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 Legacy Rehabilitation And Living during CMS and state inspections, most recent first.
A resident with ESRD, CHF, DM2, and a motorized wheelchair was injured during van transport when staff failed to secure him properly before moving the vehicle. The resident fell from the wheelchair, and staff and other passengers reported that the lap/shoulder restraints were not fastened and that the driver did not verify securement before driving. The resident was later observed with bruising to the head and right side, along with pain and a small forehead skin tear.
Failure to Timely Report a Fall With Injury: A resident with multiple chronic conditions and a fall risk slid out of his wheelchair in a van when the driver did not finish buckling him before driving. Staff later observed pain and bruising to the resident’s head, right arm, ribs, flank, abdomen, and calf. Although staff stated that falls with injury were reportable and should be reported immediately, the facility did not report the allegation of neglect to the State Survey Agency within the required timeframe.
No Licensed Administrator in Place: Record review and interviews showed the facility had no current ADM listed and had been without a licensed ADM for over 30 days. The former ADM stated his license had been pulled from the building and a new ADM had not been officially onboarded, while the HRD, SW, AD, and OM all confirmed there was no ADM currently in place and no clear start date for one.
A resident with severe cardiopulmonary disease and impaired cognition had a physician’s order and care plan interventions for continuous O2 at 2–3 L/min via NC, but documentation and interviews showed she was repeatedly on room air with SpO2 of 90% and no evidence of O2 in use. Nursing notes recorded her on room air after a fall, and family members reported and photographed her sitting near the nurses’ station and during a meal without oxygen for an extended period. Staff interviews confirmed that continuous O2 should not be removed and that refusals should be documented, and facility policies required oxygen, as a prescribed drug, to be administered and documented as ordered, which did not occur in this case.
A resident with multiple acute and chronic conditions continued to receive four medications that were supposed to be discontinued per hospital discharge instructions. Due to errors in transcribing and verifying orders during admission, these medications were administered for several weeks before the mistake was identified and corrected. Staff interviews and record reviews confirmed the lapse in following proper medication reconciliation procedures.
A facility failed to ensure residents received mail and packages on weekends. During a Resident Council meeting, multiple residents said mail was not delivered on Saturdays and weekend packages were left in the foyer until Monday. An Act E confirmed she only distributed mail on weekdays, while the weekend receptionist said she was not aware weekend mail delivery was part of her duties, despite the job description stating the weekend receptionist would hand out mail on Saturdays.
Failure to Follow EBP During Resident Care: An LPN administered meds through a feeding tube for a resident on EBP without wearing a gown, and two CNAs provided catheter care for another resident on EBP without gowns. Both residents had device-related EBP orders and posted room signs directing staff to wear gowns for high-contact care activities. Staff later acknowledged they forgot to use the required barrier gowns.
A resident with a history of paranoid schizophrenia and cognitive impairment alleged she was raped in her room. The nurse, LVN A, delayed reporting the incident to management and authorities due to the resident's history of false allegations. The facility's policy requires immediate reporting of such allegations, but this was not followed, resulting in a delay in the investigation.
The facility failed to properly store and label medications, as observed with loose pills and improperly secured controlled substances in medication carts. A loose Meloxicam pill was found in one cart, while another cart contained loose Flexeril and an unidentifiable pill, along with a packet of Methadone pills not double locked. Staff interviews revealed that previous practices involved packaging excess medications in small packages, which contributed to the deficiencies.
The facility failed to follow prescribed dietary menus for residents requiring pureed and mechanically altered diets. Residents did not receive meals as outlined in their dietary plans, with consistent substitution of pudding for listed desserts. This affected residents with significant medical conditions, potentially impacting their nutritional intake. Staff interviews revealed a lack of awareness and adherence to dietary menus, with the RD and DM unaware of the non-compliance. The DM cited short-staffing and lack of formal kitchen policies as contributing factors.
A resident with complex medical needs was not treated with dignity during a meal service when a CNA stood while feeding him, rather than sitting, due to a lack of available chairs. The resident's care plan required one-person assistance for eating, highlighting the need for respectful and dignified care.
