Health inspection·September 5, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to treat each resident with respect and dignity for one (Resident #107) of three residents reviewed for rights, in that: The facility failed to ensure Resident #107's ostomy drainage bag was placed in a privacy bag while performing physical therapy in the facility's hallway area. Ostomy (an opening (stoma) from an area inside the body to the outside). This failure could place residents with catheters at risk for embarrassment and reduced self-esteem. The findings included: Review of Resident #107's electronic record on 9/5/24 revealed she was a [AGE] year-old female admitted to the facility on [DATE] with diagnosis of incarcerated hernia. (An incarcerated hernia is a type of hernia in which a part of the small bowel protrudes into the groin area and cannot be pushed back in). Record review of Resident #107's care plan dated 09/01/24 indicated in part: Patient would like to be able to use regular colostomy after recovery. Will be free from trauma to site and infection. Patient to have less leakage from ostomy. Record review of Resident #107's MDS dated [DATE] indicated in part: BIMS = 15 indicating resident was cognitively intact. Bladder and bowel: Ostomy checked yes. During an observation on 09/04/24 at 10:42 AM, Resident #107 was being assisted by PTA A with ambulating in the hallway with the use of the resident's walker. The resident's ostomy drainage bag was seen hanging on the walker and not covered with a privacy bag exposing the bowel movements in the drainage bag. There were other resident's seen in the hallway as well as several visitors. During an interview on 09/05/24 at 3:02 PM, Resident #107 said she was aware of her ostomy bag not being covered while out in the hallway. The resident said she did not mind it being uncovered. The resident said it did not make any difference to her if it was covered or not and that the facility staff had not asked her if they could cover it. During an interview on 09/05/24 at 3:07 PM, RN B said whenever a resident that used for example a urinary catheter bag they would make sure it was kept below the resident's waist to prevent back flow (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 4 Event ID: 455683 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 455683 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/05/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hendrick Skilled Nursing Facility 1900 Pine Abilene, TX 79601 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)