Inspection·January 12, 2023

F 0656 Cipro Tablet 250mg, give 250mg by mouth two times a day for UTI for 10 days, Level of Harm - Minimal harm or potential for actual harm start date, 01/02/23. Residents Affected - Some Record review of Resident #29's care plan, last review/revision date 12/09/22 revealed no care plans that addressed the resident's use of an antibiotic due to a UTI. Interview on 01/11/23 at 4:24 pm with MDS Coordinator/LVN revealed she was responsible to develop and update care plans. MDS Coordinator said she had not developed a care plan that addressed the focus care area of the use of an antibiotic for a UTI for Resident #29. MDS Coordinator said she had overlooked the necessary care plan for this focused area when the antibiotic was ordered by Resident #29's physician. MDS Coordinator said she should have developed a care plan for this focus area because staff must have a care plan with goals and interventions due to possible issues with dehydration and medication effects due to taking the antibiotic, Cipro. Interview on 01/11/23 at 5:20 pm with LVN B revealed he was Resident #29's charge nurse. LVN B said the purpose of a care plan was to have a set plan with goals and interventions on how to provide specific care to a resident. This care plan would inform staff how they should meet those goals. LVN B said he did not see a focus care plan for Resident #29's use of antibiotic due to a UTI. LVN B said if there was no care plan for the focus area of care, this might affect the outcome of how staff needed to address her care. Interview on 01/10/23 at 2:30 pm revealed Resident #29 did not respond to interview by surveyor due to cognitive impairment. Record review of Resident #29's MARs dated 01/01/23-01/31/23 indicated Resident #29 received the antibiotic Cipro for diagnosis of UTI. 2) Record review of Resident #1's admission record, dated 01/11/23 revealed resident was a [AGE] year-old female with an admission date of 11/29/22 with diagnoses that included cognitive communication deficit (general impairment of cognition), acute chronic congestive heart failure, presence of pacemaker (electronic medical device to help the heart beata the way it should), dementia with agitation (inability to remember, think or make decisions), acute and chronic respiratory failure with hypoxia (decreased level of oxygen). Record review of Resident #1's admission MDS annual assessment dated [DATE] revealed the resident's cognitive status was severely impaired for daily decision-making skills and required Record review of Resident #1's physician's orders dated 01/11/23 revealed an order for medication Macrobid Capsule 100mg, give one capsule by mouth two times a day for UTI for 10 days start date 01/03/23. Record review of Resident #1's care plan, last review/revision date 01/02/23 revealed no care plans that addressed the resident's use of an antibiotic due to a UTI. Record review of Resident #1's MARs dated 01/01/23 to 01/31/23 indicated Resident #1 received the antibiotic Macrobid Capsule 100mg for UTI as ordered. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676303 If continuation sheet Page 2 of 9 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 676303 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/12/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mirador 5857 Timbergate Dr Corpus Christi, TX 78414 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an observation on 01/10/23 at 2:44 pm, Resident #1 was observed lying in bed, with two family members by her bedside. Resident #1 was unable to respond to interview by surveyor due to cognitive impairment. Interview on 01/11/23 at 4:24 pm with MDS Coordinator/LVN revealed she was responsible to develop and update care plans. MDS Coordinator said she had not developed a care plan that addressed the focus care area of the use of an antibiotic for a UTI for Resident #29 and Resident #1. MDS Coordinator said she had overlooked the necessary care plan for this focused area when the antibiotic was ordered by Resident #29's and Resident #1's physician. MDS Coordinator said she should have developed a care plan for these focus areas because staff must have a care plan with goals and interventions due to possible issues with dehydration and medication effects due to taking the antibiotics. Interview on 01/12/23 at 10:29 am with the DON revealed that care plans have interventions that are used to provide care in special areas of focused care. The care plans have goals and interventions that are important. The DON said the staff had other informational modules that indicated the same guidance to staff on providing care to residents with focus areas of care, and she did not see any negative outcome of not having a care plan developed for this specific care area of taking an antibiotic for a UTI. 3.) Record review of resident # 7 admission record dated 09/01/22 documented a [AGE] year-old female with an admission date of 09/01/22. Resident #7 diagnosis include: Chronic