Trucare Living Centers - Selma

Inspectors wroteBased on interview and record review the facility failed to ensure the physician reviewed the resident's total program of care, including medications and treatments, and write, sign, and dated progress notes at each visit for 4 of 5 residents (Resident #1, #2, #4, and #5) reviewed for physician visits for 1 of 2 physicians (Physician A), in that:1. Resident #1's physician (Physician A) did not provide physician visit notes between 06/08/2025 and 04/22/2026 when Physician A reported he had seen Resident #1 every other month.2. Resident #2's physician (Physician A) did not provide any physician visit notes since the resident's readmission on [DATE] when Physician A reported he had seen Resident #2 every other month.3. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to store, prepare, distribute, and serve food for 1 of 1 kitchen in accordance with professional standards for food service safety. The facility failed to keep a crate of milk off the floor. The facility failed to date items in the nourishment refrigerator. The facility failed to label items in the nourishment refrigerator/freezer. This deficient practice could place residents at risk for food borne illness.

Inspectors wroteBased on record review and interview, the facility failed to permit a resident to return to the facility after being hospitalized and failed to document sufficient preparation and orientation to residents to ensure a safe and orderly transfer or discharge from the facility for 1 of 3 residents (Resident #18) reviewed for transfer and discharge rights:The facility failed to ensure Resident #18 was readmitted to the facility, after being sent to the hospital on 1/19/26 for evaluation and treatment related to behavioral symptoms. The facility did not document Resident 18's medical record the reason for not accepting Resident #18 to return to the facility. This failure could place discharged residents and residents residing in the facility at risk of being discharged and not allowed to return to the facility causing a disruption in their care and/or services.

Inspectors wroteBased on record review and interview the facility failed to send a copy of the residents' discharge notice, prior to discharge, to the representative of the Office of the State Long-Term Care (LTC) Ombudsman of the residents' transfer or discharge and the reasons for the move, for 1 of 3 residents (Resident #18) reviewed for notifying the LTC Ombudsman of the residents' discharge. Resident #18 was discharged on 1/19/26 without any notice to the State LTC Ombudsman. This failure could place residents at risk of not knowing their rights or receiving the services of the State LTC Ombudsman.

Inspectors wroteBased on interview and record review, the facility failed to ensure the resident assessment accurately reflected the resident's status for 2 of 6 residents (Resident #3 and Resident #6) who were reviewed for resident assessments. 1. The facility failed to correctly document Resident #3's use of insulin injections on the quarterly MDS assessment. 2. The facility failed to correctly document Resident #6's use of antidepressant medications on the quarterly MDS assessment. These failures could place residents at risk of improper or incorrect care and services necessary for their physical, mental, and psychosocial well-being.

Inspectors wroteBased on interviews, and record review, the facility failed to ensure preadmissions screening for individuals with a mental disorder and individuals with intellectual disability for 1 of 6 residents (Resident #39) reviewed for PASARR accuracy. The MDS Case Manager failed to accurately screen Resident #39 for mental illness upon admission to the facility. This deficient practice could place the residents at risk of not receiving the necessary care and services.

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 for 1 of 18 residents (Resident #5) reviewed for accidents and hazards:The facility failed to ensure Resident #5 did not have a pair of scissors in his room. This failure could place residents at risk of harm or injury and contribute to avoidable accidents and a decline in health.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure drugs and biologicals used in the facility were labeled in accordance with currently accepted professional principles for 1 of 2 medication carts (the 300/400 hall medication aide cart) assessed for medication storage and labeling. The facility failed to ensure all medications located inside the 300/400 hall medication aide cart were stored in properly labeled containers. This failure could place residents at risk of receiving inadequate treatments or ingesting medications for which they were not prescribed.

