Health inspection·May 16, 2024

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents for two (Hall 400 and 500) of six halls and one resident shower rooms on Hall 400 observed for environment. The facility failed to ensure resident rooms on Halls 400 and 500 and the resident shower room on Hall 400 were clean, safe, and in good repair. This failure could place residents at risk for diminished quality of life due to the lack of a well-kept environment. Findings included: An unidentified complainant had notified the surveyor that several months prior to this investigation, one of the rooms on 500 Hall had been closed off due to the collapse of the ceiling and a smell of mold. Upon investigation on 05/14/24 at 12:00 pm, room [ROOM NUMBER] was observed to have a large hole in the ceiling approximately 3 feet square with an adjacent piece of ceiling about the same size with the drywall to the ceiling removed and covered only by insulation. Insulation was hanging out of the open part of the ceiling and was occasionally dripping water into one of 2 large barrels located on the floor beneath the opening. There was an odor of mold or mildew in the room. The room was devoid of furniture, call lights or any decorations. During an interview with the Administrator on 05/14/24 at 12:40 pm, the administrator stated the facility had experienced several leaks throughout the building. The Administrator stated they had attempted to repair the leaks but were unable to find the exact spot where a repair would be effective. When asked about other areas affected, the Administrator stated they had to move a resident out of the 400 Hall, room [ROOM NUMBER], and the shower room on 400 Hall had been affected. Observation of room [ROOM NUMBER] on 05/14/24 at 1:49 pm revealed a sign on the door that was in the form of a Stop sign that had Stop DO NOT ENTER on it. Upon opening the door, a corner of the room above the overbed light had ceiling drywall torn off in about a 2 ½ foot circumference with a black substance on the dry wall. The room was also devoid of furniture. Next door to this room and sharing a wall revealed a large resident shower room with 2 shower stalls. The wall that was shared with the adjoining resident room, had a very large area approximately 8 feet in length and 4 feet in height that appeared to have been a cabinet that had been taken off the wall. There were also large pieces of drywall above and below this area that had been ripped off the wall with a black substance remaining. In the ceiling in this area, was what appeared to be a rusted fan without a cover. Page 1 of 2 675641 675641 05/16/2024 Avir at Seguin 1215 Ashby Seguin, TX 78155

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Toiletries such as soap were noted across the room near the shower stall that seemed to indicate the shower was still being used. Upon exiting this room about 2:00 pm on 05/14/24, CNA A was observed getting ready to go into the resident room across the hall from the shower room. CNA A was asked if the shower room was still in use and she said that it was. CNA A stated the residents complained about the smell of mold and mildew in the room and stated they really don't like using the shower. During an interview with the Administrator on 05/14/24 at 2:10 pm, the Administrator stated that the shower room shouldn't be used but that he knew that some residents who were more independent went in there anyway. At the request of the health survey team, a Life Safety Code surveyor came to the facility on [DATE] to look at the damaged areas and walk the property, including the roof, with the Maintenance Director. Record review of invoices for previous repairs was conducted on 05/16/24. There was a bid dated 01/22/22 with an accepted date of 04/12/22 which indicated repairs to be completed. Another invoice from another roofer dated 12/13/23 was also provided for leak repair. Pictures were provided along with these invoices which indicated the roof was patched in various places and included notations of patches done above the 400 and 500 Halls. During an interview with CNA A on 05/15/24 at 2:22 pm, CNA A stated the staff were told yesterday not to use the shower on 400 hall and take residents to the showers on the other halls. CNA A stated that prior to the surveyor's entrance, they were still using the 400 Hall shower. Interview with Resident #1 on 05/16/24 at 2:44 pm revealed he had previously been housed in room [ROOM NUMBER]. He said it did leak for a while before he was moved but it never got on him. Resident #1 said the aides complained that they got their shoes wet since there was water on the floor. Resident #1 stated the leak went on for about 5 months and then he was moved in January of this year. Resident #1 thought he would move back but was not aware the leak had not been fixed as of this date. Interview with Resident #2 on 05/16/24 at 2:56 pm revealed she did take showers in the 400 Hall shower room. Resident #2 stated she was independent but the staff knew when she was going in the shower and would come and check on her. Resident #2 stated the smell in the shower room is horrible and sometimes the water is too cold. When asked what she did about this, Resident #2 stated she would just tell the Maintenance Director about the water. Resident #2 stated she kept a fan in her room for circulation and she had had trouble with allergies since she came here 3 years ago. Resident #2 stated the water used to come through the wall like a hydrant was on. When Resident #2 was informed that a sign had been put on the door not to use the shower as of today, Resident #2 stated no one had told me about that. Administrator was asked about policies for the physical plant but he stated they just used a Maintenance Log book which was located at the Nurses Station. When something needed to be fixed, the issue was written in the book and the Maintenance Director would check it off as he completed the repair. This Maintenance Log was observed at the Nurses Station. 675641 Page 2 of 2