Average — CMS composite of the measures below.
A standard survey is most likely before around August 2026
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at La Frontera Nursing & Rehabilitation during CMS and state inspections, most recent first.
Surveyors observed multiple failures in food storage, preparation, and sanitation, including a dirty ice machine chute, improperly covered and unclean meat slicer, lack of hairnet use, grime above the steam table, melted and dirty tongs, improper storage of rice scoops, a dirty juice gun nozzle, and undated leftovers. Staff interviews revealed confusion about cleaning responsibilities and inconsistent monitoring of cleaning schedules, while record reviews showed incomplete and missing cleaning documentation.
The facility did not initiate PASRR-recommended specialized services within the required timeframe for four residents with intellectual and developmental disabilities, as evidenced by missing or outdated NFSS documentation and staff interviews confirming no recent submissions due to administrative issues. Despite ongoing care planning and IDT meetings, residents did not receive timely specialized services such as habilitation and customized equipment as recommended in their PASRR evaluations.
A resident with multiple chronic conditions, including end stage renal disease and heart disease, received Midodrine outside of physician-ordered blood pressure parameters on multiple occasions due to unclear orders and staff not following medication administration protocols. Staff administered the medication even when the resident's systolic blood pressure was above the specified threshold, contrary to the order and facility policy.
A resident with severe cognitive impairment and complex care needs did not have timely quarterly care plan reviews or meetings that included the full IDT and the resident or their representative. Required care plan revisions were not completed within the mandated timeframe, and the care plan did not reflect the resident’s current needs or personal goals. Facility staff confirmed that notifications and participation requirements were not consistently met.
A facility did not report an allegation of abuse involving a resident with severe cognitive impairment to local law enforcement within the required 24-hour period. Although internal assessments and interviews were conducted and the involved nurse was suspended, law enforcement was not notified until seven days after the initial allegation, contrary to regulatory requirements.
A resident with severe cognitive impairment eloped from a facility through an inadequately monitored door, despite having a Wanderguard. The door alarm was triggered, but staff failed to investigate or notify others, leading to the resident being found by a passerby and taken to a nearby facility. The resident was later returned without injury, highlighting a deficiency in supervision and alarm response.
The facility failed to conduct a comprehensive assessment for emergencies, specifically cyber-attacks, leading to a technology blackout and loss of access to electronic health records. The administrator and clinical staff were unprepared, resulting in delayed access to MARs and TARs. Interviews revealed the facility had no specific assessment for cyber-attacks, and the existing Continuity of Operations Planning policy did not address this type of emergency.
A cyber-attack disrupted access to electronic health records, leading to incomplete and inaccurate documentation for several residents. Nurses administered care and medications from memory, resulting in missing records for wound care and medication administration. Staff were unprepared for the cyber-attack, and the facility lacked a backup system to maintain continuity of care.
The facility failed to provide individualized in-room activity plans for five residents, leading to potential risks of isolation and cognitive decline. Residents with various health issues were observed without documented activity plans, and the Activity Director admitted to not maintaining proper documentation or structured plans.
A facility failed to maintain an infection prevention and control program, leading to a deficiency when a CNA did not perform proper hand hygiene or change gloves during incontinence care for a resident with a history of UTI and hemiplegia. The CNA admitted the lapse, and the DON confirmed the expectation for standard precautions.
The facility failed to accurately post daily nurse staffing information, including actual hours worked by RNs, LVNs, and CNAs, over several days. The posted information did not reflect the actual hours worked, leading to potential confusion about staffing and resident care. The DON and Administrator acknowledged the oversight, which violated the facility's policy.