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 disease and infection for 1 of 2 residents (Residents #5) reviewed for infection control:The facility failed to ensure CNA E utilized proper hand hygiene between glove changes and did not place a clean brief on the resident's bed during incontinent/peri-care on Resident #5. This failure could place residents at-risk for infection due to lack of hand hygiene and could result in infection or illness.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that all allegations involving abuse, neglect, and misappropriation were reported immediately, but no later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse, to the State Survey Agency for 1 of 4 residents (Resident #1) reviewed for abuse. The facility did not report to the State Survey Agency (HHSC) an incident of Resident #1 being physically abused by the RP in the facility. This failure could place residents at risk for harm to include physical abuse, a diminished quality of life, and psychosocial harm.

Inspectors wroteBased on observations, interview and record review, the facility failed to treat each resident with respect and dignity and care for each resident in a manner and environment that promoted personal privacy for each resident's individuality for 1 (Resident #6) of 12 residents reviewed for dignity in that: Resident #6's Foley catheter bag was observed without a privacy cover on it to provide dignity and privacy. This failure could affect the privacy and dignity of residents with Foley catheters.

Inspectors wroteBased on observation, interview and record review, the facility failed to notify the residents representative when the resident experienced a change in physical condition for 1 (Resident #1) of 12 residents reviewed for change in condition. The facility failed to notify Resident #1's resident representative when Resident #1 had episodes of diarrhea, a temperature and exhibited increased lethargy. This failure could result in the family or guardian not being aware of conditions that may require them to make medical decisions.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide care and services to prevent complications for 1 (Resident# 6) of 3 residents reviewed for enteral nutrition, in that; Resident #6's enteral feeding order did not include a frequency for changing the formula bottle or tubing. This failure could affect residents receiving enteral feedings by placing them at risk of complications related to expired formula, clogged tubing, delay in care and decline in health.

Inspectors wroteBased on interview and record review, the facility failed to have complete and accurate documented medical records for 1 (Resident #1) of 12 residents whose clinical record was reviewed for accuracy. The facility failed to identify and discontinue an order for a fluid restriction for Resident #1 that was listed on Resident #1's MAR twice and listed as an intervention in Resident #1's care plan. This deficient practice could place residents at risk for not receiving necessary care and services due to the staff not having an accurate record upon which to make care decisions.

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 to help prevent the development and transmission of communicable diseases and infections for 2 of 7 residents (Residents #121 and #55) reviewed for infection control in that: 1. The facility failed to ensure CNA-A followed proper infection control practices while providing peri -care to Resident #121 by not wiping in the proper direction (front to back) and by not changing her gloves after going from dirty to clean. 2. The facility failed to ensure LVN-C followed Enhanced Barrier Precautions (EBP) when she did not wear a gown while administering medications via g-tube for Resident #55. These failures could place residents at risk for cross contamination and the spread of infection.

Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure that all drugs and biologicals used in the facility were labeled and stored in accordance with professional standards for 1 of 1 medication rooms reviewed for drugs and biologicals. 1. The facility failed to ensure one over-the-counter medication Feosol was removed from the medication room when it had expired on 06/2024. 2. The facility failed to ensure medications for 2 of 2 discharged residents (DR's #1 and #2) were removed from current medication supply for proper disposition. These failures could place residents at risk of not receiving the therapeutic benefit of medications, adverse reactions to medications, medication misuse, and drug diversion.