atrial fibrillation (irregular, faster heartbeat), malignant neoplasm of pancreas, acute on chronic systolic (congestive) heart failure, chronic kidney disease stage 3, primary adrenocortical insufficiency (affecting the adrenal glands), type 2 Diabetes Mellitus (high blood sugars), Unspecified Asthma, Essential (primary) Hypertension (high blood pressure), Urinary (tract) Infections, Retention of Urine, Hypothyroidism (decreased production of thyroid hormones), major depressive disorder, anxiety disorder, osteoarthritis (degenerative joint disease), anemia, gout (inflammation of joints due to excess uric acid), muscle wasting and atrophy (shrinkage of muscles and nerve tissue), muscle weakness, lack of coordination, cognitive communication deficit. Record review of resident #7 active physician orders dated 12/29/22 documented an order for a stage 2 injury to sacrum: cleanse with Cleanse with DWC (dermal wound cleanser) or NS (normal saline), pat dry, and apply skin prep to peri-wound (area around wound). Apply medi-honey to wound bed followed by calcium alginate. Cover with a foam dressing daily and PRN (as needed) everyday shift. Further record review of resident #7 active physician orders dated 01/11/23 documented an order for Cefdinir Capsule (antibiotic) 300 MG (milligrams), give 1 capsule orally two times a day for UTI (urinary tract infection) until 01/16/2023 23:59 (or 11:59 p.m.). Record review of resident #7 Minimum data set (MDS) dated [DATE] documented a brief interview mental status (BIMS) score of 05 indicated severe cognitive impairment. Record review of Resident #7's care plan dated 12/30/22 revealed no mention of pressure ulcer care and/or wound care. It did not specify plans on how to care for the pressure ulcers/wounds, goals, or interventions. Instead, the care plan listed potential/actual impairment to skin integrity related to edema, along with corresponding goals and interventions. 4.) Record review of resident # 137 admission record dated 12/16/22 documented a [AGE] year-old male with an admission date of 12/16/22. Resident #7 diagnosis include: wedge compression fracture of (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676303 If continuation sheet Page 3 of 9 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 676303 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/12/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mirador 5857 Timbergate Dr Corpus Christi, TX 78414 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some first lumbar vertebra, heart failure, organ limited amyloidosis (condition in which amyloid proteins build up on organs), chronic atrial fibrillation (irregular, faster heartbeat), retention of urine, acute kidney failure (condition when an abrupt reduction in kidney's ability to filter waste products occurs), muscle weakness, unsteadiness on feet, lack of coordination, history of falling. Record review of resident #137 active physician orders dated 12/18/22 documented an order to monitor surgical incision to lower back, change dry dressing if soiled, report changes or signs of infection to MD every shift. Record review of resident #137 Minimum data set (MDS) dated [DATE] documented a brief interview mental status (BIMS) score of 15 indicated resident was cognitively intact. Record review of Resident #7's care plan dated 12/29/22 revealed no mention of pressure ulcer care and/or wound care. It did not specify plans on how to care for the pressure ulcers/wounds, goals, or interventions. An interview with the DON on 1/11/22 revealed the MDS was responsible for entering data into the care plans of all the residents. An interview with MDS on 1/12/22 at 09:15 a.m. revealed she was responsible for entering care plans for all residents. At this time MDS confirmed resident #7 did not have care plan for pressure ulcer/wound care or antibiotic treatment and stated she had entered it upon learning it was missing in resident care plan. Record review of facility policy and practices titled Care Plans, Comprehensive Person-Centered with a revised date 03/2022, quoted in part, A comprehensive, person-centered care plan that includes measurable objectives and timetables to meet the resident's physical, psychosocial and functional needs is developed and implemented for each resident .The comprehensive, person-centered care plan: includes (a) measurable objectives and timeframes; describes (b) describes the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental and psychosocial well-being, including: (1) services that would otherwise be provide for the above, but are not provided due to the resident exercising his or her rights including, the right to refuse treatment; (2) any specialized services to be provided as a result of PASSAR recommendations; and (3) which professional services are responsible for each element of care; (c) includes the resident's stated goals upon admission and desired outcomes; (d) builds on the resident's strengths; and (e) reflects currently recognized standards of practice for problem areas and conditions. