it not being operational since 12/31/2025. This failure placed residents at risk for delay in meal service.

Inspectors wroteBased on observation, interview, and record review, the facility failed to treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement quality of life for one (Resident #14) of eight residents reviewed for dignity. CMA H failed to feed Resident #14 at eye-level on 02/15/26. This failure could place the residents at risk of poor self-esteem and decrease self-worth.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices for two (Resident #26 and Resident #79) of 10 residents reviewed for quality of care, in that:RN O signed the TAR for treatment for Resident #26's treatment completion despite the treatment not being completed on 01/31/2026. The Wound Care Nurse failed to label Resident #79's wound dressing observed on her left ankle on 02/15/2026. These failures affected one resident and placed 72 additional residents who resided in the facility at risk of not receiving prompt medical interventions.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident who was incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections for 2 of 3 (Resident #67 and Resident #72) residents reviewed for urinary catheters. The facility failed to ensure Resident #72's Foley bag was off the floor and failed to ensure Resident #67 Foley tubing was draining urine into the Foley bag. This failure placed residents who had a urinary Foley at risk of contracting a UTI.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure all drugs and biologicals used in the facility was labeled in accordance with currently accepted professional principles, and included the appropriate accessory and cautionary instructions, and the expiration date when applicable for 1 of 2 residents (Resident #4) reviewed for pharmacy services enteral feedings .The facility failed to label Resident #4's enteral feeding (also known as tube feeding, is a method of delivering nutrition directly into the stomach when a person cannot eat safely or adequately by mouth) with staff initials and the date on 02/15/26. This failure could place residents at risk of inaccurate drug administration and not having appropriate therapeutic effects.

Inspectors wroteBased on interview and record review, the facility failed to maintain medical records on each resident that were complete and accurately documented for 1 of 4 residents (Resident #26) whose medical records were reviewed in that:The facility failed to accurately document on Resident #26's wound care on her Treatment Administration Record (TAR). This deficient practice affected one former resident and could place 14 residents with pressure sores at risk of inaccurate records. Record review of Resident #26's face sheet dated 02/16/2026 revealed an [AGE] year-old female with admission date 01/22/2026. Record review of Resident #26's history and physical dated 02/12/2026 revealed a medical history of the following: [...]

Inspectors wroteBased on interview and record review the facility failed to ensure that the assessment accurately reflected the resident's status for 1 (Resident #2) of 14 resident reviewed for accuracy of MDS assessment, in that:The facility failed to ensure that Resident #2's Significant Change Assessment reflected Resident #2 required total assistance of two persons with bed mobility. The facility failed to ensure that Resident #2's Significant Change Assessment documented in Active Diagnoses resident had two types of autoimmune skin diseases. This failure could place residents at risk of not receiving appropriate interventions or care to meet their current needs.

Inspectors wroteBased on interview and record review the facility failed to establish procedures for storing and disposing of drugs and biological in accordance with federal, state, and local laws. The facility failed to ensure medications pending return to the pharmacy were stored in a locked cabinet in the DON's office. This failure could place 68 residents living at the facility at risk of drug diversion.

Inspectors wroteBased on interview and record review, the facility failed to maintain clinical records on each resident that were complete and accurately documented, in accordance with accepted professional standards and practices, for 1 of 14 residents (Resident #2) reviewed for clinical records with transfer assistance. The facility failed to give access to the contracted agency CNA to document in the residents' electronic record the care provided to assigned residents in the 100-Hall. This failure place residents at risk of having incomplete and accurate clinical records.

Inspectors wroteBased on observation, interview and record review the facility failed to treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life, recognizing each resident's individuality for 1 of 4 residents (Resident #15). The facility failed to ensure resident call lights were within reach for 1 resident (Resident #15). This failure placed residents at risk of having their needs unmet when they are unable to contact staff.

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement a person-centered comprehensive care plan to include measurable objectives and timeframes to attain or maintain the resident's highest practical physical, mental, and psychosocial well-being for 1 of 14 (Resident #2) residents reviewed for comprehensive care plans in that: The facility failed to revise or update Resident #2's care plan to reflect the need for two people for bed mobility due to pain caused by autoimmune skin disease. The facility failed to revise or update Resident #2's care plan to reflect physician's orders to treat autoimmune skin disease. This failure could place residents at risk of not receiving appropriate interventions or care to meet their current needs.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan for 1 (Resident #1) of 1 reviewed for quality of care. The facility failed to ensure that Resident #1 received an initial neurological check and continued neurological checks for 72 hours following an unwitnessed fall as per the facility's policy on fall management and and neurological checks, from 09/25/2025 to 09/27/2025. This failure could place residents at risk of head related injuries, decrease cognitive and functional abilities and not receiving the necessary care and services.

