Paradigm At The Prairies

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

dignity. In an interview on 11/18/2025 at 1:20 PM, the Administrator stated a catheter bag without a privacy bag was a dignity issue because the content of the catheter bag could be seen from the hall way. She said

the staff assisting a resident to eat should be sitting down and within eye level of the resident also to provide dignity. She said all the staff, even her, were responsible in providing dignity to all residents. He said staff must do their due diligence in ensuring that the residents had a dignified existence while in the facility.

The Administrator said she would coordinate with the DON to make sure that the staff were aware of the meaning of providing dignity. Record review of the facility's policy entitled, Resident Rights, Dignity and Privacy Handout undated, reflected Resident Dignity: Treating residents with the utmost respect, recognizing their inherent worth and value as individuals. It involves honoring their autonomy, privacy, and personal preferences, while also ensuring their physical and emotional well-being is maintained. Record

review of the facility's policy entitled Catheter Care Policies and Procedures revised 02/2024 reflected Catheter Management . Privacy: Store the catheter bag in a privacy bag to maintain dignity.

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

11/18/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Paradigm at the Prairies

106 Del Norte Dr El Campo, TX 77437

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 0558 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

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

dated 11/05/2025, reflected the resident was at risk for falls and injuries. One intervention was to ensure

the call light was within reach and answer it promptly. During an observation and interview on 11/17/2025 at 10:47 AM, Resident #14 was lying in bed awake. The call light was on the floor at the head of the bed. An attempt to interview Resident #14 revealed she was unable to answer questions appropriately related to her cognitive status. CNA J was in the hall and came to Resident #14's room. She picked up the call light and clipped it to the resident's pillow to ensure she could reach it. CNA J stated it was important for Resident #14's call light to be within reach in case she needed to call for help. In an interview on 11/18/2025 at 8:40 AM, the DON stated call lights were safety measures wherein the residents could call the staff if they needed something or needed to do something that needed assistance. She said residents might try to go to

the bathroom by themselves because she had no way to call the staff that might result to a fall and injuries.

The DON said all the staff were responsible for the call lights, including her. The DON said the expectation was for the staff to scan the resident's room when they do their rounds and ensure the call lights were within reach of the residents before they leave the room. The DON said an in-service was already initiated but she would monitor the staffs' compliance about call lights. In an interview on 11/18/2025 at 10:31 AM, ADON A stated call lights should be with the residents at all times when the residents where inside the room because the call lights were the only way they could reach out to the staff if they were in distress or just needed water. She said the call light were for all residents, whether independent or dependent. She said an independent resident might be having a heart attack and could not call anybody because the call light was not with the resident. She said she was also responsible in checking if the call lights were with the residents. She said an in-service had been going around and that she would coordinate with the DON to randomly check if the call lights were with the residents. During an interview on 11/18/2025 at 12:27 PM, LVN L stated the residents' call lights should have been within reach. She stated it was important to ensure residents were able to reach staff if they needed assistance. She stated the facility had begun in-services.

During an interview on 11/18/2025 at 12:40 PM, ADON K stated call lights should have been on the residents' beds. She stated all the call light cords had a clip to secure to the bed. She stated it was important to ensure the residents' call lights were in their reach in case they needed help. In an interview on 11/18/2025 at 1:20 PM, the Administrator stated the staff should make sure that the call lights were with the residents before they leave the room. She said for some residents, the call lights were their sense of protection that if something happened to them, they would be able to call the staff for help. She said without

the call light the residents might feel helpless. She said everybody was responsible in making sure the call lights were with the residents, whether the resident was independent or not. She said she would collaborate with the DON about the issue regarding call lights. Record review of the facility's policy Call Lights, revised December 2023, reflected The facility will provide a call light system that is accessible, functional, and responsive to meet the needs of the residents.Call lights will be placed within reach of the resident's bed or sitting area in the resident's room.

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

11/18/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Paradigm at the Prairies

106 Del Norte Dr El Campo, TX 77437

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 0583 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

indicating why the medication was being administered, and the name of the pharmacy. It was observed that nobody was attending the cart and the cart was facing the hallway. During an interview on 11/17/2025 at 9:25 AM, MA E stated she was not with her medication cart because she was administering a resident's medication. She said she should have put the blister pack inside the medications cart before leaving her cart because Resident #7's medical medication was on the blister pack. She said she would be mindful that no information about the resident would be left on top of the cart because it was a HIPAA violation. In an

interview on 11/18/2025 at 8:40 AM, the DON stated personal and medical information about a resident should not be exposed for everybody to see because it was confidential. She said the health information of

