The Crescent

F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

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

Foley catheter tubing and dislodging the Foley catheter. CNA B said she was not assigned to Resident #1 and was just assisting with her care. Interview on 11/13/25 at 5:40 PM, the DON said all residents with Foley catheters should have a leg strap to prevent dislodging the Foley catheter. Record review of the NF policy on Catheter Care, Urinary, revised September 2014, reflected in part: .Ensure that the catheter remains secure with a leg strap to reduce friction and movement at the insertion site. (Note: catheter tubing should be strapped to the resident's inner thigh).

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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

11/18/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

The Crescent

11353 Sugar Park Lane Sugar Land, TX 77478

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

small amount of red drainage was observed. RN A cleaned the wound bed with Dakins solution 1/4 strength cleaning the wound bed from the inside out one wipe at a time. When RN A was done cleaning the sacral wound, he packed the sacral wound with a sponge material, covered it with a translucent tape and attached the wound vac tubing in the center of the dressing. RN A proceeded to clean the right ischium/buttock area with the same solution and in the same fashion, pat dry and applied santyl ointment to

the wound bed. The wound bed to the right ischium/buttock area was observed with some black discolored areas in the wound bed with a small amount of red drainage. When RN A was done, he discarded all soiled materials inside of a red biohazard bag, washed hands along with the ADON and CNA B. Interview on 11/13/25 at 5:22 PM, the ADON said the reason she did not place on full PPE when assisting with Foley catheter care and wound care for Resident #1 was due to her being distracted. The ADON said she placed Resident #1 at risk for cross contamination. Interview on 11/13/25 at 5:30 PM, RN A said he was supposed to wear a gown when he changed Resident #1's wounds. RN A said he forgot to put on his disposable gown. RN A said this placed the resident and himself at risk for cross contamination. Interview on 11/13/25 at 5:35PM, CNA B said she forgot to put on the disposable gown. CNA B said placing on full PPE was for infection control. Interview on 11/13/25 at 5:40 PM, the DON said the staff should have been wearing full PPE that consisted of disposable gowns and gloves when providing direct care for Resident #1 due to the resident having wounds and a Foley catheter. The DON said these measures were taken to prevent cross contamination and infection control. The DON said she would be in-servicing the staff. Record review of the facility's policy on Infection Control, dated November 2017, reflected in part: .The facility must establish an infection prevention and control program that must include: a system for prevention, identifying, reporting, investigations, and controlling infections and communicable diseases for all patients, staff, volunteers, visitors, and other individuals. Record review of the facility's policy on Enhanced Barrier Precautions, revised March 2024, reflected in part: .Enhanced Barrier Precautions (EBP) is an infection control intervention to reduce transmission of multidrug-resistant organisms (MDROs) that employs targeted gown and gloves use during high- contact resident care activities.EBP is indicated for residents with any of the following: chronic wound (pressure ulcers, diabetic foot ulcers, unhealed surgical wounds and venous stasis ulcers (open sore on the lower leg, often on the ankle, cause by poor vein function and fluid buildup) and/or indwelling medical devices (.urinary catheter.) even if the resident is not known to be infected or colonized (when germs are present on or in the body without causing illness).with a CDC-targeted MDRO. EBP will be used when performing the following high-contact resident care activities: dressing, bathing/showering, transferring, providing hygiene, changing linens, changing briefs, or assisting with toileting, device care (central line, urinary catheter, feeding tube, tracheostomy (surgical procedure that creates an opening in the neck to place a tube into the windpipe to help a person breathe), wound care.

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