Inspection·July 10, 2025

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 on observation, interviews, and record reviews, the facility failed to 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 disease and infection for 1 of 2 residents (Resident #1) reviewed for infection control, in that: - CNA Z and CNA R failed to wear PPE for EBP, when they provided incontinence care to Resident #1.- The facility failed to have Enhanced Barrier Precaution signage on the door or anywhere visible in Resident #1's room.- The facility failed to have PPE readily available for staff to don before entering Resident #1's room. This deficient practice could place residents at risk for infection, sepsis (infection throughout body), and hospitalization due to cross contamination.Findings included: Record review of Resident #1's undated face sheet revealed he was a [AGE] year-old male admitted on [DATE], with diagnoses of dementia (decline in mental ability severe enough to interfere with daily life), hemiplegia and hemiparesis (paralysis and weakness) after a stroke, affects from a stroke, history of falling, unspecified psychosis (psychotic disorder where the symptoms are present but don't fully meet the criteria for a more specific diagnosis), acute embolism and thrombosis (blockage/blood clot in a blood vessel) of deep veins in lower extremity, major depression, aphasia (trouble speaking), muscle wasting and atrophy (muscle decreases in size), and muscle weakness. Record review of Resident #1's Quarterly MDS Assessment, dated 7/1/2025, revealed a BIMS could not be performed due to the resident's condition. The resident had moderately impaired cognitive skills for daily decision making. The MDS indicated the resident had impairment on one side of his upper and lower extremities and had a limb prosthesis. The resident was dependent (the helper does all of the effort, or the assistance of 2 or more helpers is required) with all ADL's. The resident was always incontinent of bowel and bladder. The MDS indicated Resident #1 had 1 unstageable (wound has dead tissue and wound bed cannot be seen) pressure ulcer and was receiving wound care. Record review of Resident #1's care plan dated 12/13/23, revealed the care plan did not have the resident's pressure ulcer or the EBP on it. Record review of Resident #1's Progress Notes from 6/26/25 by LVN F, revealed the Wound Care MD recommended an MRI of the L ankle/foot due to an unstageable wound on the L heel. Record review of Resident #1's Progress Note from 6/27/25 by NP M, revealed he was being seen for an unstageable wound on the L heel. The resident had just finished abx for a wound infection and there was concern about the wound not healing over the past couple weeks. Record review of Resident #1's Physician Orders revealed the following orders from MD C:- Wound Treatment to left heel: Cleanse with Dakin's solution (wound cleanser), pat dry, apply Santyl (wound debridement), Bactroban (antibiotic), cover with alginate (promotes wound healing), and secure with dry dressing. Ordered on 6/25/25 at 2:06pm.- MRI of the ankle and foot. DX: LT heel wound. Ordered on 7/1/25 at 9:25am.Enhanced Barrier Precautions due to wounds. Ordered on 7/2/25 at 12:55pm. In an observation on 7/9/25 at 1:22pm, Resident #1 was lying in bed on his back, sleeping. His L heel had a pressure relieving boot on it and his heels Residents Affected - Few (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: 676006 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 676006 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/10/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Richmond Health Care Center 705 Jackson St Richmond, TX 77469 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)