a resident should be protected and could not be shared without the permission of the resident or the resident's responsible party. She said all employees were expected to provide full confidentiality and secure any information for all residents. The DON stated she would start an in-service about privacy and confidentiality of the residents' information. In an interview on 11/18/2025 at 10:31 AM, ADON A stated the staff should make sure that no information about any resident was left on top of the cart before leaving the cart unattended. She said the resident's information was confidential and should not be seen by unauthorized individuals. She said that was a HIPAA violation. She said the expectation was for the staff not to leave any personal or medical information about a resident. She said she would coordinate with the DON to do an in-service about privacy and confidentiality. In an interview on 11/18/2025 at 1:20 PM, the Administrator stated the staff must make sure the residents' information was not exposed and protected because it was a violation of the resident's privacy and confidentiality of the care/treatment they were receiving. She said the expectation was for all the staff to make sure the personal and medical information of a resident was not visible to unauthorized individuals. She said she would collaborate with the DON to do

an in-service about privacy and confidentiality. Record review of the facility's policy entitled, Resident Rights, Dignity and Privacy Handout undated, reflected Resident Privacy . confidentiality . 4. Right to Privacy and Confidentiality . Confidential handling of medical, personal, and financial information.

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

11/18/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Paradigm at the Prairies

106 Del Norte Dr El Campo, TX 77437

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 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Based on observations, interviews and record reviews, the facility failed to provide a safe, sanitary, and homelike environment including but not limited to treatment and support for daily living safely when one of one sit-to-stand transfer chair was reviewed for environment.The facility failed to ensure the sit-to-stand transfer chair was thoroughly cleaned and sanitized.This deficient practice could place residents at risk of living in an unclean and unsanitary environment which could lead to a decreased quality of life. Findings included:An observation and interview on 11/17/2025 at 10:18 AM revealed CNA J pushing a sit-to-stand transfer chair in the hallway near nurses' station 1. There was no resident in the chair. There was dirt and dried food particles on the footrest of the chair. The base appeared to be covered in dust that had accumulated causing it to appear several shades darker than the cream upper portion of the chair. CNA J stated she was not sure who was responsible for cleaning it. ADON A was sitting at nurses' station 1 and stated she would put in a maintenance order to have it cleaned. She stated it was important to ensure resident equipment was cleaned. During an interview on 11/17/2025 at 12:16 PM, the DON stated the DOS was responsible for ensuring the sit-to-stand was cleaned. The DON stated there was no set cleaning schedule, but she was going to create one to ensure it was routinely cleaned and sanitized. She stated the sit-to-stand transfer chair was used for different residents and should also be wiped down after each use.

During an interview on 11/18/25 at 10:32 AM, ADON A stated she had taken the sit-and-stand and cleaned

it herself after it was brought to her attention. She stated it looked like there was a wad of hair and food and dirt particles on the footrest. She stated it became gummy when she sprayed it with cleaner, so she knew it was not only food. She stated dust had accumulated all over the sit-to-stand. ADON A stated she spoke with the DON and there would be a cleaning log created to ensure it was routinely cleaned. During an

interview on 11/18/25 at 11:41 AM, the DOS stated he had been in the role since August of this year and was over maintenance, laundry, and housekeeping. He stated the housekeeping staff would be responsible for cleaning the equipment used to transfer residents. He stated it was important to ensure equipment used by residents was routinely cleaned and sanitized. He stated he spoke with the DON, and they were creating

a cleaning log to ensure it was routinely cleaned.During an interview on 11/18/2025 at 1:58 PM, the Administrator stated she was currently the interim administrator, and it would soon be a permanent position. She stated there was usually a schedule for nursing or maintenance staff to clean equipment used for residents routinely and in between as needed. She stated she spoke with the DON and DOS, and a schedule was being created to ensure wheelchairs, mechanical lifts, and sit-to-stand transfer chairs were routinely cleaned and sanitized. She stated it was important to prevent cross contamination and the spread of germs between residents. Record review of the facility's policy Infection Control: Cleaning and Disinfecting Resident Care Equipment, revised June 2024, reflected Equipment will be maintained and kept clean or disinfected in accordance with acceptable policies. Manufacturers' recommendations will be followed when cleaning or disinfecting medical equipment.

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

11/18/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Paradigm at the Prairies

106 Del Norte Dr El Campo, TX 77437

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 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

stated the expectation was for the staff to follow the right procedure for administering medications via g-tube. She said she was not a clinician and would let the DON take the lead in educating the staff about

the issue. Record review of the facility's policy entitled Enteral Feeding Policies and Procedures revised 09/2023 reflected Policy: The facility will provide adequate care for residents with enteral feeding tubes to prevent complications . Residual Check . Check residual every shift and with signs/symptoms of intolerance.

