Inspection·August 28, 2024

F 0635 Provide doctor's orders for the resident's immediate care at the time the resident was admitted. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure 1 of 4 sampled residents (CR #3) were admitted with physician orders for immediate care, in that: Residents Affected - Few The facility failed to have physician's orders that indicated CR #3's need for dressing to healing tracheostomy. This failure places residents with medical needs at risk for a decrease in their quality of care. Findings included: Record review of CR #3's face sheet, dated 08/25/2024, revealed a [AGE] year-old male who was admitted to the facility on [DATE] and was diagnosed with anoxic (without oxygen) brain damage and chronic respiratory failure with hypoxia (lack of oxygen). Record review of CR #3's care plan, not dated, revealed no mentioning of resident's trach status or post trach status. Record review of CR #3's MAR, dated 08/25/2024, revealed there were no orders for trach site care. Record review of CR #3's MDS, dated [DATE], reflected resident was not documented to receive tracheostomy care. Record review of CR #3's nurses notes, dated 08/05/2024 - 08/25/2024, revealed no notes regarding trach site care. Record review of CR #3's skin assessment, dated 08/09/2024, revealed there were no notes made regarding a healing trach site. Record review of CR #3's skin assessment, dated 08/16/2024, revealed there were no notes made regarding a healing trach site. In an interview with LVN A on 08/28/2024 at 2:21 PM, she stated she performed both of CR #3's skin assessments on 08/09/2024 and 08/16/2024 during his stay in the facility. She stated CR #3 admitted with his trach completely out and he had very small penpoint opening at the site. She stated by the next day they did not need to prepare for treatment because it was closed. She stated the trach was closed when he came in and they were even trying to figure out why the resident came with dressing on the trach site in the first place. (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: 675557 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 675557 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/28/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Oasis at Pearland 3400 E Walnut Pearland, TX 77581 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)