Sterling Nursing And Rehab

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

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

would use the oxygen. LVN C said Resident #12 wore his oxygen most of the time and also when he went to bed. During an interview on 09/11/2025 at 2:02 PM, the DON said it was expected for oxygen signs be posted outside of resident rooms that were using oxygen. The DON said she was not sure why there were no signs on the 2 rooms as they usually had them posted. She said the signs might have fallen off. The DON said the signs were supposed to be posted for safety of the residents or fires. During an interview on 09/11/2025 at 2:22 PM, the Administrator was made aware of the observation of the resident rooms without oxygen signs posted outside of the doors. The Administrator said it was expected for those resident rooms to have the signs and that they must have forgotten to post them. Record review of the facility undated policy, titled Oxygen administration, indicated in part: Supplies/equipment - appropriate oxygen signs for door and room. Place appropriate oxygen signs per facility policy.

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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

09/11/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Sterling County Nursing Home

309 Fifth St Sterling City, TX 76951

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 0805 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

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

said Resident #5 had an order for mechanical soft for pleasure feeding. The ADON stated she did not normally supervise meals, usually the charge nurse did. Interview on 09/11/2025 at 2:17 PM, the DON stated mechanically altered diets needed to be soft so the resident could chew it, and she want the residents to have some sort of gravy to moisten dry meat. The DON said a chopped meat diet had meat that was chopped to probably dime sized and a mechanical soft had to be about 1 centimeter. The DON said a puree diet needed to be a pudding consistency. The DON said the charge nurse should be at the window checking tickets to make sure the ticket and the plate matched. The DON stated if the texture was wrong, she expected the nurse to ask for the correct texture and not give it to the resident. The DON stated rice sized pieces of food was not puree. The DON stated the nurses did not catch it and were trusting what came out kitchen was ok. The DON added the CNAs should have probably caught too, because the aides knew the residents. The DON said she thought there was confusion when a resident got mechanical soft verses a puree diet. The DON said Resident #5 was supposed to get both and the order did say on request.

Surveyor requested a policy and any in-services on what the nurses were responsible for doing regarding a specialized diet. Interview 09/11/2025 at 2:51 PM, the Administrator said his understanding of a chopped meat diet was up to dime sized pieces. The Administrator stated when he usually saw a mechanical soft diet it looked like ground up hamburger meat. The Administrator said a puree diet had to have some consistency like mashed potatoes, not runny. Review of the Diet Guide for the cooks, undated revealed:Soft Chopped Diet is food cut by hand into even bite sized pieces or as prescribed by a doctor. Food must be moist throughout and cannot include any food that is hard, sticky, or crunchy. Ground Diet - is food that is moist, soft-textured and easily formed in a rounded ball in the mouth. Meats are ground or minced into pieces no larger than a quarter inch; all pieces are moist and stick together slightly (cohesively).Pureed Diet is food with very smooth consistency or foods that have been well processed in a food processor or blender to a very smooth consistency or texture. No solid pieces or parts can be noticed in the food. Pureed food has no lumps and feels very soft and smooth in the mouth. Review of the Meal Service Report, dated 9/9/25, revealed there were 5 residents on a chopped meats diet, 2 residents on a mechanical soft diet, and 2 residents on a puree diet.

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

09/11/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Sterling County Nursing Home

309 Fifth St Sterling City, TX 76951

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)

Federal health inspectors cited STERLING COUNTY NURSING HOME in STERLING CITY, TX for a deficiency under regulatory tag F-F0880 during a standard health inspection conducted on 2025-09-11.

Category: Infection Control Deficiencies

The facility was found deficient in the following area: Provide and implement an infection prevention and control program.

Scope/Severity Level F: widespread, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 4 deficiencies cited during this inspection of STERLING COUNTY NURSING HOME.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-10-10.

F 0908

Keep all essential equipment working safely.

Level of Harm - Minimal harm or potential for actual harm

Based on observation and interview, the facility failed to maintain all mechanical, electrical, and patient care equipment in safe operating condition for 1 of 1 kitchen reviewed for physical environment. The facility failed to ensure the dishwasher met manufacturer's recommendation of 120 degrees Fahrenheit for the wash and sanitize cycle. This failure could place residents at risk of foodborne illnesses and residents and staff.

Findings included: Observation and interview on 9/10/25 at 1:38 p.m. revealed DA H said the dish machine was supposed to get up to 120 degrees. DA H ran the machine three times, and the wash temperature got to 100 degrees, the sanitizer level reached 114 degrees. After reading the posted machine instructions DA H stated he needed to report the dish machine not reaching temperature to the Dietary Manager.

Observation on 9/10/25 at 1:51 p.m. revealed Dietary Manager verified the machine was not reaching the correct temperature, took a picture of the dial and sent it to the Maintenance Director. Interview on 09/11/2025 at 2:41 PM, DA H stated the dish machine was brand new and he thought they turned down the water temperature because it had not worked correctly since the weekend. DA H said he did not tell anyone because he did not realize it needed to be reported. Interview on 09/11/2025 at 2:51 PM, the Administrator said the dish machine was just changed out. The Administrator said the thought maintenance lowered the temperature to raise the sanitization level. He said he did not know, he was not there. Surveyor requested

the policy on dish sanitization if there was one. There was no policy provided. Review of the Dish Machine Logbook for September 2025 (9/1/25 - 9/10/25) revealed: AM Wash Temp AM Final Rinse9/1/25 95 degrees 114 degrees9/2/25 110 degrees 122 degrees 9/3/25 110 degrees 120 degrees 9/4/25 112 degrees 123 degrees 9/5/25 114 degrees 123 degrees9/6/24 115 degrees 120 degrees9/7/25 116 degrees 120 degrees9/8/25 115 degrees 120 degrees9/9/25 116 degrees 120 degrees9/10/25 112 degrees 121 degrees Noon Wash Temp Noon Final Rinse Temp 9/1/25 100 degrees 123 degrees9/2/25 105 degrees 121 degrees9/3/25 110 degrees 120 degrees9/4/25 106 degrees 120 degrees9/5/25 110 degrees 120 degrees9/6/25 110 degrees 121 degrees9/7/25 111 degrees 120 degrees9/8/25 116 degrees 120 degrees9/9/25 115 degrees 120 degrees 9/10/25 114 degrees 119 degrees PM Wash Temp PM Final Rinse Temp9/1/25 105 degrees 125 degrees9/2/25 110 degrees 122 degrees9/3/25 110 degrees 120 degrees9/4/25 111 degrees 120 degrees9/5/25 115 degrees 122 degrees9/6/25 114 degrees 120 degrees9/7/25 115 degrees 122 degrees9/8/25 114 degrees 120 degrees9/9/25 116 degrees 120 degrees

Review of the posted General Operating Instructions, undated, by the manufacturer revealed:It is recommended that 140 degrees water be used. Report to your supervisor if it is lower than 120 degrees or higher than 160 degrees.

Residents Affected - Many

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

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