Caraday of Lampasas

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident had a right to a dignified existence and to treat each resident with respect and dignity for 1 of 6 residents (Resident #1) reviewed for resident rights. The facility failed to ensure, on 07/07/2026, CNA A did not yell sit down now to Resident #1 when CNA A was walking outside Resident #1's room. This failure could lead to residents at risk of experiencing feelings of disrespect, a profound loss of dignity, triggering heightened anxiety, confusion, and a desire to withdraw socially.

Inspectors wroteBased on interview and record review the facility failed to designate a registered nurse to serve as the director of nursing on a full-time basis for 1 of 1 DON reviewed for DON coverage and failed to use the services of a registered nurse for at least 8 consecutive hours a day, 7 days a week for 1 of 1 facility reviewed for nursing services. The facility failed to have a full-time Director of Nursing on 2/14/2026 and 2/15/2026 as of 02/26/2026. This failure could place residents at risk of lack or nursing oversight and a higher level of care.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for kitchen sanitation. The facility failed to have expiration dates on foods in the freezer. The facility failed to have expiration dates on dry food in the kitchen. The facility failed to keep the ice machine clean. These failures could place residents who received meals from the main kitchen at risk for foodborne illnesses.

Inspectors wroteBased on observation, interview, and record review, the facility failed to 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 2 (Resident #3 and Resident #4) of 5 residents reviewed for infection control practices, in that: The facility failed to ensure LVN B sanitized blood pressure monitor in between Resident #3 and Resident #4 while obtaining blood pressure. This failure could place residents at risk for cross-contamination and infections.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to provide nutrition and hydration care and services for two of three residents (Resident # 24 and Resident #18), consistent with the resident's comprehensive care plan. The facility failed to provide sufficient fluids for two of three residents to prevent dehydration and infections. This deficient practice placed the residents at risk for increased confusion, lethargy, increased urinary tract infections, kidney issues, excessive thirst, dry skin, decline in status, pain, illness, hospitalization and affects their psychosocial wellbeing.

Inspectors wroteBased on observation, interviews and record review, the facility failed to store, prepare, distribute food in accordance with professional standards for food service safety for one of one kitchen reviewed for food and nutrition services. The facility failed to ensure the green beans in the refrigerator were discarded after the handwritten discard date and that food temperatures were tested in a manner that prevented food contamination. This failure places the residents at risk for being served food past the expiration date and foodborne illness from eating contaminated food.

Inspectors wroteBased on observations, interviews, and record review the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights, which included measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs for 1 (Resident #20) of 5 residents reviewed for comprehensive care plans. Record Review of Resident #20's comprehensive care plan did not reflect that Resident #20 had a blister-like lesion to the mid portion of her bottom lip that was purplish-blue in color of unknown origin date per medical record review . The wound was approximately two centimeters in size. This deficient practice could place residents at risk for receiving improper care and services due to inaccurate care plans.

Inspectors wroteBased on Interview and Record Review, the facility failed to determine that drug records are in order and that an account of all controlled drugs is maintained and periodically reconciled (a system of recordkeeping that ensures an accurate inventory of medication by accounting for controlled medications that have been received, dispensed, administered, and/or, including the process of disposition ). The documentation was incomplete on the controlled medications (narcotics) count logs for one of four medication carts reviewed. The facility failed to ensure all controlled medications (narcotics) were accurately reconciled at the start and end of each shift on 11/01/2024. This failure could place residents at risk of misappropriation by drug diversion and could result in diminished health and well-being.

Inspectors wroteBased on observation, interviews and record review the facility failed to ensure residents had the right to be free from abuse for 10 (Resident's # 1-10) of 16 residents on the memory care unit. The facility failed to ensure a safe environment free from verbal abuse for residents on the memory care unit when LVN C was yelling at Residents # 1-10 in the common room on 2/28/2024. This failure could affect all residents in the memory care unit by placing them at risk for physical, mental, and emotional decline, psychosocial harm, and can lead to isolation and withdrawal from activities of enjoyment. This was determined to be a Past Noncompliance (2/28/2024-2/29/2024) due to the facility having to implemented actions that corrected the noncompliance prior to the investigation.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure that pain management was provided to residents who required such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents' goals and preferences, for one of four residents (Resident #39) reviewed for pain management. The facility failed to ensure Resident #39 was assessed, monitored, and received pain medication prior to wound care provided for a stage III pressure ulcer (Full thickness tissue loss. Subcutaneous fat may be visible, but bone, tendon or muscle is not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.) his right lateral heel. This failure could place residents at risk for unnecessary pain and discomfort.

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute food in accordance with professional standards for food service safety for one of one kitchen reviewed for kitchen sanitation. 1. The facility failed to ensure the [NAME] (one cook) wore a beard net during food service. 2. The facility failed to properly label food in two of four open front refrigerators located in the kitchen and one of one vegetable freezers located in the dry storage room.

Inspectors wroteBased on observation, record review, and interview the facility failed to ensure a PASRR screening was completed for residents with a mental disorder or an intellectual disability for one of three residents (Resident #26) reviewed for PASRR [NAME] I (PASRR 1) screenings The facility failed to ensure an accurate PASRR Level I screening (a preliminary assessment completed for all individuals prior to admission to a Medicaid-certified nursing facility to determine whether they might have a mental illness or intellectual disability) was completed for Resident #26. This failure could place residents at risk for a diminished quality of life and not receiving necessary care and services accordance with individually assessed needs.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents unable to conduct activities of daily living (ADLs) received the necessary services to maintain good grooming and personal hygiene for one of eight residents (Resident # 27) reviewed for quality of life. The facility failed to ensure Resident #27 fingernails were trimmed and cleaned. These failures could place residents at risk for poor hygiene, dignity issues and decreased quality of life.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that residents received care, consistent with professional standards of care to prevent development or worsening of pressure ulcers for one of four (Resident #39) residents reviewed for pressure ulcers. -The facility failed to ensure Resident #39 received his physician ordered treatment to his right heel pressure ulcer. -The facility failed to ensure Resident #39 received his physician ordered pressure ulcer preventative measures routinely. This failure could place residents at risk for worsening pressure ulcers leading to discomfort, pain, and potential infections.