Country Village Care
Inspection Findings
F-Tag F0550
F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
privacy bags on their urinary catheter bags. CNA A said they would tell the nurse if they saw a resident without a privacy cover and would put a cover on if the nurse told them to. CNA A agreed with LVN A that a resident not having a privacy cover on their urinary catheter bag would be a dignity and privacy issue for
the resident. During observation and interview on 8/25/25 at 2:04 p.m., it was revealed that a privacy cover was on top of the dresser in Resident #1's room. CNA A said Resident #1 was in the gym. CNA A said Resident #1 takes off the privacy cover because he liked to empty the urinary catheter himself. LVN A said
they educate Resident #1 about letting nursing staff empty his urinary catheter and he would take off the privacy cover.During observation and interview on 8/25/25 at 2:06 p.m., Resident #2 was in bed with no privacy cover noted to her urinary catheter bag. CNA A said Resident #2 had a shower today. LVN A found
a privacy cover in the top drawer of the dresser in Resident #2's room and placed the privacy cover on at
this time. During interview on 8/25/25 at 3:36 p.m., the DON said Resident #1 did like to take care of his own Foley (device that drains urine from bladder into a collection bag). The DON said Resident #1 was not able to get out of bed on her own and she recently returned to the facility from the hospital. The DON said that it was a dignity issue if the resident did not have a privacy bag on their Foley catheter. During interview
on 8/25/25 at 5:15 p.m., the DON said she had looked but could not a find a policy with information regarding privacy covers for urinary catheters. Record review of facility's policy that was undated the purpose to prevent urinary tract infections and reduce urethral irritation but did not include any information regarding privacy covers.
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 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
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
08/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Country Village Care
721 W Mulberry Angleton, TX 77515
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-Tag F0692
F 0692 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
could not say why but guessed it was related to the resident not being compliant. MD A said she did not feel that any delay in the fluid restriction order contributed to fluid overload for Resident #3 as she was already
on diuretics. MD A said she did not feel that because fluid restriction was not followed strictly that it would have caused Resident #3 to become hospitalized . Attempt to contact LVN B by phone on 8/25/25 at 1:42 p.m. by state surveyor with message left with request to call state surveyor and no return call back received.
Attempt to contact LVN C who had written progress notes for Resident #3 on 1/14/25 by phone on 8/25/25 at 4:53 p.m. by state surveyor with message left with request to call state surveyor and no return call back received. Record review of facility's policy Quality of Care that was undated revealed the purpose was to ensure identification an provision of needed care and services that are resident-centered, in accordance with the resident's preferences, goals for care and professional standard of practice that will meet each resident's physical, mental and psychosocial needs.
Event ID:
Facility ID:
If continuation sheet
Country Village Care in Angleton, TX inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Angleton, TX, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Country Village Care or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.