Deficient Food Storage, Preparation, and Sanitation Practices
Penalty
Summary
The facility failed to maintain food storage, preparation, and sanitation practices in accordance with professional standards, as observed during multiple kitchen inspections. Surveyors found the ice machine chute had a removable black-brown substance, identified as possible mold and dirt, embedded in scratches along the edge where ice was dispensed. The meat slicer was not properly covered, with dust and debris present on both the cover and the exposed slicer. Employees were observed entering the kitchen without hairnets, and hairnets were not readily available at the kitchen entrances, only being found inside the kitchen on top of the ice machine. The underside of the shelf above the steam table, where food was held, had a removable gritty, brownish substance in clumps. Additionally, black plastic tongs were found to be melted and had deep crevices containing a flakey, brownish substance. An 18-quart container of rice in dry storage had a scoop inside it, and the scoop used was an ordinary cup rather than a proper utensil. The juice gun nozzle was found to have a thick red substance stuck inside, and leftover items in the refrigerators were not labeled with use-by dates. Interviews with dietary staff and the registered dietitian revealed a lack of clarity regarding cleaning responsibilities and procedures. The dietary supervisor acknowledged that the black-brown substance in the ice machine resembled mold and dirt, and that the meat slicer should have been properly covered to prevent contamination. She also admitted to not monitoring the cleaning schedule beyond checking if tasks were marked as completed. The registered dietitian confirmed that all food-related items should be labeled and dated, including use-by dates, and that improper cleaning and labeling could result in foodborne illness. The dietary aide stated that the juice gun was supposed to be cleaned every two days, but was unsure of the last cleaning date and admitted the inner nozzle was not clean. Review of facility records showed significant gaps in the completion and documentation of daily, weekly, and monthly cleaning tasks. Many tasks, such as cleaning the juice machine, wearing hair restraints, and cleaning and sanitizing the slicer, were frequently not marked as done. Several weeks of cleaning checklists were missing entirely. In-service records indicated that staff had received training on cleaning, sanitation, and food storage, but these practices were not consistently followed. Facility policies required daily cleaning of the juice machine and proper storage of scoops, but these procedures were not adhered to, as evidenced by the observations and staff interviews.
Failure to Initiate PASRR Specialized Services and Submit Required Documentation
Penalty
Summary
The facility failed to incorporate recommendations from the PASRR Level II determination and evaluation reports for four residents reviewed for PASRR. Specifically, the facility did not initiate Nursing Facility Specialized Services (NFSS) within 20 business days following the date the services were agreed upon in the Interdisciplinary Team (IDT) meetings for these residents. This was confirmed through interviews and record reviews, which showed that the required NFSS forms were either outdated or missing, and no recent submissions had been made as required by regulation. For one male resident with diagnoses including unspecified intellectual disabilities, mental disorder, functional quadriplegia, legal blindness, and mood disorder, records indicated that the most recent NFSS form was submitted several years prior, and no current or recent forms were available. The care plan and progress notes documented ongoing needs for specialized services such as independent living skills training and customized durable medical equipment, but there was no evidence that these services were initiated within the required timeframe. Similar findings were noted for a female resident with cerebral palsy, epilepsy, and intellectual disabilities, whose records also lacked current NFSS documentation despite recommendations for continued habilitation and specialized therapies. Interviews with facility staff, including the PASRR Program Specialist, DON, and MDS nurse, revealed that the facility had not submitted any NFSS forms since a change in facility ownership, which resulted in the loss of their NPI number and inability to upload required forms. Despite ongoing IDT PASRR meetings and continued care planning, the absence of current NFSS submissions meant that residents did not receive timely specialized services as recommended. The facility's policy required specialized rehabilitative services to be provided according to assessment and care plan, but this was not followed for the residents reviewed.
