Avir at Texarkana

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents were free from abuse for 1 of 10 residents (Resident #1) reviewed for abuse. 1. The facility failed to ensure Resident #1 was free from physical abuse on 01/30/26, when CNA A open-handed slapped Resident #1 in the face, which was witnessed by CNA B. 2. The facility failed to ensure Resident #1 was protected from further abuse by CNA A on 01/30/26, when CNA B briefly left the room to notify the nurse. The noncompliance was identified as PNC. The immediate jeopardy (IJ) began on 01/30/26 and ended on 02/02/26. The facility had corrected the noncompliance before the survey began. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure pain management was provided to residents who require such services, consistent with professional standards of practice for 1 of 3 residents (Resident #2) reviewed for pain. The facility failed to ensure Resident #2 had his scheduled pain medication Hydrocodone-Acetaminophen tablet 10-325 mg by mouth three times daily from [DATE] - [DATE]. The facility failed to notify the Physician when Resident #2 was experiencing uncontrolled, excruciating pain with behavioral changes. The facility failed to ensure that Resident #2 received adequate pain medication management options. An IJ was identified on [DATE]. The IJ template was provided to the facility on [DATE] at 09:49 AM. [...]

Inspectors wroteBased on interview, observation and record review, the facility failed to provide pharmaceutical services, including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals, to meet the needs of each resident for 2 of 4 residents (Resident #1 and Resident #2) reviewed for pharmacy services. The facility failed to administer Resident #1's ordered Topamax 25 mg (seizure prevention medication) by the physician from 02/10/2026 - 02/15/2026 (5 days). Resident #1 missed 15 dosages of Topamax resulting in Resident #1 being hospitalized for seizure like activity on 02/13/2026 and 02/15/2026. The facility failed to obtain Resident #1's ordered Topamax (medication used to decrease seizure activity) 25 mg from the pharmacy as instructed by the facility Nurse Practitioner on 02/13/2026. [...]

Inspectors wroteBased on interviews and record review, the facility failed to notify the resident's representative and hospice services when there were changes in the resident's physical, mental, or psychosocial status for 1 of 11 residents (Resident #1) reviewed for notification of changes. The facility failed to notify Resident #1's hospice agency and her RP of a falls on [DATE] and [DATE] The facility failed to notify Resident #1's hospice agency and her RP of bruising to her hand and foot on [DATE]. The facility failed to notify Resident #1's RP of behavioral changes or medication changes on [DATE]. The facility failed to notify Resident #1's RP of two falls, behavioral changes, and medication changes on [DATE]. The facility failed to notify Resident #1's RP of a fall on [DATE]. These failures could place residents at risk of not receiving adequate and timely intervention and a decline in condition.

Inspectors wroteBased on interview and record review the facility failed to ensure, in accordance with accepted professional standards and practices, medical record maintained for each resident were complete and accurately documented for 1 of 11 residents (Resident #1) reviewed for resident records. The facility failed to ensure LVN C documented the incident/fall on 11/20/2025 reported by the hospice aide (CNA G). This failure could place residents at risk for delayed interventions, appropriate interventions, health complications and decreased quality of life.

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in the facility's only kitchen reviewed for food safety requirements.1. The facility failed to ensure Dishwasher A wore a facial covering to cover facial hair while serving food in the kitchen on 11/05/25.2. The facility failed to ensure Dishwasher A wore a hairnet and facial covering to cover his hair and facial hair while in the kitchen area on 11/06/25.3. The facility failed to ensure [NAME] B wore a facial covering to cover facial hair while preparing food in the kitchen on 11/06/25. These failures could place residents at risk for food contamination.

Inspectors wroteBased on interviews and record review, the facility failed to ensure each resident received adequate supervision and assistance devices to prevent accidents for 1 of 2 memory care units and 2 of 9 residents (Resident #1 and Resident #2) reviewed for adequate supervision to prevent accidents. The facility failed to ensure the residents in the Unit 2 Memory Care were adequately supervised while CNA C was in another resident's room getting residents up for breakfast and there was no other staff in the memory unit on 10/09/25, which left residents unsupervised in the dining area resulting in Resident #1 and Resident #2 getting into an altercation. This failure could place residents at an increased risk of injury.

