Above average — CMS composite of the measures below.
The next survey window likely opens around February 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Mcallen Transitional Care Center during CMS and state inspections, most recent first.
A resident with COPD, DM2, dementia, stroke-related hemiplegia, and mood disorder had a care plan for her medical and nursing needs, but it did not include repeated refusals of meds or skin checks. Records showed she refused meds many times and refused skin assessments on multiple occasions, while staff documented that they educated and encouraged her, notified the PA, and respected her right to refuse. The MDS Nurse, ADON, and DON stated these refusals should have been included in the care plan.
Incomplete Documentation of Weekly Skin Assessments: An LPN failed to document weekly skin checks or refusals for a resident with COPD, DM2, dementia, hemiplegia, and incontinence. The resident said she sometimes refused skin checks, and the LPN stated he notified the PA but was unsure whether he documented the refusals. The ADON and DON confirmed the weekly assessments or refusal notes were missing, despite the facility policy requiring weekly licensed nurse skin evaluations and documentation.
Improper food storage and pest concerns were identified when surveyors observed undated sliced cheese, uncovered tomatoes and cucumbers in the refrigerator, and open raw biscuits in the freezer. Two residents also reported seeing large roaches in their rooms for a couple of days. The dietary admin and DM acknowledged that refrigerated and frozen items should be dated, covered, and sealed, and the facility policy referenced date marking requirements for ready-to-eat TCS foods.
Failure to care plan paranoid schizophrenia: A resident with severely impaired cognition and an active schizophrenia diagnosis did not have paranoid schizophrenia included in the comprehensive care plan. The LVN responsible for the care plan verified the omission and stated it was missed because the resident was a readmission. The DON stated the diagnosis should be in the care plan to help staff be familiar with it and guide proper care and treatment.
Medication Administration Without Identifying Drugs or Indications: A CMA administered multiple morning meds to a cognitively intact resident without stating the names of the meds or what they were for. The resident had diagnoses including HTN, atrial fibrillation, GERD, and hyperlipidemia, and the CMA said she did not provide the information because she believed the resident already knew it. RN B stated she tells residents what each med is for, and the DON said he expected staff to provide residents with all information about the meds they receive.
A resident with a PEG tube, severe cognitive impairment, and multiple neurologic and respiratory diagnoses received meds via the tube while an LVN donned PPE, paused the feeding pump, disconnected and reconnected tubing, and changed gloves without hand hygiene between glove changes. The LVN stated she did not need to change gloves after touching the pump and did not need hand hygiene between glove changes, and the DON agreed the task was done correctly despite the facility hand hygiene policy requiring hand hygiene after changing gloves.
Pest control was not effective in keeping the kitchen and resident rooms free of roaches. Surveyors found pest droppings and a dead roach in the dry storage area, and two residents reported seeing large roaches in their rooms that moved into the closet. The DM said pest control came twice a month, but records showed only routine visits and no extra documented treatments, and the pest control policy was not provided.
A resident with severe cognitive impairment and multiple comorbidities, including Alzheimer’s disease, CKD, generalized muscle weakness, and dysphagia, was care planned to require staff assistance with eating. During a meal, a CNA fed the resident while standing beside her instead of sitting at her level, despite facility protocol and staff training requiring staff to sit when assisting with feeding to maintain dignity. Nursing leadership, including the ADON and DON, confirmed that standing while feeding is inconsistent with resident rights and the facility’s dignity policy, although no physical injury or distress was observed.
A resident with quadriplegia, fully dependent on staff for all ADLs, did not have eating assistance included in the care plan or clearly specified in the Kardex. Multiple staff confirmed the resident required a one-person assist for feeding, but this was omitted due to an oversight during care plan updates. The facility's policy required comprehensive, person-centered care plans, but the documentation did not accurately reflect the resident's needs for eating and transfers.
A resident with multiple complex medical conditions received nutritional supplements based on physician orders that lacked required details such as route of administration and dosage. Nursing staff and leadership confirmed the orders were incomplete according to facility policy, though the supplements were still administered as intended.