Inspectors wroteBased on interviews and record reviews, the facility failed to ensure before a resident was transferred or discharged the facility must notify the resident and the resident's representative of the transfer or discharge and the reasons for the move in writing and in a language and manner they understood and the facility must send a copy of the notice to a representative of the Office of the State Long-Term Care Ombudsman for 1 of 5 residents (Resident #1) reviewed for transfer or discharge. in that: The facility failed to give the representative of Resident #1 written documentation which informed them of the facility- initiated decision to discharge the resident. This deficient practice could affect residents who are discharged from the facility and could place them at risk of having their discharge rights violated.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure the comprehensive care plan described the services that were to be furnished to attain or maintain the residents' highest practicable physical, mental, and psychosocial well-being for 2 of 4 residents (Residents #1 and #4) reviewed for care plans, in that: 1. The facility failed to ensure Resident #1's care plan was revised on (2) occasion, to reflect the use of bedrails, diagnosis of OSA, and the use of CPAP. 2. The facility failed to ensure Resident #4's care plan was revised on (2) occasions, to reflect the discontinuation of hospice services and diuretic medications. These failures could place residents at risk of current needs not being met.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive care plan, and the residents' choices for 1 of 4 residents (Resident #1) reviewed for quality of care/treatment, in that: The facility failed to obtain device orders for Resident #1 on (2) occasions. These failures could place residents at risk for improper care due to inaccurate records.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that a resident who needs respiratory care, including tracheostomy care and tracheal suctioning, is provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, the residents' goals, and preferences for 2 of 4 (Resident #1 and Resident #2) reviewed for respiratory care. 1. The facility failed to ensure Resident #1 was assessed for the use of a CPAP to obtain orders. 2. The facility failed to ensure Resident #2 received CPAP treatments at bedtime or while sleeping per physician orders. These failures could place residents who receive CPAP treatments at risk of no receiving the full therapeutic treatments.

Inspectors wroteBased on observation, interview, and record review the facility failed to provide pharmacological services to meet the needs of each resident for 1 of 4 residents (Resident #4) reviewed for pharmacy services. The facility failed to obtain medication orders for Resident #4. These failures could place residents at risk for improper care due to inaccurate records.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to maintain medical records, in accordance with accepted professional standards and practices, which were complete and accurately documented for 1 of 5 residents (Resident #1) reviewed for documentation. Resident #'1's electronic medical record did not contain complete and accurate documentation that CNA A recorded the resident's toileting activity numerous days in the month of March 2024. This failure could result in residents' records not accurately documenting interventions, monitoring, and information provided to nursing staff and the RP and could lead to the assumption that residents do not receive incontinent care and could develop skin issues and infections.

Inspectors wroteBased on interview and record review the facility failed to refer a resident with newly evident or possible serious mental disorder for a PASRR Level II resident review upon a significant change of condition for 3 of 3 Residents (Residents #8, #53 and #62) reviewed for PASRR The facility failed to refer Resident #8 for a PASRR Evaluation upon admission due to a primary diagnosis of bipolar disorder. The facility failed to refer Resident #53 for a PASRR Evaluation upon admission for schizophrenia and upon receiving later diagnoses of anxiety disorder and major depressive disorder. The facility failed to refer Resident #62 for a resident review after updating the Resident's diagnosis to indicate a diagnosis of mental illness. These failures could place residents at risk of not receiving the needed PASRR services.

Inspectors wroteBased on interviews and record review, the facility failed to ensure all Pre-admission Screening and Resident Review (PASRR) Level I residents with mental illness were provided with a PASRR Evaluation assessment for 2 of 2 residents (Residents #8 and #53) reviewed for PASRR screening, in that: Residents #8 and #53 did not have an accurate PASRR Level 1 assessment when they had a diagnosis of mental illness. These failures could place residents with an inaccurate PASRR Level 1 Evaluation at risk for not receiving care and services to meet their needs.

Inspectors wroteBased on observation, interview and record review, the facility failed to dispose garbage and refuse properly for 2 of 2 dumpsters reviewed for proper storage of garbage and refuse in that: The facility failed to keep the dumpsters lids closed and the area free of trash and outside of the dumpster. This failure could affect the residents placing them at risk for infection and a decreased quality of life due to having an exterior environment which could attract flying pests, rodents and other animals. The evidence is as follows: On 10/03/2023 at 10:05 a.m. the following observations and interviews were made: Two dumpsters enclosed in a locked fence behind a solid enclosure. Items on the ground in various places on the outside of the dumpsters on the ground were identified by the DM as bags of trash on both sides of each dumpster that should have been placed in the dumpsters. [...]