Inspectors wroteBased on observation, interview, and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed for kitchen sanitation. 1. The facility failed to ensure food stored in the kitchen refrigerator and freezer was labeled and dated on 6/9/25. 2. The facility failed to ensure food stored in the pantry was labeled and dated on 6/9/25. 3. The facility to ensure pitchers of prepared drinks were labeled and dated on 6/9/25, 6/10/25 and 6/11/25. 4. The facility failed to ensure the handwashing sink had paper towels on 6/9/25. 5. The facility failed to ensure refrigerators and freezers temperatures were recorded on 6/9/25. 6. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide an ongoing program to support residents in their choice of activities, both facility-sponsored group and individual activities and independent activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being for residents 1 of 1 secure unit reviewed for activities, in that: The facility failed to ensure there were organized activities available to secured unit residents on 6/9/25 and 6/10/25. The facility failed to ensure a current activities calendar was posted in the resident's room. The facility failed to ensure the posted activities calendar was followed. These failures placed residents at risk for a diminished quality of life, behaviors, isolation, and lack of stimulation.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure each resident received adequate supervision and assistance devices to prevent accidents for 1 of 2 memory care units (Women's Memory Care) and 2 of 5 residents (Resident #39 and Resident #25) reviewed for adequate supervision and assistive device to prevent accidents. The facility failed to ensure the residents in the Women's Memory Care were supervised while CNA O was in a resident's room with the door closed and CNA B left the Women's Memory Care unit to go to the Men's Memory Care unit on 6/10/25 for at least five minutes. The facility failed to ensure Resident #39's wheelchair brakes engaged on 6/9/25 and 6/10/25. The facility failed to ensure Resident #25 had proper footwear on 6/9/25, 6/10/25 and 6/11/25. These failures could place residents at an increased risk for injury.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a medication error rate of less than 5 percent. There were 11 errors out of 32 opportunities, resulting in a 34.38 percent medication error rate for 3 of 4 residents reviewed for medication error. (Resident's #6, #16, and #25) The facility did not ensure the following: 1. Resident #25 was given calcium plus vitamin D3 500 mg, citalopram 20 mg (antidepressant), and MiraLAX 17 GM (laxative) as ordered by the physician during the medication pass on 06/10/25. 2. Resident #16 was given aspirin 81mg (delayed release), Senna-S (laxative), potassium 10 mEq, and primidone 50 mg (anticonvulsant) as ordered by the physician during the medication pass on 06/10/25. 3. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure an infection prevention and control program designed to provide a safe and sanitary environment and to help prevent the development and transmission of communicable diseases and infections for 4 (Resident #25, Resident #39, Resident #1 and Resident #13) of 15 residents reviewed for infection control. The facility failed to ensure CNA L performed hand hygiene between going back and forth, several times, feeding Resident #25 and Resident #39 lunch on 06/09/25. The facility failed to ensure COTA M performed hand hygiene between going back and forth, feeding Resident #1 and Resident #13 lunch on 06/09/25. These failures could place residents at risk for cross-contamination and the spread of infection.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to treat each resident with respect and dignity and provide care in a manner that promoted maintenance or enhancement of his or her quality of life for 2 of 17 residents (Resident #28 and Resident #39) reviewed for resident rights. 1. The facility failed to ensure COTA G treated Resident #28 with respect, had a dignified existence, and was not pulled backwards in a geriatric reclining rolling chair. 2. The facility failed to ensure CNA L assisted Resident #39 with eating in a dignified manner on 6/09/25. These failures could place residents at risk of humiliation, diminished quality of life, loss of dignity and self-worth.

Inspectors wroteBased on observation, interview and record review, the facility failed to promote resident self-determination through support of resident choice for 1 of 15 residents reviewed for resident rights. (Resident #17) The facility failed to assist Resident #17 out of bed after he requested to be gotten out of bed. This failure could place dependent residents at risk for feelings of depression, lack self-determination and decreased quality of life.