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

11/18/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Paradigm at the Prairies

106 Del Norte Dr El Campo, TX 77437

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 0695 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

breathing mask were not bagged. She said she was responsible for bagging them when the residents were not using them. In an interview on 11/18/2025 at 8:40 AM, the DON stated the staff were responsible in making sure the nasal cannula and the breathing masks were bagged when not in use to prevent cross contamination and respiratory infection. She said it was her responsibility to check if the staff were compliant. She said she would do an in-service about bagging the nasal cannula and the breathing mask when not in use and would randomly monitor the staff if they were bagging them when not in use. In an

interview on 11/18/2025 at 10:31 AM, ADON A stated the nasal cannula and the breathing mask should be stored properly to prevent cross contamination and respiratory infections. She said whoever administered

the breathing treatment was responsible for cleaning it and storing it in a plastic bag. She said the nasal cannula should not be on the trash can. She said the expectation was for the staff to bag the nasal cannula and the breathing mask to when not in use. She said she would coordinate with the DON to do an in-service about the issue with respiratory care. In an interview on 11/18/2025 at 1:20 PM, the Administrator stated the expectation was for the staff to bag the nasal cannula and the breathing mask when not in use to prevent respiratory issues. She said the nasal cannula should not be in the trash can for

the same reason. She said she would coordinate with the DON to make sure the nasal cannula and the breathing masks were clean. Record review of the facility's policy entitled RESPIRATORY TREATMENT, CARE AND SERVICES Nursing Policies and Procedures revised June 2019 reflected Policy: The Facility ensures the safe, appropriate and effective provision of respiratory treatment . 6. Infection control practices including standard and transmission-based precautions are followed during . B. Handling of equipment, including cleaning, storage.

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

11/18/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Paradigm at the Prairies

106 Del Norte Dr El Campo, TX 77437

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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

was not accessible to the residents. She said confused residents might ingest it and suffer adverse reactions especially if somebody who accidentally ingested the medications was allergic to the medications. She said the nystatin powder should not be inside the room, and she was not sure why nobody noticed it. She said the resident might misuse it or other residents might get a hold of it and put them in their mouth or eyes. She said the expectation was the medicated ointment and the nystatin powder be placed inside the carts to secure it, and that the staff would check the residents' room for medications.

She said she would do an in-service making sure no medications were accessible to the residents. In an

interview on 11/18/2025 at 10:31 AM, ADON A stated zinc oxide and the nystatin powder should not be left or stored inside the residents' rooms because the residents might administer or use them incorrectly that could result in adverse reactions. She said the medicated ointments should be stored in the cart because it had chemicals that could be toxic when consumed. She said she was not sure why nobody saw the nystatin powder inside the basket with the resident's shampoo in it. She said the expectation was for the staff to be observant to see if there were medications inside the residents' room and to be mindful not to leave the medicated ointment inside the residents' rooms. She said she would coordinate with the DON to do an in-service about medication storage. In an interview on 11/18/2025 at 1:20 PM, the Administrator stated the expectation was no medications inside the residents room to prevent accidental consumption that could result to adverse reactions like allergy, stomach upset, and irritations. She said she would coordinate with

the DON to educate the staff about the matter. Record review of the facility's policy entitled Medication Administration and Management Nursing Policies and Procedures revised 06/2019 reflected 5. Only authorized medical and licensed nursing staff will administer medications ordered by the physician.

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

11/18/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Paradigm at the Prairies

106 Del Norte Dr El Campo, TX 77437

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

equipment

Level of Harm - Minimal harm or potential for actual harm

Record review of the facility's policy entitled Enhanced Barrier Precautions Policies and Procedures revised March 2024 reflected Policy: Enhanced Barrier Precautions is an infection control intervention designed to reduce the transmission of multidrug-resistant organisms and employs targeted gown and glove use during high-contact resident care activities for targeted residents . EBP are indicated for residents with any of the following . indwelling medical devices . feeding tubes.

Residents Affected - Some

Policy and procedure for infection control was requested via email to the DON and Administrator on 11/18/2025 at 10:30 AM but was not provided prior to exit.

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

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

11/18/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Paradigm at the Prairies

106 Del Norte Dr El Campo, TX 77437

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 0919 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

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

sure they were working. In an interview on 11/18/2025 at 1:20 PM, the Administrator stated somebody should have noticed that the call lights inside the memory care unit were not operating. She said it was important that the call lights were working, not just inside the memory care unit, but in all residents' rooms so that they would have a way to call the staff when needed. Record review of the facility's policy Call Lights Policies and Procedures revised December 2023, reflected The facility will provide a call light system that is accessible, functional, and responsive to meet the needs of the residents . Functionality . Call lights will be

in working order . Call lights will be monitored routinely to assess functionality

Event ID:

Facility ID:

If continuation sheet