Below average — CMS composite of the measures below.
A standard survey is most likely before around October 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Avir At Camp Wood during CMS and state inspections, most recent first.
A resident with severe cognitive impairment and multiple psychiatric diagnoses was discharged AMA at the request of the responsible party, but the facility failed to complete or maintain required inventory documentation of the resident’s personal belongings at admission or discharge. The Administrator, DON, LVNs, and a CNA all either could not confirm or specifically stated that no inventory sheet was completed, and no initial, updated, or discharge inventory records could be located. Although staff described a standard practice to inventory personal items and the facility’s transfer/discharge policy required documentation of the disposition of personal effects, this was not carried out or recorded for this resident.
A resident with diabetes, post-amputation, and limited mobility did not have wound care treatments documented on multiple occasions as required by physician orders. The TAR lacked entries for these treatments, and the DON confirmed that missing documentation meant it was unclear if care was provided. Facility policy required all treatments to be recorded to support care team communication, but this was not done.
Failure to conduct and document a facility-wide assessment to determine the resources needed to care for residents competently during day-to-day operations and emergencies. The facility had 79 residents, and the administrator stated the prior assessment was on the previous administrator's personal computer and could not be secured. The administrator also stated no new facility-wide assessment had been developed since new ownership took responsibility for the facility, and no policy regarding the assessment requirements had been received.
Informed consent for psychotropic and related medications was not properly documented for three residents. One resident with schizophrenia and depression received trazodone, divalproex, ziprasidone, and haloperidol, but the consent forms were blank for risks and benefits. Two residents with dementia or schizophrenia had verbal consents for divalproex, lorazepam, or risperidone documented without a second nurse witness and signature, and representatives stated they did not recall giving the consents.
Unsanitary and damaged shower rooms were observed in 4 of 4 shower areas, with black substance along the edges, loose baseboards, cracked tiles, and a dirty appearance. One shower also had a brown substance on a stall and a grate full of hair. The DON, housekeeping, and maintenance staff confirmed the conditions, and the maintenance supervisor stated there was no documentation of deep cleaning for showers.
Failure to Maintain Commercial Clothes Dryer: The facility failed to keep 1 of 3 commercial clothes dryers operational in the laundry department. The Housekeeping director stated the dryer had been out of service for more than 3 months and needed replacement, and the Administrator stated the facility was waiting on the ownership corporation to address the issue. A policy for maintenance of essential equipment was requested but not provided.
Failure to Include Residents in Care Plan Conferences: The facility failed to invite and include two residents and/or their representatives in care plan meetings. One resident had intact cognition with diagnoses including anemia, schizophrenia, osteoarthritis, pre-DM, and HTN, and stated she had not been invited to any care plan conference since admission. Another resident, also assessed with intact cognition, had diagnoses including osteoporosis, CVA, insomnia, anxiety, MDD, dysphagia, dementia, and ataxia, and stated she had not participated in a care plan conference since admission. The MDS Nurse said families were notified by mail or email if available, but residents did not sign attendance or indicate they were present.
Two residents on Medicare/Medicaid services did not receive complete SNF-ABN notices because the estimated cost to the resident was left blank for OT and daily skilled nursing care. Records showed both residents had BIMS scores of 9/15, and staff interviews confirmed the MDS nurse was unsure of the cost and did not review the notices with the residents; the DON identified the MDS nurse as responsible for ABN letters.
Failure to Monitor New Antidepressant Therapy: A resident with dx including dementia, anxiety, depression, insomnia, dysphagia, ataxia, osteoporosis, and cerebral infarction was started on Paroxetine for major depressive disorder, but the MAR and progress notes did not show assessment or monitoring for the new psychotropic medication or adverse reactions. The care plan addressed antidepressant use generally, but the new medication was not identified after it was initiated, and staff stated new meds should be monitored for side effects for at least 72 hours.
