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

said she also had to worry about the other residents and fire hazards. She said it could cause stress on someone when given same day notice. Record review of email, dated 10/07/25 at 4:19 p.m., reflected Social Worker sent referral for CR #1 to home health services agency for RN, OT, and PT services. Home health agency representative sent a thanks response email back to Social Worker on 10/07/25 at 4:20 p.m.

Record review of the facility's Admissions Agreement, read in part .Health, Safety, and Personal Rights.2. [nursing facility name] is a non-smoking facility and therefore will not admit any smokers into the facility. *This includes E-cigarettes and vapes. Record review of the facility's Transfer & Discharge policy, release date: December 2016, read in part .The transfer and discharge process must provide sufficient preparation and orientation to residents to ensure a safe and orderly transfer or discharge from the facility.

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

11/21/2025

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 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

comprehensive plan of care developed that includes goals, measurable objectives and timetables to meet their medical, nursing, mental, psychosocial needs identified during comprehensive assessment. The comprehensive care plan must describe services that are provided to the resident to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being. The comprehensive plan of care will include: Address the resident's individual needs, strengths, and preferences.Be periodically reviewed and revised by the interdisciplinary team as changesin the resident's care and treatment occur.

The Director of Nurses (DON) and/or its designee shall be responsible for implementation of this policy.

Re-evaluate and modify care plans as necessary to reflect changes in care, service and treatment, quarterly, and with significant change in status assessment. Care plan evaluation must occur in response to changes in the resident'sphysical, emotional, functional, psychosocial, or communicative status as they occur, as well as following the RAI guidelines.

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

11/21/2025

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 0695

Provide safe and appropriate respiratory care for a resident when needed.

Level of Harm - Minimal harm or potential for actual harm

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

observation, interview, and record review, the facility failed to ensure that a resident who needs respiratory care was provided such care, consistent with professional standards of practice for 1 of 7 residents (Resident #5) reviewed for oxygen.- The facility failed to ensure Resident #5 had a physician's order for oxygen, when he was being administered 3L O2 via NC on 9/26/25.This failure could place residents at risk for inadequate or inappropriate amounts of oxygen delivery and ineffective treatment.Findings included:Record review of Resident #5's undated face sheet revealed he was an [AGE] year-old male admitted on [DATE REDACTED] with diagnoses of heart failure (heart does not pump effectively), seizures, and chronic kidney disease (kidneys do not filter). The picture of the resident on the face sheet revealed he had oxygen

on via NC.Resident #5's MDS assessment had not been completed yet.Record review of Resident #5's Baseline Care Plan dated 9/20/25 by the DON, revealed the resident was receiving oxygen under Therapy and Nursing Services.Record review of Resident #5's previous hospital records dated 9/15/25 at 7:16am by MD K, revealed the resident was on 3 L/min O2 via NC.Record review of Resident #5's admission summary dated [DATE REDACTED] at 7:47pm by unknown nurse, revealed the resident was on continuous oxygen.Record review of Resident #5's Physician Orders by MD B, reviewed on 9/26/25, revealed no orders listed for oxygen.In an

interview and observation on 9/26/25 at 9:59am, Resident #5 was sitting up in bed with family present. He had 3L O2 via NC on. The resident said he was on continuous oxygen and used it continuously at home as well.In an interview on 9/26/25 at 12:40pm, RN A said he knew how much oxygen to put a resident on by looking at the order in the chart. He said the oxygen administration was also documented in the MAR-TAR.

He said there was not an order for Resident #5's oxygen but he knew he was on 3L. He did not know why there was not an order for the oxygen. He said if someone was taking care of the resident and did not know him well, they would not know how much oxygen he was supposed to be on. RN A called the DON and informed her the resident was on 3L O2 via NC and there was not an order. She told him to go ahead and put an order in for it.In an interview on 9/26/25 at 4:25, the DON said if there was not an order in the resident's chart it could cause harm, or the resident could miss treatment.Record review of the facility's policy and procedures on Oxygen Administration, Nasal Cannula (Updated August 2017) read in part: It is

the policy of this facility to provide oxygen support when indicated via appropriate delivery device to achieve or maintain adequate oxygenation to the respiratory compromised resident.Oxygen is a drug and as such there must be a physician's order for its use.Document O2 administration in Nurses Notes according to order, reason for use and resident's response to treatment. Post the Oxygen sign and explain to the resident, his/her roommate and all visitors the regulations regarding the use of smoking materials near oxygen.Record the oxygen use in the resident medical record.

Residents Affected - Few

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

11/21/2025

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 0698 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

resident's stay. The physician supervises the medical care of residents by means of participating in the resident's. assessment and care planning, monitoring changes in resident's medical status, and providing consultation or treatment when contacted by the facility. It also includes, but is not limited to, prescribing medications and therapy.Physician Visits. During physicians' visit, the attending physician will: Review the resident's total program of care, including medications and treatments, at each visit; Physician visits will include an evaluation of the resident's condition and total program of care, including medications and treatments, and a decision about the continued appropriateness of the resident's current medical regimen.Write, sign, and date progress notes at each visit as well as sign and date all orders. During visits,

the physician will also sign and date all orders.

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

11/21/2025

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 0880 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

and/or indwelling medical devices (e.g., central line, urinary catheter, feeding tube, tracheostomy/ventilator) regardless of MDRO colonization status. During high-contact resident care activities: Dressing, Bathing/showering, Transferring, Providing hygiene, Changing linens, Changing briefs or assisting with toileting, Device care or use: central line, urinary catheter, feeding tube, tracheostomy/ventilator, Wound care: any skin opening requiring a dressing.Record review of the facility's policy and procedure on Indwelling Catheter Care (Updated February 2017) read in part: To ensure the care of the urinary catheter is carried out in a manner that minimizes trauma and infection risks.Perform hand hygiene and put on gloves.For male patients, cleanse suprapubic [above the pelvic bone] and pubic [private area] area with approved cleanser and washcloth. Grasp the shaft of the penis firmly. Cleanse urinary meatus and glans [top part] with approved cleanser and washcloth beginning at the urethral opening.Cleanse in a circular motion moving from the meatus downward and outward towards the shaft [bottom] of the penis.Remove gloves, perform hand hygiene and don [apply] a new pair of nonsterile gloves.Clean the catheter from the insertion site to approximately six (6) inches distally [away] with hospital approved cleanser and washcloths.

Event ID:

Facility ID:

If continuation sheet