Houston House

Inspectors wroteBased on observation, interview, and record review, the facility failed to store and distribute food under sanitary conditions, increasing the risk of cross-contamination and food-borne illness. This had the potential to affect all residents. The facility census was 74. Review of the facility's policy titled, Food Receiving and Storage, revised November 2022, showed: - Dry foods and goods are handled and stored in a manner that maintains the integrity of the packaging until they are ready to use;- Food in designated dry storage areas are kept at least six inches (in.) off the floor (unless packaged for case lot handling, for example, dollies, pallets, racks and skids) and clear of sprinkler heads, sewage/waste disposal pipes and vents. Review of the facility's policy titled, Cleaning Rotation, dated November 2016, showed: [...]

Inspectors wroteBased on interview and record review, the facility failed to provide the bed hold fee on the bed-hold policy upon transfer to the hospital for five residents (Residents #3, #13, #20, #27, and #81), failed to include the name, address, or the telephone number of the Office of the State Long Term Care Ombudsmen (advocate for the resident in nursing facilities), mailing and email address for agency for protection and advocacy for residents with intellectual disabilities, and mailing, email address and telephone number for agency for protection and advocacy for residents with mental illness, within the transfer and discharge notices for six residents (Resident #1, #3, #13, #20, #27, and #81), and the facility failed to include the resident or responsible party's signature on the transfer/discharge form for one resident (Resident #27) out of six sampled residents. [...]

Inspectors wroteBased on interview and record review, the facility failed to document an accurate Minimum Data Set (MDS - a federally mandated assessment instrument completed by facility staff) for two residents (Residents #13 and #47) out of 18 sampled residents. The facility census was 74. Review of the facility policy, Resident Assessments, dated October 2023, showed:- Information in the MDS assessments will consistently reflect information in the progress notes, plans of care, and resident observations/interviews. Review of the Resident Assessment Instrument (RAI) Manual, dated October 2025, showed:- H0300: Code 9, not rated: during the seven-day look-back period the resident had an indwelling bladder catheter (a sterile tube inserted into the bladder to drain urine) for the entire seven days. 1. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure one resident (Resident #13) out of two sampled residents had a completed hospice (care for the terminally ill with a life expectancy of six months or less) coordinated plan of care with all of the care required by the resident such as a urinary catheter (a sterile tube inserted into the bladder to drain urine) and wound care. The facility census was 74. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure placement of the urinary indwelling catheter (a sterile tube inserted into the bladder to drain urine) drainage bag and tubing was maintained for two residents (Residents #3 and #13) out of four sampled residents. The facility census was 74. Review of the facility's policy titled, Urinary Catheter Care, dated August 2022, showed:- The purpose of this procedure is to prevent urinary catheter associated complications;- Be sure the catheter tubing and drainage bag are kept off the floor. 1. Review of Resident #3's medical record showed:- admission date of 05/09/23;- Diagnosis of obstructive and reflux uropathy (conditions where urine flow is blocked or flows backward into the kidneys, causing swelling and potential kidney damage). [...]

Inspectors wroteBased on interview and record review, the facility failed to identify, assess, and provide supportive interventions for one resident (Resident #4) with a diagnosis of post-traumatic stress disorder (PTSD - a mental health condition triggered by a terrifying event - either experiencing it or witnessing it; symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event) out of one sampled resident. The facility's census was 74. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to adhere to enhanced barrier precautions (EBP - precautions for use during high-contact resident care activities for residents infected with a multidrug-resistant organism (MDRO - microorganisms that are resistant to one or more classes of antimicrobial agents) or any resident who has a chronic wound and/or indwelling medical device) for two residents (Residents #13 and #25) when staff did not wear gowns to provide direct care and for one resident (Resident #25) during intravenous (IV - administer in the vein) medication administration out of six sampled residents. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to accurately code the Minimum Data Set (MDS), a federally mandated assessment instrument completed by the facility staff, for one resident (Resident #55) out of 18 sampled residents. The facility census was 76. Review of the facility's policy titled, Certifying Accuracy of the Resident Assessment, revised November 2019, showed: - The information captured on the assessment reflects the status of the resident during the observation (look back) period for that assessment. 1. Review of Resident #55's medical record showed: - An admission date of 11/03/23; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to store and distribute food under sanitary conditions, increasing the risk of cross-contamination and food-borne illness when the facility failed to utilize pasteurized eggs to prepare fried eggs without a congealed yolk for seven residents (Residents #13, #42, #53, #54, #56, #57 and #63) out of 15 sampled residents. These practices had the potential to affect all residents. The facility census was 76. Review of the facility's policy titled, Hair Restraints, dated 2016, showed: - Staff shall wear hair restraints in all food production, dishwashing, and serving areas; - Hair restraints, hats, and/or beard guards shall be used to prevent hair from contacting exposed food. [...]

