Health inspection·December 9, 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** The facility failed to ensure that a resident who needed respiratory care and services, including oxygen administration, was provided with such care, consistent with professional standards of practice for 1 (Resident #1) of 5 residents reviewed. The facility failed to apply Resident #1's APAP (Automatic Positive Airway Pressure- a type of non-invasive mechanical ventilator) machine at HS (Hour of Sleep) for 15 days out of 29 for the month of October. This failure could place residents who require respiratory care at risk of distress including respiratory failure leading to hospitalizations or even death.Findings include: Record review of Profile Face Sheet dated 10/29/2025 reflected Resident #1 was admitted on [DATE] with diagnosis of Cerebral Palsy, Spastic Quadriplegic Cerebral Palsy, Muscle Weakness, and Dysphagia.[JM1] Record review of Resident #1's Physicians Orders reflected an order to Apply APAP (Automatic Positive Airway Pressure) machine at HS (Hour of Sleep) dated 04/24/2025. Record review of Resident #1's care plan dated 10/02/2025 reflected Problem: PULMONARY: Resident #1 has potential for SOB[JM2] and/or respiratory complications related to recent respiratory failure now with order for APAP at HS. Goal: [NAME] [JM3] will have no respiratory complications or signs or symptoms of shortness of breath. Intervention: Provide treatment per physician's orders and monitor for response. Observe for side effects and inform physician. The Care plan also reflected that Resident #1 Required total assistance with ADLs including mobility and transfers, Record review of Resident #1s MDS dated [DATE] reflected he had a BIMS of 06 indicating impaired cognition. The MDS also reflected Resident #1 used a noninvasive mechanical ventilator. Record review of Treatment record Dated October 2025 reflected that Resident #1s APAP machine was applied at HS with no documented refusals each night. Record review of Resident #1s progress notes for October 2025 reflected there were no documented refusals of APAP application. Record review of Resident #1s APAP Compliance Calendar Report (an internal device report) for the month of October 2025 provided by The Respiratory Company showed that Resident #1 had 15 days without his APAP device usage. This report indicated that the device was not turned on or used for dates 10/01/25, 10/02/25, 10/07/25, 10/08/25, 10/09/25, 10/10/25, 10/11/25, 10/12/25, 10/15/25, 10/18/25, 10/22/25, 10/24/25, 10/25/25, 10/25/25, and 10/26/25. In an interview on 10/29/25 at 9:00am Resident #1's responsible party stated she had received a call from the supply company of the APAP machine. The RP stated they were concerned for Resident #1s condition due to no usage data shown from the internal report x15 days for the month of October. The RP stated she asked the Unit Supervisor and was told Resident #1 sometimes refused his APAP machine. She stated the unit manager said that Resident #1 had been more compliant over the last couple of weeks. The RP stated the machine was very important for Resident #1 to wear because without it he could stop breathing and have respiratory failure. The RP stated she was unsure if he refused one time, they were going back to offer the machine again to ensure he is wearing it. The RP stated the nurses must place the face mask on and turn the machine on due to Resident #1s limited mobility related to cerebral palsy. In an observation on 10/29/25 at Residents Affected - Some (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 2 Event ID: 455983 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 455983 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE St. Catherine Center 300 West Highway 6 Waco, TX 76712 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)