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676303 If continuation sheet Page 4 of 9 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 676303 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/12/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mirador 5857 Timbergate Dr Corpus Christi, TX 78414 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure all drugs and biologicals used within the facility were secured in accordance with currently accepted professional standards for 1 of 5 residents observed, in that: 1. Med Aide G walked back to medication cart to crush Lorazepam 1 mg tablet (for anxiety) leaving Enulose solution 30 ml (for constipation) in medication cup at side of bed on nightstand with resident # 30 and visitor in room. This deficient practice placed residents in the facility at risk for having their medications diverted and/or receiving another resident's medication, drug reactions and a decreased quality of life because of improper labeling/unsecured medication left unattended at resident's bedside. Findings Include: Record review of Resident # 30's admission record dated 08/10/22 documented an [AGE] year-old female with an admission date of 05/03/22. Diagnoses include Parkinson's disease (disorder that affects the nervous system), dementia (disorder that causes problems with thinking, memory and daily life), Alzheimer's disease (disorder of the brain that causes problems with memory, thinking and daily life), major depressive disorder (state of being depressed or sad), anxiety (distress or uneasiness, insomnia (inability to obtain sufficient sleep). Record review of Resident #30's active physician orders dated 01/12/23 documented an order for Enulose Solution 10 grams (GM/15 milliliters (ML) (Lactulose Encephalopathy) Give 30 ml by mouth three times a day for constipation (hold for loose stools) with a start date of 10/03/22. Observation of a medication pass on 01/11/23 at 04:00 p.m. revealed Medication Aide G knocked on the door, introduced herself to Resident #30, explained the procedure and walked back to the medication cart where she prepared medications. Medication Aide G sanitized hands and proceeded to prepare medications including Lorazepam 1 mg in a medication cup and measured 30 mL of Ensulose Solution in a separate medication cup. Medication Aide G locked the computer screen and medication cart and walked to the resident's bedside, placed medications on nightstand, and prepared to administer medications to Resident #13. She then turned and stated she forgot to crush Lorazepam 1 mg. With only 1 medication cup in hand, Medication Aide G turned and walked away from the nightstand leaving behind the second medication cup (Enulose) at Resident #30's bedside within reach of Resident #30 and accessible to a visitor in room. She walked back to the medication cart where she crushed Lorazepam 1 mg in vanilla pudding. Afterwards, she sanitized hands, returned to the resident's bedside, administered both medications, and collected and disposed of trash. She excused herself and washed her hands. Interview with Medication Aide G on 01/11/23 at 04:00 p.m. revealed she was responsible for the medications she was administering. When asked what would happen if medications went missing while her back was turned to them, she stated she would be in trouble by the nurse in charge for leaving unattended medications in the room. Interview with the DON on 01/11/23 at 05:35 p.m., the DON was presented with the prior information. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676303 If continuation sheet Page 5 of 9 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 676303 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/12/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mirador 5857 Timbergate Dr Corpus Christi, TX 78414 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete The DON revealed staff who do not follow physician orders for medications have consequences with the facility. She also mentioned that staff are not supposed to leave medications unattended with residents or visitors and that in doing so would bring consequences to the staff member(s) involved. Record review of facility policy and practices titled Storage of Medications with a revised date of 11/2020, quoted in part, The facility stores all drugs and biologicals in a safe, secure, and orderly manner .The nursing staff is responsible for maintaining medication storage and preparation areas in a clean, safe, and sanitary manner. Event ID: Facility ID: 676303 If continuation sheet Page 6 of 9 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 676303 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/12/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mirador 5857 Timbergate Dr Corpus Christi, TX 78414 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 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, interview, and record review, 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 3 residents (Resident #35) reviewed for infection control, in that: Residents Affected - Few 1. The facility failed to ensure CNA D followed proper hand hygiene before and after perineal care of Resident #35. CNA D failed to wash his hands for at least 20 seconds per facility policy. 