Health inspection·July 19, 2024

F 0835 Administer the facility in a manner that enables it to use its resources effectively and efficiently. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review, the facility failed to be administered in a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of all r esidents reviewed. Residents Affected - Some -The Administrator failed to ensure the staff had gloves readily available to staff to provide care for the residents. This failure could cause residents not to receive care or delay of care resulting in an increase in infections and hygiene concerns . Findings include: In an interview on 7/19/24 at 10:00 a.m., the Central Supply Supervisor stated she ordered supplies every Monday and Wednesday. She stated she started working at the facility 4 months ago in March 2024 and the supply closets were full. She stated she was not having any problems with contracts for PPE. The Central Supply Supervisor stated she had a contract with Company C and she had no problems with her contracts with them. She stated she ordered supplies on Mondays and received supplies on Tuesdays. She stated for the storm they got notified that they needed to be prepared and could not order. She ordered on Wednesday so that way they could receive. She did not receive the supply order until Wednesday the following week, but they never ran out of supply. She stated the facility never ran out of gloves. She stated she did not require the staff buy their own gloves and she always used Company C. She stated she does not know anything about any problems with the bills, she keeps ordering and she keeps receiving supply. The July order was submitted by Corporate because she was on leave . In an anonymous interview on 7/19/24 at 10:30 a.m., it was stated the facility had issues with having gloves, gloves were not easy to find and they waited for a long time to get the gloves. The interviewee said the gloves were not available and they would have to wait for central supply to get to the facility and pull out the gloves daily. The facility used to keep gloves in the residents' rooms but they did not anymore. The interviewee said on today 7/19/24 they just got gloves after 10 am. Gloves arrived just now. The interviewee said the facility would only pass out the gloves and they told them there were no gloves. The interviewee stated they waited for the central supply to bring the gloves to them. In an anonymous interview on 7/19/24 at 10:45 a.m., it was stated staff have had problems with getting gloves. They had to go and ask the central supply/scheduler to give them gloves. The interviewee stated the staff had to walk around to find gloves or ask the dialysis team to see if they have Page 1 of 3 676064 676064 07/19/2024 Paradigm at Katy 1480 Katy Flewellen Katy, TX 77494

F 0835 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some enough to give them gloves,. They had to wait or ask for the gloves every day. The interviewee stated was told the supplies had not arrived yet and this had been going on for a while now. In an anonymous interview on 7/19/24 at 11:30 a.m., it was stated if there were no gloves they asked Central Supply. Intervieww stated that sometimes Central Supply came in around 10 a.m. or 11 a.m. Interviewee stated when that happened they asked someone at the nursing station or charge nurse and if they do not have any gloves, then they had to wait for central supply to get to the facility. The interviewee stated the facility gave the staff the on-call number and sometimes they just have to wait for someone to get to the facility to get them gloves, that it made it hard to get all residents cleaned up because it takes time to start changing residents. In an interview on 7/19/24 at 11:50 a.m., an anonymous resident stated the facility staff did have the supplies, but sometimes they had to hunt for them. The resident said it does not take them a long time to find the supplies. The resident stated sometimes the facility had to really skim to have enough pairs to go around for the briefs. The residetn stated the facility always managed but it was a struggle. In an interview on 7/19/24 at 12:05 p.m., an anonymous resident stated on an unknown date a CNA came to her room at 9:30 a.m. to change her and at 11:30 a.m. she still had not been changed . She stated another time (unknown date) the staff could not put on the right size adult brief because they did not have any and had to put on a larger adult brief. The resident stated they believed the facility was having a problem ordering supplies. In an interview on 7/19/24 at 1:22 p.m., a representative from Company C stated the facility needed to speak with someone in their accounts payable department. She stated the last order the facility made was placed on 7/17/24 and the facility did not receive their order, she said the facilities supply orders were on hold. In an interview on 7/19/24 at 1:31 p.m., a representative from Company B stated the facility had not paid their invoice yet. He stated there had been 3 total orders for the facility's company and they had not paid for any of the 3 orders that they processed. Company B stated they would not authorize any other supplies until they have been paid. In an interview on 7/19/24 at 1:48 p.m., the DON stated on last Monday she was told a supply was put in for the preparation of the storm. She stated the staff were told the supplies did not come because the supplies were delayed from the storm. The DON stated Corporate said they would get them supplies and they did and their order came in the next day. She stated she did not know why the facility was not paying the bills. She stated she had seen the orders and the shipments coming in, but she did not know. She stated she had only been working at the facility for 10 days. In an interview on 7/19/24 at 2:40 p.m., the Administrator stated the bills were above her. The Administrator stated if there was a hold or back order she was told by the vender or Corporate. She stated the last few weeks had been different because of the Hurricane. She stated she had used the online store, picked up supplies from stores, and they used Company A to order the supplies and made sure to pay them. The Administrator stated the facility had 2 other supply company's (Company B and Company C) to order from. The Administrator stated Company C should be good because the facility just got an order of supplies last week. The Administrator stated the facility should be good to go next week because they made a payment on Friday. She stated she did not know when the facility pays or how much they pay, she just orders the supplies they need and if they do not have it she reaches out to 676064 Page 2 of 3 676064 07/19/2024 Paradigm at Katy 1480 Katy Flewellen Katy, TX 77494

F 0835 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some another supply company. The Administrator stated there had not been a time when they ran out of supplies and/or gloves. She stated she had a lot of supplies in the Pods at the facility and when the Hurricane happened there was a back order, and they would also call their sister facility for assistance with supplies. She stated not everybody has access to the supplies anymore because they had supplies walking out. She stated the staff had access to the central supply but the gloves are not in the supply. She stated the gloves, gowns and adult briefs were walking away. She stated she had a call with Company C to make sure they would be paid and she stated she will order even more gloves. The Administrator stated she went to local stores, and online stores to make sure the staff had the supplies to take care of the residents. Record review of facility policy on Resident Rights dated February 2021 revealed Federal and state laws guarantee certain basic rights to all residents of this facility. These rights include the resident's right to: a dignified existence; be treated with respect, kindness, and dignity; be free from abuse, neglect, misappropriation of property, and exploitation . Record review of Facility policy on Ordering of Supplies and Equipment revised November 2009 revealed, The purchasing agent shall process and order all supplies and equipment. Policy interpretation and implementation with the exception of supplies for the dietary and pharmacy departments, the purchasing agent shall be responsible for ordering all supplies and equipment . 676064 Page 3 of 3