Inspectors wroteBased on observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment, and to help prevent the development and transmission of communicable diseases and infections for one of fourteen residents (Resident #2) reviewed for Enhanced Barrier Precautions. The facility failed to implement their policy on Enhanced Barrier Precautions for Resident #2 who had wounds, indwelling medical devices and was incontinent of bowel and bladder. This failure could place residents at risk for healthcare associated cross-contamination and at risk of the transmission of multi-drug-resistant organisms (MDROs).

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents the right to reside and receive services in the facility with reasonable accommodation of resident needs and preferences for 2 (Residents #1 and Resident #4) of 4 residents reviewed for accommodation of needs. The facility failed to ensure that Residents #1's call light was within reach. The facility failed to ensure that Resident #4's call light was within reach. This failure placed residents at risk of not being able to call have their needs met.

Inspectors wroteBased on interview and record review, the facility failed to implement written policies that prohibit and prevent abuse for 2 of 4 employees (Van Driver & ADON) reviewed for development of abuse policy. The facility failed to conduct the annual EMR check for the Van Driver. The facility failed to conduct the annual EMR check for the ADON. This failure could place residents at risk of potential abuse or ongoing abuse.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure medical records, in accordance with accepted professional standards and practices, were maintained on each resident that were accurately documented for 1 of 4 residents (Resident #9) reviewed for medical records. The facility failed to ensure documentation was being done for showers being given to Resident #9 or being refused by Resident #9. This deficient practice could place residents at risk of records being inaccurate due to documentation errors.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a resident who was incontinent of bladder received appropriate treatment and services to prevent urinary tract infections for one resident (Residents #1) who was provided incontinence care by two (CNA A and CNA B) of two CNAs observed. 1. CNA A and CNA B failed to perform hand hygiene during incontinent care for Resident #1. 2. CNA A failed to clean Resident #1 from vagina to buttocks. These failures can place residents at risk for urinary tract infections.

Inspectors wroteBased on observation, interview, and record review the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for one of one resident (Resident #1) reviewed for infection control. -CNA A failed to perform hand hygiene before providing perineal care to Resident #1. -CNA A and CNA B failed to perform hand hygiene after disposing of dirty wipes and briefs, and before applying new briefs on Resident #1. These failures can place residents at risk for urinary tract infections.

Inspectors wroteBased on interviews, and record reviews, the facility failed to maintain clinical records that were complete and accurate, in accordance with accepted professional standards and practices, for 1 of 2 residents (Resident #2) whose closed medical records were reviewed in that: -The Facility failed to have Resident #2's hospital documentation from her injury to her left eyebrow and under her left eye on 2/03/25 in her facility medical records. This deficient practice could affect residents and result in errors in care and treatment.

Inspectors wroteResident #10 FTag Initiation 12/03/24 03:53 PM During observation on 12/03/2023 at 9:09 AM #10 [NAME] peri care observed with [NAME] CNA, one person assist stated resident should be a 2 person assist, but it was only her. She did not ask for help. She turned resident on side with wedges in place toward wall. Bed was locked.

Inspectors wroteResident #79 Respiratory Care 12/02/24 01:49 PM Ms. [NAME] was in bed at this time. Her brother was visiting they both stated that the staff from the facility are very professional and they are very respectful. Ms. [NAME] had no complaints from the facility or staff and said she had no concerns. Scrapes on wall. She was wearing her nasal cannula and there was no oxygen sing posted outside the room. Posting of cautionary and safety signs indicating the use of oxygen policy was provided and it stated in part. Respiratory Policies and Procedures: Oxygen Therapy. Procedures- C. Check the patient's/resident's room to make sure it's safe for oxygen administration, place oxygen precautions sign on the door of the patient's/resident's room. 12/03/24 12:51 PM Observation 210 [NAME]. Call light was pressed at this time to interview on Oxygen. [...]