Failure to Prevent Significant Medication Errors in Blood Pressure Management
Penalty
Summary
The facility failed to ensure that a resident was free from significant medication errors related to the administration of Midodrine, a medication used to treat hypotension. The resident, a male with diagnoses including End Stage Renal Disease, dependence on renal dialysis, Type 2 Diabetes, hypertensive heart and chronic kidney disease, atherosclerotic heart disease, and peripheral vascular disease, had physician orders for Midodrine with specific blood pressure parameters. However, there was a lack of clarity in the physician's order regarding the exact blood pressure parameters for holding the medication, with conflicting instructions noted in the order and medication administration record (MAR). Despite the order to hold Midodrine for a systolic blood pressure (SBP) greater than 120, the medication was administered eight times in May when the resident's SBP exceeded this threshold. Documentation showed that staff, including a medication aide, an RN, and an LVN, administered the medication outside of the ordered parameters, with blood pressures recorded as high as 167/82 at the time of administration. Interviews with staff revealed that some were aware of the intended use of Midodrine but did not consistently follow the ordered parameters, sometimes due to being rushed or misunderstanding the order. The resident was cognitively intact and reported feeling well, with no complaints of adverse effects at the time of interviews. Facility policy required staff to follow prescription instructions and resolve discrepancies before administering medications, but this was not adhered to in this case. The failure to clarify the order and to administer the medication as prescribed constituted a significant medication error for the resident.
Failure to Ensure Timely and Interdisciplinary Care Plan Review and Resident/Representative Participation
Penalty
Summary
The facility failed to ensure that each resident and/or their representative, as well as the full interdisciplinary team (IDT), were invited to and participated in care plan meetings, including both comprehensive and quarterly review assessments. Specifically, for one resident with severe cognitive impairment and multiple complex diagnoses, there was no evidence that quarterly care plan reviews or meetings were held with the appropriate IDT members and the resident or their representative for two out of three required quarters. Additionally, the care plan was not revised within seven days following a quarterly assessment, as required. Record reviews showed that the resident was completely dependent on staff for all activities of daily living and had a BIMS score indicating severe cognitive impairment. Documentation revealed that while some meetings were held, they did not consistently include all required IDT members or the resident’s representative. For example, the only facility staff present at a PASRR meeting was the MDS nurse, and there was no documentation that the resident’s representative was contacted for that meeting. Furthermore, the care plan did not reflect the resident’s current needs as indicated in the most recent MDS assessment, nor did it address the resident’s expressed goal of learning to write her name, despite this being a focus in her habilitation service plans. Interviews with facility staff confirmed that the last documented IDT meeting was several months prior, and that notifications to the resident’s representative about care plan meetings were not documented in the facility’s messaging system. Staff acknowledged that not all required disciplines or the resident’s representative were present at meetings, and that the care plan was not updated in a timely manner following assessments. The facility’s own policy requires interdisciplinary collaboration and timely care plan updates, but these procedures were not followed in this case.
Failure to Timely Report Alleged Abuse to Law Enforcement
Penalty
Summary
The facility failed to ensure that an allegation of abuse involving a resident was reported to local law enforcement within the required 24-hour timeframe. On the evening of 01/14/2025, a housekeeper notified the administrator and DON of a suspicion of abuse regarding a male resident with Alzheimer's disease and severe cognitive impairment. The resident was dependent on staff for activities of daily living and had a care plan addressing multiple risks, including emotional distress and self-care deficits. The housekeeper reported observing a nurse responding to the resident with a rough attitude when the resident called for assistance. Despite the facility's policy and in-service training emphasizing timely reporting of abuse allegations, the facility did not notify local law enforcement until 7 days after the initial report was made. Documentation and interviews confirmed that the administrator and DON believed they had reported the incident within 24 hours, but law enforcement records and statements indicated the report was not made until 01/21/2025. The administrator and DON initiated an internal investigation, suspended the involved nurse, and conducted assessments and interviews, but the required external reporting was delayed. The failure to report the allegation to law enforcement within the mandated timeframe was substantiated by both facility and police records. The facility's own investigation and interviews with staff and law enforcement confirmed the delay, and the administrator acknowledged responsibility for reporting such incidents. The deficiency was identified during a review of records and interviews with facility staff and law enforcement personnel.