2. The facility failed to ensure CNA D cleansed the urinary tract of Resident #35 in a manner that promoted cleanliness and prevented infection while providing incontinent care. CNA D failed to cleanse Resident #35 by cleansing the urethral area in a circular motion down to the base of the glans using a single wipe each time he swiped per facility policy. These deficient practices could place residents at risk for infection. The findings include: Record review of Resident #35's admission record dated 09/28/22 documented a [AGE] year-old male with an admission date of 09/28/2022. Primary diagnosis include: Alzheimer's disease (brain disorder that causes problems with memory, thinking and behavior), hyperlipidemia (high lipids levels in bloodstream), essential hypertension (high blood pressure), anxiety disorder (examples of feeling nervous, restless or tense), and major depressive disorder, recurrent, severe with psychotic (mental health disorder that affects mood, behavior, and overall health). Record review of Resident #35's most recent MDS, dated [DATE] revealed the facility was unable to conduct a BIMS due to the resident rarely/never understood. The MDS also revealed Resident #35 had incontinence of bowel and bladder and received substantial/maximal assistance for toileting hygiene. Record review of resident #35 care plan initiated 12/28/22 documented: o The resident [#35] had ADL (activity of daily living) self-care performance deficit r/t (related to) Alzheimer's with interventions of Toilet use: the elder requires (extensive assistance) by (2) staff with for toileting o The resident [#35] had incontinence of bowel and bladder r/t (related to) dementia with interventions: check elder every two hours and assist with toileting as needed, provide loose fitting, easy to remove clothing, and provide pericare (cleaning the perineal areas of a resident) after each incontinent episode. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676303 If continuation sheet Page 7 of 9 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 676303 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/12/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mirador 5857 Timbergate Dr Corpus Christi, TX 78414 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Observation on 01/12/23 at 01:25 p.m. while providing incontinent care for Resident #35, after briefly setting up for the procedure, gathering supplies, and explaining the procedure to the resident, CNA D washed his hands for only 10 seconds. He then gathered supplies, donned (put on)gloves, positioned the resident in a dorsal recumbent position (laying on his back with his legs bent and slightly apart), and pulled back the resident's blankets. CNA D continued by removing Resident 35's clothing and soiled brief. Using one wipe, CNA D cleansed in a downward motion on each side of Resident #35's pubic area. CNA D then turned Resident #35 to the left side and pushed the soiled brief under the resident and tucked a new brief under the resident. CNA D continued to cleanse Resident #35's perineal area (area between scrotum and anus) from front to back using one wipe per swipe. CNA E, who assisted in the procedure, pulled the soiled brief from under the resident and assisted turning the resident onto his back. CNA E removed soiled gloves, and donned new gloves. CNA E placed a new pad under the resident. Resident #35 was repositioned in a semi-Fowler's position (onto his back) and then covered with blankets. CNA D collected trash, soiled linen, and disposed of them. CNA D removed soiled gloves, and washed hands for 15 seconds before exiting the room. In an interview with CNA D on 01/12/23 at 01:35 p.m., , CNA D stated that he was responsible for performing proper hand hygiene and peri care. CNA D responded that the greatest consequence of not performing proper peri-care on a resident would be infection. CNA D responded that the greatest consequence for not performing proper hand hygiene would be risk for infection to the resident. CNA D stated that he had been working for the company for approximately 5 years and that the last in-service on hand-hygiene and peri-care was approximately 2 months ago by the DON and administrator for check off's. In an interview with the DON on 01/12/23 at 03:45 p.m. the DON explained that the proper technique for peri-care used at their facility for a male included swiping in a singular circular motion with one wipe down the penis. The DON responded that the greatest risk of not performing proper peri-care on a resident would be infection isolated to the team member who was not performing proper hand hygiene and proper peri-care. Record review of facility