Inspectors wroteBased on observation and interview, the facility failed to store and distribute food under sanitary conditions, increasing the risk of cross-contamination and food-borne illness. This deficient practice had the potential to affect all residents. The facility census was 74. The facility did not provide a dietary policy. Observations on 12/11/23 at 11:07 A.M., of the kitchen showed: - The top of the commercial range covered in food debris and a buildup of a brown substance; - The front door panel and the handle of the commercial range covered with a brown sticky substance; - An air vent located on the ceiling located near the entrance door covered with a dark brown substance; - 10 ceiling fluorescent light fixtures with no covers. Observation on 12/11/23 at 11:10 A.M., of the dry storage room showed one 6 pound (lb.) dented can of fruit mix on the canned food rack. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure staff treated residents with dignity and in a respectful manner by leaving two residents (Resident #69 and #225) out of nine sampled residents exposed during care. The census was 74. Review of the facility's policy titled Dignity, revised February 2022, showed: - Residents are treated with dignity and respect at all times; - Staff promote, maintain and protect resident privacy, including bodily privacy during assistance with personal care and during treatment procedures. 1. Review of Resident #69's medical record showed: - admission date of 11/03/23; [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to complete ongoing re-evaluations for the continued need of a restraint (a device that limits a person's movement) for three residents (Residents #6, #30, and #46) out of three sampled residents. The facility census was 74. The facility failed to provide a restraint policy. 1. Review of Resident #6's medical record showed: - An admission date of 06/23/21; - Diagnoses of dementia (a disorder marked by memory loss, personality changes, and impaired reasoning that interferes with daily functioning), weakness, confusion, anemia (a condition in which the blood doesn't have enough healthy red blood cells), degenerative joint disease (a type of arthritis that occurs when flexible tissue at the ends of bones wears down), and difficulty walking; - Required assistance of one staff for toileting; [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to identify, assess and provide supportive interventions for two residents (Resident #69 and #70) with a diagnosis of post-traumatic stress disorder (PTSD) (a mental health condition triggered by a terrifying event - either experiencing it or witnessing it; symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event) out of two sampled residents. The facility's census was 74. The facility did not provide a PTSD policy. 1. Review of Resident #69's medical record showed: - Date of admission of 11/03/23; - Diagnosis of PTSD; - Trauma assessment dated [DATE] shows resident to trigger for PTSD. Review of the resident's Physician Order Sheet (POS), dated December 2023, showed: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain adequate infection control practices to prevent the transmission of infection when staff demonstrated poor hand hygiene for eleven residents (Resident #17, #22, #30, #36, #43, #49, #50, #65, #69, #175 and #225) out of 12 sampled residents and one resident (Resident #15) outside the sample. The facility also failed to maintain adequate infection control practices during catheter (a tube inserted into the bladder to drain urine) care for two residents (Resident #36 and #69), emptying of the catheter drainage bag for one resident (Resident #69), and proper placement of a catheter drainage bag for one resident (Resident #36) out of three sampled residents. Review of the facility's policy titled,Handwashing/Hand Hygiene, dated August 2019, showed: [...]