Inspectors wroteBased on observations, interviews, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 1 of 1 CNA (CNA-A) staff observed during incontinent care. The facility failed to ensure CNA-A performed proper hand hygiene for Resident #4, Resident #10, and Resident #52. These failures placed residents of the facility at risk of infections from improper incontinent care and hand hygiene while performing incontinent care.

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure 1 of 1 resident (Resident #10) received adequate supervision to prevent accidents CNA-A failed to perform a 2 person assist for Resident #10 during incontinent care after precautions were put in place after a fall while performing resident care. This failure could place residents at risk for being provided care or treatment different from the plan of care.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure residents who are incontinent of bladder received appropriate treatment and services to prevent urinary tract infections for 2 of 2 residents (Resident #4 and Resident #5), The facility failed to ensure CNA-A performed proper peri-care (incontinent care) Resident #4, and Resident #52. These failures placed residents of the facility at risk of infections from improper incontinent care and hand hygiene while performing incontinent care. Resident #4 Record review of Resident #4's face sheet dated 12/04/2024 revealed, the resident was a [AGE] year-old male admitted to the facility on [DATE]. [...]

Inspectors wroteBased on observation, interview, and record review facility failed to ensure residents were provided supervision and assistive devices to prevent accidents for 1 of (Resident #1) of 10 residents reviewed for accidents. The facility failed to ensure Resident #1 had adequate supervision to prevent a choking episode on 02/06/24 when CNA F left her lunch bag unsupervised out in the hallway. Resident #1 grabbed a granola bar from CNA F and choked, resulting in loss of consciousness. This failure resulted in an identification of an Immediate Jeopardy (IJ) on 02/23/24. The IJ template was provided to the Administrator and DON. The IJ was removed on 02/23/24, but the facility remained out of compliance at a scope of isolated and a severity of potential of more than minimal harm that is not an Immediate Jeopardy, due the facility's need to monitor their plan of removal. [...]

Inspectors wroteBased on observation, interview and record review the facility failed to develop and implement comprehensive person-centered care plan that includes measurable objectives and time frames to meet a resident medical and nursing needs to be furnished to attain or maintain the residents highest practicable physical, mental, and psychosocial well-being for 2 (Resident #1 and Resident #2) of 6 reviewed for care plans. The facility failed to develop a comprehensive care plan to address Resident #1 minced/ moist texture diet. The facility failed to develop a comprehensive care plan to address Resident #2 regular diet consistency on 12/15/23. This deficient practice could place residents in the facility at risk of not receiving the necessary care or services and having personalized plans developed to address their needs.

Inspectors wroteBased on observations, interview and record review , the facility failed to ensure that all alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source, are reported immediately, but no later than 2 hours after the event, if the events result in serious bodily injury, or no later than 24 hours if the events do not result in serious bodily injury, to the Administrator of the facility and to other officials (including to the State Survey Agency) in accordance with state law through established procedures for 2 (Resident #1 and Resident #2) of 5 residents reviewed for abuse. CNA K failed to immediately notify the Administrator on 01/13/2024 of allegations of abuse by CNA L and involving Resident #1 and Resident #2. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for professional standards for food service safety. -The facility kitchen was observed on 01/24/2024 with 1 bag of frozen French fries located in the walk-in freezer that was removed from the original package, dated 1/21/24 and was not sealed. -The facility kitchen was observed on 01/24/2024 with 1 bag of tater tots located in the walk-in freezer was found out of original package, was not sealed, or labeled. -Cook O was observed on 01/24/2024 with - with a beard and was not wearing a beard net while preparing food in the kitchen. These failures could place residents at risk of food-borne illness.

Inspectors wroteBased on interview and record review the facility failed to ensure they employed a qualified social worker on a full-time basis for eight of eight weeks reviewed. The facility, licensed for 126 beds, failed to have a full time Social Worker for eight weeks, from 11/27/2023 to 01/24/2024. This failure could place residents at risk of unmet psychosocial needs and poor quality of life.

Inspectors wroteBased on observation, interviews, and record reviews, the facility failed to allow residents the right to reside and receive services in the facility with reasonable accommodation of needs and preferences for 2 residents (Resident #35 and Resident #241) of 6 reviewed for resident rights. The facility failed to ensure Resident #35, and Resident #241 were not found with their call lights out of reach on 10/17/23 and 10/19/23. This failure could cause a decline in health in residents if their call lights are not within reach, preventing them from calling for assistance.

