Health inspection·January 30, 2025

F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based 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 1 of 5 residents (Resident #1) observed for infection prevention. Residents Affected - Few The facility failed to ensure Enhanced Barrier Precautions (EBP) were implemented and used when CNA-A provided peri and catheter care for Resident #1. This deficient practice could place residents at-risk for spread of infection. Findings include: Record review of Resident #1's face sheet dated 01/30/2025 revealed she was a [AGE] year-old woman, with an initial admission date of 04/04/2024, with re-admission on [DATE] and with diagnoses which included: Non-traumatic subarachnoid hemorrhage (bleeding in the space between the brain and the tissue covering the brain); Gastrostomy status (presence of surgically created opening in stomach through which a feeding tube can be placed); Pressure ulcer of right hip, stage 4 (a severe wound that extends deep into tissue potentially with bone or muscle exposure on hip); Pressure ulcer of left buttock stage 4; and Neuromuscular dysfunction of bladder (condition where bladder muscles and nerves do not function properly). Record review of Resident #1's Quarterly MDS assessment dated [DATE] revealed a BIMS score of 15, indicating intact cognition. Further review revealed Resident #1 was assessed as having an indwelling catheter. Record review of Resident #1's Active Orders dated 01/30/2025 revealed a orders which included: Enhanced Barrier Precautions start date 06/25/2024. Foley Catheter: Provide catheter care every shift start date 01/26/2025. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 455020 Printed: 05/15/2026 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 455020 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at New Braunfels 821 US Hwy 81 W New Braunfels, TX 78130 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)