Resident Elopement Due to Inadequate Supervision and Alarm Response
Penalty
Summary
The facility failed to ensure adequate supervision for a resident who was unaccounted for approximately two hours. The resident, who had severe cognitive impairment due to Alzheimer's and dementia, eloped from the facility through an employee dining area door. The door alarm was triggered, but the dietary aide who heard it did not investigate further or notify other staff members. The resident was later found by a passerby and taken to a nearby facility. The resident had a Wanderguard, but the door they exited was not equipped with a Wanderguard alarm, only a regular alarm. The resident was ambulatory and did not require mobility devices, which may have contributed to their ability to leave the facility unnoticed. Interviews with staff revealed that the resident did not exhibit exit-seeking behaviors prior to the incident, and the staff did not have a clear protocol for responding to door alarms. The incident occurred on a weekend, and the ADON was notified by the administrator after the resident was returned to the facility. The nearby facility attempted to contact the original facility multiple times without success, eventually involving local law enforcement. The resident was assessed upon return and found to have no injuries or distress. The facility's failure to respond appropriately to the door alarm and ensure the resident's safety led to the deficiency.
Facility Unprepared for Cyber-Attack, Lacks Access to Resident Records
Penalty
Summary
The facility failed to conduct and document a comprehensive facility-wide assessment to determine the necessary resources for competent resident care during both routine operations and emergencies, specifically in the event of a cyber-attack. This deficiency was identified during a survey where it was observed that the facility was experiencing a technology blackout due to a viral cyber-attack. The administrator reported that the facility was instructed to disconnect all internet-capable devices, resulting in the loss of access to electronic health records, including physician orders, MARs, and TARs. The administrator and clinical staff were unprepared for the cyber-attack, which led to a lack of access to critical resident information. The facility resorted to using paper charting and personal hot spots, but these measures were not fully effective. The contracted pharmacy was notified of the situation, and paper MARs and TARs were eventually delivered, but there was a significant delay. During this period, a new LVN was unable to obtain necessary orders for residents, highlighting the facility's lack of preparedness for such an event. Interviews with the Interim DON and ADON revealed that the facility had not anticipated a cyber-attack and had no specific facility assessment for such an event. The facility's Continuity of Operations Planning policy, last revised in 2018, did not adequately address the need for maintaining access to electronic health records during a cyber-attack. The facility's failure to prepare for this type of emergency could have led to inappropriate care or treatment for residents due to the unavailability of current physician orders and medication records.
Cyber-Attack Leads to Documentation Deficiency
Penalty
Summary
The facility failed to maintain medical records in accordance with accepted professional standards and practices, affecting five residents who were reviewed for medical records. The deficiency was primarily due to a cyber-attack that disrupted access to electronic health records from 08/28/2024 to 08/30/2024. During this period, the facility was unable to provide electronic health record access upon request, and the written paper MARs/TARs provided were backdated. The facility's collective written nursing notes lacked specific room numbers and nursing signatures, and documentation was incomplete for many residents. The cyber-attack led to significant documentation issues, with nurses and staff unable to access or document care accurately. Nurses were instructed to perform wound care and administer medications from memory, as they did not have access to orders, MARs, or TARs. This resulted in incomplete and inaccurate documentation of medication administration and wound care for several residents. For instance, wound care for residents with pressure ulcers and diabetic ulcers was not consistently documented, and medications such as Mirtazapine, Lisinopril, and Carbidopa/Levodopa were not recorded as administered according to physician orders. Interviews with staff revealed that they were unprepared for the cyber-attack and lacked a backup system for maintaining continuity of care. Staff members expressed concerns about the potential negative impact on resident care due to the lack of accurate documentation. The facility's Charting and Documentation policy, which requires significant observations and services to be documented in the resident's clinical records, was not adhered to during the cyber-attack period. The facility's interim DON and ADON acknowledged the lack of preparedness for such an event and the potential for inappropriate care or treatment due to the absence of readily available physician's orders, MARs, and TARs.