A resident with severe cognitive impairment and on a mechanically altered diet was not allowed to choose preferred foods, consistently receiving pudding instead of listed desserts. Staff interviews revealed a lack of adherence to the menu for pureed diets, with the RD and DM unaware of the issue. The DM cited staffing shortages and lack of formal kitchen policies as contributing factors.
A resident with COPD did not receive proper respiratory care as the facility failed to change the nebulizer tubing and mask weekly as ordered by the physician. Observations revealed the equipment was dirty and dated incorrectly, indicating it had not been changed as required. Staff confirmed the oversight, acknowledging the risk of infection due to non-compliance with the facility's policy on maintaining clean respiratory equipment.
The facility failed to provide residents with reasonable access to private telephone communication. Nine residents reported having to use the Nurse's Station or staff offices, which did not offer privacy, especially after business hours. Staff and the Administrator confirmed the lack of a portable phone for private use, violating the facility's policy on Resident Rights.
Failure to Secure Resident in Van During Transport
Penalty
Summary
The facility failed to ensure that a resident’s environment remained as free from accident hazards as possible and failed to ensure adequate supervision and assistance devices to prevent accidents. Resident #1 was admitted with a history that included orthopedic aftercare following surgical amputation, ESRD, Type 2 DM, CHF, and dependence on renal dialysis. The resident’s admission MDS showed a BIMS score of 15, indicating normal cognitive function, and the resident used a motorized wheelchair or scooter. The baseline care plan identified a risk for falls related to impaired mobility and visual impairment. On 04/29/2026, Resident #1 fell in the facility van while being transported to or from dialysis. The record and interviews indicated the resident was not properly secured in the wheelchair before the van was placed in motion. The van driver stated she forgot to check that all residents were secure and that she forgot to finish buckling Resident #1. The resident reported that only the strap on the back wheel had been used, that the van moved while still in the parking lot, and that he went flying from the chair. Other residents on the van stated that the resident’s belts were not secure and that he flipped or fell sideways because he was not strapped in properly. After the incident, the resident was observed with bruising on the right flank, lower right abdomen, right rib area, right calf, and a discolored area on the forehead. Staff interviews and documentation also described a small skin tear to the forehead, pain to the right side, back pain, and pain over the ribs. The transportation policy stated that residents must be secured in their wheelchair and secured in the vehicle before any movement of the vehicle occurs, and that the driver is responsible for ensuring all passengers wear safety belts and are properly secured at all times. The incident was identified by surveyors as an Immediate Jeopardy related to failure to secure the resident properly during transport.
Failure to Timely Report a Fall With Injury
Penalty
Summary
The facility failed to report to the State Survey Agency an allegation of neglect involving a fall with injury within 2 hours of the allegation for one resident. Resident #1 was a [AGE]-year-old male with a history of orthopedic aftercare following surgical amputation, end stage renal disease, Type 2 diabetes, congestive heart failure, and dependence on renal dialysis. His admission MDS showed a BIMS score of 15, indicating normal cognitive function, and his care plan identified a risk for falls related to impaired mobility and visual impairment. Record review showed that Resident #1 fell in the van when he slid out of his wheelchair after the van driver forgot to check all residents before driving and did not finish buckling his wheelchair. The resident later reported pain on his right side, and staff observed bruising and discoloration to his forehead, right upper arm, right calf, right flank, right ribs, and right abdomen. Interviews with staff showed they understood that falls with injury were reportable and should be reported immediately, and the transportation aide stated she wrote a statement of the fall on the incident report and thought the fall was reported. The facility’s policy stated that alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source, must be reported immediately, not later than 2 hours after the allegation is made if the events involve abuse or result in serious bodily injury, and not later than 24 hours if they do not involve abuse and do not result in serious bodily injury. The report states the facility failed to report the fall with injury on [DATE] for Resident #1 to the State Survey Agency within the required timeframe.
