Avir At San Antonio

F 0584 Level of Harm - Actual harm Residents Affected - Few

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

observation of skin assessment for Resident #1 on 9/18/25 at 3:11 pm, small circular scars were noted to

the resident's bilateral thighs and right flank area. Resident #1 and Treatment Nurse said these scars were because of ant bites.During an interview on 9/18/25 at 3:14 pm, Resident #1 said on 9/5/25 about 6:00 am there were ants in her bed, fire ants. Resident #1 further said she could not feel and did not realize the ants were on her. Resident #1 said she felt something on her shoulder and told CNA A, who said it was an ant.

Resident #1 further said when CNA A removed the covers, there were more ants on the bed. Resident #1 said there were a whole bunch, on that day (9/5/25) they (the ants) were big and bit me. Resident #1 further said the ants were coming from the window/AC area.During an interview on 9/19/25 at 10:47 am, the DON said she first learned about the ants in Resident #1's bed on the morning of 9/5/25 about 9:45 am. On 9/19/25 at 12:45 pm, the DON verified Resident #1 did not have any skin breakdown on 9/4/25 as documented on her shower sheet. During an interview on 9/19/25 at 10:51 am, LVN A] said he was notified about ants in Resident #1's bed on 9/5/25 about 9:40 am.During an interview on 9/19/25 at 2:11 pm, the MS said he saw the ants in Resident #1's room, which were coming from the AC unit.During an interview

on 9/19/25 at 3:21 pm, CNA A said on 9/5/25, at about 8:30 am - 9:00 am, Resident #1 said she felt like something was crawling on her shoulder. CNA A further said when she removed the resident's covers to check the bed she noticed more ants on the bed. CNA A said she placed a sheet under the resident to provide a barrier until a second staff arrived to help transfer the resident out of bed using the lift. CNA A further stated she did not notice any food in or around the resident's bed.During an interview on 9/20/25 at 2:46 pm, CNA A said she had not noticed any redness to Resident #1's thighs or between her thighs before.During an interview on 9/20/25 at 4:16 pm, Resident #1 said she felt bad the ants being in her bed.

Resident #1 further said that sometimes she felt like something was crawling on her arm.Record review of

the facility's Maintenance Logs revealed ants were reported in Resident #1's bed on 9/5/25.During an

interview on 9/20/25 at 3:31 pm, the Administrator said it was important to check for the facility for pests and treat any identified issues, as they did with the ants on 9/5/25, and ensure no other issues with pests.

The Administrator further said the MS and herself were responsible for ensuring the facility was pest free.

The Administrator said the nursing staff were responsible for reporting any pest activity. The Administrator further said that residents were at risk for bug bites if the facility had increased pest activity. Record review of the facility's policy, Abuse/ Reportable Events, undated, revealed: .The facility will provide and ensure the promotion and protection of resident rights.This facility establishes an environment that is as homelike as possible and includes a culture and environment that treats each resident with respect and dignity.

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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

09/20/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Avir at San Antonio

50 Briggs Ave.

San Antonio, TX 78224

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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

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

said it was important to check for the facility for pests and treat any identified issues, as they did with the ants on 9/5/25, and ensure no other issues with pests. The Administrator further said the MS and herself were responsible for ensuring the facility was pest free. The Administrator said the nursing staff were responsible for reporting any pest activity. The Administrator further said that residents were at risk for bug bites if the facility had increased pest activity[KA1] .Record review of the facility's policy, Abuse/ Reportable Events, undated, revealed: .It is everyone's responsibility to recognize, report, and promptly investigate actual or alleged abuse, neglect, exploitation, mistreatment of residents or misappropriation of resident property abuse and situations that may constitute abuse or neglect to any resident in the facility. Adverse event: untoward, undesirable, and usually unanticipated event that causes death or serious injury, or the risk thereof. Reporting: Facility employees must report all allegations of: abuse, neglect, exploitation, mistreatment of residents, misappropriation of resident property or injury of unknown source to the facility administrator. The facility administrator or designee will report the allegation to HHSC. If the allegations involve abuse or result in serious bodily injury, the report is to be made within 2 hours of the allegation.

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