Mexia LTC Nursing and Rehabilitation

Inspectors wroteBased on interviews and record reviews, the facility failed to maintain medical records on each resident that were complete, accurately documented, readily accessible, and were systematically organized, for 3 of 5 residents (Residents #23, Resident #29 and Resident #44) reviewed for consents for accurate medical records.1. The facility failed to document on Resident #23's smoking assessment dated [DATE] Resident #23's ability to smoke unsupervised.2. The facility failed to document on Resident #29's smoking assessment dated [DATE] Resident #29's ability to smoke unsupervised.3. The facility failed to document on Resident #44's smoking assessment dated [DATE] Resident #44's ability to smoke unsupervised. This failure could place residents at risk of harm due to not having supervision when needed while the residents are smoking.

Inspectors wroteBased on interview and record review the facility failed to ensure assessments accurately reflected the resident's status for 2 of 5 residents (Resident #23 and Resident #38) reviewed for accuracy of assessments. 1. The facility failed to ensure Resident #23's annual MDS, dated [DATE], accurately reflected her smoking status.2. The facility failed to ensure Resident #38's annual MDS, dated [DATE], accurately reflected her smoking status. These failures could place residents at risk of inadequate supervision due to an inaccurate assessment of smoking status.

Inspectors wroteBased on observation, interview, and record review, the facility failed to be 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 from each resident's bedside and toilet and bathing facilities, for 4 of the facility's 4 halls (Halls 100, 200, 300, 400) reviewed for resident call system, The facility failed to have a functioning call light system for residents who resided in the facility on Halls 100, 200, 300, and 400 when the call system failed on 11/11/25 and was still down 11/15/25. This failure could place the residents at risk of not receiving the care and services to maintain their highest level of well-being.

Inspectors wroteBased on interview and record review the facility failed to review and revise the person-centered care plan to reflect the current condition for 1 of 7 (Resident #1) residents reviewed for care plan revisions. The facility failed to revise Resident #1's care plan to reflect interventions for falls related to unsteadiness during transfers and only able to stabilize with staff assist initiated on 10/28/20 and revised on 07/26/22. This failure could affect residents by placing them at risk of not receiving appropriate interventions to meet their current needs. Findings Included: Record review of Resident #1's admission record dated 11/14/25 documented a [AGE] year-old male who was admitted to the facility on [DATE]. Resident #1 had diagnoses which included: [...]

Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure that residents received treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices for 1 of 6 residents (Resident #1) reviewed for quality of care, in that:The facility failed to conduct weekly skin assessments for Resident #1 on 7/10/25 and 07/17/25. These failures placed residents at risk of physical harm, pain, and a decreased quality of life.

Inspectors wroteBased on observations, interviews, 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 #99 and Resident #23) of 6 residents reviewed for infection control. CNA A failed to perform hand hygiene with a glove change when cleansing from back to front during peri-care and Foley catheter care for Resident #99 and the aide donned gloves from her pants pocket. VLN A failed to perform hand hygiene when changing gloves when providing wound care for Resident #23. These failures have the potential to affect all residents in the facility by exposing them to care that could lead to the spread of viral or secondary infections and communicable diseases.

Inspectors wroteBased on observations, interviews, and record reviews the facility failed to ensure residents received services in the facility with reasonable accommodations of resident's needs and preferences except when to do so would endanger the health and safety of the resident or other residents for 1 of 25 residents (Resident #3) reviewed for resident rights; in that: The facility failed to ensure Resident #3''s call light was within reach. This failure could place residents at risk of needs not being met.

Inspectors wroteBased on interviews and record review the facility failed to ensure assessments accurately reflected the resident's status for 1 of 7 residents (Residents #37) reviewed for resident assessments. The facility failed to ensure Resident #37's Quarterly MDS reflected that Resident #37 had difficulty chewing. This deficient practice could place residents at-risk for inadequate care due to inaccurate assessments.

Inspectors wroteBased on 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, that included measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment for 1 of 7 residents (Residents #37) reviewed for comprehensive care plans. Resident #37's comprehensive care plan did not reflect Resident #37's diet included chopped meat. This deficient practice could place residents at risk for not receiving proper care and services due to inaccurate care plans.

Inspectors wroteBased on interview, and record review the facility failed to ensure residents were free of accidents/hazards for one of twenty residents (Resident #34) reviewed for Quality of Care. A) The facility failed to ensure Resident #34 had been assessed for hot liquid safety prior to serving her two cups of hot coffee on 05/27/2023. Resident #34 spilled the hot coffee on her thighs resulting in 2nd degree burns. B) The facility failed to ensure all residents had safety evaluations for handling hot liquids prior to serving them hot liquids. An IJ was identified on 08/07/2023. The IJ template was provided to the facility on [DATE] at 4:50 PM. While the IJ was removed on 08/08/2023, the facility remained out of compliance at a severity level of actual harm and a scope of isolated harm due to the facility continuing to monitor the implementation and effectiveness of their Plan of Removal. [...]

Inspectors wroteBased on interview and record review, the facility failed to consider the views of a resident or family group and act promptly upon the grievances and recommendations of such groups concerning issues of resident care and life and failed to demonstrate their response and rationale for such response for one of one resident council. There was no documentation of the facility's effort to resolve grievances collected at Resident Council meetings on 03/17/2023, 04/18/2023, 05/23/2023 and 06/27/2023. This failure placed residents at risk of indignity and a diminished quality of life.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source, are reported immediately, but no later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury for one (Resident #34) of nine residents reviewed for accidents resulting in injury. The facility failed to report the injuries sustained by Resident #34 to HHSC as required. This deficient practice could place all 47 residents in the facility with the potential to be abused, neglected, exploited, or mistreated, or have injuries of unknown source to be at risk for compromised protection from abuse, neglect, exploitation or mistreatment.

Inspectors wroteBased on observation, interview and record review, the facility filed to ensure assessments accurately reflected the status of 1of 15 residents reviewed for assessments (Resident #7) The facility failed to ensure Resident #7's assessment was properly coded for his Gastrostomy-tube status. These failures could place residents at risk of not having individual needs met.

Inspectors wroteBased on interview observations, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the residents' rights, that included measurable objectives and timeframes to meet a resident's medical, nursing, and mental, and psychosocial needs for 1 of 15 residents (Residents #14) reviewed for care plans. Resident #14's comprehensive care plan did not address the resident's smoking. These deficient practices could place residents at risk of receiving inadequate interventions that were not individualized to their care needs.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure 1of 16 residents reviewed with limited range of motion (Resident #7), received appropriate treatment and services to prevent a decline in range of motion. The facility failed to ensure Resident #7 had interventions in place for his right-hand contracture (A permanent tightening of the muscles, tendons, skin, and surrounding tissues that causes the joints to shorten and stiffen and a decrease in ROM) to prevent further decline of the range of motion in his right hand. This deficient practice placed residents with contractures at risk for decrease in mobility, range of motion, and contribute to worsening of contractures. Findings Include: [...]

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure that residents who needed respiratory care were provided with such care, consistent with professional standards of practice for 1 (Resident #30) of 4 residents reviewed for respiratory care, in that: The facility failed to: A.) date the oxygen tubing for Resident #30. B.) bag resident #30's oxygen tubing when not in use. These deficient practices could place residents that receive oxygen therapy at risk for inadequate care and respiratory infection. Findings Included: Resident #30 Record Review of Resident #30's admission record dated 07/18/23 revealed the resident was a [AGE] year-old female admitted on [DATE]. [...]