Health inspection·February 12, 2026

F 0728 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training. Based on interview and record review the facility failed to ensure that nurse aides were able to demonstrate competency in skills and techniques necessary to care for residents' needs, as identified through resident assessments, and described in the plan of care for 2 Nurse Aides (NA A and NA B) of 4 nurse aides reviewed for proficiency of nurse aides. The facility failed to ensure NA A and NA B were CNAs after four months of being hired. This failure could place residents at risk of not being provided care by qualified staff, which could cause inadequate care and injury resulting in decreased health and psycho-social well-being. Findings include:1. Record review of NA A's employee record revealed she was hired 03/1/25 as a Nurse Aide trainee. Her Texas Performance Nurse Aide Program training was completed on 03/30/25, and NA A completed skills checkoffs on resident care and services. There was no proof of her being a Certified Nurse Assistant. Record review of NA A's Timesheet at [This Facility] revealed her date of hire was 03/1/25 and started working regular hours on 03/1/25. NA A was still employed at facility as of 2/8/2026. Observation was made of NA A providing resident care on 2/8/2026 at 1:45pm. 2. Record review of NA B's employee record revealed she was hired on 08/6/25 as a Nurse Aide trainee. Her Texas Performance Nurse Aide Program training was completed on 01/30/26 and she completed skills checkoffs on resident care and services. There was no proof of her being a Certified Nurse Assistant. Record review of NA B's Timesheet at [This Facility] revealed she was hired on 08/6/25 and started working regular hours on 07/13/24. Observation of NA B providing resident care on 02/8/26. Interview on 02/8/26 at 1:00 PM, the DON stated they had NA's who provided care to the residents but as of today NA A and NA B were not going to work until they passed the CNA test. DON stated she did not have a date on when NA A and NA B were going to take their CNA test. DON states she became DON in November 2025 and knew the NA's had completed their classes and competencies done but did not know that NAs needed to be certified within 120 days of hire. Record review of the facility Policy (no title), undated revealed the following: In Texas, trained but non-certified nurse aides (often referred to as temporary nurseaides) may work in nursing homes for up to four months while pursuing certification,according to Texas Health and Human Services (HHSC) regulations. While they mustoperate under the general supervision of a licensed nurse, they are not strictly required tohave a Certified Nurse Aide (CNA) present at all times, provided they have completed thenecessary training, as explained in eCFR.Key Requirements and Constraints: Four-Month Limit: A facility cannot employ a non-certified aide for more than fourmonths; they must pass the state certification exam within this timeframe. Supervision: While they do not need a CNA alongside them, they must be under thegeneral supervision of a licensed nurse (RN or LVN). Scope of Practice: Uncertified aides may only perform tasks they have been trainedfor and found proficient in by their instructor. COVID-19 Waivers Ended: The emergency waivers that allowed for longer periodsof uncertified work have ended, with most requiring certification to be finalized bymid-2023.The facility must ensure the aide is on the path to being listed on the Nurse Aide Registry Event ID: Facility ID: 675364 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 675364 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/12/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Homestead Nursing and Rehabilitation of Baird 224 E 6th St Baird, TX 79504 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 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for one (Resident #1) of 2 residents reviewed for Infection Control. The facility failed to ensure NA A performed hand hygiene and glove change while providing incontinent care to Resident #1 on 02/8/26. This failure could place residents at risk of cross-contamination and development of infections.Findings included:Record review of Resident #1's Face Sheet, dated 2/8/26 reflected Resident #1 was an [AGE] year-old female with admission date of 02/26/24. Resident #1 has diagnoses including hemiplegia and hemiparesis (condition that affects movement on one side of the body), sepsis (life threating infection), and kidney failure (kidneys do not filter waste and toxins from blood). Record review of Resident #1's Quarterly MDS Assessment indicated Resident #1 has BIMS score of 00 (severely cognitively impaired). Transferring max assistance, toileting max assistance, and bathing max assistance. Record review of Resident #1's Comprehensive Care Plan dated 2/1/26, risk of pressure ulcer and other skin issues- interventions, check for incontinence during rounds, provide care as needed. During an observation on 02/08/2026 at 1:45 PM NA A performed peri care to Resident #1. NA A did not perform hand washing, hand hygiene, or glove changes in between dirty and clean brief change or redressing resident. Interview on 02/11/26 at 9:00 AM, NA A stated she should have changed her gloves after cleaning the perineal area and before opening the new brief. She also said she also should have changed her gloves after cleaning the resident's bottom and before touching the new brief again. She said she did not do any hand hygiene all throughout incontinent care. She said she would be mindful to change her gloves after touching something dirty and doing hand hygiene.In an interview on 02/11/2026 at 3:35 PM, the DON stated the expectation was for the staff to follow the policy and procedures pertaining to infection control. Cross contamination could contribute to infection. DON states she will in-service staff on proper hand hygiene and peri-care policy. Record review of the facility Perineal Care Policy dated 2001 MED-PASS, indicated the following: PurposeThe purpose of this procedure is to provide cleanliness and comfort to the resident, to prevent infections and skin irritation, and to observe the residents' skin condition.Preparation1. Review the resident's care plan/profile to assess any special needs of the resident.2. Assemble the equipment and supplies as needed.Steps in the Procedure1. Beginning stepsa. Wash hands. Wear gloves and follow Standard Precautions if contact with blood or body fluids is likely. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675364 If continuation sheet Page 3 of 3