Above average — CMS composite of the measures below.
A standard survey is most likely before around December 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 John Paul Ii Nursing Home during CMS and state inspections, most recent first.
A resident with multiple diagnoses, including Alzheimer's and Parkinson's disease, experienced an unwitnessed fall in her room resulting in a subdural hematoma and subarachnoid hemorrhage. Despite the serious injury and regulatory requirements, the facility did not report the incident to the State Survey Agency within the mandated two-hour timeframe, as staff believed the circumstances of the fall were known. Facility policy requiring such reporting was not followed.
A resident with multiple diagnoses suffered an unwitnessed fall resulting in serious head injuries, but the facility did not conduct or document a thorough investigation or report the incident to the state health authority, as required by policy. Interviews with the DON and Administrator confirmed that no self-report or in-service training was completed following the event.
A medication cart was left unlocked and unattended by an LVN during a medication pass while she checked on a resident, contrary to facility policy requiring carts to be secured at all times. The DON confirmed the LVN was new and reiterated the importance of locking medication carts, as outlined in facility procedures.
A resident's personal refrigerator contained unlabeled and undated food items, posing a risk of foodborne illness. Staff interviews confirmed the oversight, and the facility's policy requiring labeled and dated food was not followed. Housekeeping was responsible for removing such items, but the task was not monitored effectively.
Failure to Timely Report Serious Injury of Unknown Origin
Penalty
Summary
The facility failed to report an incident of an unwitnessed fall resulting in serious injury for one resident within the required two-hour timeframe to the State Survey Agency, as mandated by regulation and facility policy. The resident, an elderly female with Alzheimer's disease, anxiety disorder, and Parkinson's disease, was identified as being at risk for falls and was ambulatory with a walker. On the date of the incident, she was found on her bedroom floor with blood on the back of her head and complaints of neck and back pain, less than 30 minutes after last being seen in bed by staff. She was subsequently transported to the hospital, where she was diagnosed with a subdural hematoma and subarachnoid hemorrhage related to the unwitnessed fall. Despite the serious nature of the injury and the requirement to report such incidents of unknown origin within two hours, the facility did not notify the State Survey Agency. Interviews with the DON, Administrator, LVN, and CNA confirmed that the event was not reported because staff believed the circumstances of the fall were known, as it occurred in the resident's room. The facility also did not provide in-service training to nursing staff related to this incident, as it was not self-reported to the authorities. The facility's own policy required reporting injuries of unknown origin with serious bodily injury, but this was not followed in this case.
Failure to Investigate and Report Injury of Unknown Origin with Serious Bodily Injury
Penalty
Summary
The facility failed to provide evidence that all allegations of injuries of unknown origin involving serious bodily injury were thoroughly investigated and documented for one resident. Specifically, a female resident with Alzheimer's disease, anxiety disorder, and Parkinson's disease experienced an unwitnessed fall in her room, resulting in blood on the back of her head, complaints of neck and back pain, and subsequent hospital admission where she was diagnosed with a subdural hematoma and subarachnoid hemorrhage. Despite the serious nature of the injury, there was no facility self-report investigation or documentation of a thorough investigation related to the incident. Interviews with the DON and Administrator confirmed that the event was not reported to the state health authority, and no in-service training or internal investigation was completed, as the facility believed the circumstances of the fall did not require reporting. Review of facility policy indicated that such incidents should be reported and investigated, but this was not followed in this case.
Medication Cart Left Unlocked and Unattended by LVN
Penalty
Summary
A medication cart on the second hallway was observed left unattended and unlocked by an LVN during a medication pass. The LVN stated in an interview that she had left the cart unsecured while checking on a resident, which she claimed was not her usual practice. She acknowledged that leaving the cart unlocked could allow unauthorized access to medications, potentially leading to misappropriation or misuse. The Director of Nursing (DON) confirmed that the LVN was a relatively new staff member and emphasized the importance of securing medication carts at all times. The facility's policy requires that medication carts be locked if left unattended, even in emergencies. The DON also described oversight measures in place, including random checks and daily monitoring by the MDS nurse, but the incident demonstrated a failure to adhere to these protocols.
Deficient Food Storage Practices in Resident's Refrigerator
Penalty
Summary
The facility failed to maintain safe and sanitary storage of food items in a resident's personal refrigerator. Observations revealed that the refrigerator contained a cinnamon roll and a cupcake in an unlabeled and undated zip-lock bag. The resident could not recall how long the items had been there or who brought them. Interviews with staff, including an LVN, CNA, and the housekeeping supervisor, confirmed the presence of the unlabeled and undated food items. They acknowledged the risk of foodborne illness from consuming potentially spoiled food. The facility's policy requires all food in refrigerators to be covered, dated, and labeled, with staff inspecting the contents weekly to dispose of expired, unlabeled, or undated food. However, the policy was not followed in this instance. The Director of Nursing and the Administrator confirmed that housekeeping was responsible for removing undated and unlabeled food items daily, while nursing staff was expected to label and date food brought in by families. The Administrator noted that families sometimes bring food without informing the nursing staff, and the housekeeping supervisor was not monitoring the task effectively.
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Illustrative
What surveyors actually found near you
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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.
Illustrative
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Nursing homes near Kenedy
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Kenedy Health & Rehabilitation | 0.3 mi | ★★★★★ | 12 | 0 |
| Bluebonnet Nursing And Rehabilitation | 10.5 mi | ★★★★★ | 38 | 0 |
| Yorktown Nursing And Rehabilitation Center | 23.2 mi | ★★★★★ | 13 | 0 |
| Frank M. Tejeda Texas State Veterans Home | 27.9 mi | ★★★★★ | 12 | 0 |
| Harmony Care At Floresville | 28.3 mi | ★★★★★ | 18 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.