Inspection·July 21, 2023

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure residents were treated with respect and dignity and care for each resident in a manner and in an environment, that promotes maintenance or enhancement of his or her quality of life, for one Resident (Resident #120) of eight residents reviewed for dignity issues. The facility failed to place the urinary catheter drainage bag in a privacy bag, leaving the urine in the bag visually exposed. This failure could place residents at risk of feeling uncomfortable and disrespected and could decrease residents' self-esteem and/or quality of life. Findings included: Record review of Resident # 120's physician orders, dated 7/21/23 indicated Resident #120 was an [AGE] year-old male, was admitted to the facility on [DATE]. Resident #120's diagnosis included hyperlipidemia (abnormally elevated levels of any or all lipids or lipoproteins in the blood), extended spectrum beta lactamase resistance (enzymes produced by bacteria that provide multi-resistance to beta-lactam antibiotics) and urinary tract infection. Physician orders indicated an order to check catheter every shift for placement and may use leg strap to secure catheter in place, order date, 07/13/23. Record review of Resident #120's care plans, initiated on 07/13/23 indicated Resident #120 had a catheter. Interventions included to monitor for s/sx of discomfort on urination and frequency. Observation on 07/18/23 at 2:16 pm revealed Resident #120 in his room, in bed. Resident #120's urinary catheter drainage bag was half full and was clipped to his bedrail, without a privacy bag and touching the floor. Resident #120 said he was not aware that his urinary catheter drainage bag was not covered with a privacy bag. Resident #120 said I do not want anyone to see my urine, because it is embarrassing. Interview on 07/18/23 at 2:18 pm with CNA A said Resident #120's urinary catheter bag should be placed in a privacy bag and should not be touching the floor. CNA A said Resident #120 might be embarrassed that everyone who came into the room to assist him or visit him would see his urine. CNA A said the urinary catheter bag also needed to be in a privacy bag in case it touched the floor as it was because it could get bacteria and cause infections for the resident. CNA A said the CNAs were (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 5 Event ID: 676495 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 676495 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Starr County Nursing and Transitional Care 5260 Brand St Rio Grande City, TX 78582 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)