Thrive Rehabilitation Of Pearland

F 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

facility is endangered. Supporting information is documented in the resident's medical record.-The health of individuals in the facility would otherwise be endangered.- Supporting information is documented in the resident's medical record.- The facility ceases operating.-Refusal of treatment would not constitute grounds for transfer.-A discharge order is obtained by nursing from the physician indicating where the resident is being discharged , why the resident is being discharged , and if the resident is to be discharged with or without medication.-Nursing notifies the business office of the transfer or discharge so that appropriate procedures can be implemented. Provide the information in wring and in a language and manner they understand.-Explain the residents' right to appeal the transfer/discharge.-Provide the name, address, and phone number of the state long term care ombudsman- Review the plan with the resident, and/or his or her family or responsible party, at least 24 hours before the resident's discharge from the facility.-The interdisciplinary team prepares the discharge summary-On the day of transfer or discharge, nursing prepares the resident-Provide notice, in writing, of the facility's bed-hold and readmission policies to the resident and an immediate family member, surrogate or representative.-Residents who were transferred for hospitalization or therapeutic leave, and whose absence exceeds the bed-hold period are permitted to return to the facility in the first available bed. The progress notes must include at least the following, as they may apply:-The reason(s) for the transfer or discharge.- That an appropriate notice of discharge was provided to the resident and/or representative.- That the residents and/or representative participated in a pre-discharge orientation program.-The date and time of the transfer or discharge. -The mode of transportation.- A summary of the resident's overall medical (including the condition of the skin), physical, and mental condition.- If medications are sent with the resident (list names, dosages, and amounts if medications are given to the resident).-Disposition of personal effects.- The signature of the person recording the data in the medical record

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

10/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Thrive Rehabilitation of Pearland

3406 Business Center Drive Pearland, TX 77584

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 0656 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few

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

allowed to provide direct care until training has been completed Inservice training was conducted by DON and/or DSD regarding policy on post-surgical orthopedic care initiated on 10/23/2025 for nursing staff and will be completed on 10/26/2025. Any staff that have not been trained yet will not be allowed to provide direct care until training has been completed. Training in care planning and one-two person transfers will be included for new hires and will be reviewed yearly by DSD/ and DON during the annual performance review. The annual training calendar for licensed nurses and CNAs will include providing care planning and patient transfer competencies as part of its annual in-service for licensed nurses beginning the month of October 2025. Monitoring of the plan for removal included: Following acceptance of the facility's plan of removal, the facility was monitored from 10/24/2025 from 10:30 am to 10/24/2025 at 5:39 pm., to remove

the IJ which will continue until every staff is trained by: Record review of facility ongoing training and policies updates for nurses and certified nursing assistants. Resident # 2's care plan was updated to reflect adaptive devices. CNAs, master competency worksheet updated to reflect training on transfer, gait, one-two person assist and Hoyer lift (a medical device used to assist individuals with limited mobility in transferring between surfaces such as beds, chairs, or wheelchairs) during new employee orientation. An ongoing training rosters for gait belt, Hoyer lift, and one-two person transfer were presented with staff signatures.

Staff who were not working on 10/22/2025 to 10/24/2025 would be trained upon their return to work.

Observation of CNA H and CNA I on 10/24/2025 at 2:03 pm, revealed they successfully completed a gait belt transfer from wheelchair to bed and vice versa. Observation and examination on 10/24/2025 at 11:48 a.m., revealed all mechanical lift devices were functioning properly, including charging locations on the halls. A total of fifteen direct care staff were trained. Interviews were conducted with CNAs , therapists, and nurses on 10/24/2025 at 12:119 p.m., to 10/24/2025 at 4:35 p.m., CNA B, CNA G, CNA H, CNA I, CNA J, RN B, RN C, LVN A, LVN B, LVN C, revealed they were reeducated on the use of mechanical lift, gait belt, one-two persons transfer, reviewing the Kardex prior to Resident transfer.Administrator was informed that

the IJ was removed on 10/24/2025 at 05:39 p.m. The facility remained out of compliance at a severity of removed. The facility remained out of compliance potential for more than minimal harm that is immediate treat due to the facility's need to evaluate the effectiveness of the corrective systems that were put in place.