No Licensed Administrator in Place
Penalty
Summary
The facility failed to ensure its governing body had appointed an Administrator who was licensed by the state to manage the facility and report to the governing body. Record review of the employee list printed on 5/1/26 showed no Administrator listed for the facility. During an interview on 5/1/26 at 8:40 am, the former ADM stated he was no longer the ADM over the building and had his license pulled from the building in March. He stated it had been over 30 days since the facility had had an ADM and that a new ADM had not been officially onboarded. Additional interviews confirmed there was no current ADM in place. The HRD stated the former ADM had pulled his license from the facility and that she did not have information on the next ADM because he had not been hired yet. The SW stated there was no current ADM and she did not know how long the facility had been without one. The AD stated the facility had not had an ADM since March and did not know when one would start. The OM stated he was still in training and would hopefully finish his ADM training in the fall or spring, and he confirmed there was not an ADM currently. He also stated there were no policies for having an ADM.
Failure to Provide Ordered Continuous Oxygen Therapy
Penalty
Summary
The deficiency involves the facility’s failure to provide ordered continuous oxygen therapy to a resident with significant cardiopulmonary conditions. The resident was an elderly female admitted with diagnoses including pulmonary embolism, COPD, right lung cancer, pulmonary hypertension, acute on chronic diastolic heart failure, and acute and chronic respiratory failure with hypoxia. Her quarterly MDS showed severely impaired cognition (BIMS score of 6) and documented that she was receiving oxygen therapy while a resident. The comprehensive care plan included multiple focus areas (oxygen therapy, COPD, chronic pain, and congestive heart failure) with interventions directing staff to provide oxygen therapy as ordered by the physician. Record review showed a physician’s order dated 11/04/25 for oxygen at 2–3 L/min via nasal cannula (NC), to be given continuously. However, oxygen saturation documentation on 11/18/25 at 5:00 PM and 8:15 PM, completed by LVN B, showed the resident’s oxygen saturation was 90% on room air at both times, indicating she was not receiving oxygen therapy when her oxygen level was checked. Progress notes for that date, including a note by LVN B at 5:00 PM after the resident was found on the floor, documented an oxygen saturation of 90% on room air but did not mention any resistance to oxygen use or removal of the NC by the resident. Interviews and photographic evidence further supported that the resident was not receiving continuous oxygen as ordered. A family member reported visiting the resident for about an hour and a half during the evening meal and stated the resident did not have oxygen on at any time during the visit while seated near the nurses’ station. Another family member, who participated via FaceTime, provided 15 time-stamped photographs from that visit showing the resident without oxygen between 5:31 PM and 6:14 PM. Facility staff, including the ADON, RN C, OM, LVN A, and the DON, acknowledged in interviews that residents with continuous oxygen orders should not have it removed, though some stated residents may refuse and that staff should chart refusals and monitor oxygen saturations. Facility policies on oxygen therapy and medication administration required that oxygen, as a prescribed drug, be administered as ordered and that refusals be documented on the MAR or eMAR, which was not reflected in the records for this resident on the date in question.
Failure to Discontinue Medications per Hospital Discharge Orders
Penalty
Summary
The facility failed to ensure that a resident's drug regimen was free from unnecessary drugs, as required. Upon admission from an acute care hospital, a female resident with diagnoses including metabolic encephalopathy, acute pancreatitis, acute kidney failure, and depression was supposed to have four medications (mirtazapine, escitalopram, tizanidine, and tramadol) discontinued per the hospital's discharge instructions. However, these medications continued to be administered for up to 24 days after admission, as evidenced by medication administration records and interviews with facility staff. The error occurred during the transcription of hospital discharge orders into the facility's electronic health record (EHR). The process involved charge nurses, MDS nurses, and at times, assistant directors of nursing (ADONs), but there was confusion and lack of clarity regarding who was responsible for entering and verifying the orders. The MDS RN indicated that the ADON entered the orders for this resident, but the ADON did not recall doing so. The facility's policies required review and documentation of psychotropic medications on admission, but there was no clear policy for transcribing all hospital orders into the EHR. Additionally, the facility was unable to provide an unnecessary medication policy when requested. Multiple staff interviews confirmed awareness that administering discontinued medications could negatively impact residents, depending on the medication. The nurse practitioner (NP) who identified the error stated she noticed the medications had not been discontinued upon her return from vacation and subsequently notified staff, but there was a delay in this notification due to her being behind on charting. The resident received the discontinued medications until the error was discovered and corrected, with documentation showing daily administration of mirtazapine and escitalopram, and multiple doses of tramadol, while tizanidine was not administered.
