Floy Dyer Nh

F-F880 was also cited during the last annual recertification survey.

Findings include:

A record review of the facility policy titled Enhanced Barrier Precautions, dated 10/23, revealed, It is the policy of this facility to implement enhanced barrier precautions for the prevention of transmission of multidrug-resistant organisms .Enhanced barrier precautions refer to the use of gown and gloves for use

during high-contact resident care activities .(residents with wounds or indwelling medical devices) . c. Clear signage will be posted on the door or wall outside of the resident room indicating the type of precautions, required personal protective equipment (PPE), and the high-contact resident care activities that require the use of gown and gloves .

Record review of facility policy titled, Infection Prevention and Control Program, undated, revealed, It is a policy of this facility 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.

Resident #1

During an interview on 3/30/25 at 5:25 PM, Resident #1 stated he had wounds on his lower legs. A hanging isolation organizer was noted on his door. There was no signage on his door that indicated what type of isolation the resident was in or what type of Personal Protective Equipment (PPE) was needed.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 10 of 12 255306 Department of Health & Human Services Printed: 08/31/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 255306 B. Wing 04/02/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Trend Health and Rehab of Houston 1000 East Madison Street Houston, MS 38851

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 During an interview on 3/31/25 at 10:30 AM, the Infection Preventionist/Treatment Nurse stated that Resident #1 had Methicillin Resistant Staphylococcus Aureus (MRSA) in his leg wounds and was on contact Level of Harm - Minimal harm or isolation for this infection. She stated he was receiving antibiotics and after completing those, a repeat potential for actual harm culture would be done. She stated the proper use of PPE helped prevent the spread of an infection. She acknowledged the resident did not have signage on his door to indicate what type of isolation the resident Residents Affected - Some was on or what type of protective equipment needed to be used.

An interview with the Administrator on 3/31/25 at 11:40 AM confirmed that Resident #1 was in contact isolation due to MRSA in a wound and signage on or near the resident's door was required. She stated when

a resident was placed in contact isolation, the type of precaution and the PPE to be used was required to be placed in a visible area outside of the resident's room. She stated signage was necessary to inform staff and visitors what PPE was needed to help prevent the spread of infection. She confirmed the facility failed to place proper infection control signage on or near a resident's door to identify the type precautions and the appropriate PPE to use.

Record review of Resident #1's Order Summary Report revealed an order dated 3/25/25 to Maintain contact precautions due to MRSA infection in lower leg every shift related to bacterial infection.

Record review of Resident #1's Admission Record revealed the resident was admitted to the facility on [DATE REDACTED]. Diagnoses included Bacterial Infection, Non-pressure Chronic Ulcer of left and right lower legs, and Venous Insufficiency.

Record review of Resident #1's Quarterly Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 1/13/25, revealed a Brief Interview for Mental Status (BIMS) of 10 which indicated the resident had moderate cognitive impairment.

46013

Resident #9

An observation on 4/01/25 at 8:25 AM revealed Licensed Practical Nurse (LPN) #1 administered Resident #9's medications through a PEG tube without wearing a gown for EBP. She confirmed she failed to wear a protective gown and revealed she knows that she should have. She revealed that EBP is supposed to be utilized when providing care to the resident since he has a PEG tube. She revealed we even discussed wearing the gown when I gave him his medications this morning, but I got nervous and forgot to do it.

During an interview on 4/01/25 at 2:24 PM, the Interim Director of Nurses (DON) confirmed that the nurse should have worn the PPE when administering his medications through the PEG. She revealed that EBP is implemented to protect the residents and the staff from spreading germs.

During an interview on 4/02/25 at 12:06 PM, the Infection Control Nurse revealed that for any residents under EBP, the facility's requirements and expectations are that the staff wear the proper PPE to reduce the possible spread of infections.

Record review of Resident #9's Order Summary Report with active orders as of 4/1/25 revealed an order for EBP related to PEG every shift.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 11 of 12 255306 Department of Health & Human Services Printed: 08/31/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 255306 B. Wing 04/02/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Trend Health and Rehab of Houston 1000 East Madison Street Houston, MS 38851

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 Record review of Resident #9's Admission Record revealed he was admitted to the facility on [DATE REDACTED] with medical diagnoses that included Hemiplegia and Hemiparesis following Cerebral Infarction and Gastrostomy Level of Harm - Minimal harm or status. potential for actual harm

Residents Affected - Some

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 12 of 12 255306