Health inspection·December 12, 2024

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few touching the floor at that time. CNA C stated if Resident's #66 foley bag was on the floor, the bag could get contaminated, and the resident could get an infection. CNA C said that she would replace the privacy bag for a new one and would put the foley catheter bag inside it. CNA C said that the last in-service on foley catheters and infection control was done last week. During an interview with CNA A on 12/11/24 at 1:05 PM CNA A said that it was important for the bag not to touch the floor because the resident could be at risk for getting an infection. CNA A said that if bag was on the floor staff could step on it. CNA A said that the last in-service on infection control was last week but could not recall the exact date. During an interview with CNA B on 12/11/24 at 1:10 PM CNA B said she checked the Foley bags on residents every time she went into the resident's room. CNA B said it was important to keep foley bags in the privacy bags to prevent the bags touching the floor because the resident could get an infection. CNA B said that the last in-service on infection control was last week. During an interview with CNA D on 12/12/24 at 9:30 AM CNA D said that the Foley bags should be on the sides inside the privacy bag that was attached to the bed. CNA D said that if the foley bag was in the floor, someone could step on it. CNA D said that foley bag was not supposed to be on the floor because the resident could be at risk of getting an infection. During an interview with LVN E on 12/12/24 at 1:40 PM LVN E said that Foley bags should be below the bladder level and the foley bag inside a privacy bag. LVN E said that the foley bags should not be on the floor because the bag could tear, and the resident could get an infection. LVN E said that the last in-service on infection control was last month. During an interview with RN F on 12/12/24 at 2:15 PM RN F said she checks during her shift that was placed correctly and not touching the floor. RN F stated that foley bag should never be touching the floor because it could get pinched, or it could cause a leakage if the foley bag was on the floor. RN F said that the last in-service on infection control was yesterday. During an interview with the ADON on 12/12/24 at 3:05 PM the ADON said that nurses were in charge on checking the Foley bags every shift and that managers made rounds every morning. The ADON said that she educated staff to make sure everything complied. The ADON said that the bag should not be touching the floor to prevent any infections. The ADON said that the last in-service was last Friday, 12/6/2024. During an interview with the DON on 12/12/24 at 3:10 PM the DON said all staff were responsible to check that the Foley catheters had a privacy bag. The DON said that he provided 3 privacy bags for each resident that had a foley catheter. He said that 2 bags were attached to the bed and the third one was attached to wheelchair or walker depending on each resident needs. The DON said that if a foley bag was touching the floor, the bag could get contaminated and could introduce and infection or bag could get a leak. The DON said that the last in-service was last week. Record Review of a policy titled, Infection Prevention and Control Program with revision and review date 12/2023, reflected, The infection prevention and control program is a facility-wide effort involving all disciplines and individuals and is an integral part of the quality assurance and performance improvement program. Goal is to decrease the risk of infection to residents and personnel. Record Review of a policy titled, Catheter Drainage Bag with the revision and review dated 12/2023, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676042 If continuation sheet Page 2 of 5 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 676042 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/12/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McAllen Transitional Care Center 2109 South K St MC Allen, TX 78503 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 0690 reflected, Position the drainage bag below the level of the resident's bladder and without resting on the floor. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676042 If continuation sheet Page 3 of 5 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 676042 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/12/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McAllen Transitional Care Center 2109 South K St MC Allen, TX 78503 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 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure that a resident who needed respiratory care was provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, and the resident's goals and preferences for 1 of 3 residents (Resident's #234) reviewed for respiratory care. Residents Affected - Few 1. The facility failed to ensure Resident #234's oxygen was placed on 2 liters per minute via nasal cannula as ordered by the physician. These failures could place residents who receive respiratory care at risk of developing respiratory complications and a decreased quality of care. Finding included: 1.Record review of Resident #234's face sheet, dated 12/10/24 indicated she was a [AGE] year-old female originally admitted to the facility on [DATE] and re-admitted on [DATE] with diagnoses which included chronic obstructive pulmonary disease also known as COPD, (a chronic inflammatory lung disease that causes obstructed airflow from the lungs). Record review of Resident #234's quarterly MDS assessment was in process. Record review of Resident #234's physician's order dated 12/6/24 indicated Oxygen at 2 liters per minute continuous via nasal cannula every shift for COPD. Record review of Resident #234's comprehensive care plan, dated 12/06/24, indicates Resident #234 required oxygen therapy related to ineffective gas exchange. The intervention of the care plan was for staff to give medications as ordered by physician. Monitor/document side effects and effectiveness. During an observation on 12/10/24 at 9:23 a.m., Resident #234 was lying in her bed with oxygen set at 2.5 liters per minute via nasal cannula. During an observation on 12/12/24 at 9:35 am Resident #234 was lying in her bed with oxygen set at 2 liters per minute via nasal cannula. During an interview on 12/10/24 at 2:40 p.m., LVN G looked at Resident #234's oxygen rate and said it was at 2.5 liters per minute per nasal cannula. He said he thought she was supposed to run at 2 liters per minute. He looked in the electronic medical records for Resident #234 and read her order for oxygen at 2 liters per nasal continuously for COPD. LVN G said that he checked the setting this morning when he started his shift. LVN G said that he thought the humidifier bottle moved the settings and LVN G put the setting at the correct rate. LVN G said that if resident receiving the incorrect order, the resident could be harm. LVN G said that the inservice were done frequently but could not remember the exact date. During an interview on 12/12/24 at 9:22 a.m., LVN E said that nurses were responsible to check every shift the oxygen settings at the beginning of the shift and at the end of the shift. LVN E said that if not administered the correct order the resident could be harm. LVN E could not remember when (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676042 If continuation sheet Page 4 of 5 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 676042 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/12/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE McAllen Transitional Care Center 2109 South K St MC Allen, TX 78503 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 0695 was the last inservice. Level of Harm - Minimal harm or potential for actual harm During an interview on 12/12/24 at 10:20 am, RN F said that the floor nurses were in charge to check the oxygen settings when starting the shift, during shift, and at the end of the shift. RN F said that if not giving the correct order to the resident, the resident could be hyper-oxygenated (too much oxygen). RN F said that the last inservice was yesterday. Residents Affected - Few During an interview on 12/12/24 at 2:00 pm with ADON said that the nurses were responsible to check the oxygen settings every shift, specially when was a continuous oxygen, ADON said that management made morning rounds each morning. the ADON said that an adverse reaction to the resident was that the oxygen level could drop if not administer the appropriate oxygen ordered by the physician. ADON said that the last inservice was last Friday. During an interview on 12/12/24 at 3:06 p.m., the DON said the charge nurses were responsible for following the physician's orders and to check oxygen settings at the beginning of the shift and as needed during the shift and at the end of the shift. He said that if given less than the oxygen order the Resident's oxygen level could need more oxygen, and if given more than what was prescribed by the doctor, DON said that would not affect the resident if it was only increase by 0.5 liters per minute than the order. DON said that inservices were done weekly for the past few months and monthly. Record review of facility policy titled, Oxygen Administration revision date as of April 2016, revealed it is the policy of this facility that oxygen therapy is administered, as ordered by the physician or as an emergency measure until the order can be obtain. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676042 If continuation sheet Page 5 of 5