Health inspection·November 20, 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 4 residents (Resident #1) reviewed for infection control practices, in that: CNA A used cleansing wipe multiple times when performing incontinent care for Resident #1.This failure place residents who use cleansing wipes during incontinent care at-risk for urinary tract infections due to cross contamination. The findings were: Record review of Resident #1's electronic face sheet dated 11/20/25 revealed the resident was a [AGE] year-old male admitted to the facility on [DATE]. Resident #1's diagnosis included type 2 diabetes mellitus (a chronic disease in which glucose levels in the blood were higher than normal because the body does not make enough insulin or use it the way it should), muscle weakness, muscle wasting and atrophy (decrease in size or wasting away of a body part or tissue), dementia (loss of cognitive functioning, such as thinking, remembering and reasoning to such an extent that it interferes with a person's daily life and activities).Record review of Resident #1's undated comprehensive person-centered care plan, reflected Resident #1 had an ADL self-care performance deficit r/t generalized body weaknessDate Initiated: 04/05/2022. PERSONAL HYGIENE: The resident requires assistance by (1) staff with personal hygiene and oral care. Date Initiated: 04/05/2022. Revision on: 10/16/2023. TOILET USE: The resident requires assistance by (2) staff for toileting. Date Initiated: 04/05/2022. Revision on: 10/16/2023.Record review of Resident #1's Quarterly MDS dated [DATE] reflected Resident #1 had a BIMS of 03 which indicated a severe impairment of mental status. Resident #1 required substantial/maximal assistance for self-care in toileting hygiene. Resident #1 had bowel incontinence and an indwelling catheter. During an incontinent care observation on 11/19/25 at 1:45 PM., CNA A and CNA B performed incontinent care on Resident #1. CNA A grabbed a wipe and wiped the tip of the penis, crumpled the wipe in his hand, and wiped the tip of the penis again using the same wipe. CNA performed the same technique 2 more times. CNA A cleansed the remainder of the front genital area. CNA A grabbed a wipe and wiped one side, crumpled the wipe in his hand and reused the wipe. CNA performed the same technique to the other side. When the front area was completed, CNA B assisted Resident # 1 to his left side. CNA A grabbed a wipe, wiped between the buttocks, crumpled the wipe in his hand and wiped again using the same wipe. CNA A grabbed another wipe and cleansed one side of the buttocks, crumpled the wipe in his hand and wiped again using same wipe. CNA A performed the exact same technique to the other side of buttocks. CNA A did not use one wipe per swipe throughout the whole procedure.In an interview on 11/19/25 at 2:00 pm, CNA A said the facility had infection control training at least once a month and the training included incontinent care for residents. CNA A said during incontinent care they used disposable wipes, they wiped once, folded the wipe and wiped again using the same wipe but could not use the contaminated site of the wipe. CNA A said that was what they taught at the facility training. CNA A Residents Affected - Few Page 1 of 2 455621 455621 11/20/2025 Valley Grande Manor 1212 S Bridge Weslaco, TX 78596

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few said that was the way to prevent infections for residents.In an interview on 11/19/25 at 2:15 pm CNA B said they always had in-services on peri-care and infection control. CNA B said they received training at every meeting. CNA B said they were not supposed to reuse a wipe. CNA B said they just used a wipe once, disposed and used another wipe. CNA B said she saw CNA A use one wipe per swipe. CNA B then said CNA A did use the same wipe, but he turned it around. CNA B said sometimes they did that with washcloths. CNA B said she had never been instructed to fold over disposable wipes and reused them. CNA B said they swiped once with a wipe and threw it away. She said in-services and trainings enforce this was best way for infection control. In an interview on 11/19/25 at 3:34 pm LPN C said they went over infection control during monthly meetings. This investigator asked LPN C if during incontinent care, CNAs wiped with a disposable wipe, folded over the wipe, then reused the wipe. LPN C said she hoped they did not. LPN C said CNAs should not reuse or fold used disposable wipes and use again. LPN C said CNAs should wipe once and throw the disposable wipe away. She said it would be against infection control. In an interview on 11/20/25 at 2:20 pm ADON D said they went over infection prevention and control information with staff monthly to quarterly and upon hire. ADON D said they checked off skills upon hire and quarterly. ADON D said she believed infection prevention and control training was required once a year, but she also liked to complete if she saw any trends. ADON D said disposable wipes use was a gray area. ADON D said it depended on the condition of the wipe, during incontinent care CNAs could wipe once with a disposable wipe then dispose of the wipe or they could wipe, fold over the wipe, and use a clean area of the wipe to wipe again. ADON D said if wipe was visibly soiled, staff should dispose of it. ADON D said that common practice was to throw the wipe away after one use. ADON D said when she trained or in-serviced, she instructed CNAs to wipe once then throw the wipe away because that was best practice. ADON D said the use of one wipe per swipe left no room for error for cross contamination. Record review of Competency Assessment Perineal Care dated 7/10/25 indicated CNA A was checked off as met on the following: A) PurposeThe purposes of this procedure are to provide cleanliness and comfort to the resident, to prevent infections and skin irritation, and to observe the resident's skin condition.D) Steps in the Procedure.For a male resident:.a. Wet washcloth and apply soap or skin cleansing agent.b. Wash perineal area starting with urethra and working outward. 9. Discard disposable items into designated containers.Record review of facility's Perineal Care policy revised February 2018, reflected, PurposeThe purposes of this procedure are to provide cleanliness and comfort to the resident, to prevent infections and skin irritation, and to observe the resident's skin condition.Equipment and SuppliesDisposable wipes.Steps in the Procedure.For a male resident:e. Cleanse perineal area starting with urethra and working outward.j. Thoroughly rinse perineal area in same order, using disposable wipes.8. Discard disposable items into designated containers. Record review of FDA guidance on Disposable Wipes, reflected, Disposable wipes are made for baby care, hand washing, feminine and other personal cleansing.Who Regulates Wipes, and How?This depends on their intended use:Wipes intended for cleansing or moisturizing the skin, such as those for baby care, hand washing, makeup removal, washing the body when bathing is not practical, or feminine or other personal cleansing, are regulated as cosmetics.But cosmetics must be safe when people use them as directed on the label, or in the customary or usual way.The information below is about wipes that are regulated as cosmetics:Using Wipes Safely: Tips for ConsumersHow consumers use and store wipes can affect their safety. Here are some safety tips: . Discard used wipes immediately to prevent cross contamination, and as directed on the label. 455621 Page 2 of 2