Inspectors wroteBased on interview, and record review, the facility failed to make residents and residents family members aware of the grievances process and allowing them to exercise their right to file a grievance leading to the facility not addressing the grievances of residents for resident reviewed who attended Resident council Meetings (9 residents). 1. The facility failed to make residents and family members aware of how to file a grievance These failures put residents and family members at risk of decreased opportunities to present grievances and recommendations.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to store biologicals under proper temperature controls for 1 medication cart (300 Hall) of 3 medication carts reviewed for medication storage. -The facility failed to ensure that a container of thickened water was kept under appropriate temperatures after it was opened. This failure could cause a decline in health in residents if medications were to be given after not being stored at correct temperatures.

Inspectors wroteBased on observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections in 2 out of 6 residents reviewed for infection control. The facility failed to ensure CNA F and CNA I maintained proper hand hygiene and use gloves while performing perineal care for Resident #30 and Resident #15. This failure could place other residents who receive perineal care at risk of cross-contamination.

Inspectors wroteBased on interview and record review, the facility failed to ensure all alleged violations involving abuse, neglect, exploitation were thoroughly investigated for 1 (Resident #242) of 6 residents reviewed for neglect. -The facility failed to thoroughly investigate an incident on 08/12/23 when Resident #242 complained of leg pain and was found to have a broken femur. This failure could place residents at risk of abuse and neglect if incidents are not thoroughly investigated.

Inspectors wroteBased on interview and record review, the facility failed to send a copy of the notice of discharge and the reasons for the move in writing to a representative of the Office of the State Long-Term Care Ombudsman for one (Resident #294) of 18 residents reviewed for admission/transfer/discharge rights. The facility failed to ensure the Long-Term Care Ombudsman was notified that Resident #294 was denied readmission after being sent to the hospital. This failure could put residents at risk of not having the opportunity to appeal discharge, not having their rights honored regarding facility-initiated discharges, and homelessness.

Inspectors wroteBased on interview and record review, the facility failed to develop and implement a baseline care plan within 48 hours of a resident's admission for one (Resident #294) of 18 residents reviewed for baseline care plans. The facility failed to develop and implement a baseline care plan within 48 hours after admission for Resident #294. This failure could put residents at risk of not having their care needs identified and met.

Inspectors wroteBased on interview and record review, the facility failed to develop and implement comprehensive person-centered care plan that includes measurable objectives and time frames to meet a resident medical and nursing needs to be furnished to attain or maintain the residents highest practicable physical, mental, and psychosocial well-being for 2 of 12 residents (Resident #89 and Resident #241) reviewed for care plans in that: 1. The facility failed to ensure that Resident #89's comprehensive care plan included his behavior of pulling out his G-Tube. 2. The facility failed to ensure that Resident #241's comprehensive care plan included her ADL needs. These failures could place residents in the facility at risk of not receiving the necessary care or services and not having personalized plans developed to address their needs.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident who is unable to carry out activities of daily living receives the necessary services to maintain good nutrition, grooming, and personal and oral hygiene for 2 (Resident #9 and Resident #15) of 6 residents observed for assistance with ADL's. The facility failed to ensure Resident #9 and Resident # 15, who required assistance with ADLs, and were not observed to have long nails. This failure could affect residents who were dependent on assistance with ADLs and could result in poor care, lack of dignity, and skin tears due to long nails.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that a resident who needs respiratory care is provided such care, consistent with professional standards of practice and the comprehensive person-centered care plan for one (Resident #33) of 5 residents reviewed for respiratory care. The facility failed to ensure that Resident #33's oxygen concentrator was delivering oxygen at the physician-ordered rate (liters per minute). This failure could put residents at risk of oxygen toxicity.

Inspectors wroteBased on interview and record review, the facility failed to maintain clinical records that were complete and accurately documented for 1 (Resident #30) of 18 residents reviewed for clinical records. 1. The facility failed to document on 08/13/23 when CNA reported resident #30 had a swollen left ankle. 2. The facility failed to document a pain assessment on 08/13/23 when Resident #30 complained of pain to left ankle. 3. The facility failed to document the administration of Diclofenac Sodium Gel that was administered to Resident #30 on 08/13/23 for pain to left ankle. This failure could put residents at risk of not receiving prescribed pain medications as ordered.