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

10/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Thrive Rehabilitation of Pearland

3406 Business Center Drive Pearland, TX 77584

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 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few

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

and certified nursing assistants. Resident # 2's care plan was updated to reflect adaptive devices. CNAs, master competency worksheet updated to reflect training on transfer, gait, one or two persons assist and Hoyer lift during new employee orientation. An ongoing training rosters for gait belt, Hoyer lift, and one -two persons transfer were presented with staff signatures. This will continue until every staff is trained. Staff who were not working on 10/22/2025 to 10/24/2025 would be trained upon their return to work. Observation of CNA H and CNA I on 10/24/2025 at 2:03 p.m., revealed they successfully completed a gait belt transfer from wheelchair to bed and vice versa. Observation and examination on 10/24/2025 at 11:48 am, revealed all mechanical lift devices were functioning properly, including charging locations on the halls. Interviews were conducted with CNAs , therapists, and nurses on 10/24/2025 at 12:119 p.m., to 10/24/2025 at 4:35 p.m., CNA B, CNA G, CNA H, CNA I, CNA J, RN B, RN C, LVN A, LVN B, LVN C, revealed they were reeducated on the use of mechanical lift, gait belt, one -two persons transfer, reviewing the Kardex prior to Resident transfer. While the training was ongoing, a total of fifteen direct-care staff were in-serviced on proper transfer with the right equipment.Administrator was informed that the IJ was removed on 10/24/2025 at 05:39 p.m. The facility remained out of compliance at a severity of isolation with potential for more than minimal harm due to the facility continuing to monitor the implementation and effectiveness of their Plan of Removal.

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

10/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Thrive Rehabilitation of Pearland

3406 Business Center Drive Pearland, TX 77584

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 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

follow up for effectiveness of the medication and call the doctor. He said Resident # 2 was monitored every shift for pain assessment. He said on 07/07/2025 and 07/08/2025 pain monitoring was not recorded. He said the pain assessment task would be located in the MAR and would not be cleared up until completed.

During an interview on 10/24/2025 at 4:32 p.m., Nurse 1 said pain assessment/monitoring was when the patient was complaining of pain. She said an order for pain monitoring was an assessment of acute or chronic pain based on resident's health report. She said she would ask residents on a scale 1 to 10 and note any facial expression or behavior and check vitals. She said they were to complete an assessment every day according to a physician order. She said the assessment was regarding any surgeries and all the components of the body. She said for Resident # 2 she would check for pain in hip. She said she was not sure if she completed an assessment for Resident # 2 on 07/07/2025 or 07/08/2025. She said she may have completed pain monitoring on a pain assessment tool sheet. She said the risk of not completing or documenting a pain assessment could aggravate other causes and triggers for the resident. During an

interview on 10/24/2025 at 4:38 p.m., Nurse C said there was an order on every shift for assessing pain and there was an option for 0 - 10, and documentation was located on the TAR. Nurse C said if the resident's pain was level 0 that was to be entered. She said if the resident was alert you took whatever the resident told you or observed if the resident was making an expression or holding on to the body part and make a note. She said some residents did not tell you when they were in pain and would say they are not in pain. She said an assessment was to reposition residents that cannot move themselves and to view any skin breakdowns document in progress notes. She said she cannot remember and if Resident # 2 had pain medications or complained of pain. She said if pain assessment was not completed it could be a risk, this could intervene with therapy which was why Resident # 2 was admitted to the facility.Record review of the facility's pain screening and assessment policy dated 11/2024 revealed:-It is the policy of the facility to screen and assess each resident for pain.-Every shift, a pain score will be documented for each Resident.-Nursing will document a comprehensive pain assessment for Residents with a positive pain score. -Reassessments will occur at specific intervals following the initiation of a pain treatment plan.-Reassessment will minimally include pain location, intensity, side effects, functional status and adherence or substance abuse concerns.-Pain treatment effectiveness/outcomes and resulting revisions in

the pain treatment plan will be documented in the medical records.-Anytime routine vitals are taken, the 0-10 pain intensity rating scale must be included as the 5th vital sign.-The screening of cognitively impaired residents may also required the observation of behavioral factors that signal pain or discomfort.-When possible, the [NAME] Faces pain rating scale may be used.

Event ID:

Facility ID:

If continuation sheet