Health inspection·January 31, 2026

F 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few disrupts normal bladder control, leading to issues like incontinence). Record review of Resident #2's quarterly MDS assessment, dated 1/19/2026, revealed BIMS score of 15 indicating intact cognition. Further review of Resident #2's assessment revealed she had frequent incontinence (7 or more episodes of urinary incontinence). Record review of Resident #2's Care Plan, revised on 01/09/2026, reflected Resident #2 had recurrent urinary tract infections - Resident currently takes antibiotics for preventative. Resident #2 has ADL self-care performance deficit related to need for assistance with personal care and interventions indicated to check for incontinence. Wash, rinse and dry soiled areas. An observation on 01/31/2026 at 2:25 p.m. of peri-care for Resident #2 revealed CNA A did not conduct hand hygiene between gloves changes during and after cleaning Resident #2's front perineum area and before moving to the back (anal) area. The CNA A touched Resident #2's bedding and her clothes while assisting Resident #2 with repositioning after taking his gloves off without sanitizing hands. CNA B assisted CNA A with handing wipes to him during the peri-care for Resident #2. An interview with CNA A on 1/31/2026 at 02:32 p.m., revealed he received a hand hygiene and peri care in-service a month ago. He stated that he was not aware of the need to sanitize his hands between changing gloves during peri care. He stated that washing before and after completing peri-care was all he needed to do for hand hygiene during peri-care for residents. CNA A stated that potential risk to residents if not following proper hand hygiene could be a cross contamination. An interview with CNA B on 1/31/2026 at 02:36 p.m., revealed she received hand hygiene and peri care in-service a few months ago. She stated that she was trained on sanitizing hands between gloves changes during peri care procedure. She stated nursing staff was responsible for following proper infection control and hand hygiene to prevent spread of infection to residents and staff at the facility. An interview on 1/31/2026 at 4:19 p.m. with the ADON, revealed she was an Infection Preventionist at the facility. She stated that she received training on the EBP policy a month ago which required all nursing staff to wear PPE including gowns and gloves while performing high-contact resident care (e.g., wound care) to prevent cross contamination. The ADON stated that all nursing staff was responsible for following proper hands hygiene policies including sanitizing hands between gloves changes during residents' peri- care procedure. The ADON stated the training on infection control and hand hygiene for all staff was conducted last month and during annual skills training sessions, weekly audits, and in huddles. The ADON stated a potential negative outcome for residents if not followed proper infection control procedures could be cross contamination. An interview on 1/31/2026 at 4:36 p.m. with the DON revealed she was trained on the facility's policy on EBP which required all nursing staff to wear PPE including gowns and gloves to prevent transmission of infections to other vulnerable residents. She stated that proper hand hygiene protocol during peri care procedure included sanitizing hands between changing gloves. The DON stated the last training on infection control and hand hygiene was conducted last month and during annual skills training sessions. She stated that ADONs and DON were responsible for monitoring nursing staff in following proper infection control policies. The DON stated a potential negative outcome for the residents could be cross contamination. An interview on 1/31/2026 at 4:40 p.m. with the ADM revealed all nursing staff were trained on the infection control policy, hands hygiene and following enhanced barriers precautions on an annual basis and periodic clinics with returned demonstrations. The ADM stated that hand hygiene during residents' peri care included sanitizing hands between changing gloves. She stated the DON and clinical managers provided training to nursing staff on following facility's infection control policy and were responsible for monitoring nursing staff during random observations. She stated that it was very important to follow infection control policies to prevent cross contamination. Record review of Peri care and Hand Washing Policy/Procedure, (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676374 If continuation sheet Page 2 of 3 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 676374 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/31/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midlothian Healthcare Center 900 George Hopper Rd Midlothian, TX 76065 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 FORM CMS-2567 (02/99) Previous Versions Obsolete dated 07/2013, indicated that It is the policy of this facility to cleanse hands to prevent transmission of possible infectious material and to provide clean, healthy environment for residents and staff. This policy did not indicate donning/doffing of gloves before, during, and after the peri-care procedure including sanitizing hands between changing gloves which was clarified during interviews. Record review of facility's Infection Control policy, revised 3/2024, indicated that Enhanced Barrier Protection: used in conjunction with standard precautions and expand the use of PPE through the use of gown and gloves during high-contact resident care activities that provide opportunities for indirect transfer of MDROs to staff hands and clothing then indirectly transferred to residents or from resident-to-resident. (e.g., residents with wounds and indwelling medical devices are especially high risk of both acquisition of and colonization with MDROs). Event ID: Facility ID: 676374 If continuation sheet Page 3 of 3