Texas Nursing Home Inspection Reports

ALWAYS ASK…

“Please show me the most recent nursing home inspection report.”

Find a Texas Skilled Nursing Facility

Each year, the State inspects every Texas nursing home and prepares nursing home inspection reports (survey report) regarding nursing home violations. This report cites deficiencies found by state surveyors during inspections of the facilities. It describes these violations in detail and facility efforts to correct the problem.

If the documented problems show poor care of residents, incompetent staff, a callous attitude by management or if a facility took too long to correct problems, you probably do not want your loved one there. Sometimes, poor care creates new problems. For example, unanswered call lights can lead to urinary incontinence when a person needs help going to the bathroom.

By law, nursing homes must make these and other compliance reports available to you. The facility must provide an accessible and well-lit place for you to review the documents. The facility must also post a notice informing you that these documents are available. If the facility fails to meet any of these requirements during your visit, notify the Texas Department of Aging and Disability Services.

Remember, facilities are often at their best when the State inspects them. Unannounced visits by family members often show a complete view of the facilities cleanliness and environment.

Most Texas nursing homes have some violations; this does not necessarily mean the facility provides poor care. You will be more concerned about some violations than others.

Standards exist for several areas, including nursing care, quality of life, dietary services, physician services, rehabilitative services, infection control, pharmacy services, facility management and observation of resident rights. Violations of these standards are labeled by “F-tags” on the survey report. READ the specific allegations.

Following is a brief summary of the violations to look for in a facility’s survey reports:

F-223, 224, or 225 – Physical, verbal, sexual, mental abuse, and involuntary seclusion and misappropriation of resident property are unlawful; the law specifies proper staff treatment of residents, and proper investigation and reporting of abuse allegations.
F-241 – Residents’ dignity and individuality must be respected.
F-246 – Residents’ needs and individual preferences must be accommodated.
F-253 – Housekeeping and maintenance for a sanitary, comfortable, orderly environment must be maintained.
F-254 – Beds and bath linens must be clean and in good condition.
F-272 – Each resident’s needs must be assessed to determine an appropriately tailored care plan.
F-279 – Each resident should have a comprehensive care plan for meeting his or her medical, nursing, mental, and social needs.
F-309 – Each resident must receive the quality care necessary to attain the highest practicable well-being and prevent avoidable decline.
F-310 – A resident’s abilities in activities of daily living (bathing, toilet, eating, dressing, grooming, moving) should not be allowed to deteriorate unless this is clinically unavoidable.
F-312 – A resident unable to carry out activities of daily living must receive help to maintain good nutrition, hygiene, and grooming.
F-314 – A resident should not develop pressure sores unless they are clinically unavoidable, and a resident who does have pressure sores should get treatment to promote healing and prevent new sores.
F-315, 316 – In cases of urinary incontinence, no catheters should be used unless clinically necessary; infections should be prevented; normal bladder function in incontinent residents should be restored when possible.
F-317, 318 – Residents should be helped, with active or passive exercise, to maintain range of motion in order to prevent the decline of their ability to move.
F-319, 320 – Residents should receive help with mental or social problems; residents who enter a facility without mental or social adjustment problems should not become angry, depressed, or withdrawn.
F-321, 322 – No nasogastric tubes should be used to feed residents unless unavoidable; residents fed by tubes must not develop problems related to poor nasogastric care (ulcers, pneumonia, dehydration).
F-323, 324 – The facility must provide adequate help to prevent accidents and minimize accident hazards.
F-325, 326, 327 – Adequate diet and hydration must be provided to each resident.
F-328 – Residents’ special medical needs must be met (injections, colostomy, prostheses, foot care, for example).
F-329, 330 – Residents must not be given unnecessary drugs.
F-332, 333 – Residents must not be subjected to significant medication errors.
F-353 – The facility must provide sufficient staff to meet resident needs and maintain or attain the highest practicable physical, mental and social well-being.
F-354 – There must be a registered nurse at the facility eight hours a day, seven days a week.
F-363, 364 – Food must be nutritious and palatable.
F-441, 442 – A facility must have an infection control program to prevent development and spread of disease.

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