Avir at Waco

Inspectors wroteBased on observation, interview, and record review, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for one (Resident #1) of four residents reviewed for infection control. The facility failed to ensure staff practiced hand hygiene when performing perineal care (Incontinence care). The failure put residents at risk for infection, hospitalization, and decreased quality of life.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the resident environment remained as free of accident hazards as was possible to prevent accidents for 1 (Resident #1) of 5 residents reviewed for accidents and hazards. The facility failed to label a large plastic bottle of purified water, which was kept in Resident #1's room, as hummingbird water, which RN A poured into Resident #1's CPAP water reservoir on 03/09/2026. This failure could place residents at risk of infection or exposure to fungus.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident who needed respiratory care, was provided such care, consistent with professional standards of practice for 1 (Resident #1) of 5 residents reviewed for respiratory care. RN A knowingly used a bottle of water labeled purified water instead of using distilled water, as she was trained to use by the facility to fill Resident #1's CPAP reservoir on 03/09/2026. RN A failed to follow the care plan and training to use only distilled water resulting in Resident #1's CPAP air being humidified with sugar water and Resident #1 being without the use of her CPAP on 03/11/2026. These failures could place residents at risk of receiving incorrect or inadequate treatment and could result in exposure to fungus and/or infection.

Inspectors wroteBased on interview 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 3 of (Resident #30. Resident #62 & Resident #83) of 5 residents reviewed for pharmacy services. The facility failed to administer Resident #30's antipsychotic medication Risperidone 1mg two times a day for schizophrenia as prescribed from 02/01/2026-02/03/2026 during the standard time frame. The facility failed to administer Resident #62's antipsychotic medication Risperidone 0.5mg two times a day for schizophrenia as prescribed from 02/01/2026-02/05/2026 during the standard time frame. [...]

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 sanitation.1. The facility failed to ensure sanitation practices (cleaning the dishwasher from buildup).2. The facility failed to ensure all items were covered and stored properly in the pantry and freezer.3. The facility failed to label and date all food items in the kitchen. This failure could place residents at risk of foodborne illness.

Inspectors wroteBased on observation, interviews and record reviews, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, which included measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs for 1 of 5 residents (Resident #14) reviewed for care plans. The facility failed to include that Resident #14 was on droplet precautions in her comprehensive care plan. The facility failed to provide interventions for the care plan problem of Resident #14 having a UTI. This failure could place residents at risk for not receiving necessary care and services or having important care needs identified and met.

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain an infection prevention and control program designated to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable disease and infection for one (Resident # 68) of six residents reviewed for infection control. IP A failed to wear enhanced barrier precautions (a protective layer over clothing to prevent the spread of germs) during an observation of wound care on 2/05/2026. This failure could place residents at risk of cross contamination which could result in infections or illness.

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 one of one kitchen reviewed for sanitation. 1. [...]

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure menus were followed for all residents for 2 of 3 meals observed. The facility failed to follow the posted cycle menus for two lunch services served at the facility on Sunday, 12/29/24 and Tuesday, 12/31/24. These failures could place residents that eat food from the kitchen at risk of poor intake, and/or weight loss.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to serve foods that were palatable and attractive and prepare food by methods that conserve nutritive value, flavor, and appearance for 1 of 1 kitchen observed. 1. The kitchen test tray of the lunch meal foods was unappealing and lacked flavor. The kitchen test tray lacked condiments and the dessert of pound cake was unappealing and very dry. There was no garnishment on any foods or meal tray. 2. The lunch meal tray on 12/31/24 for Resident # 220 who has an order for a pureed diet consisted of a packaged plastic ware utensils with one salt and one pepper packet, a glass full of ice and ¼ full of water as the beverage, a scoop of pureed BBQ brisket, a scoop of pureed creamed corn, a scoop of pureed black-eyed peas, and a container of packaged applesauce. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident who is fed by enteral means receives the appropriate treatment and services to prevent complications for 1 of 1 resident (Resident #32) reviewed for medication administration via a gastric tube. The facility failed to ensure Resident #32's gastric tube was flushed according to the physician's order and the facility's policy during resident's medication administration. This failure could place residents at risk of gastric tube clogging, which could have required the resident to repeat an unnecessary invasive procedure (gastric tube replacement).