Improper Positioning of Urinary Catheter Bag: A resident with a suprapubic catheter, severe cognitive impairment, and a history of urinary issues was observed in a wheelchair with the drainage bag tied above the level of the bladder. A CNA identified the bag as too high and repositioned it lower, and the charge nurse, DON, and Administrator confirmed the bag should be kept below the bladder to allow free urine flow and prevent CAUTIs.
A facility failed to maintain an effective pest control program when 3 to 4 live roaches were observed scattering in a 100-hall shower room as the light was turned on. A resident said the shower room was dirty and needed to be refurbished, and the LHS/Maintenance Supervisor confirmed the roaches were present. Records showed monthly pest control treatment, but the log did not identify the type of bugs treated.
The facility failed to file laboratory reports in the clinical records for five residents, with delays ranging from 98 to 243 days. This deficiency resulted in auxiliary providers not having necessary information for dietary consultations and other medical decisions.
Failure to Maintain Accurate Inventory Documentation of Resident Personal Belongings
Penalty
Summary
The deficiency involves the facility’s failure to maintain complete and accurate medical records, specifically related to documentation of a resident’s personal belongings at admission and discharge. An 83-year-old female resident with Alzheimer’s disease, major depressive disorder, and anxiety was admitted and later discharged against medical advice (AMA) at the request of her responsible party (RP). The resident’s quarterly MDS showed a BIMS score of 0, indicating severe cognitive impairment. Record review showed no documentation that the resident’s personal items were inventoried at admission or at the time of discharge, despite the resident’s discharge summary and nurse notes documenting the AMA discharge. Multiple staff interviews confirmed uncertainty or lack of action regarding the inventory of the resident’s personal items. The Administrator stated she was not certain whether an inventory sheet had been completed at admission or discharge, although she reported that the family took all of the resident’s personal items home. LVN A and LVN C both stated they could not recall whether an inventory of personal items was done at discharge. CNA B specifically stated that the family left with all of the resident’s possessions and that an inventory sheet was not completed. The DON confirmed he could not locate any initial, updated, or discharge inventory sheet for the resident. The RP confirmed by telephone that the family took all of the resident’s personal items and did not recall signing any inventory sheet at admission, during the stay, or at discharge. The Administrator and DON both described a standard practice that resident personal items should be inventoried at admission, during the stay when new items arrive, and at discharge, but they acknowledged this was not done for this resident. The facility was unable to provide a policy on inventory of resident personal items at the time of the survey, although its Transfer or Discharge, Facility-Initiated policy required documentation of the disposition of personal effects in the medical record. This lack of documentation and missing inventory records for the resident’s personal items at admission and discharge constituted the cited deficiency.
Failure to Document Wound Care Treatments in Medical Record
Penalty
Summary
The facility failed to maintain complete and accurate medical records in accordance with accepted professional standards for one resident. Specifically, the treatment administration record (TAR) did not reflect documentation of wound care treatments on three separate dates, despite physician orders requiring daily wound care to the left plantar medial foot. The electronic medical record showed missing entries for these dates, and the Director of Nursing (DON) confirmed that a blank entry indicated the nurse had not documented whether the treatment was provided or refused. This lack of documentation meant that staff could not verify if the wound care was performed as ordered. The resident involved was a male with a history of type 2 diabetes with complications, post-surgical amputation, and anemia. He was at risk for pressure ulcers, had limited lower extremity mobility, and required significant assistance with daily activities. During observation, the resident was found with an above-the-knee amputation and reported ongoing wound issues. The facility's policy required all treatments and services to be documented in the medical record to ensure communication among the care team, but this was not followed in the cited instances.
