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F0550
D

Failure to Ensure Respectful Communication and Dignified Care

San Marcos, Texas Survey Completed on 11-25-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to treat two residents with respect and dignity, and did not provide care in a manner that promoted or enhanced their quality of life. Both residents were on hospice care and had intact cognition, as indicated by their BIMS scores of 15. Their care plans included goals to remain comfortable and free from distress, with interventions to monitor and document for side effects and effectiveness of medications. Despite these plans, both residents reported negative interactions with a CNA, specifically regarding the removal of food trays and the manner in which call lights were answered. One resident reported that the CNA acted as if she was in charge, was not patient, and removed coffee cups and a milk carton from her table without asking. The resident stated she had reported the CNA's rude behavior to a nurse several times. The second resident described the CNA as unwilling to help, recounting an incident where the CNA responded to a request for pain medication with impatience and a dismissive tone. This resident expressed feeling sad as a result of the CNA's behavior and stated she no longer wanted the CNA to care for her. Both residents communicated their concerns to nursing staff, and one also spoke with the social worker during an interview. Interviews with staff revealed that the CNA in question had worked at the facility on an as-needed basis and claimed to always ask residents before removing items. The CNA also stated she was aware of abuse, neglect, and exploitation (ANE) policies. Other staff, including nurses and the DON, confirmed they had received ANE training and understood the requirement to report suspected abuse or neglect. The administrator reported that she had not previously received complaints about the CNA, but upon learning of the allegations, she suspended the CNA and initiated an investigation. Facility policy required immediate reporting and investigation of any suspected abuse or neglect.

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