Robstown Nursing and Rehabilitation Center

Inspectors wroteBased on interviews and record review, the facility failed to ensure that all alleged violations involving the reasonable suspicion of a crime were reported immediately to a law enforcement entity for its political subdivision, within two hours if the events that cause the allegation involve abuse or result in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury, to the administrator of the facility and to other officials (including to the State Survey Agency and adult protective services where state law provides for jurisdiction in long-term care facilities) in accordance with State law through established procedures for 1 (Resident #1) of 5 residents reviewed for abuse/neglect. [...]

Inspectors wroteBased on observation, interviews and record review, the facility failed to store food in accordance with professional standards for food service safety for 1 of 3-unit refrigerators (1 of 3 resident refrigerator) reviewed for storage, preparation and sanitation. -The facility failed to ensure food items in the resident's refrigerator were sealed properly. -The facility failed to ensure food items in the resident's refrigerator were not expired. -These failures could place residents at risk of complications from food contamination

Inspectors wroteBased on observation, interview and record review the facility failed to store all drugs and biologicals in locked compartments on 1 of 3 medication carts reviewed for storage of drugs. The facility failed to ensure LVN D's medication cart located by the nurse station was locked when not in use. This failure could affect residents who have medications on the nurse's medication cart and could result in lost medications, drug diversion, or harm due to accidental ingestion of unprescribed medications.

Inspectors wroteBased on observation, record review, and interview, 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 of five Residents (Resident #6) that were reviewed for infection control and transmission-based precautions policies and practices. The facility failed to ensure LVN A performed hand hygiene after removing gloves after pat drying Resident #6's wound. This failure could place residents at risk of infection through cross contamination of pathogens and infectious diseases.

Inspectors wroteBased on observations, interview, and record reviews the facility failed to provide the required 80 square feet per resident in 48 of 48 resident rooms (101, 102, 103, 104, 105, 106, 107, 108, 109, 202, 203, 204, 205, 206, 207, 208, 209, 210, 301, 302, 304, 305, 306, 307, 401, 402, 403, 404, 405, 406, 407, 501, 502, 503, 504, 505, 506, 507, 508, 509, 510, 600, 601, 602, 604, 606, 608, and 609.) All 48 rooms did not account for 80 square feet per resident. This failure could restrict the amount of resident care equipment and resident's personal effects that could be accommodated in these resident rooms and limit the residents' ability to move about the room. On 01/06/26 at 10:00 am, this surveyor utilized an agency laser measuring device and obtained measurements of a sample of 6 resident rooms (101, 206, 302, 406, 506, and 609). [...]

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. The facility failed to maintain the floors safely. The facility failed to ensure utensils were clean and sanitized. The facility failed to ensure dishes were clean and sanitary. The facility failed to ensure juice guns were maintained and sanitary. The facility failed to ensure ingredients were not left open to air. The facility failed to ensure food in the refrigerator was not expired. The facility failed to ensure food in the dry storage area was properly covered. The facility failed to ensure food in the freezer was properly packaged. The facility failed to ensure equipment was maintained and sanitary. [...]

Inspectors wroteBased on interviews and record review, the facility failed to develop a comprehensive person-centered care plan based on assessed needs that included measurable objectives and timeframes to meet the resident's medical, nursing, mental, and psychosocial needs and describes the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being for 1 (Resident #48) of 8 residents reviewed for comprehensive person-centered care plans. The facility failed to develop and implement Resident #48's care plan to keep the bed in a low position. This failure could affect the resident by placing them at risk for not receiving care and services to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide the required 80 square foot per resident in 47 of 47 multiple resident rooms numbers (101, 102, 103, 104, 105, 106, 107, 108, 109, 203, 204, 205, 206, 207, 208, 209, 210, 301, 302, 303, 304, 305, 306, 307, 401, 403, 404, 405, 406, 407, 501, 502, 503, 504, 505, 506, 507, 508, 509, 510, 600, 601, 602, 604, 606, 608, and 609). The facility failed to provide 80 square feet per resident in 47 shared resident rooms. This failure could affect residents who resided in the facility and could result in inadequate space for resident's activities of daily living in their rooms.