A resident with an indwelling catheter and multiple chronic conditions did not have Enhanced Barrier Precautions (EBP) signage or a PPE cart outside her room, as required by facility policy. Staff interviews confirmed awareness of the policy but noted the absence of these infection control measures, with the DON attributing the lapse to a possible miscommunication after a room transfer.
A CNA failed to follow infection control protocols while providing incontinent care to a resident with an indwelling catheter, PEG tube, and pressure ulcer. The CNA did not wear a gown at the start of care, inconsistently performed hand hygiene between glove changes, and reused wipes against facility policy. Staff interviews confirmed that these actions did not align with established infection prevention procedures.
A resident with a neurogenic bladder had their Foley catheter bag observed lying on the floor, contrary to the facility's infection control policies. Staff interviews confirmed awareness of the importance of keeping catheter bags off the floor to prevent infections, yet the deficiency occurred. The facility's policies clearly stated the need to position drainage bags below the bladder level without resting on the floor.
A resident with COPD was observed receiving oxygen at 2.5 liters per minute instead of the physician-ordered 2 liters per minute. Staff interviews revealed inconsistencies in monitoring oxygen settings and uncertainty about inservice training frequency. The facility's policy requires adherence to physician orders for oxygen therapy.
A resident with dementia and a UTI eloped from a facility without staff knowledge, traveling to a nearby store in a motorized wheelchair. The front door was not locked or alarmed, allowing the resident to exit unnoticed. Staff were occupied in other areas and did not anticipate the elopement, as the resident had not shown exit-seeking behavior before.
Care Plan Did Not Include Repeated Medication and Skin Assessment Refusals
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for one resident that included measurable objectives and time frames to meet her medical, nursing, mental, and psychosocial needs. The resident had diagnoses including COPD, type 2 diabetes mellitus, unspecified dementia, hemiplegia/hemiparesis following cerebral infarction affecting the left non-dominant side, mood disorder due to a physiological condition, and major depressive disorder. Her quarterly MDS assessment reflected a BIMS score of 15 and impairment in one upper extremity, with no impairment to the lower extremities. The resident’s care plan addressed her stroke-related hemiplegia, self-care performance deficit, and bowel/bladder incontinence, with interventions such as giving medications as ordered, monitoring/documenting/reporting to the MD, providing assistance, and weekly skin monitoring. However, the care plan did not reflect repeated refusals of medications or skin assessments. Record review showed the resident refused all medications on multiple dates across May, June, and July 2026, and refused skin assessments on multiple weekly dates during the same period. During interviews, the resident stated she took medications when she wanted and allowed skin checks when she let staff, and that there were times she told staff no to everything because she was fine. Staff stated they educated and encouraged her, notified the PA, and respected her right to refuse. The MDS Nurse, ADON, and DON each stated the refusals should have been included in the care plan, and the MDS Nurse stated the omissions occurred because the refusals were not added or reported for inclusion in the plan.
Incomplete Documentation of Weekly Skin Assessments
Penalty
Summary
The facility failed to maintain complete and accurately documented medical records for one resident when weekly skin assessments were not documented in the electronic medical record. Resident #2 was a female with diagnoses including COPD, type 2 diabetes mellitus, unspecified dementia, hemiplegia/hemiparesis following cerebral infarction affecting the left non-dominant side, mood disorder due to a physiological condition, and major depressive disorder. Her quarterly MDS reflected a BIMS score of 15, indicating intact cognition, and her care plan included monitoring the skin at least weekly because of bowel/bladder incontinence and self-care deficits. Record review showed a skin check on 05/13/26 with no new skin issues, but no other skin checks were completed until 07/15/26, when a rash was noted on the left lower quadrant midline. There was no documentation of skin assessment refusals or progress notes for 05/20/26, 05/27/26, 06/03/26, 06/10/26, 06/17/26, 06/24/26, 07/01/26, and 07/08/26. The resident stated that nurses checked her skin when she allowed them and that there were times she refused because she felt fine. During interviews, LVN C stated the resident refused skin assessments, that he could not force her, and that he was unsure whether he documented the refusals. He stated he explained the need for the skin checks and notified the PA, but there were no other interventions or orders. The ADON and DON both confirmed that the weekly skin assessments should have been completed or documented as refusals, and the DON stated that if the resident refused, the physician should have been notified and a progress note documented. The facility’s skin and wound policy required licensed nurses to assess skin at least weekly and document the evaluations or refusals.
