Health inspection·June 6, 2025

F 0583 Keep residents' personal and medical records private and confidential. Level of Harm - Minimal harm or potential for actual harm Based on interview, record review, and observation, the facility failed to ensure residents have a right to personal privacy for 1 of 2 resident (Resident #6) reviewed for privacy, in that: Residents Affected - Few CNA A and CNA B did not close Resident #6's privacy curtain while providing incontinent care on 06/05/2025. This deficient practice could place residents at-risk of loss of dignity due to lack of privacy. The findings included: Record review of Resident #6's face sheet, dated 06/06/2025, revealed an admission date of 06/03/2023 and, a readmission date of 04/10/2024, with diagnoses which included: Alzheimer's disease (brain disorder that slowly destroys memory and thinking skills), Type 2 diabetes mellitus (high level of sugar in the blood), Hyperlipidemia (Elevated level of any or all lipids(fat) in the blood), Vascular dementia (problems with reasoning, planning, judgment, memory and other thought processes caused by brain damage from impaired blood flow to the brain.), Anxiety (A group of mental illnesses that cause constant fear and worry), Chronic kidney disease (gradual loss of kidney function), Major depressive disorder (mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure), Non-Hodgkin lymphoma (Blood cancer). Record review of Resident #6's Quarterly MDS assessment, dated 04/08/2025, revealed the resident had a BIMS score of 11, indicating her cognition was moderately impaired. Resident #6 was always incontinent of bowel and bladder. She required extensive assistance in activities of daily living. Record review of Resident #6's care plan, dated 05/07/2025, revealed a problem of has (MIXED)bowel/ bladder incontinence r/t weakness, Alzheimer's, OAB, with a goal of The resident will remain free from skin breakdown due to incontinence and brief use through the review date and, intervention of Clean peri-area with each incontinence episode. Observation on 06/05/2025 at 2:22 p.m. revealed CNA A and CNA B did not completely close the privacy curtain while they provided incontinent care for Resident #6, exposing the resident's genital area during care. The resident's bed area was partially uncovered and the resident's roommate was in the room at the time of care. The privacy curtain was broken and could not be completely closed. During an interview with CNA B on 06/05/2025 at 2:30 p.m., CNA B confirmed the privacy curtain was not completely closed while they provided care for Resident #6 but it should have been. She confirmed she received resident rights training within the year. She did not know how long the privacy (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: 455869 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 455869 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/06/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Guadalupe Valley Nursing and Rehabilitation Center 1210 Eastwood Dr Seguin, TX 78155 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)