Failure to Conduct and Document Facility-Wide Assessment
Penalty
Summary
The facility failed to conduct and document a facility-wide assessment to determine what resources were necessary to care for residents competently during day-to-day operations and emergencies. A record review of the facility census dated 7/28/2025 showed 79 residents living at the facility. During an interview on 7/31/2025 at 5:00 PM, the administrator stated the facility had an assessment of its capabilities and resources, but the document was on the previous administrator's personal computer and efforts to obtain it had been unsuccessful. The administrator also stated that no facility-wide assessment had been developed since March 1, 2025, when new ownership became responsible for the facility. A policy was requested to address the facility assessment requirements, and as of 8/5/2025, a policy regarding the expectations and requirements for a facility-wide assessment had not been received.
Informed Consent for Psychotropic Medications Not Properly Documented
Penalty
Summary
The facility failed to ensure residents were informed of and participated in their treatments for three residents reviewed for informed consent prior to treatment. The deficiency involved psychotropic and related medications, including antipsychotic, antidepression, antiepileptic, and anxiolytic drugs, where the documentation did not show that the residents or their representatives were properly informed of the medications’ benefits and risks, or that verbal consents were witnessed as required by facility practice described in the report. Resident #2 was admitted with diagnoses including schizophrenia and depression, had a BIMS score of 11, and was described in the care plan as having impaired cognitive function, hallucinations, yelling, and psychotropic medication use. The resident received trazodone, divalproex, ziprasidone, and haloperidol. The medical record contained consent forms dated 2/12/2025 for ziprasidone, divalproex, haloperidol, and trazodone, but the sections for the probable clinically significant side effects and risks, and for the need for and benefits of the proposed treatment, were blank. During observation and interview, nursing staff stated the resident was confused and that they were unaware whether informed consent had been obtained because the representative had no contact with the facility. Resident #25 was admitted with dementia and had a BIMS score of 04, indicating severe cognitive impairment. The resident’s record showed orders for divalproex and lorazepam, and the consent forms documented verbal consent for these medications without a second nurse witnessing and signing the consent. Resident #25’s representative stated he could not recall giving verbal consent but said he wanted the resident to receive medications if needed. Resident #59 was admitted with schizophrenia and vascular dementia, had a BIMS score of 04, and had an order for risperidone. The record showed a consent form documenting verbal consent without a second nurse witness and signature. Resident #59’s representative stated she did not recall giving verbal consent for the medication but wanted the resident to receive prescribed medications. Interviews with nursing leadership showed differing statements about whether verbal consent required a second nurse witness, and the regional clinical nurse stated the facility expectation was that verbal consent would be witnessed and signed by a second nurse.
Unsanitary and Damaged Shower Rooms
Penalty
Summary
The facility failed to provide a safe, functional, sanitary, and comfortable environment in 4 of 4 shower rooms. Observations and interviews identified black substance along the edges of the 100-hall, 300-hall, secure hall, and 400-hall shower rooms, along with loose baseboards and cracked tiles that had a dirty appearance. In the 300-hall shower room, a brown substance was observed on one of the shower stalls and the shower grate was full of hair. A resident stated the 100-hall shower was dirty and needed to be refurbished. The DON, Corporate nurse, Laundry/Housekeeping Supervisor, and Maintenance Supervisor confirmed the conditions in the shower rooms during the survey. The Maintenance Supervisor stated the shower rooms needed to be cleaned and repaired and said there was no documentation of deep cleaning for showers, although housekeepers do clean them. The DON stated the shower rooms could affect residents and that the brown substance and hair in the grate could make a resident apprehensive to take showers. Record review showed the housekeeping checklist last dated 6/29/25 did not include resident showers, and the facility's Homelike Environment policy stated residents are to be provided with a safe, clean, comfortable, and homelike environment.
Failure to Maintain Commercial Clothes Dryer
Penalty
Summary
The facility failed to maintain all mechanical, electrical, and patient care equipment in safe operating condition, as 1 of 3 commercial clothes dryers in the laundry department was not operational. During an observation and interview on 7/28/2025 at 3:25 PM, the laundry department was found to have 3 commercial clothes dryers, and 1 of them was not working. The Housekeeping director stated the dryer had not been functioning for longer than 3 months and needed to be replaced. During an interview on 7/31/2025 at 5:00 PM, the Administrator stated the facility was awaiting the ownership corporation to address replacement of the commercial clothes dryer. A policy to address essential equipment maintenance was requested, and the Administrator stated the facility follows HHSC guidelines. As of 8/5/2025, a policy for maintenance of essential equipment had not been provided.