Improper Food Storage and Pest Concerns
Penalty
Summary
The facility failed to store food in accordance with professional standards in the kitchen refrigerator and freezer. During the initial kitchen tour, surveyors observed one block of sliced cheese wrapped in clear plastic but undated, a box of tomatoes uncovered, cucumbers uncovered and exposed to air in the refrigerator, and a box of raw biscuits open and exposed to air in the freezer. The report states these items were not properly dated or sealed as required for food storage safety. The report also states the facility failed to keep residents' rooms free from pests after Resident #42 and Resident #79 reported seeing large roaches in their rooms for a couple of days. In interviews, the dietary administrator and the director of maintenance acknowledged that food items in the refrigerator and freezer should be dated, covered, and sealed, and the DM stated the cheese should have had a date when it was placed in the refrigerator. The facility policy and FDA Food Code section on date marking were reviewed in the report.
Failure to Care Plan Paranoid Schizophrenia
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for Resident #12 that included his diagnosis of paranoid schizophrenia. Resident #12 was a [AGE]-year-old male with an original admission date of 01/04/2025 and a readmission noted on 03/11/2026. His pertinent diagnosis of paranoid schizophrenia had an onset date of 02/23/2026. The MDS completed on 03/02/2026 showed a BIMS score of 5, indicating severely impaired cognition, and listed schizophrenia as an active diagnosis. Record review of the care plan completed on 02/24/2026 showed no mention of paranoid schizophrenia except in the diagnoses list on the bottom of the last page. In interview, the LVN responsible for completing the care plan verified that the diagnosis had not been care planned and stated she missed it because the resident was a readmission. The DON stated the diagnosis should be in the care plan so staff are familiar with it and to help guide proper care and treatment. The facility policy stated the interdisciplinary team shall develop a comprehensive person-centered care plan for each resident that includes measurable objectives and timeframes to meet medical, nursing, mental, and psychosocial needs identified in the comprehensive assessment.
Medication Administration Without Identifying Drugs or Indications
Penalty
Summary
The facility failed to provide pharmaceutical services to meet the needs of each resident when a CMA administered morning medications to a resident with intact cognition without identifying the medications or explaining what they were for. The resident’s record showed diagnoses including mild protein-calorie malnutrition, muscle weakness, blindness in the right eye, hypertension, atrial fibrillation, gastritis, osteoarthritis, GERD, and hyperlipidemia. The resident’s BIMS score was 15, indicating intact cognition, and the care plan did not include a focus, goal, or intervention stating the resident should not receive medication indications. During observation, the CMA gave the resident multiple medications, including amiodarone, furosemide, metoprolol, losartan, famotidine, diltiazem, clopidogrel, atorvastatin, apixaban, iron, docusate sodium, multivitamin with minerals, and senokot, all in a clear medication cup. The CMA did not identify the medications to the resident or state their indications, and the resident swallowed them with water. In interview, the CMA stated she did not tell the resident the names or purposes of the medications because she believed the resident already knew and said she never tells residents what their medications are for. RN B stated she gives medications one at a time and tells residents what each medication is for, and the DON stated he expected staff to provide residents with all information about the medications they received.
Hand Hygiene and Glove Use Not Followed During PEG Medication Administration
Penalty
Summary
The facility failed to maintain an infection prevention and control program when LVN B did not change gloves and perform hand hygiene during Resident #47’s medication administration via gastrostomy tube. Resident #47 was an [AGE]-year-old male with diagnoses including cerebral infarction, chronic respiratory failure with hypoxia, gastrostomy status, dysphagia, vascular dementia, and cognitive communication deficit. His BIMs assessment showed severe impairment, and his care plan identified tube feeding with a goal that the feeding tube insertion site remain free of signs and symptoms of infection. During observation, LVN B donned a gown and gloves, prepared medications and water, paused the feeding pump, disconnected the tubing from the PEG tube, checked placement and residuals, and administered medications through the tube. After the medications were given, LVN B reconnected the feeding tubing and restarted the pump, then changed gloves without performing hand hygiene between the glove change. LVN B later washed her hands after removing PPE and exiting the room. In interview, LVN B stated she did not need to change gloves after touching the feeding pump and did not need hand hygiene between glove changes because she had not done incontinent care. The DON stated he did not feel there was a reason to change gloves during the medication administration and believed the task had been done correctly. The facility’s hand hygiene policy stated hand hygiene is required after changing gloves and after touching contaminated surfaces.
