Inspection·December 10, 2025

F 0695 Provide safe and appropriate respiratory care for a resident when needed. 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 ensure that a resident who needs respiratory care was provided such care, consistent with professional standards of practice for 1 of 2 residents (Resident #1) reviewed for oxygen.- The facility failed to ensure Residents #1 had an order for oxygen, when she was on 2L O2 via NC.This failure could place residents at risk for inadequate or inappropriate amounts of oxygen delivery and ineffective treatment.Findings included:Record review of Resident #1's undated face sheet revealed she was a [AGE] year old female admitted on [DATE] with diagnoses of acute and chronic respiratory failure (not enough oxygen in the blood), cerebral infarction (stroke), aphasia (unable to speak), type 2 diabetes mellitus (body does not produce insulin or resists it), pneumonitis (inflammation) due to inhalation of food and vomit, and a stage 3 pressure ulcer to her sacrum (pressure ulcer revealing fat but not to the bone, of her tailbone). The picture of the resident on the face sheet revealed she had oxygen on.Record review of Resident #1's admission MDS assessment dated [DATE] revealed a BIMS score of 0 out of 15, which indicated severely impaired cognition. The resident was dependent (the helpers did all the effort and resident does none of the effort) for all self-care and mobility. According to the MDS, the resident was on oxygen.Record review of Resident #1's Baseline Care Plan dated 9/5/25, revealed the resident was receiving oxygen and had a Focus: oxygen use: required supplemental oxygen, with a goal to maintain adequate oxygen saturation levels and respiratory comfort through the review date. The interventions included assessing for signs of hypoxia (not having enough oxygen), changing the tubing when soiled or contaminated, following physician orders for oxygen therapy delivery, monitoring for side effects of oxygen therapy (dry mucous membranes, oxygen toxicity) and report to MD as needed, monitor/clean the oxygen concentrator filter as needed, provide humidification as indicated, and routinely monitor the resident's oxygen saturation levels.Record review of Resident #1's Comprehensive Care Plan dated 9/5/25, revealed a Focus: Oxygen Use: required supplemental oxygen (Initiated: 9/8/25). The goal was to maintain adequate oxygen saturation levels and respiratory comfort through the review date (Initiated: 9/8/25, Target: 9/22/25). The interventions included following physician orders for oxygen therapy delivery, monitoring for side effects of oxygen therapy (dry mucous membranes, oxygen toxicity) and report to MD as needed and routinely monitor the resident's oxygen saturation levels.Record review of Resident #1's previous hospital records dated 9/3/25 at 12:53am by CRRT M, revealed she was on O2 at 2L via NC.Record review of Resident #1's Admission/readmission assessment dated [DATE] at 4:38pm by unknown nurse, revealed the resident was using O2 at 2 LPM.Record review of Resident #1's oxygen saturations from 9/5/25-9/23/25, revealed she was on oxygen via nasal cannula.Record review of Resident #1's Progress Notes dated 9/6/25 at 10:52am by LVN R, revealed the resident's O2 was 98% and the method was oxygen via nasal cannula. The note also said the resident was provided education on oxygen management.Record review of Resident #1's H&P dated 9/8/25 at 10:00am by NP C, revealed .Continues to require oxygen via nasal cannula Residents Affected - Few (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 3 Event ID: 455714 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 455714 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/10/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Paradigm Northwest 17600 Cali Dr Houston, TX 77090 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)