Failure to Deliver Resident Mail and Packages on Weekends
Penalty
Summary
The facility failed to ensure residents had reasonable access to and privacy in their use of communication methods by not ensuring mail and packages were delivered to residents on Saturdays and by not ensuring items delivered by means other than the postal service were delivered on Saturdays and Sundays. During a Resident Council meeting, 13 anonymous residents stated they had not received mail on Saturdays. One resident reported that Act E delivered mail only Monday through Friday, and another stated packages delivered outside of weekday business hours sat in the foyer until Act E returned to work on Monday. An interview with Act E confirmed she delivered mail only while working Monday through Friday and was unsure who handled Saturday mail. She stated weekend packages were left in the foyer until Monday and acknowledged that leaving mail on a resident’s bed or nightstand could allow others to take it without the resident knowing. The Administrator stated Recp F worked weekends and should have delivered mail and packages, but Recp F stated she was not aware this was part of her weekend receptionist duties and that she had been told to place Saturday mail on top of a shredded document storage container for Act E to distribute on Monday. The receptionist job description stated that on Saturdays, the weekend receptionist would hand out mail.
Failure to Follow Enhanced Barrier Precautions During Resident Care
Penalty
Summary
The facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. During observation, LVN A administered medications through a feeding tube to a resident who had diagnoses including metabolic encephalopathy, herpes viral encephalitis, cerebral infarction, malnutrition, and dysphagia, and whose care plan and active orders required Enhanced Barrier Precautions (EBP) for device care related to a PEG tube and central line. LVN A used handwashing, ABHR, and gloves, but did not wear a barrier gown during the procedure, despite a posted sign above the bed instructing staff to wear a gown for device care or use involving a feeding tube. During another observation, CNA B and CNA C provided catheter care for a resident with diagnoses including urinary tract infection, flaccid neuropathic bladder, neuromuscular dysfunction of the bladder, and muscle weakness. The resident’s record showed an indwelling urinary catheter and active orders and care plan interventions for EBP related to the Foley catheter. Both CNAs performed hand hygiene and glove changes, but neither wore a gown during catheter care, even though the sign above the bed instructed staff to wear a gown for device care or use involving a urinary catheter. Interviews confirmed the missed EBP steps. LVN A stated she realized halfway through the medication administration that she should have put on a barrier gown. CNA B and CNA C each stated they forgot to wear a gown and acknowledged that the residents were on EBP and that a gown should have been used. The DON and ADON reported that staff were expected to wear gowns and gloves when EBP was required, and the ADON stated CNA C had been verbally trained but had missed written training on EBP.
Failure to Timely Report Alleged Abuse
Penalty
Summary
The facility failed to report an alleged violation of abuse/neglect immediately, as required by state law, for a resident who alleged she had been raped. The incident was reported to have occurred on January 22, 2025, but was not reported to the appropriate authorities until January 26, 2025. The delay in reporting was attributed to the nurse, LVN A, who initially received the report from the resident but did not inform management until four days later. LVN A backdated her note and cited the resident's history of false allegations as a reason for the delay. The resident involved was a female with a history of paranoid schizophrenia, major depressive disorder, anxiety disorder, and mild intellectual disabilities, among other conditions. She was moderately cognitively impaired and required assistance with most activities. On the night of the alleged incident, the resident reported to LVN A that a man entered her room and raped her while she was asleep. LVN A, who was on duty that night, did not believe the allegation was legitimate due to the resident's history and the presence of staff who would have noticed any unauthorized individuals. The facility's policy requires that all alleged violations be reported immediately to the administrator and appropriate officials. However, this policy was not followed in this case, leading to a delay in the investigation of the alleged abuse. The administrator acknowledged the facility's noncompliance with reporting requirements and indicated awareness that they would be cited for this deficiency.