Pest Control Program Failed to Keep Kitchen and Resident Rooms Free of Roaches
Penalty
Summary
The facility failed to maintain an effective pest control program to keep resident rooms and the kitchen free of pests. Survey observations in the kitchen dry storage room found pest droppings on the floor, including numerous droppings in the right back corner and a small dead roach on the floor. The Dietary Manager stated pest control comes twice a month and sprays for pests, and also stated the kitchen is kept as clean as possible to keep pests and rodents down. Resident #42, a 77-year-old male with diagnoses including DM, HTN, unspecified mood disorder, and muscle wasting and atrophy, reported that he and a visiting family member saw two large roaches in his room the prior week. He stated the family member tried to kill the roaches, but they went into the closet and could not be found. He said he notified the CNA and had not seen any roaches since that day. Resident #79, a male with diagnoses including PVD, HTN, DM, and depression, also reported seeing two big roaches in his room sometime the prior week. He stated the roaches went toward the closet and had not been seen again after he told the CNA. Record review showed pest control receipts for several visits, with the last monthly visit on 03/03/26 spraying for gnats, roaches, and silverfish, but no additional visits were documented. The pest control policy was requested twice by the surveyor and was not provided by the Dietary Manager or Maintenance Man.
Failure to Maintain Resident Dignity During Assisted Feeding
Penalty
Summary
The deficiency involves the facility’s failure to ensure a resident was assisted with eating in a manner that promoted dignity, as required by resident rights and facility policy. A female resident with Alzheimer’s disease, chronic kidney disease, generalized muscle weakness, dysphagia, cognitive communication deficit, and a need for assistance with personal care was care planned to require total assistance by one staff member for eating. Her quarterly MDS showed a BIMS score of 2, indicating severely impaired cognition, and documented that she required partial/moderate assistance for eating. During a lunch observation, a CNA was seen feeding this resident while standing to the resident’s left side, despite a chair being available behind the CNA. The CNA remained standing until an ADON moved a chair behind her, at which point she sat down a few minutes later. The resident was not interviewable and was observed to be without injury or distress. In interviews, the CNA, ADON, and DON all stated that facility protocol and training required staff to sit at the resident’s level when feeding to maintain dignity, and the ADON additionally cited aspiration prevention and dignity as reasons staff should not stand while feeding. The DON stated that feeding a resident while standing constituted a dignity issue and that, although there was no negative physical outcome or injury, the resident might have felt uncomfortable or rushed. The facility’s written Resident Rights, Dignity and Respect policy stated that all residents must be treated with kindness, dignity, and respect, and that staff must display respect for residents as affirmation of their individuality and dignity.
Failure to Develop and Implement Comprehensive Care Plan for Dependent Resident
Penalty
Summary
The facility failed to develop and implement a comprehensive, person-centered care plan for a resident with quadriplegia, resulting in the omission of necessary interventions for eating assistance. The resident, a male with quadriplegia and muscle atrophy, was entirely dependent on staff for all activities of daily living (ADLs), including eating, transfers, and personal care. Despite this, the resident's care plan did not include eating as an intervention, and the Kardex did not specify the required level of assistance for feeding, although it did provide details for transfers and other ADLs. Observations and interviews with the resident and multiple staff members, including CNAs and an LVN, confirmed that the resident required a one-person assist for eating and a two-person assist with a mechanical lift for all other ADLs. Staff reported relying on the Kardex to determine the level of care needed, but the Kardex lacked clear instructions regarding eating assistance. The omission was attributed to a failure to check off the relevant task during the resident's baseline care plan update upon re-admission. The facility's policy required the interdisciplinary team to develop a comprehensive, person-centered care plan with measurable objectives and timeframes for each resident, based on their comprehensive assessment. However, the care plan and Kardex for this resident were not updated to reflect the actual assistance required for eating and transfers, as confirmed by staff interviews and record reviews. This failure could result in the resident not receiving individualized care and services to meet his needs.
