Health inspection·September 19, 2025

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure a resident who was incontinent of bladder received appropriate treatment and services to prevent urinary tract infections and to restore continence to the extent possible for 1 of 2 resident (Resident #10) reviewed for incontinent care, in that: CNA A did not pull back Resident #10's foreskin (skin covering the head of the penis) and did not clean under the shaft of the penis and the top of the scrotum (sac of skin protecting the testicles) during incontinent care. This facility failure could place residents at-risk for infection and skin break down due to improper care practices. Findings included: Record review of Resident #10's face sheet, dated 09/18/2025, revealed an admission date of 01/27/2016, and a readmission date of 11/24/2023, with diagnoses which included: Parkinsonism (brain conditions that cause slowed movements, rigidity (stiffness) and tremors), Alzheimer's disease (brain disorder that slowly destroys memory and thinking skills) and, Hemiplegia (Paralysis of one side of the body). Record review of Resident #10's quarterly MDS dated [DATE] revealed the resident had a BIMS score of 05 indicating severe cognitive impairment. Resident #10 required total care for his activities of daily living and was always incontinent of bowel and bladder. Review[TT1] of Resident #10's care plan dated 07/24/2022, revealed a problem of Has bowel/bladder incontinence related to Dementia (Decline in cognitive ability), IMMOBILITY, a goal of Will decrease frequency of urinary incontinence through the next review date and an intervention of Monitor/document for signs and symptoms of UTI: pain, burning, blood tinged urine, cloudiness, no output, deepening of urine color, increased pulse, increased temp, Urinary frequency, foul smelling urine, fever, chills, altered mental status, change in behavior, change in eating patterns. Observation on 09/18/2025 at 11:20 a.m., revealed while providing incontinent care for Resident #10, CNA A did not pull back the resident's foreskin (skin covering the head of the penis) and did not clean under the shaft of the penis and the top of the scrotum (sac of skin protecting the testicles). During an interview on 09/18/2025 at11:30 a.m., CNA A stated she knew to retract the skin when the resident was not circumcised (surgical removal of the foreskin, the tissue covering the head of the penis) and knew to clean under the penis shaft, but she was nervous and forgot. She stated she received training for incontinent care and infection control this year. During an interview with the DON on 09/18/2025 at 5 p.m., she stated in the case of a male resident who was not circumcised the foreskin must be pulled back. The underside of the shaft and top of the scrotum must be cleaned. The DON stated staff received training on incontinent care at least yearly and their skills are checked yearly and as needed Review of annual skills check for CNA A revealed CNA A passed competency for incontinent care on 06/06/2025. Review of facility policy and procedure, titled Perineal care, undated, revealed to wash [ .] as well as the penis and scrotum. Retract foreskin of the uncircumcised male and wash carefully to remove secretions. Wash area under scrotum. 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 3 Event ID: 675766 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 675766 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/19/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Courtyard Rehabilitation and Healthcare Center 3401 E Airline Dr Victoria, TX 77901 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)