Health inspection·August 1, 2025

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some not perform hand hygiene before she entered and exited Resident #1's room. MA A did not sanitize the blood pressure cuff. Observed MA A go into Room# 509 and passed medication to Resident #3. MA A went into Room# 510 and took Resident #4's BP and did not sanitize the blood pressure cuff. Observation and interview on 08/01/25 at 6:38 AM, MA A stated staff did not have to wear PPE to go into Resident #1's room because staff only had to wear PPE when they provided direct care to the resident#1. MA A continued to the other side of building to pass medication. MA A stated she thought she had wiped down the blood pressure cuff. Observation of the medication cart revealed no sanitation wipes on the medication cart. Interview and observation on 08/01/25 at 6:45 AM revealed CNA B put on full PPE before she entered Resident #1's room. CNA B stated she had to put on PPE to prevent the spread of infection to other residents. Interview on 08/01/25 at 8:10 AM, the IP stated Resident #1 was on isolation contact precautions which meant staff, visitors and providers must put on gloves and a gown before entering and remove when exiting. The IP stated staff should wash their hands before entering and exiting Resident#1's room. The IP stated these precautions prevented other residents and staff from being exposed to the infection. Interviews on 08/01/25 at 9:15 AM to 9:50 AM with CNA B, CNA D, CNA E, LVN G, and LVN F, they stated when a resident was on EBP, PPE was worn when care was being provided to the resident such as during incontinent care, wound care and catheter care. LVN F stated when a resident was on contact precautions staff were supposed to wear a gown, gloves and could wear a face mask, shield and shoe covers if necessary. CNA B stated Resident #1 had a little loose stool this morning and it looked like diarrhea. The staff stated putting on PPE prevented the spread of infection to staff, visitors and other residents. Interview on 08/01/25 at 8:26 AM over the phone with the PCP revealed Resident #1 was on isolation because he was diagnosed with C. Diff. The PCP stated Resident #1 should stay on contact precautions until he had formed stools. The PCP stated staff should wear secretion general precautions (refer to the measures taken to prevent the transmission of microorganisms from both recognized and unrecognized sources. These precautions are essential for protecting both healthcare workers and patients by reducing the risk of infection) such as a mask, gloves and gown to prevent the spread of the infection. Interview on 08/01/25 at 10:30 AM revealed the ADON and Administrator stated they completed an in-service with staff about the TBP. The ADON stated staff were nervous because the surveyor did observation with them. The ADON stated the facility would work on the infection control concerns. Record review of facility policy titled Isolation-Categories of Transmission-Based Precautions, dated 2021 reflected : Policy statementTransmission-based precautions are initiated when a resident develops signs and symptoms of a transmissible infection; arrives for admission with symptoms of an infection; or has a laboratory confirmed infection; and is at risk of transmitting the infection to other resident.2.) Transmission based precautions are additional measures that protect staff, visitors, and other residents from becoming infected. These measures are determined by the specific pathogen and how it is spread from person to person.5.) When a resident is placed on transmission-based precautions, appropriate notification is placed on the room entrance door. a.) The signage informs the staff of that type of CDC precautions(s), instructions for use of PPE.6.) When transmission -based precautions are in effect, non-critical resident - care equipment items. a) If re-use of items is necessary, then the items will be cleaned and disinfected according to current guidelines before use with another resident.Contact precautions: 1. Contact precautions are implemented for residents known or suspected to be infected with microorganisms that can be transmitted by direct contact with the resident or indirect contact with environmental surfaces or resident-care items in the residents' environment. Record review of website at http://www.cdc.gov/handhygiene/providers/index.html; titled: Clinical Safety: Hand Hygiene for Healthcare Workers dated (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455626 If continuation sheet Page 2 of 3 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 455626 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Oakmont Guest Care Center 2712 N Hurstview Hurst, TX 76054 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)

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete 02/27/24, reflected: .according to the Centers for Disease Control and Prevention (CDC), strict adherence to glove use is the most effective means of preventing hand contamination with C. difficile spores as these spores are not killed by ABHR and may be difficult to remove even with thorough hand washing. Additional information on appropriate hand hygiene practices may be found in CDC's Hand Hygiene in Healthcare Settings. Record review of website https://www.cdc.gov/infectioncontrol/guidelines/mdro/index.html,; titled: Guidelines and Guidance library dated 04/25/25, and Transmission based precautions, dated 04/03/24 reflected: .Contact Precautions Contact precautions are intended to prevent transmission of pathogens that are spread by direct (e.g., person-to-person) or indirect contact with the resident or environment (e.g., C. difficile, norovirus, scabies), and requires the use of appropriate PPE, including a gown and gloves before or upon entering (i.e., before making contact with the resident or resident's environment) the room or cubicle. Prior to leaving the resident's room or cubicle, the PPE is removed, and hand hygiene is performed. Event ID: Facility ID: 455626 If continuation sheet Page 3 of 3