Health inspection·August 19, 2025

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 establish and 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 diseases and infections for one of three residents (Resident #1) reviewed for infection control. 1. The facility failed to place Enhanced Barrier Precautions signage near Resident #1's room.2. CNA A and CNA B failed to implement Enhanced Barrier Precautions while providing incontinent care to Resident #1. 3. CNA A failed to perform hand hygiene while providing incontinent care to Resident #1.These failures could place residents at risk for healthcare associated cross contamination and infections. Findings include:Record review of Resident #1's face sheet, dated 08/19/25, reflected an [AGE] year-old male, who most recently admitted to the facility on [DATE]. Resident #1 had diagnoses which included sepsis (a life-threatening complication of an infection which occur when chemicals released in the bloodstream to fight an infection trigger inflammation throughout the body), functional quadriplegia (complete immobility due to severe disability or frailty from another medical condition without injury to the brain or spinal cord), and urinary tract infection (an illness in any part of the urinary tract, the system of organs that makes urine).Record review of Resident #1's MDS Assessment, dated 07/07/25, reflected he had a catheter (a thin, flexible medical tube used to drain fluids or deliver medications to or from the body, most commonly a urinary catheter which drains urine from the bladder ).Record review of Resident #1's Physician's Orders, dated 08/19/25, reflected he was on Enhanced Barrier Precautions and Standard Precautions due to having a catheter. The orders specified, .Resident is not limited to room or activities. [NAME] PPE inside the room.Staff must don gown and gloves when performing high contact care such as bathing/showering, peri -care/brief changes, dressing changes, meds via enteral tube or central line, toileting, transfers, providing hygiene, changing linens, device care. The start date for this order was 07/01/25 and there was no set end date.Record review of Resident #1's Care Plan, dated 08/19/25, reflected he had a catheter due to his diagnosis of benign prostatic hyperplasia and urinary obstruction. A goal for Resident #1 was to show no signs or symptoms of urinary infection. The start date for this focus area was 07/01/25 and there was no set end date. The Care Plan did not specify any focus area for Enhanced Barrier Precautions or standard precautions.Observation on 08/19/2025 at 12:20 PM revealed there was no Enhanced Barrier Precaution signage by Resident #1's room. Neither CNA A nor CNA B donned a gown upon entering Resident #1's room to provide incontinent care . When performing incontinent care, CNA A did not perform hand washing or hand hygiene or change gloves between wiping Resident #1's perineum and obtaining new wipes from the clean wipe pack. When CNA A did change gloves, she did not wash her hands or apply hand sanitizer before putting on another pair of gloves.During an interview with CNA A on 08/19/2025 at 12:30 PM, she stated she was allergic to hand sanitizer and forgot to wash her hands between glove changes. She stated the failure placed residents at risk for healthcare associated Residents Affected - Few (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: 676352 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 676352 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/19/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Stonemere Rehabilitation Center 11855 Lebanon Road Frisco, TX 75035 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)