Medication Storage and Labeling Deficiencies
Penalty
Summary
The facility failed to ensure that drugs and biologicals were stored and labeled according to currently accepted professional principles. During an observation of the 2C-1 medication cart, a loose pill identified as Meloxicam was discovered. An interview with Medication Aide D revealed that having loose pills in the medication cart could lead to a missed medication dose for the resident. Additionally, an observation of the medication cart for the 100 Skilled Hall revealed two loose pills, one identified as Flexeril and the other unidentifiable, along with a packet of 50 Methadone pills that were not double locked. Licensed Vocational Nurse B acknowledged that the presence of loose pills could result in residents not receiving their medication and that not double-locking controlled substances could lead to drug diversion. Further interviews revealed that the previous Assistant Director of Nursing (ADON) had a practice of packaging excess medications in small packages to simplify narcotic counts for staff. The ADON would take medications from residents' stock, place them in pill crusher pouches, and either staple or tape them shut to send medication home with residents. A review of the facility's policy on medication access and storage indicated that all drugs and biologicals should be stored in locked compartments, with controlled medications stored separately under double lock. However, these procedures were not followed, leading to the deficiencies observed.
Failure to Follow Prescribed Dietary Menus
Penalty
Summary
The facility failed to adhere to the prescribed dietary menus for residents requiring pureed and mechanically altered diets. Specifically, on multiple occasions, residents did not receive the meals as outlined in their dietary plans. For instance, Resident #19 did not receive a pureed pancake for breakfast, and Resident #16 did not receive toast with her breakfast. Additionally, Residents #16, #19, and #21 were consistently given pudding instead of the desserts listed on the menu, such as cream pie, dessert empanada, and mixed berry cake. These discrepancies were observed over several days, indicating a pattern of non-compliance with the dietary requirements. The residents involved had significant medical conditions that necessitated specific dietary modifications. Resident #16, diagnosed with dementia, dysphagia, and diabetes, was on a mechanically altered diet requiring pureed bread and cakes. Resident #19, with Huntington's disease and dysphagia, was on a pureed texture diet. Resident #21, also with dementia and dysphagia, required a pureed texture diet with nectar thick liquids. Despite these specific dietary needs, the facility failed to provide the appropriate meals, potentially impacting the residents' nutritional intake and overall health. Interviews with staff revealed a lack of awareness and adherence to the dietary menus. The Registered Dietitian (RD) and Dietary Manager (DM) were unaware that the menu for residents with pureed diets was not being followed. The DM admitted to being short-staffed and lacking formal policies for kitchen operations, which contributed to the oversight. The RD emphasized the importance of following the menu to ensure residents receive the necessary caloric intake and nutrients. The failure to provide the correct meals as per the dietary plans could lead to nutritional deficiencies and dissatisfaction among residents, as evidenced by Resident #21 expressing disappointment over not receiving the same desserts as other residents.
Failure to Uphold Resident Dignity During Meal Service
Penalty
Summary
The facility failed to treat a resident with respect and dignity, as required by federal resident rights, during a meal service. A certified nursing assistant (CNA) was observed standing next to a resident's Geri-chair while feeding him his lunch, rather than sitting down to provide assistance. This action was noted during a surveyor's observation in the dining room. The CNA later explained that the dining room was crowded, and she intended to find a chair once other residents left the area. The resident involved was a male with a complex medical history, including a history of transient ischemic attack, cerebral infarction, hemiplegia, hemiparesis, type 2 diabetes, and several mental health disorders. His care plan indicated a complete dependency on staff for all activities of daily living (ADLs), including eating, which required one-person assistance. The facility's policy on resident rights emphasizes the importance of a dignified existence and self-determination, which was not upheld in this instance.