Failure to Include Residents in Care Plan Conferences
Penalty
Summary
The facility failed to ensure residents and/or their representatives were invited to and included in the development and implementation of person-centered care plans for 2 of 8 residents reviewed. Resident #3, a [AGE]-year-old female admitted with diagnoses including anemia, schizophrenia, poly osteoarthritis, pre-diabetes, and hypertension, had a BIMS score of 15 indicating intact cognition and no diagnosis of dementia on her face sheet. Record review showed a care plan meeting was held on 2/6/25, but neither the resident nor her representative was included. During interview, Resident #3 stated she had not been invited to any care plan conference meeting since admission and said she was familiar with such meetings from a previous facility. Resident #79, a [AGE]-year-old female admitted with diagnoses including osteoporosis, cerebral infarction, insomnia, anxiety, major depressive disorder, dysphagia, dementia, and ataxia, had an MDS BIMS score of 14 indicating intact cognition. Record review showed care plan meetings were held on 12/12/24 and 2/20/25, and neither the resident nor her representative was included. Resident #79 stated she had been informed of care plan meetings but had not attended or participated in one since admission. The MDS Nurse stated family members were notified by mail or email if available, and that residents were met with but did not sign attendance or indicate they were present for review meetings. The facility policy stated residents are to be informed of their right to participate and given advance notice of care planning conferences, and if participation is not practicable, the reason and steps taken to include them must be documented.
Missing SNF-ABN Cost Information for Two Residents
Penalty
Summary
The facility failed to inform each Medicaid-eligible resident, in writing, when the resident became eligible for Medicaid of other items and services that the facility offers and for which the resident may be charged. For Resident #1, record review showed she was admitted and re-admitted on Medicare/Medicaid services, had a Quarterly MDS indicating Medicare and/or Medicaid certification with a BIMS score of 9/15, and had an SNF Beneficiary Protection Notification Review with a last day of service of 7/16/2025. The SNF-ABN began on 7/16/2025 for Occupational Therapy and Daily Skilled Nursing Care was marked, but the estimated cost to the resident was left blank. For Resident #16, record review showed he was admitted and re-admitted on Medicare/Medicaid services, had a Quarterly MDS indicating Medicare and/or Medicaid certification with a BIMS score of 9/15, and had an SNF Beneficiary Protection Notification Review with a last day of service of 5/29/2025. The SNF-ABN began on 5/29/2025 for Occupational Therapy and Daily Skilled Nursing Care was marked, but the estimated cost to the resident was blank. During interview, the MDS nurse stated she was not sure of the cost and did not review it with Residents #1 and #16. The DON stated the MDS nurse was responsible for ABN letters, and the ADM stated he was not aware of the issue and said they follow Federal requirements when asked for policy.
Failure to Monitor New Antidepressant Therapy
Penalty
Summary
The facility failed to ensure Resident #79’s drug regimen was free from chemical restraints with adequate monitoring for a new psychotropic medication. Resident #79 was a [AGE]-year-old female admitted with diagnoses including osteoporosis, cerebral infarction, insomnia, anxiety, major depressive disorder, dysphagia, dementia, and ataxia. Her MDS dated [DATE] showed a BIMS score of 14, indicating intact cognition. Her MAR for 3/1/25-3/31/25 showed a new order for Paroxetine HCl 10 mg by mouth at bedtime for major depressive disorder, recurrent unspecified, with a start date of 03/24/2025. The MAR did not show assessment or monitoring for the new medication or for adverse reactions, and progress notes from 3/24/25 through 3/31/25 did not reflect assessment or monitoring for adverse reactions to the new medication. The care plan identified antidepressant use related to depression and included a goal that the resident would be free from adverse reactions related to antidepressant therapy, but Paroxetine was not identified in the care plan after it was started. During interviews, an LVN stated residents with a new medication should be monitored for at least 3 days for adverse side effects, and the DON stated new medications were expected to be monitored for 72 hours on initial onset for adverse side effects.
