Weslaco Nursing and Rehabilitation Center

Inspectors wroteBased on observation, interviews, and record reviews, the facility failed to ensure the resident's right to personal personal medical records and to personal privacy during medical treatment for 4 (unknown resident, Residents #20, #111, and #84) of 8 residents reviewed for Privacy. 1. The facility failed to ensure the privacy of the unknown resident by not locking the computer screen on a medication cart, leaving the resident's personal and medical information exposed. 2. The facility failed to ensure MA J closed the door, the privacy curtain and the window during medication administration for Residents #20, #111, and #84 on 07/27/2026. These failures could place residents at risk of resident-identifiable information being accessed by unauthorized persons and of not having their personal privacy maintained during medical treatment.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure parenteral fluids must be administered consistent with professional standards of practice and in accordance with physician orders, the comprehensive person-centered care plan, and the resident's goals and preferences for one (Resident #7) of six residents reviewed for intravenous fluids. The facility failed to ensure physician orders were written for IV flush (rinsing an intravenous tube with sterile salt water to keep the line clean, clear, and free of blockages) on 7/16/2026 to 7/27/2026. This failure could place residents at risk for infection, catheter occlusion (blockage), and chemical vessel irritation (inflammation of a vein caused when a harsh medication or fluid passing through an IV irritates the lining of the blood vessel). [...]

Inspectors wroteBased 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 6 of 16 (Resident #39, # 84, #94, #45, #7, and #61) residents reviewed for infection control, 1. The facility failed to ensure that an Enhanced Barrier Precaution (EBP) sign was displayed outside the room of Resident #39. 2. The facility failed to ensure that CMA J performed hand hygiene for at least 20 seconds after medication administration for Resident #84. 3. The facility failed to ensure CNA K performed hand hygiene while assisting Resident #94 and Resident #45 with their lunch on 7/26/26. 4. The facility failed to ensure Resident #7's IV dressing was clean and clearly labeled on 7/27/26. 5. [...]

Inspectors wroteBased on interview, observation, and record review, the facility failed to ensure the right to be free from chemical restraint was provided for 1 (Resident #13) of 6 residents reviewed for unnecessary medications. The facility failed to ensure Resident #13 had an appropriate diagnosis for Zyprexa (used to treat schizophrenia and bipolar disorder). This failure could place residents at risk of receiving unnecessary psychotropic medications.

Inspectors wroteBased on interview, and record review, the facility failed to develop and implement a person-centered care plan for each resident 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 8 residents (Resident #39) reviewed for comprehensive care plans in that: The facility failed to develop and implement a comprehensive person-centered care plan for Resident #39's Enhanced Based Precautions. These failures could place residents at risk of not receiving the appropriate care, services or treatment needed in a timely manner. Record review of Resident #39's face sheet, dated 07/28/2026, reflected a [AGE] year-old male admitted on [DATE] with an original admission date of 03/01/2025. [...]

Inspectors wroteBased on interview and record review, the facility failed to have services provided by qualified persons in accordance with each resident's written plan of care for 1 of 1 resident (Resident #26) reviewed for care plan in that: CNA D administered liquid cough medication to Resident #26 on 7/23/26, which was not in her scope of practice. This failure could place residents who received medication at risk for improper care.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that a resident who needed respiratory care was provided such care consistent with professional standards of practice, the comprehensive person-centered care plan, and the resident's goals and preferences for 1 of 3 (Resident #133) residents reviewed for respiratory care. The facility failed to ensure Resident #133's oxygen was administered on 07/26/26 as ordered by the physician. This deficient practice could place residents who receive respiratory care at an increased risk of developing respiratory complications and a decreased quality of care.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure all drugs and biologicals were stored in locked compartments and labeled in accordance with currently accepted professional principles for 1 (hall 300 med aide cart) of 4 medication carts reviewed for storage and labeling. The facility failed to ensure three boxes of eye drops were labeled with an open date on 7/26/26 at 2:10 p.m This failure could place residents at risk for adverse effects and not having received the therapeutic effects of the medication or treatment.

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 in 1 of 1 kitchen reviewed for kitchen sanitation. On 07/26/26, the facility failed to ensure drink items in the refrigerator were labeled and dated. On 07/26/26, the facility failed to ensure a drink item in the refrigerator was covered and sealed to prevent exposure to air and cause cross contamination. These failures placed all residents who had drinks served by the kitchen at risk for food-borne illness.