Failure to Provide Individualized In-Room Activity Plans
Penalty
Summary
The facility failed to provide an ongoing program to support residents in their choice of activities, both facility-sponsored group and individual activities and independent activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident. This deficiency was observed in five residents who did not have in-room activity plans developed and implemented to meet their individual interests, abilities, and needs. The lack of individualized activity plans could place the residents at risk for isolation, decline in cognitive status, and decreased feelings of well-being within their environment. Resident #17, an elderly female with multiple diagnoses including hypertension, atrial fibrillation, and chronic obstructive pulmonary disease, was observed lying in bed with no in-room activity plan despite her care plan indicating she should have one. The Activity Director admitted to seeing the resident occasionally but did not have a structured plan or documentation for in-room activities. Similarly, Resident #19, who had a recent fall and hip fracture, was on bedrest and had no documented in-room activity plan, although she expressed interest in activities like coloring and pet visits. Resident #26, who has intellectual disabilities and other health issues, was also found without a documented in-room activity plan. The Activity Director mentioned occasional visits but lacked proper documentation. Resident #33, with mood disorder and dementia, had minimal participation in activities and no specific in-room activity plan. Lastly, Resident #56, who has severe cognitive impairment and multiple health issues, was observed in bed with no documented in-room activity plan. The Activity Director admitted to not documenting visits or completing activity assessments for these residents, leading to a failure in providing consistent, goal-oriented, and individualized recreation opportunities as per the facility's policy.
Infection Control Deficiency Due to Improper Hand Hygiene
Penalty
Summary
The facility failed to establish and maintain an infection prevention and control program, which led to a deficiency in the care provided to a resident. During an observation of incontinence care, a CNA did not perform hand hygiene or change gloves appropriately. The CNA washed her hands and donned gloves before starting care but did not sanitize her hands or change gloves after removing a soiled brief and before touching clean linen and a new brief. This lapse in infection control practices was acknowledged by the CNA, who admitted through an interpreter that she should have changed gloves and sanitized her hands to prevent cross-contamination. The Director of Nursing (DON) confirmed that aides were expected to follow standard precautions, including hand hygiene and changing gloves, and acknowledged that failure to do so could result in adverse outcomes for residents due to infection. The resident involved had a history of urinary tract infection (UTI), urinary retention, and hemiplegia, and was always incontinent of bowel and bladder. The resident's cognitive impairment was moderate, with a BIMS score of 10. The facility's policy on hand hygiene, revised in February 2018, emphasized the importance of handwashing to prevent the spread of infections. The policy outlined specific situations requiring handwashing with soap and water or the use of an alcohol-based hand rub. Despite recent infection control training, the CNA did not adhere to these guidelines, leading to a potential risk of infection for the resident.
Failure to Accurately Post Daily Nurse Staffing Information
Penalty
Summary
The facility failed to ensure that the daily nurse staffing information was accurately posted, including the actual hours worked by RNs, LVNs, and CNAs, as well as the resident census. This deficiency was observed over several days, with the staffing information posted on the door of the medication room not reflecting the actual hours worked by licensed and unlicensed staff. Specifically, on multiple occasions, the posted staffing pattern only showed the number of staff scheduled for each shift but did not include the actual time worked during those shifts. During interviews, the Director of Nursing (DON) acknowledged the requirement to update and post the nurse staffing information daily but indicated that the Administrator was responsible for posting the staffing sheet. The Administrator admitted that not posting the actual hours worked was an oversight. The facility's policy, revised in July 2016, mandates that the daily staffing information should include the facility name, date, resident census, shift schedule, type and category of nursing staff, and the actual time worked during each shift. The failure to comply with this policy could lead to confusion regarding staffing and resident care issues, as well as provide inaccurate information to residents and the public about the number of staff and hours worked on any given shift.
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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.
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Nursing homes near Laredo
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Laredo Nursing And Rehabilitation Center | 1.6 mi | ★★★★★ | 8 | 0 |
| Las Alturas Nursing & Transitional Care | 2.3 mi | ★★★★★ | 13 | 0 |
| Laredo Medical Center | 2.6 mi | ★★★★★ | 1 | 0 |
| Laredo West Nursing And Rehabilitation Center | 3.8 mi | ★★★★★ | 21 | 0 |
| Laredo South Nursing And Rehabilitation Center | 4 mi | ★★★★★ | 1 | 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 August 2026) and official state health department websites.