Inspectors wroteBased on observation, interview and record review, the facility failed to consult with the resident's physician and representative when there was a significant change in the resident's physical, mental, or psychosocial status (that is, a deterioration in health, mental, or psychosocial status in either life-threatening conditions or clinical complications) for 1 of 15 residents (Resident #39) reviewed for quality of care. The facility failed to notify the NP/MD of Resident #39's swallowing difficulties observed on 6/9/25 and 6/10/25. This failure could place residents at risk of not receiving adequate and timely intervention and a decline in condition.

Inspectors wroteBased on interview and record review the facility failed to ensure residents were free from abuse for 2 of 11 residents (Resident's #20 and #38) reviewed for resident abuse. The facility failed to ensure Resident #20, and Resident #38 were free from physical abuse, when Resident #20 pulled Resident #38's ear, and Resident #38 bit Resident #20 on the right wrist, on 05/27/25. The non-compliance was identified as past non-compliance. The noncompliance began on 05/27/25 and ended on 05/27/25. The facility had corrected the noncompliance before the survey began. This failure could place residents at risk of physical harm, mental anguish, or emotional distress.

Inspectors wroteBased on interview and record review the facility failed to ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source and misappropriation of resident property, were reported immediately, but no later than 24 hours after the allegation was made, for 2 of 11 residents (Resident's #20 and #38) reviewed for abuse on the male secured unit. The facility failed to report an allegation of resident-to-resident physical abuse on 05/27/25 to HHSC within 24 hours. This failure could place the residents at increased risk for abuse and neglect.

Inspectors wroteBased on interview and record review the facility failed to ensure assessments accurately reflected the resident status for 1 of 17 residents (Resident #5) reviewed for MDS assessment accuracy. The facility failed to accurately reflect Resident #5's active diagnoses to not include a diagnosis of schizophrenia (a disorder that affected a person's ability to think, feel, and behave clearly) on her 3/07/25 MDS assessment. These failures could place residents at risk for not receiving care and services to meet their needs.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure each resident's drug regimen was free from unnecessary medications (is a medication used: In excessive doses (including duplicate therapy); or for excessive duration; or without adequate monitoring; or without adequate indication for its use; or in the presence of adverse consequences which indicate the dose should be reduced or discontinued) for 2 of 5 residents (Resident #4 and Resident #25) reviewed for unnecessary medications. The facility failed to ensure Resident #4 had monitoring for diuretic (are medicines that help reduce fluid buildup in the body) related to edema (swelling caused by excess fluid trapped in your body's tissues). The facility failed to ensure Resident #25's behaviors were documented to provide indication of use for antidepressant and antianxiety medications. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to maintain all essential equipment in safe operating condition, for 1 of 1 stove in the kitchen reviewed for food service in that: The facility failed to ensure the kitchen's only gas stove did not have two missing burners in the middle of the stovetop. The facility failed to ensure the kitchen's oven door was not broken. The facility failed to ensure the kitchen's oven door was not held in place with a piece of cardboard. These failures could place residents who eat out of the kitchen at risk for injury and under cooked food.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure each resident received adequate supervision and assistance devices to prevent accidents for 1 of 2 memory care units reviewed for adequate supervision to prevent accidents. The facility failed to ensure the Residents in the Unit 1 Memory Care were supervised while CNA A left the memory care unit on a bathroom break on 2/24/25 for at least six minutes observed by state surveyor. This failure could place residents at an increased risk for injury.

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards in 1 of 1 kitchen reviewed for food service safety. 1. The facility failed to remove carbon build-up from 2 baking sheets and 1 skillet. 2. The facility failed to ensure that male kitchen staff properly wore facial hair covers while in the kitchen. 3. The facility failed to ensure the scoop for the sugar bin was properly stored. 4. The facility failed to ensure that all food items had been properly dated and labeled in Freezer #1, Freezer #2 and Refrigerator #1. These failures could place residents at risk of foodborne illness and food contamination.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for 1 of 5 Halls reviewed for environment. (200 Hall Memory Care Unit) The facility failed to silence a loud, continuous alarm from a malfunctioning call light system on the 200 Hall Memory Care Unit. This failure placed residents at risk of an uncomfortable environment and a decrease in quality of life and self-worth.

