Meridian Care of Hebbronville

Inspectors wroteBased on observation, interviews, and record reviews, the facility failed to ensure the right to be free from abuse for one (Resident #1) of 8 residents reviewed for abuse. The facility failed to protect Resident #1 on 05/08/26 from LW who verbally and physically abused Resident #1 when she slapped the resident in the face and called the resident a whore, fucking crazy, and stupid. CNA A failed to intervene and report while the altercation between the LW and Resident #1 occurred. This deficient practice could place residents at risk of harm, humiliation, and a diminished quality of life. The noncompliance was identified as PNC. The noncompliance began on05/08/28 and ended on 05/10/26. The facility had corrected the noncompliance before the survey began.

Inspectors wroteBased on interview and record review, the facility failed to ensure residents were free from any significant medication errors for one of five residents (Resident #5) reviewed for medication errors. 1. The facility failed to hold Resident #5's losartan (blood pressure medication) when Resident #5's blood pressure was outside of physician's parameters on November 6th and 26th of 2025. 2. The facility failed to hold Resident #5's hydralazine (blood pressure medication) when Resident #5's blood pressure was outside of physician's parameters on November 2nd, 6th, 17th, and 26th of 2025. This failure could place residents at risk for complications such as increased blood pressure, exacerbation of symptoms, and potential hospitalization.

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain medical records on each resident that were complete and accurately documented in accordance with accepted professional standards and practices for 2 of 5 residents (Resident #13 and Resident #36) reviewed for documentation. The facility failed to ensure LVN A documented relevant information (redness/rash to abdomen) and did not document incorrect information (dependence on staff for eating due to tube feeding) on Resident #13's admission Nursing Assessment form dated 11/26/25. The facility failed to ensure LVN B documented relevant information (presence of arterial ulcers, pressure ulcer, abrasion, and redness/rash to abdomen) and did not document incorrect information (reason for skilled services: [...]

Inspectors wroteBased on observations, interviews and record review, the facility failed to develop and implement a comprehensive person-centered care plan for 1 of 5 residents (Resident #38) whose care plans were reviewed. The facility failed to ensure Resident #38's call light was within reach at all times while in his room, as stated in the care plan. This deficient practice could place residents in the facility at risk of not being provided with the necessary care or services, and the implementation of personalized plan of care developed to address their specific needs.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that residents who needed respiratory care were provided such care consistent with professional standards of practice, physicians orders, the comprehensive person-centered care plan, and the resident's goals and preferences for 1 of 5 residents (Resident #9) reviewed for respiratory care. The facility failed to ensure LVN A transcribed a physician's telephone order during her shift for oxygen at 2 Lpm as needed to maintain oxygen levels above 90% into PCC for Resident #9. This deficient practice could place residents at-risk for insufficient or inappropriate care due to other staff not being aware the physician's order existed.

Inspectors wroteBased on interview and record review, the facility failed to readmit one of five residents (Resident #1), immediately, or to the next available bed after the hearing officer determined the discharge was inappropriate. The ADM failed to allow Resident #1 to return to the facility when the hearing officer determined Resident #1's discharge was inappropriate and Resident #1 won his discharge appeal. This failure could place residents at risk of not receiving the appropriate care and services to maintain their highest practicable well-being and at risk of a diminished quality of life.

Inspectors wroteBased on interviews and record review, the facility failed to ensure that one of five residents (Resident #1) reviewed for transfer or discharge had the required contents in the written notice. The facility discharged Resident #1 on 4/11/25 without including a specific location where Resident #1 was going after discharge. This failure could put residents at risk for inappropriate discharge from the facility.

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 one of one resident (Resident #8) reviewed for enteral feeding tubes. The facility failed to ensure staff followed physician ordered water flushes before and after medication administration given via the G-Tube for Resident #8. This failure could place residents at risk of tube obstruction and a decrease in hydration.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that its medication error rate was not 5% or greater. The medication error rate was 33.33% based on 10 errors out of 30 opportunities for 2 (Resident # 26 and Resident #6) of 3 residents observed for medication administration in that: 1. The facility failed to ensure that MA B did not mix eight crushed medications in one pill cup for Resident #26. 2. The facility failed to ensure that MA B did not incorrectly hold medications based on administration parameters for Resident #6. These failures could place residents at risk for not receiving the intended therapeutic effects of their medications and could contribute to possible adverse reactions.

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 one resident (Resident #4) of two residents observed for infection control practices during wound care in that: 1.) The facility failed to ensure LVN A performed hand hygiene for at least 20 seconds during and after wound care for Resident #4. This failure could place residents that require assistance with personal care at risk for healthcare associated cross-contamination and infections.