Health inspection·January 6, 2024

F 0910 Ensure resident rooms meet each resident's needs. 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 of residents' rooms revealed the facility failed to equip for adequate nursing care, comfort, and privacy of residents, 8 out of 8 Rooms (110, 212, 210, 209, 208, 408, 514, and 512) reviewed for equipped for adequate nursing care, in that: Residents Affected - Some rooms [ROOM NUMBERS], were used as storage rooms. Rooms 210, 209, 208, 408, and 514, AC blower was not working. room [ROOM NUMBER], the AC unit was not working. These failures could result in rooms not being available for an influx of new residents in the event of a local or national emergency. The findings were: Observation on 01/04/24 at 4:12 PM of room [ROOM NUMBER] (Hall 100) revealed: the room was used for storage of PPE boxes, about 50 ; 3 briefs boxes; 2 gauze bags; and 13 hand sanitizers. Observation on 01/04/24 at 4:15 PM revealed: room [ROOM NUMBER] was used for storage; no resident was present. Room temperature taken by Maintenance Director's laser reader revealed: average of 67 F and hot water in the sink was 98 F. The blower wheel for the AC system was not working. During an interview on 01/04/23 at 4:33 PM, the Maintenance Director stated: the blower wheel in the PTAC was not working in rooms 212, 210 , 209, and 208; the unit had been down for six months. The Maintenance Director stated, no work order was present for rooms 212, 210 , 209, and 208 . and no parts have been ordered. Observation on 01/04/24 at 4:35 PM revealed, room [ROOM NUMBER] revealed: no residents were present, AC wheel blower was not working; air temperature was 65 F; H20 was 98 F. During an interview on 01/04/24 at 4:40 PM, the Administrator stated: rooms 212, 210, 209, and 208 had not been repaired because there were no plans to house the residents in the said rooms. The Administrator stated, we have plenty of empty rooms for new admissions. Observation on 01/04/24 at 4: 43 PM revealed :room [ROOM NUMBER]: no residents were present, AC wheel blower not working; air temperature was 65 F; H20 was 98 F. Page 1 of 2 676274 676274 01/06/2024 River Bend Healthcare 1339 Eastwood Dr Seguin, TX 78155

F 0910 Level of Harm - Minimal harm or potential for actual harm Observation on 01/04/24 at 4:45 PM revealed: room [ROOM NUMBER]: no residents were present, AC wheel blower not working; air temp was 67 F; H20 was 101 F. Observation on 01/04/24 at 4:47 PM revealed: room [ROOM NUMBER]: no residents were present, AC wheel blower not working; air temp was 68 F; H20 was 98 F. Residents Affected - Some During an interview on 01/04/24 at 4:51 PM, the Maintenance Director stated that rooms [ROOM NUMBER] were repaired in December 2023. Observation on 01/04/24 at 4:55 PM revealed: room [ROOM NUMBER]: no residents were present; AC blower motor not working; air temperature was 72 F and H2O was 98. During an interview on 01/04/24 at 5:01 PM, the Maintenance Director stated: the AC motor had been out over one month in room [ROOM NUMBER]; work order was present. The Maintenance Director stated, .Part [for room [ROOM NUMBER]] should arrive early next week. The Maintenance Director stated, the facility did not maintain written maintenance logs. Instead the Maintenance Director annotated work orders in a computer system. The Maintenance Director stated that no work orders were documented in the computer system as of 01/04/24 for the AC/Heating systems in Rooms 212, 210 , 209, and 208. Observation on 01/04/24 at 5:05 PM revealed: room [ROOM NUMBER]: no residents were present, AC/Heat unit not working. Air temperature was 69 F; H20 was 98 F. Observation on 01/04/24 from 4:12 PM to 5:05 PM revealed the facility's air and hot water temperatures were within regulatory limits for rooms occupied by residents. Record review of facility's water temperature logs and for December 2023 and January 2024 revealed temperature for hot water temperatures were within regulatory limits. Record review of facility air temperature readings on 01/04/24 revealed air temperatures were within regulatory limits. Record review of facility's Emergency Operations Manual, undated, read: We also have systems for immediate equipment and physical plant repairs necessary for receiving an influx of admissions due to local emergencies .within 72 hours . Record review of facility's Maintenance Service policy dated revised 2009 read: The Maintenance Department is responsible for maintaining the buildings, grounds, and equipment in a safe and operable manner at all times. Record review of the facility's Maintenance Logs from October 2023 to January 06, 2024, revealed no logs and no work orders to repair the AC/Heating systems in rooms 208, 209, 210, 212, 408 and 514 were present [facility did not keep written logs.]. 676274 Page 2 of 2