Inspectors wroteBased on observation, interview, and record review, the facility has failed to ensure that the resident environment remains as free of accident hazards as possible and provide supervision to prevent avoidable accidents for 3 of 8 residents reviewed for accidents. (Residents #15, Resident #19, and Resident #201) 1. The facility failed to ensure CNA A and the DON performed a safe mechanical lift transfer for Resident #15. 2. The facility failed to ensure CNA B and CNA C performed a safe mechanical lift transfer for Resident #19. 3. The facility failed to keep Resident #201's smoking materials locked up at the nurse's station. This failure could place residents at risk of injury from accident and hazards.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure residents reviewed received reasonable accommodation of needs for 1 of 19 residents (Resident #42) reviewed for resident rights. The facility failed to ensure Resident #42 had a call light within reach. This failure could place residents at risk of injury that could lead to possible falls, major injuries, hospitalization, and unmet needs.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure all patient care equipment was in safe operating condition for 1 of 16 residents (Resident #27) reviewed for safe, functional equipment. The facility failed to ensure Resident #27's wheelchair had a functioning right brake. This failure could result in resident falls and injury while using their wheelchairs.

Inspectors wroteBased on observations, interviews and record review, the facility failed to ensure resident rooms were adequately equipped to allow residents to call for staff assistance through a communication system which relays the call directly to a staff member or to a centralized staff work area for 1 of 19 residents (Resident #201) reviewed for resident rights. The facility failed to ensure Resident #201 had a functioning call light. This failure could place residents at risk of injury that could lead to possible falls, major injuries, hospitalization, and unmet needs.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the right to be free from abuse was provided for 1 of 11 reviewed for abuse. (Resident #1) The facility failed to ensure Resident #1 was free from abuse when CNA A raised her voice and cussed at her on the morning of 04/02/24 . This failure could place residents at risk for abuse and psychosocial harm.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that all alleged violations involving abuse, neglect, or mistreatment are reported immediately or not later than 2 hours for 1 of 11 residents reviewed for abuse and neglect. (Resident #1) The Activity Director and Business Office Manager failed to report the allegation that CNA A verbally abused Resident #1 to the Administrator immediately or within 2 hours of witnessing the abuse. This failure could place residents at risk for further abuse and neglect.

Inspectors wroteBased on observation, interviews and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed for kitchen sanitation in that: 1. Chicken was thawed in a sink without being completely submerged under running water. 2. Food was not labeled or dated. These deficient practices could place residents who received meals from the main kitchen at risk for food borne illness.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for 1 o1 facility and 3 of 15 residents reviewed for environment. (Resident #47, Resident #159, Resident #21) The facility failed to repair damaged ceilings in the dining room and in the hall outside of room [ROOM NUMBER]. The facility did not ensure florescent light fixtures on the 300 Hall were covered with intact protective coverings. The facility did not ensure Resident #47, Resident #159, and Resident #21 had furniture in good repair. These failures placed residents at risk of an unsafe or uncomfortable environment and a decrease in quality of life and self-worth.

Inspectors wroteBased on observation, interview, and record review the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights, that includes measurable objectives and timeframes to meet a resident's mental and psychosocial needs that are identified in the comprehensive assessment for 1 of 19 residents (Resident #9) reviewed for comprehensive person-centered care plans. The facility failed to care plan Resident #9 as PASRR positive for mental illness. These failures could place residents at risk of not having individual needs met and a decreased quality of life.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident who was unable to carry out activities of daily living received the necessary services to maintain good nutrition, grooming, and personal hygiene were provided for 1 of 15 residents (Residents #309) reviewed for ADLs care. The facility failed to ensure Resident #309 was provided with timely incontinent care throughout the day. This failure could place residents at risk of not receiving care/services, decreased quality of life and loss of dignity.