Inspectors wroteBased on observation, interviews and record review, the facility failed to ensure, in accordance with accepted professional standards and practices, medical records were maintained on each resident that were complete, accurately documented, readily accessible, and systematically organized for 1 of 16 residents (Resident #39) reviewed for resident records. The facility failed to ensure a physician order was written for enhanced barrier precautions for Resident #39 on 07/19/2026. This failure could place residents at risk for incorrect treatment decisions, evaluation, and treatment plans compromising patient safety due to inaccurate medical records. Record review of Resident #39's face sheet, dated 07/28/2026, reflected a [AGE] year-old male admitted on [DATE] with an original admission date of 03/01/2025. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure the assessment accurately reflected the residents' status for 1 of 8 residents (Resident #10) reviewed for assessments: Resident #10's Quarterly MDS assessments dated 03/12/2026 and 06/08/2026, were not coded to include his diagnosis of Anxiety. This failure could place residents at risk for inadequate care due to inaccurate assessments. Record review of Resident #10's face sheet, dated 07/27/2026, reflected a [AGE] year-old male admitted on [DATE]. His pertinent diagnoses included Depression, Anemia, Muscle Wasting and Atrophy (a wasting away or progressive decline of the muscle), and Type 2 Diabetes Mellitus (high blood sugar levels). Record review of Resident #10's Quarterly MDS assessment, dated 06/08/2026, reflected a BIMS score of 07, indicating he was severely cognitively impaired. [...]

Inspectors wroteBased on interview, and record review the facility failed to ensure the assessment accurately reflected the resident's status for 1 (Resident #1) of 4 residents reviewed for accuracy of assessments. The facility failed to ensure Resident #1 was coded in the MDS for use of a BiPAP device. This failure could place residents at risk of receiving care and services to meet their needs.

Inspectors wroteBased on interview 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 includes 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 (Resident #1) of 4 residents reviewed for care plans.1. The facility failed to ensure Resident #1's most current undated care plan reflected the use of grab bars.2. The facility failed to follow Resident #1's care plan when she was identified with scabbed over scratches on left wrist and did not report findings to MD/NP. This deficient practice could place residents in the facility at risk of not being provided with the necessary care or services and not having personalized plans developed to address their specific needs.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure residents received treatment and care in accordance with professional standards of practice for 1 (Resident #2) of 5 residents reviewed for quality of care. The facility failed to perform a head-to-toe skin assessment immediately after finding a new skin tear on Resident #2 on 10/22/25. The failure could affect residents currently residing in the facility, resulting in not receiving needed care to maintain optimal health and placing them at risk for injury or deterioration in their condition.

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 #1) reviewed for medication errors. The facility failed to hold administration of Resident #1's nifedipine (blood pressure medication) when Resident #2's blood pressure was outside parameters on 10/01/25. This failure could place residents at risk for complications due to discomfort or their health being jeopardized.

Inspectors wroteBased on interview and record review, the facility failed to ensure residents had the right to formulate an advance directive for 1 (Resident #262) of 8 residents reviewed for Advance Directives. The facility failed to ensure Resident #262's OOH-DNR was completed. The OOH-DNR form did not have the physician's signature. This failure could affect all residents who have implemented Advance Directives and established their choice not to be resuscitated at risk of receiving CPR against their wishes.

Inspectors wroteBased on interview, and record review the facility failed to ensure the assessment accurately reflected the resident's status for 1 (Resident #40) of 8 residents reviewed for accuracy of assessments. The facility failed to ensure Resident #40 was coded in the MDS for a fall on 3/30/25. This failure could place residents at risk of receiving care and services to meet their needs.

Inspectors wroteBased on interview 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 includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment for 2 (Resident #40 and Resident #23) of 8 residents reviewed for care plans, in that: 1. The facility failed to ensure Resident #40's most current undated care plan reflected his diagnosis of dementia. 2. The facility failed to develop a comprehensive person-centered care plan to address Resident #23's antibiotics for pneumonia. This deficient practice could place residents in the facility at risk of not being provided with the necessary care or services and not having personalized plans developed to address their specific needs.

Inspectors wroteBased on interview and record review the facility failed to ensure Seroquel had a proper diagnosis for 1 (Resident #50) of 1 residents reviewed for drug regimen review, in that: The facility failed to address Seroquel (antipsychotic) being given to a resident with diagnosis of dementia. This deficient practice could place residents at risk of receiving unnecessary medications and dosages.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure drugs and biologicals were stored and labeled in accordance with currently accepted professional principles for 1 (200 hallway cart) of 4 medication carts. The facility failed to ensure expired supplies and medications were removed from the nurses' medication cart for 200 hall. The facility's failures could place residents receiving medication at risk for drug diversion, lack of drug efficacy, and adverse reactions.

Inspectors wroteBased on observation, interviews, and record reviews, the facility failed to maintain effective pest control for 1 of 1 facility in that: The facility failed to have pest control effectively treat the facility for roaches. This deficient practice could place residents at risk of exposure to pests, diseases, infections, and diminished quality of life.