Inspectors wroteBased on interviews and record review, the facility failed to ensure that all alleged violations involving the reasonable suspicion of a crime were reported immediately to a law enforcement entity for its political subdivision, within two hours if the events that cause the allegation involve abuse or result in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury, for 1 (Resident #1 ) of 7 residents reviewed for abuse/neglect. The facility failed to report Resident #1's allegations of abuse to the local law enforcement agency within the allotted time frame of 2 hours on 08/18/24 when Resident #1 was injured in a physical altercation initiated by Resident #2 at around 2 PM, sustaining a skin tear to his right forearm. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure each resident had the right to be free from abuse for three residents (Resident #1, Resident #2, and Resident #3) of 12 residents reviewed for abuse/neglect. The facility failed to ensure: -Resident #1 and Resident #2 were free of abuse, Resident #1 and Resident #2 sustained facial injuries from being hit in the face by Resident #3 multiple times, while they laid in bed resulting in bruising, cuts and discoloration to their face. -Facility nursing staff failed to assess residents after being notified of residents with injuries. -Resident #1 verbalized he was fearful of the alleged perpetrator and fearful that he was going to get assaulted again, since the perpetrator was not removed from the vicinity. An IJ was identified on 02/21/24. The IJ template was provided to the facility on [DATE] at 10:01 AM. [...]

Inspectors wroteBased on interview, observation and record review, the facility failed to implement its policies and procedures that prohibit and prevent abuse, neglect, and exploitation of residents for three residents (Resident #1, Resident #2, and Resident #3) of 12 residents reviewed for abuse and neglect. 1. The facility failed to immediately implement an investigation after they were made aware of an abuse allegation involving Resident #1, Resident #2, and Resident #3. 2. The facility failed to report the abuse allegation to the State Survey Agency and local law enforcement in accordance with state law. 3. The facility failed to ensure that all residents were protected from physical and psychosocial harm after made aware of the incident involving a resident to resident assault when Resident #3 assaulted Resident #1 and Resident #2 and they sustained facial bruising, cuts, and discoloration. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that residents received treatment and care in accordance with professional standards of practice and the comprehensive person-centered care plan, for two residents (Resident #1 and Resident #2) of 12 residents reviewed for quality of care, in that: The facility failed to promptly respond and assess Resident #1 and Resident #2 on 2 separate occasions by 2 different LVNs when they were made aware of Resident #1 and Resident #2 having injuries from an assault after being hit in the face multiple times, while they laid in bed resulting in bruising, cuts and discoloration to their face. An IJ was identified on 02/21/23. The IJ template was provided to the facility on [DATE] at 10:01 AM. [...]

Inspectors wroteBased on record review, and interview, the facility failed to ensure nurse aides were able to demonstrate competencies in skills and techniques necessary to care for residents' needs, as identified through resident assessments, and described in the plan of care, for three residents (Resident #4, Resident #5, and Resident #6) of 12 residents reviewed for competent nursing staff, in that: Uncertified Nurse Aides were scheduled to work independently, performing hands-on care to residents, without any formal certification or competency trainings. These deficient practices could affect residents that are dependent upon staff for personal care and could potentially result in medical complications.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure that all allegations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property were reported immediately, but not later than 2 hours after the allegation was made, if the events that caused the allegation involved abuse or resulted in serious bodily injury, to the administrator of the facility and to other officials which included to the State Survey Agency, in accordance with State law through established procedures for three residents (Resident #1, Resident #2 and Resident #3) of 12 residents reviewed for abuse/neglect. [...]

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 1 of (Resident #4) of 12 residents reviewed for pharmacy services. The facility failed to administer Resident #4's medication appropriately. LVN D left Resident #4's lifesaving medications on his bedside table, without ensuring Resident #4 took the medication appropriately. This failure could place residents at risk for not receiving medications as ordered.

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 and 1 of 1 nutrition room, for kitchen sanitation. 1. The facility failed to ensure spices were properly covered and sealed. 2. The facility failed to ensure steam tables were kept clean. 3. The facility failed to ensure plastic dishes were kept clean. 4. The facility failed to ensure the air vent in the kitchen was clean. 5. The facility failed to ensure the ice machine was cleaned. 6. The facility failed to ensure food items in the nutrition area were labeled and dated. 7. The facility failed to ensure the temperature in the nutrition room wasn't too hot. These failures could place residents at risk of foodborne illnesses.

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 (R#200) of five residents reviewed for infection control. 1. The facility failed to ensure CNA A performed hand hygiene and changed gloves prior to perineal care and after touching multiple surfaces. 2. The facility failed to ensure dietary staff immediately exited the facility after testing positive for COVID-19. These failures could place residents at risk for infection through cross contamination of pathogens.