Health inspection·December 15, 2025

F 0919 Make sure that a working call system is available in each resident's bathroom and bathing area. Level of Harm - Minimal harm or potential for actual harm Based on observations, interviews and record review, the facility failed to ensure the facility was adequately equipped to allow residents to call for staff assistance through a communication system which relays the call directly to a staff member or to a centralized staff work area for 1 of 1 call light systems reviewed for resident call system in that: The facility failed to provide a reliable and effective nurse call system and timely staff response.This failure could result in delayed staff response and placed residents at risk of respiratory compromise and injury related to delayed call light response. Interviews on 12/13/2025 at varies time between 1:00PM - 3:00PM with direct care staff (CNA D, Staff J, Nurse A, RT A) stated that the facility nurse call system does not provide audible alerts which could be heard and relied on staff visually monitoring hallway lights. Staff stated that if they were in resident rooms or other areas, they might not see the activated call lights promptly. Staff stated that the residents and staff had previously complained about the call light system and the system had been repaired (September/2025) but audible alerts could not be heard. Staff stated this limited staff ability to monitor and respond to resident calls for assistance and could have placed residents at risk for delayed response to care needs. Staff denied notifying the administrator and DON of the inability to hear audible alerts. Staff denied having knowledge of any residents who had sustained injury related to delayed call light response times. Interview on 12/13/2025 at 3:30PM, the Maintenance staff stated he was not informed of ongoing concerns or complaints related to the nurse call system's effectiveness or delayed response times reported by residents.Interview on 12/13/2025 at 3:40PM, the DON stated she was not aware of resident or staff concerns regarding delayed nurse call light response times or ineffectiveness of the nurse call system.Interview on 12/13/2025 at 12:53PM, the Administrator stated he was not informed of staff or resident concerns related to the nurse call system. The Administrator further stated the nurse call system had been repaired in September 2025 and indicated he believed the system was functioning as intended at that time.Observation on 12/13/2025, the surveyor tested the nurse call system in residents (Resident #1 and Resident #2) rooms, and the system activated a visual hallway light, with no audible alert in the hallway, and a low audible alert at the nurse station. The activated 400 hallway light for Resident #2 was not visible from the nurse station. Record review of maintenance log, revealed no repairs made to call light system during the 30-day look back period. Record review on of repair invoice on 12/16/2025 revealed call light system had been repaired with audible sound on 12/16/2025. Interviews on 12/16/2025 at varies time between 2:00PM - 4:00PM with direct care staff (Nurse B, RT E) stated that the facility nurse call system provided audible alerts which could be heard and relied on by staff. Record review revealed in-service and training documentation related to abuse and neglect, and call light response had been provided by the facility 12/2025. Review of the facility's current policy not dated, titled Call Lights reflected:The Facility will provide a call light system that is accessible, functional, and responsive to meet the needs of the residents. Call lights will be placed within Residents Affected - Some (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: 676064 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 676064 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Paradigm at Katy 1480 Katy Flewellen Katy, TX 77494 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)