Incomplete Physician Orders for Nutritional Supplements
Penalty
Summary
The facility failed to maintain complete and accurate clinical records for one resident, specifically regarding physician orders for nutritional supplements. The orders for a house supplement and liquid protein did not include essential information such as the route of administration and, in the case of the house supplement, the dosage. These omissions were identified during a review of the resident's medical records, which showed that the supplements were administered without the required details being documented in the orders. The resident involved was an elderly female with multiple significant diagnoses, including sepsis, mild protein-calorie malnutrition, cognitive communication deficit, dementia, chronic kidney disease, and dependence on renal dialysis. She also had a history of pressure ulcers and was at risk for malnutrition, as reflected in her care plan. The care plan included interventions for nutritional support and wound healing, which required accurate and complete physician orders for supplements. Interviews with nursing staff and facility leadership confirmed that the orders were incomplete and did not meet the facility's policy requirements, which specify that orders must include the resident's name, dosage, frequency, route, and diagnosis. Staff acknowledged that the missing information rendered the orders incomplete, although they stated that the supplements were administered as intended. The facility's policy on physician orders was reviewed and found to require the missing elements.
Failure to Implement Enhanced Barrier Precautions for Resident with Indwelling Catheter
Penalty
Summary
The facility failed to establish and maintain an effective infection prevention and control program for a resident with an indwelling catheter. Observations revealed that there was no Enhanced Barrier Precautions (EBP) signage posted on the resident's door or room, and no personal protective equipment (PPE) cart was available outside the door, despite the resident having a permcath for dialysis and an indwelling Foley catheter. Interviews with staff, including a CNA, LVN, and the DON, confirmed that facility policy required EBP signage and PPE for residents with indwelling medical devices, but these measures were not in place for this resident. Staff acknowledged the absence of required signage and PPE, and indicated that this was not in accordance with facility policy. Record reviews showed that the resident had multiple diagnoses, including type 2 diabetes, hypertension, and irritable bowel syndrome, and required assistance with personal care. The care plan documented the presence of an indwelling catheter and outlined interventions for its management. Despite these documented needs and the facility's infection control policy, the required EBP measures were not implemented for this resident, and staff were unable to provide a reason for the omission, with the DON suggesting a possible miscommunication due to a recent room transfer.
Failure to Follow Infection Control Protocols During Incontinent Care
Penalty
Summary
A deficiency was identified when a certified nursing assistant (CNA) failed to follow established infection prevention and control procedures while providing incontinent care to a resident with multiple risk factors, including an indwelling catheter, PEG tube, and a stage 3 pressure ulcer. The CNA did not don a personal protective equipment (PPE) gown prior to starting care, despite facility policy and the resident's Enhanced Barrier Precautions (EBP) status requiring both gown and gloves for high-contact care activities. The CNA only applied the gown after beginning care and being reminded, which was confirmed by both the assistant director of nursing (ADON) and the CNA during interviews. During the care episode, the CNA also failed to consistently perform hand hygiene between glove changes, only washing hands after every second glove change and not using hand sanitizer between other glove changes as required by facility policy. The CNA was observed to use one wipe per swipe initially, but then began folding and reusing wipes for multiple swipes, contrary to the facility's policy that specifies using a clean portion of the wipe for each cleansing motion and disposing of wipes after use, especially when soiled. The CNA's actions were inconsistent with both the facility's infection control and incontinent care policies, which were reviewed and confirmed by the director of nursing (DON) and other staff. Interviews with the CNA, LVN, ADON, and DON revealed that all staff had received training on infection control, EBP, and proper incontinent care procedures, including the use of PPE and hand hygiene. The CNA acknowledged forgetting to put on the gown due to nervousness and demonstrated confusion about the correct frequency of hand hygiene between glove changes. The DON and ADON confirmed that the observed practices did not align with facility policy and that proper PPE and hand hygiene are essential to prevent the spread of infection, especially for residents on EBP.
