Inspection·May 15, 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 maintain an infection prevention and control measure designed to provide a safe, sanitary environment to help prevent the development and transmission of communicable diseases and infections for 4 of 6 residents (Resident #12, Resident #58, Resident #159, and Resident #160) reviewed for infection control. Residents Affected - Some RN A failed to disinfect vital signs equipment between each resident while performing morning medication administration for Resident #12, Resident #58, Resident #159, and Resident #160. This deficient practice could place residents and nursing staff at risk of transmission of communicable diseases and infections. Findings included: Review of Resident #12's face sheet, dated 5/14/2025, revealed Resident #12 was an [AGE] year-old female admitted on [DATE] with diagnoses of spine fracture and type 2 diabetes. Review of Resident #58's face sheet, dated 5/14/2025, revealed Resident #58 was an [AGE] year-old female admitted on [DATE] with diagnoses of critical illness myopathy (diseases related to the muscles), dementia and hypothyroidism (underactive thyroid). Review of Resident #159's face sheet, dated 5/14/2025, revealed Resident #159 was an [AGE] year-old female admitted on [DATE] with diagnoses of asthma and lack of coordination. Review of Resident #160's face sheet, dated 5/14/2025, revealed Resident#160 was a [AGE] year-old admitted on [DATE] with diagnoses of muscle wasting, asthma, and vitamin D deficiency. Review of Resident #160's care plan, dated 5/13/2025, revealed that the resident has a wound on right forearm and wound was at risk for infection. The goal listed for the wound was wound will be free of signs or symptoms of infection. In an observation on 5/14/2025 at 7:24am, RN A was measuring vital signs for Resident #12, Resident#58, Resident #159, and Resident #160 during morning medication administration. RN A did not disinfect blood pressure cuff and oximeter in between the 4 residents. In an interview on 5/14/2025 at 9:24am, RN A stated that she was nervous and forgot to disinfect vital signs equipment. She stated that the risk of not sanitizing equipment was the spread of infection between residents. (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: 676407 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 676407 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Purehealth Transitional Care at Thr Arlington 800 W. Randol Mill Road, 6th Floor Arlington, TX 76012 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)