Health inspection·August 21, 2025

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few gloves, washed her hands and put on clean gloves. CNA B then returned to the bedside and used a peri-wipe to wipe the urine off the mattress, and with the same soiled gloves, pulled the clean sheet and clean brief under the resident. Both staff then rolled the resident onto her back and CNA B provided pericare, going from front to back and downward toward the clean brief, while still wearing soiled gloves. Both staff then closed the resident's brief. Both staff removed their PPE, gathered the trash, and soiled linens, performed hand hygiene and left the room. In an interview on 08/20/25 at 09:45 a.m. with CBA A and CNA B, CNA A stated she was supposed to do hand hygiene before and after care and stated she should have washed her hands before going from dirty to the clean portion of the resident's care. CNA B stated they were to sanitize their hands between glove changes. CNA B stated she thought she had done that, but then realized after she had cleaned the mattress she now had on soiled gloves. CNA A stated she realized she had forgot to put her gown back on when she returned to the room. Both staff stated anyone who was on Enhance Barrier Precautions required them use a gown and gloves for all direct care to the resident. Both staff stated failing to perform hand hygiene after gloves changes and failing to utilize proper PPE exposed the resident to infections. 2. An observation and interview on 08/20/25 at 11:15 a.m. of the Hall 500 shower room revealed CNA A in the shower room with Resident #2. A sheet, towel and blanket were observed laying on the shower room floor under the sink area. CNA A stated it did not belong to Resident #1. She stated it was laying on the floor when she entered the shower room with Resident #1. CNA A stated they were not supposed to place dirty linen on the floors, but instead were to place them in a plastic bag. She stated putting dirty linen on the floor caused the risk of spreading germs throughout the building. In an interview with ADON C who was also the facility's infection preventionist on 08/20/25 at 03:00 p.m. stated staff were to always perform hand hygiene between gloves changes. She stated they had to perform hand hygiene when going from dirty to clean. She stated any resident who had a wound or any implanted medical device required the use of enhanced barrier precautions to prevent the potential spread of drug-resistant infections. She stated she had just completed an in service on hand hygiene and infection control on 08/08/25 because she had started to see an increase in urinary tract infections. She stated she does spot checks on her daily rounds and will watch the staff provide direct care. In an interview with the DON on 08/20/25 at 4:54 p.m. she stated staff were to change their gloves and sanitize their hands when going from dirty to clean. She stated staff were always required to perform hand hygiene before care and after care and to wear a gown and gloves for direct care for any resident who was on enhanced barrier precautions. She stated the staff had been taught to never place soiled linens on the floor. She stated they do train on infection control during their skills checks and anytime they had any issues with infections in the building. She stated the risk of not adhering to the protocol was increased risk of infections. Record review of the Facility's policy titled, Enhanced Barrier Precautions, dated August 2022, reflected, Enhanced Barrier Precautions (EHPs) are utilized to prevent the spread of multi-drug resistant organisms (MDROs) to residents.EBP employ targeted gown and glove use during high contact resident care activities when contact precautions no not otherwise apply.Examples of high-contact resident care activities requiring the use of gown and gloves for EBP's include.changing linens.changing briefs.EBPs remain in place for the duration of the residents stay or until resolution of the wound.Staff are trained prior to caring for resident on EBPs.Signs are posted in the door or wall outside the resident room indicating the type of precautions and PPE required. Record review of the facility's policy titled, Handwashing/Hand Hygiene, dated August 2019, reflected, This facility considers hand hygiene the primary means to prevent the spread of infection.Wash hands with soap(antimicrobial or non-antimicrobial) and water for the following.When hands (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675441 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 675441 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renaissance Care Center 1400 Blackshill Dr Gainesville, TX 76240 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 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete are visibly soiled.After contact with a resident with infectious diarrhea.Use an alcohol-based hand rub.Soap.and water for the following.Before and after direct contact with residents.Before moving from a contaminated body site to a clean body site during resident care.After removing gloves.Hand hygiene is the final step after removing and disposing of personal protective equipment.The use of gloves done replace hand washing/hand hygiene.Record review of the facility's policy titled, Laundry and Bedding, Soiled, dated September 2022, reflected, Soiled laundry/bedding shall be handled, transported and process according to best practices for infection prevention and control.All used laundry is handled a potentially contaminated using standard precautions.Contaminated laundry is bagged or contained at the point of collection (i.e., location where it was used).Contaminated line and laundry bags/containers are not held close to the body or squeezed during transport. Event ID: Facility ID: 675441 If continuation sheet Page 3 of 3