Failure to Prevent Catheter Bag Contamination
Penalty
Summary
The facility failed to ensure that a resident with an indwelling catheter received appropriate treatment and services to prevent urinary tract infections. Specifically, the facility did not prevent the resident's urinary catheter bag and tubing from touching the floor, which could lead to cross-contamination and infection. The resident, a male with a neurogenic bladder, was observed with his Foley catheter bag lying on the floor under his bed. This observation was made despite the care plan indicating that the catheter bag should be positioned below the bladder and away from the floor. Interviews with various staff members, including CNAs, LVNs, and RNs, revealed a general understanding of the importance of keeping catheter bags off the floor to prevent infections. However, the incident still occurred, indicating a lapse in adherence to the facility's infection control policies. Staff members acknowledged the risk of contamination and infection if the catheter bag touched the floor, and they were aware of the facility's policy to keep the bag in a privacy bag attached to the bed. The facility's policies on infection prevention and catheter drainage bags were reviewed, and they clearly stated the need to position drainage bags below the bladder level without resting on the floor. Despite recent in-service training on infection control, the deficiency occurred, suggesting a need for more effective implementation of these policies. The Director of Nursing confirmed that all staff were responsible for ensuring catheter bags were properly positioned and that privacy bags were provided for each resident with a Foley catheter.
Failure to Adhere to Physician's Order for Oxygen Administration
Penalty
Summary
The facility failed to provide appropriate respiratory care for a resident with chronic obstructive pulmonary disease (COPD) by not adhering to the physician's order for oxygen administration. The resident, a female with a history of COPD, was observed with her oxygen set at 2.5 liters per minute via nasal cannula, contrary to the physician's order of 2 liters per minute. This discrepancy was noted during an observation and confirmed by LVN G, who acknowledged the incorrect setting and adjusted it to the correct rate. The LVN mentioned that the humidifier bottle might have moved the settings and expressed concern about potential harm to the resident if the incorrect order was administered. Interviews with various staff members, including LVN E, RN F, the ADON, and the DON, revealed inconsistencies in the monitoring and verification of oxygen settings. Staff members were aware of the protocol to check oxygen settings at the beginning, during, and at the end of each shift, but there was a lack of clarity on the frequency and timing of inservice training. The DON stated that an increase of 0.5 liters per minute above the prescribed amount would not affect the resident, while other staff members highlighted potential risks of incorrect oxygen administration. The facility's policy on oxygen administration, last revised in April 2016, mandates that oxygen therapy be administered as ordered by the physician.
Resident Elopes Due to Inadequate Supervision
Penalty
Summary
The facility failed to provide adequate supervision to prevent accidents, resulting in a resident eloping from the facility without staff knowledge. The resident, who had a history of dementia and was experiencing increased confusion due to a urinary tract infection (UTI), left the facility in a motorized wheelchair and traveled to a nearby corner store. The incident occurred in the early morning hours, and the resident was unsupervised for approximately 1 hour and 15 minutes before the facility became aware of the elopement. The resident's care plan indicated a risk for elopement due to disorientation and confusion related to a UTI. Despite this, the resident was able to exit the facility through the front door, which was not locked and lacked an alarm or chime to alert staff. The facility's investigation revealed that the resident left the building while staff were occupied in other hallways, and no staff were present at the front desk to witness the exit. The resident had not previously demonstrated exit-seeking behavior, and staff did not anticipate the elopement. Interviews with staff indicated that the resident was known to be independent and often moved around the facility at night. However, the staff did not perceive the resident as a risk for elopement, and routine checks were conducted every two hours. The facility's policy on elopement and unsafe wandering was not effectively implemented, as the front door's lack of an alarm system allowed the resident to leave unnoticed.
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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 Mcallen
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Windsor Las Palmas Nursing And Rehabilitation Cent | 0.2 mi | ★★★★★ | 0 | 0 |
| Alfredo Gonzalez Texas State Veterans Home | 0.7 mi | ★★★★★ | 16 | 2 |
| Grand Terrace Rehabilitation And Healthcare | 1.4 mi | ★★★★★ | 9 | 0 |
| Windsor Nursing And Rehabilitation Center Of Mcall | 1.7 mi | ★★★★★ | 5 | 0 |
| Mcallen Nursing Center | 1.7 mi | ★★★★★ | 12 | 0 |
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