Inspectors wroteBased on observation, interview, 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 biological's, to meet the needs of each resident for 1 of 1 medication storage rooms. The facility failed to ensure that expired medication administration supplies were removed from 1 of 1 medication storage rooms. This failure could place residents at risk for ineffective treatments and unnecessary invasive procedures. Use of these expired supplies and medications would not meet acceptable standards of medical practice and could cause a Central Line Catheter to need replacement due to dislodgement or infection.

Inspectors wroteBased on observation, interview, and record review the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the transmission of communicable diseases and infections for 1 of 1 laundry. The facility failed to ensure laundry staff handled and stored linens in a manner to ensure cleanliness and protect from dust and soil to prevent cross-contamination and the spread of infections. This failure could place residents at risk for development of communicable diseases and infections that could diminish a residents' quality of life.

Inspectors wroteBased on interview, and record review, the facility failed to protect one (Residents #1) of one of one reviewed, from verbal abuse, in that: The facility failed to ensure Resident #1 was not verbally abused by CNA A. This failure could place residents at risk of fear, depression, intimidation, and a diminished quality of life due to verbal abuse.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to store foods properly and maintain a sanitized food preparation area for the facility's only kitchen reviewed for food and nutrition services. 1. The facility failed to safely store food containers in the facility's only pantry, walk-in cooler, and freezer. 2. The facility failed to maintain clean kitchen surfaces/appliances. These failures placed residents at risk of exposure to food borne pathogens.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure residents receive services in the facility with reasonable accommodation for three of eight residents (Resident # 28, Resident # 42, and Resident # 44) who were reviewed for reasonable accommodations. The facility failed to ensure that call lights were within arm's reach of the resident # 28, # 42, and # 44, This failure placed residents at risk of harm by not being able to call for help when needed.

Inspectors wroteBased on interview and record review, the facility failed to ensure all Pre-admission Screening and Resident Review (PASARR) Level I Screening for residents diagnosed with mental illness were accurate and residents were provided with a PASARR Level II Screening for 1 (Resident #27) of 2 resident's reviewed for PASARR coordination, by failing to ensure: 1. Resident # 27's PASARR Level I was completed accurately for Resident #27 who had active mental health diagnosis. This failure could place residents at risk for inappropriate placement in the nursing facility for long term care and at risk of not receiving appropriate care and services from the local authority, which could result in a possible decline in mental health

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that all drugs and biologicals were stored in locked compartments for treatment cart 1 (Treatment Cart #1). 1. Treatment cart # 1 located in hallway B in the facility, outside of room B20, was observed to be unlocked and left unattended by LVN. This failure could place residents at risk of drug diversion and access to medications.

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 medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment for 1 resident (Resident #54) of 8 residents reviewed for care plans. The facility failed to develop and implement a comprehensive person-centered care plan to address Resident #54's skin concerns. This failure could place residents at risk of not having their individual care needs met, which could cause a decline in physical health, psychosocial health, and quality of care.

Inspectors wroteBased on observation, interview, the facility failed to post the following information on a daily basis: (i) Facility name. (ii) The current date. (iii) The total number and the actual hours worked by Registered Nurses, Licensed Practical Nurses or Licensed Vocational Nurses, Certified Nurse Aides and Resident Census at the beginning of each shift in a prominent place readily accessible to residents and visitors. The facility did not post the required staffing information on 10-31-2023, 11-1-2023, and 11-2-2023. This failure could place residents and visitors at risk of not knowing how many nursing staff were on duty and the actual hours worked per each shift daily.