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Complaint Investigation

Harbor Valley Health And Rehabilitation

Inspection Date: November 14, 2025
Total Violations 2
Facility ID 676478
Location San Antonio, TX
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Inspection Findings

F-Tag F0812

Nutrition and Dietary Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0812 Level of Harm - Minimal harm or potential for actual harm

know why he did not do anything. He stated it was important to follow the beard net policy and said, You don't want to contaminate the food with hair and other contaminants. Residents could be at risk of foodborne illness and other diseases. Review of the facility's Staff Attire policy, revised 01/2025, reflected, Procedures: 1. All staff members will have their hair off the shoulders, confined in a hair net or cap, and facial hair properly restrained.

Residents Affected - Many

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

Event ID:

Facility ID:

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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

11/14/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Harbor Valley Health and Rehabilitation

6211 Old Pearsall Road San Antonio, TX 78242

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)

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F-Tag F0880

Infection Control Deficiencies
Harm Level: Potential for More Than Minimal Harm

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

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

conducting rounds every hour. She stated she knew it was important to don PPE before entering and exiting residents' droplet precaution room and said, To protect yourself and the resident. Residents could be at risk of developing infection if staff were not donning and doffing. During an interview on 11/14/25 at 10:49 a.m., ADON E stated the Wound Care Nurse was the Infection Preventionist. He stated he or the Wound Care Nurse reeducated staff on infection control monthly. He stated he expected staff to wear full PPE, which included gown, gloves, mask and face shield. He stated everyone at the facility was responsible for following the donning and doffing PPE policy. He stated it was important to don PPE before entering and exiting residents' droplet precaution room and staid, Primarily for infection control, and to prevent spread of infection, such as COVID-19. Residents could be at risk of possible infection. During an interview on 11/14/25 at 11:35 a.m., ADON F stated the Wound Care Nurse was the Infection Preventionist. She stated

she was unsure when staff were most recently reeducated on infection control. She stated all staff who enter droplet precaution rooms must adhere to the donning and doffing PPE policy. She explained that staff were required to wear gown, gloves, face mask and face shield. She stated that the Wound Care Nurse, and the DON oversaw and ensured infection control policy was followed by conducting quarterly competencies on staff. She stated it was important to don PPE before entering and exiting residents' droplet precaution room and said, To prevent spread of infection. Residents could be at risk of infection spread. During an interview on 11/14/25 at 12:15 p.m., the NP stated Resident #1 recently had COVID-19.

She stated Resident #1 was on droplet precautions. She stated she expected anyone who entered droplet precaution room to don and doff PPE before entering and exiting. She stated it was important to don PPE

before entering and exiting residents' droplet precaution room and said, In order to keep COVID-19 from spreading and to protect everyone. Residents could be at risk for COVID-19 spread and epidemic. During

an interview on 11/14/25 at 12:41 p.m., the DON stated the Wound Care Nurse was the Infection Preventionist. She stated she could not recall when she most recently in-serviced staff on infection control.

She stated staff were responsible for donning and doffing PPE. She stated she expected staff to don and doff PPE before entering and exiting a droplet precaution room. She stated she, the Wound Care Nurse, and the ADONs oversaw and ensured infection control policy was followed by conducting quarterly competencies on staff. She stated it was important to don PPE before entering and exiting residents' droplet precaution room and said, To prevent infection spread. Residents could be infected. The surveyor requested the facility's infection control policy. During an interview on 11/14/25 at 1:28 p.m., the ADM stated

the Wound Care Nurse was the Infection Preventionist. He stated he was unsure when staff were most recently in-serviced on infection control. He stated he was unsure if any reeducations were given related to infection control. He stated all direct care staff were responsible for following the infection control donning and doffing policy. He stated the DON, him, and ADONs oversee and ensure infection control was followed by conducting morning rounds and taking reports from staff. He stated it was important to don PPE before entering and exiting residents' droplet precaution room and said, To minimize the spread of infection and ensure resident safety from cross contamination. The surveyor requested the facility's infection control policy. The surveyor was not provided with the facility's infection control policy before exit on 11/14/25.

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📋 Inspection Summary

Harbor Valley Health and Rehabilitation in San Antonio, 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 San Antonio, 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 Harbor Valley Health and Rehabilitation or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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