Most Recent Deficiencies for TEXAS INSTITUTE FOR CLINICALLY COMPLEX CARE

Updated as of January 01, 2020

The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.

The tables below are too small to fit on a phone. More information can be seen using a larger device such as a tablet, laptop, or desktop computer.

Deficiency Deficiency Date
Establish emergency prep training and testing. 2019-05-02
Establish staff and initial training requirements. 2019-05-02
Keep aisles, corridors, and exits free of obstruction in case of emergency. 2019-05-02
Install corridor and hallway doors that block smoke. 2019-05-02
Ensure that building systems meet requirements determined by risk assessment procedures performed by qualified personnel. 2019-05-02
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. 2018-04-12
Have approved installation, maintenance and testing program for fire alarm systems. 2018-04-12
Install an approved automatic sprinkler system. 2018-04-12
Inspect, test, and maintain automatic sprinkler systems. 2018-04-12
Ensure smoke barriers are constructed to a 1 hour fire resistance rating. 2018-04-12
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. 2018-04-12
Keep aisles, corridors, and exits free of obstruction in case of emergency. 2017-04-20
Provide properly protected cooking facilities. 2017-04-20
Properly install and monitor supervisory attachments on automatic sprinkler systems. 2017-04-20
Install corridor and hallway doors that block smoke. 2017-04-20
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. 2017-04-20
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. 2019-08-26
Respond appropriately to all alleged violations. 2019-08-26
Provide appropriate treatment and care according to orders, resident?s preferences and goals. 2019-08-26
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. 2019-08-26
Ensure each resident must receive and the facility must provide necessary behavioral health care and services. 2019-08-26
Provide care and assistance to perform activities of daily living for any resident who is unable. 2019-04-11
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. 2019-04-04
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. 2019-04-04
Ensure medication error rates are not 5 percent or greater. 2019-04-04
Provide and implement an infection prevention and control program. 2019-04-04
Provide appropriate treatment and care according to orders, resident?s preferences and goals. 2019-02-19
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. 2019-01-24
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. 2019-01-24
Respond appropriately to all alleged violations. 2019-01-24
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. 2019-01-24
Post nurse staffing information every day. 2019-01-24
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. 2019-01-24
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. 2019-01-24
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. 2019-05-02
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. 2019-05-02
Ensure medication error rates are not 5 percent or greater. 2019-05-02
Ensure that residents are free from significant medication errors. 2019-05-02
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. 2019-05-02
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. 2019-05-02
Provide and implement an infection prevention and control program. 2019-05-02
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. 2019-05-02
Provide care and assistance to perform activities of daily living for any resident who is unable. 2018-09-11
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. 2018-09-11
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. 2018-06-22
Provide safe and appropriate respiratory care for a resident when needed. 2018-03-06
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. 2018-03-06
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. 2018-03-06
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. 2018-03-06
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. 2018-04-13
Provide care by qualified persons according to each resident's written plan of care. 2018-04-13
Provide appropriate pressure ulcer care and prevent new ulcers from developing. 2018-04-13
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. 2018-04-13
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. 2018-04-13
Ensure medication error rates are not 5 percent or greater. 2018-04-13
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. 2018-04-13
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. 2018-04-13
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. 2018-04-13
Provide appropriate treatment and care according to orders, resident?s preferences and goals. 2018-04-13
1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. 2017-10-18
Reasonably accommodate the needs and preferences of each resident. 2017-07-05
Ensure that residents with limited range of motion receive appropriate treatment and services to increase range of motion or prevent further decrease in range of motion. 2017-06-21
Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. 2017-06-21
Keep accurate, complete and organized clinical records on each resident that meet professional standards. 2017-06-21
Let residents refuse treatment, refuse to take part in an experiment, or formulate advance directives. 2017-04-20
Ensure each resident receives an accurate assessment by a qualified health professional. 2017-04-20
Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. 2017-04-20
Provide care by qualified persons according to each resident's written plan of care. 2017-04-20
Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. 2017-04-20
Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible. 2017-04-20
Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. 2017-04-20
Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. 2017-04-20
Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. 2017-04-20
Have a program that investigates, controls and keeps infection from spreading. 2017-04-20
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. 2017-04-20
Make sure that nurse aides show they have the skills and techniques to be able to care for residents' needs. 2017-04-20
1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. 2017-04-20