Inspectors wroteBased on interview and record review, the facility failed to ensure that all alleged violations involving neglect, were reported immediately to the State Survey Agency, 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 of 5 residents (Resident #1) reviewed for abuse/neglect. The facility failed to report an allegation of physical resident abuse by CNA B and CNA C of Resident #1 during a bed bath. This failure could place all residents at increased risk for potential abuse to unreported allegations of abuse and neglect.

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 1 of 6 Residents (Resident #2) that were reviewed for infection control and transmission-based precautions policies and practices, in that: 1. CNA E failed to don the appropriate PPE before she entered Resident #2's room. These failures could place residents at risk for infection through cross-contamination of pathogens and infectious diseases.

Inspectors wroteBased on interview and record review the facility failed to ensure the physician acted upon and documented his or her rationale in the resident's medical record to the pharmacist report of any irregularities for 3 of 8 Residents (Resident #35, Resident #58, and Resident #87) whose records were reviewed for pharmacy services. 1. The facility failed to ensure the physician provided a rationale in response to the pharmacist recommendation to evaluate the effectiveness and continued use of Lorazepam (anti-anxiety), Hydroxyzine (antihistamine used to treat itching, anxiety, or sleepiness), and Clonazepam (treatment for seizures and panic disorder) for Resident #35. 2. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure PRN orders for psychotropic drugs were limited to 14 days unless the attending physician or prescribing practitioner believed, and documented, that it was appropriate for the PRN order to be extended beyond 14 days for one of eight residents (Resident #35) reviewed in that. The facility to continue to administer the psychotropic medication Lorazepam 0.5mg PRN after 14 days without an evaluation by the physician for continued treatment. This failure could result in residents receiving psychotropics that placed residents at risk of experiencing adverse drug reactions.

Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards or food service safety for 1 of 1 kitchen reviewed for sanitation in that: The facility failed to remove 27 gallons of water that were past the use by date from their emergency drinking water supply. This failure could place residents at risk of foodborne illnesses.

Inspectors wroteBased on interview and record review, the facility failed to ensure residents have the right to request, refuse, and or discontinue treatment and to formulate an advance directive for 2 (Resident #23 and Resident #61) of 11 residents whose records were reviewed for Out-of-Hospital Do-Not-Resuscitate Order forms in that:resident rights. The Facility did not ensure Resident #23 nor Resident #61's OOH-DNR form was completed fully and correctly. This failure could place residents at risk of not having their code status wishes met in the event they were needed.

Inspectors wroteBased on interview, and record review, the facility failed to ensure that all alleged violations involving abuse, neglect, or mistreatment, including injuries of unknown source were reported immediately to the State Survey Agency, within two hours, if the events that cause the allegation involve abuse or result in serious 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 residents ( Resident #49) of 4 residents reviewed. The facility failed to report within 24 hours, the allegations of resident abuse to the State Survey Agency for Resident #49. This failure could place all residents at increased risk for potential abuse and neglect due to unreported allegations of abuse and neglect.

Inspectors wroteBased on observation, interview, and record review, the facility failed to implement a baseline care plan for each resident that included the instructions needed to provide effective and person-centered care of the resident that meets professional standards of quality care for 1 of 4 residents (Resident #268) reviewed for care plans, in that: The facility failed to address, in Resident #268 baseline care plan, her feeding assistance upon admission. This failure could affect all newly admitted residents to the facility by placing them at risk of not receiving the care and services for health promotion and continuity of care.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a resident who was unable to carry out activities of daily living, received the necessary services to maintain good nutrition for 1 of 4 (Resident #268) residents reviewed for ADL care. The facility failed to ensure Resident #268 received assistance with eating. These failure placed residents at risk of poor nutrition, and weight loss.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that a resident who needs respiratory care was provided with professional standards of practice for 2 of 3 residents (Resident #36 and Resident #57) reviewed for quality of care in that: 1. The facility failed to ensure Resident #36's oxygen was administered at 5.0 Lpm via trach mask as ordered by physician. 2. The facility failed to ensure Resident #36's suctioning equipment was set up/connected at bedside ready for use. 3. The facility failed to ensure Resident #57's O2 saturation levels were monitored in percentage as ordered. These failures could place residents who receive respiratory care at risk of developing respiratory complications and a decreased quality of care.

Inspectors wroteBased on observations, interviews and record review the facility failed to ensure medications and biologicals were stored in locked compartments for one of eight residents (Resident # 50) reviewed for medication storage. The facility failed [NAME] prevent Resident #50 from having medication at his bedside for his personal use. This failure placed residents at risk of accidental and adverse medication reactions.

Inspectors wroteBased on observation, interview and record review the facility failed to maintain clinical records that were complete and/or accurate for one of eight (Resident #50) residents reviewed for clinical records in that: The facility failed to document in Resident #50's clinical chart that Resident #50 had family bring in medications for his personal use. This failure could place residents at risk of not having accurate medical records and could create confusion in services provided or needed to be provided.