Failure to Provide Resident Choice in Dietary Preferences
Penalty
Summary
The facility failed to ensure that a resident was allowed to choose the type of foods he preferred, which is a significant aspect of self-determination and autonomy. The resident, who had severe cognitive impairment and was on a mechanically altered diet, expressed a desire to have the same foods as other residents. However, observations revealed that the resident consistently received pudding instead of the desserts listed on the menu, such as cream pie, dessert empanada, and mixed berry cake. Interviews with staff confirmed that residents on pureed diets were not receiving the menu items as listed, and the resident expressed sadness over not receiving the same foods as others. The Registered Dietitian (RD) and Dietary Manager (DM) were unaware that the menu for residents with pureed diets was not being followed. The DM admitted to being short-staffed and lacking formal policies for kitchen operations, which contributed to the issue. The facility's policy stated that therapeutic diets should be prescribed by the attending physician and that a tray identification system should ensure each resident receives their diet as ordered. Despite this, the resident did not receive the appropriate menu items, which could lead to differences in caloric intake and nutrient loss.
Failure to Change Nebulizer Equipment as Ordered
Penalty
Summary
The facility failed to provide appropriate respiratory care for a resident, specifically by not changing the nebulizer tubing and mask as per the physician's orders. This deficiency was identified for a resident who was moderately cognitively impaired and required partial to moderate assistance with daily activities. The resident had a history of chronic obstructive pulmonary disease (COPD) and was prescribed Ipratropium-Albuterol inhalation solution four times a day, with orders to change the nebulizer equipment every night shift on Sundays. During observations, it was noted that the resident's nebulizer mask had visible particles and appeared dirty, with the tubing dated 4-21-2024, indicating it had not been changed as required. Interviews with the nursing staff confirmed that the equipment was not changed weekly as per the physician's orders, and there was an attempt to alter the date on the tubing to 6-2-2024, which was acknowledged as inappropriate by the staff. The staff admitted that failure to change the equipment could lead to infections. The facility's policy on maintaining oxygen therapy equipment in a clean and sanitary manner was not adhered to, as evidenced by the condition of the resident's nebulizer equipment. The policy required weekly replacement of tubing and masks, which was not followed, leading to the deficiency identified during the survey.
Lack of Private Telephone Access for Residents
Penalty
Summary
The facility failed to ensure that residents had reasonable access to and privacy in their use of communication methods, specifically telephones. Nine residents reported that they did not have access to a private phone to make personal calls. These residents had to use the phone at the Nurse's Station or in a staff member's office, both of which did not provide privacy, especially after 5 PM when staff offices were closed. This lack of access to private communication was confirmed through interviews with the residents, the Ombudsman, and facility staff, as well as through record reviews and observations by surveyors. Resident #1, who had been at the facility for about a year, lost access to his personal cell phone in August 2023 and had been unable to make private calls since then. He had to use the Nurse's Station phone, which was not private, or a staff member's office phone during business hours. Similar situations were reported by other residents, including Resident #2, who was cognitively intact but could not afford a cell phone, and Resident #7, who had declining eyesight and also lacked a personal phone. These residents expressed their dissatisfaction with the lack of privacy and accessibility for making personal calls. Interviews with facility staff, including the Social Worker and LVN, confirmed that residents without personal cell phones had to use the Nurse's Station phone, which was not private. The Administrator acknowledged that there was no portable phone available for residents to use in their rooms. The facility's policy on Resident Rights stated that residents have the right to reasonable access to a telephone and a place to make calls without being overheard, but this was not being upheld in practice. The deficiency was evident through multiple resident interviews, staff confirmations, and the facility's failure to provide a private and accessible communication method for its residents.
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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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Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Amarillo
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Georgia Manor Nursing Home | 1.2 mi | ★★★★★ | 11 | 0 |
| Kirkland Court Health And Rehabilitation Center | 3.2 mi | ★★★★★ | 8 | 3 |
| Hillside Heights Rehabilitation Suites | 3.4 mi | ★★★★★ | 10 | 0 |
| Amarillo Center For Skilled Care | 3.5 mi | ★★★★★ | 8 | 0 |
| Heritage Convalescent Center | 3.7 mi | ★★★★★ | 9 | 0 |
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