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Complaint Investigation

Country Village Care

Inspection Date: September 23, 2025
Total Violations 1
Facility ID 675696
Location Angleton, TX
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Inspection Findings

F-Tag F0686

Quality of Life and Care Deficiencies
Harm Level: Immediate Jeopardy

F 0686 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

protocol surrounding getting written orders instead of verbal orders. All nursing staff were in-serviced on the following:- General Wound Care with Competency and return Demonstration. - Abuse, Neglect, Exploitation prohibition. - Following MD Orders- Reporting Change of ConditionThe above in-services were initiated on 9/17/25 and are ongoing until all direct care staff has signed to be completed by 9/19/25. No one can provide direct care until they have had the in-service training given by the DON and or ADON's. In-servicing was initiated 9/17/25 and is ongoing. No staff member will be able to provide direct care until they have been educated on the above topics. DON and ADON's will provide proper training. An Ad Hoc QAPI meeting will be conducted on 9/18/25 at 9AM to review audit results and to ensure that the education given is covering the pertinent topics pertaining to this particular alleged deficient practice.DON and administrative nurses will have a collaborative effort with respect to wound care orders and implementation of those orders, and weekly during standard of care meetings on going indefinitely and will be reviewed by QAPI committee monthly for 6 months to ensure compliance. Ongoing daily monitoring by DON or designee, to review any new pressure issues or other types of wounds and to ensure that the MD order is

in place and being followed. Standard orders for any noted skin issues will be applied as per MD recommendation. Facility will be adding wound care competency check offs beginning 9/17/25 and ongoing for current and newly hired nurses and then annually ongoing. DON or designee will be responsible for competencies and check offs. No staff will be allowed to provide care to residents until they have received

the noted training and appropriate check offs. Wound Care Physician group will be signing orders in house moving forward to ensure dictation of all orders are correct and clarified. This will be both a part of our POR and POC upon receipt of legal documents. Monitoring of POR: Record review of facility Resident Rights policy, dated December 2016, read in part Federal and state law guarantee certain basic rights to all residents of this facility. These rights include the resident's right to: be notified of his or her medical condition and of any changes in condition in his or her condition. Record review of the facility's Change of Condition policy, not dated, read in part observe, record and report any condition change to the physician so proper treatment can be implemented. Procedure included notifying resident's responsible party.Record

review of the facility's Inservice Training Reporting Change, dated 9/17/2025, read in part [TRUNCATED]

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📋 Inspection Summary

Country Village Care in Angleton, TX inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

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.
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