in-service dated 12/21/22 titled, High transmission risk, handwashing, requirement of masks, quoted in part, I have been educated and provided with a copy of our most hand washing guidelines as well as information regarding use of surgical masks and our transmission risks, presenter ADON, signed by CNA D, How to Hand rub? . Duration of the entire procedure 20-30 seconds . Don't forget to Wash .3 Wash your hands for 20 seconds. Record review of facility competency checklist titled Hand hygiene Competency checklist for CNA D signed by the DON as the instructor dated 12/06/22, documented hand hygiene technique with soap and water as follows: o 1. Remove all hand and wrist jewelry from hands and fingers 2. Turn on water and wet hands with water 3. Apply enough soap to cover all hand surfaces 4. Rub hands palm to palm 5 Right palm over left dorsum with interlaced fingers and vice versa 6. Palm to palm with fingers interlaced 7. Backs of fingers to opposing palms with fingers interlocked 8. Rotational rubbing of left thumb clasped in right palm and vice versa 9. Rinse hands with water 10. Thoroughly dry hands and wrists with paper towel 11. Turn faucet off using a dry paper towel to touch the handle, protecting your clean hands from the contaminated handle *** Entire Procedure will be 20 seconds or longer*** (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676303 If continuation sheet Page 8 of 9 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 676303 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/12/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mirador 5857 Timbergate Dr Corpus Christi, TX 78414 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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Record review of facility policy and practices titled Infection control with a revised date 10/2018, quoted in part, This facility's infection control policies and practices are intended to facilitate maintaining a safe, sanitary, and comfortable environment and to help prevent and manage transmission of diseases and infections . The objectives of our infection control policies and practices are to: prevent, detect, investigate, and control infections in the facility, maintain a safe sanitary and comfortable environment for personnel, residents, visitors, and the general public .How to handwash . duration of the entire procedure 40-60 seconds. Record review of facility policy titled Handwashing/Hand Hygiene, with a revised date 08/2019, quoted in part, This facility considers hand hygiene the primary means to prevent the spread of infections All personnel shall follow the handwashing/ hand hygiene procedures to help prevent the spread of infections to other personnel, residents, and visitors . Procedure . Washings hands Rub hands together vigorously for at least 20 seconds, covering all surfaces of the hands and fingers. Record review of facility policy titled Perineal Care, with a revised date 02/2018, quoted in part, The purpose of this procedure are to provide cleanliness and comfort to the resident to prevent infections and skin irritation, and to observe the resident's skin condition . For a male resident .Wash perineal area starting with urethra and working outward . retract foreskin of the uncircumcised male . wash and rinse urethral area using a circular motion . continue to wash the perineal area including the penis, scrotum, and inner thighs . thoroughly rinse perineal area in same order, using fresh water and clean washcloth . reposition foreskin of uncircumcised male. Record review of Lippincott procedures, 2022, Hand Hygiene (Lippincott procedures - Hand hygiene (lww.com) quoted in part, Work up a generous lather by vigorously rubbing your hands together . for at least 20 seconds. Record review of Lippincott procedures, 2022, Perineal Care of the Male patient (Lippincott procedures Perineal care of the male patient (lww.com) quoted in part, wash the penis with the washcloth, beginning at the tip and working in a circular motion from the center to the periphery . to avoid introducing microorganisms into the urethra. Use a clean section of washcloth for each stroke to prevent the spread of contaminated secretions or discharge. If the patient is uncircumcised, gently retract the foreskin and clean beneath it Wet a clean washcloth and rinse the area thoroughly, using the same circular motion. If the patient is uncircumcised and it's appropriate, rinse well but don't dry, because moisture provides lubrication and prevents friction when replacing the foreskin. Replace the foreskin to avoid constriction of the penis, which causes edema and tissue damage. Wash the rest of the penis, using downward strokes toward the scrotum. If appropriate, rinse well and pat dry with a towel. Clean the top and sides of the scrotum; if appropriate, rinse thoroughly and pat dry. Handle the scrotum gently to avoid causing discomfort. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676303 If continuation sheet Page 9 of 9