Improper Positioning of Urinary Catheter Bag
Penalty
Summary
The facility failed to ensure appropriate care for a resident with an indwelling suprapubic urinary catheter. Resident #70 was admitted with diagnoses including retention of urine and obstructive and reflux uropathy, and the annual MDS identified severe cognitive impairment with a BIMS score of 00 and a need for an indwelling urinary catheter. The physician ordered a suprapubic urinary catheter, and the care plan directed staff to position the catheter bag and tubing below the level of the bladder. During an observation, Resident #70 was seen in a wheelchair with the urinary collection bag tied to the back of the wheelchair at the level of the mid lower back and above the bladder. A CNA stated the bag was tied too high and untied it to retie it lower on the wheelchair. The charge nurse stated the bag should be secured below the level of the bladder to facilitate urine flow, and noted the resident had a history of UTIs and that a bag positioned higher than the bladder could reduce urine flow and contribute to future UTIs. The DON and Administrator later stated that catheter bags should be kept below the bladder to ensure free flow of urine and prevent CAUTIs.
Pest Control Program Not Maintained in Shower Room
Penalty
Summary
The facility failed to maintain an effective pest control program in the 100-hall shower room, where 3 to 4 live roaches were observed scattering when the light was turned on. During the observation, a resident stated the shower room was dirty and needed to be refurbished. The Laundry/Housekeeping Supervisor and Maintenance Supervisor confirmed the roaches were present, and the Laundry/Housekeeping Supervisor stated the shower room would be cleaned and pest control would be called. The Maintenance Supervisor stated the pest control company comes once a month. Record review showed a pest control log documenting monthly pest treatment, but it did not identify what type of bugs were treated. The facility policy stated it shall maintain an ongoing pest control program to ensure the building is kept free of insects and rodents.
Failure to File Laboratory Reports in Clinical Records
Penalty
Summary
The facility failed to file laboratory reports in the residents' clinical records that were dated and contained the name and address of the testing laboratory for five residents. This deficiency was identified through interviews and record reviews. Specifically, the lab results for Residents #49, #1, #48, #66, and #15 were not uploaded into the electronic health records (EHR) within a reasonable timeframe, ranging from 98 to 243 days after receipt. This failure resulted in auxiliary providers not having the necessary information for dietary consultations and other medical decisions. Resident #49, a female with severe cognitive impairment and multiple medical conditions including Alzheimer's disease and cancer, had lab results from a blood draw on 2/20/2024 that were not uploaded as of 5/28/2024. The dietitian (RD) noted that the absence of these lab results did not change her course of treatment but expressed a preference for having the lab results available at the time of her visit. Similarly, Resident #1, a female with intact cognition and multiple medical conditions, had urinalysis results from 9/25/2023 that were not uploaded as of 5/28/2024, despite the MD being notified of the results and new orders being issued. The facility's Director of Nursing (DON) acknowledged that the Medical Records clerk was significantly behind in scanning lab results into the EHR, with some records dating back to September 2023. The DON stated that lab results should be scanned into the EHR no later than the following Monday after receipt. However, a stack of unscanned lab results was found, indicating a systemic issue in maintaining up-to-date medical records. This deficiency could potentially impact the quality of care provided to residents, as providers rely on complete and accurate data to make informed treatment decisions.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Camp Wood
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Uvalde Healthcare And Rehabilitation Center | 35.5 mi | ★★★★★ | 13 | 0 |
| Amistad Nursing And Rehabilitation Center | 36.3 mi | ★★★★★ | 0 | 0 |
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