Average — CMS composite of the measures below.
A standard survey is most likely before around November 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 Midwestern Healthcare Center during CMS and state inspections, most recent first.
A resident with advanced neurologic impairment and malnutrition, dependent on continuous enteral feeding, did not receive tube feeding for about two hours when the feeding bag ran dry and was not promptly replaced. CNAs reported the beeping pump to an RN and later to the assigned LVN, who acknowledged the reports but did not change the feeding bag before being diverted to assist another resident and then ending her shift. The oncoming LVN was told the pump needed to be changed. Review of orders and the MAR showed the resident was ordered Jevity 1.5 via continuous tube feed with water flushes for 22 hours daily, but this order was not followed during the gap in feeding.
Delayed Meal Service at Shared Tables: Two residents were seated with tablemates in the dining room, but staff served the other residents at their tables first and left them waiting 13 and 18 minutes before they received lunch. One resident said he was hungry and might have to eat by himself if not served soon, and the other said he had to be patient and wait until staff got around to him. The charge nurse stated both residents should have been served with their tablemates, and the DM said dietary should pay closer attention to who is seated in the dining room so each table can be served together.
Kitchen Sanitation Deficiencies: Surveyors observed an unclean fryer with dried food crumbs on the baskets and inside walls, a clean dish cart with food particles on it, and food particles and trash on the floor behind the stove, fryer, and oven. The Dietary Mgr stated the fryer and baskets should be cleaned after use, the clean dish cart should be cleaned before use, and floors behind equipment should be swept and mopped daily; the facility policy required food contact equipment to be cleaned and sanitized after every use.
Missing Required Staff Training: The facility failed to maintain required initial and annual in-service training for an LPN who had been employed as PRN staff and had no current training in multiple required areas, including communication, resident rights, infection control, compliance and ethics, abuse neglect and exploitation, QAPI, behavioral health, HIV, falls prevention, restraint reduction, and dementia. The ADMN and HR Coordinator acknowledged that staff training was intended for all employees and that the HR Coordinator was responsible for monitoring training, but the LPN had not completed the required topics.
Failure to develop and update a person-centered care plan: A resident with Alzheimer's disease, severe cognitive impairment, and multiple chronic conditions did not have care plan interventions for his in-room activity preferences or bedbound status. The record showed preferences for TV, movies, music, fresh air, and hunting/fishing, but the care plan lacked measurable activity goals and was not revised to reflect his current condition; the AD also noted missing activity progress documentation.
Failure to provide individualized activity programming for a resident with severe cognitive impairment and multiple chronic conditions. The resident preferred in-room activities, TV and movies, fresh air, and other personal interests, but was observed lying in bed with no in-room activity program offered during the survey period. The AD stated the resident did not have an individual in-room activity program developed to meet his interests, and activity documentation and care planning were incomplete.
A resident with severe cognitive impairment, stroke-related deficits, immobility, incontinence, poor nutrition, and a high Braden score had an order for a pressure redistribution cushion to the wheelchair, but staff observed him seated in his wheelchair without the cushion. The RN did not know whether the cushion was present, the CNA said she had never placed cushions on residents’ wheelchairs, and the DON and Administrator stated staff were responsible for ensuring at-risk residents had the appropriate pressure reduction cushion in place.
A resident with complex behavioral and medical needs was subjected to verbal abuse and inappropriate gestures by an LVN, who made disparaging remarks and escalated the situation in front of staff, other residents, and a police officer. Multiple staff members witnessed the incident but failed to report it to the DON or abuse coordinator, leaving the administration unaware and the resident unprotected until surveyor intervention. The LVN continued working after the incident due to the lack of timely reporting and investigation.
A nurse engaged in a verbal altercation with a resident with behavioral and medical needs, using derogatory language and inappropriate gestures, which escalated the situation in front of staff, residents, and a police officer. Multiple CNAs and staff witnessed or were aware of the incident but failed to report it to the DON or administrator as required, resulting in a delay in administrative awareness and intervention. The nurse continued working after the incident, and the deficiency was identified as Immediate Jeopardy due to compromised resident protection.
A resident with complex behavioral and medical needs was subjected to verbal abuse and inappropriate gestures by an LVN during a behavioral incident. The LVN made derogatory remarks, taunted the resident, and engaged in confrontational behavior in front of staff, other residents, and a police officer. Multiple staff members witnessed the incident but failed to promptly report the abuse to the DON or abuse coordinator, resulting in a delayed response and investigation.
The facility failed to adhere to food safety standards, with soiled kitchen surfaces, improperly stored and expired food items, and exposed cooking utensils. A live fly was observed in the food preparation area, indicating potential contamination risks. The facility's policies for sanitization and food storage were not followed, as evidenced by the presence of expired foods and inadequate labeling and dating of food items.
The facility failed to address grievances raised by the Resident Council, including issues with bed changes, dental care, and food portions. Concerns voiced during meetings were not followed up on, and residents were not informed of any actions taken. Interviews revealed a lack of communication and follow-up, with the Administrator and department supervisors not consistently attending meetings. This failure placed residents at risk for decreased quality of life.
Failure to Maintain Continuous Enteral Feeding as Ordered
Penalty
Summary
A resident with Parkinson’s disease, moderate protein-calorie malnutrition, dysphagia, aphasia, and quadriplegia, who received all nutrition via continuous enteral feeding, did not receive ordered tube feeding for approximately two hours. The resident had a physician’s order for Jevity 1.5 at 70 cc/hr with water flush at 50 cc/hr for 22 hours each day. On the day of the incident, the resident’s feeding pump began beeping when the feeding bag ran out at about 2:30 p.m. A CNA reported the beeping pump to an RN while the assigned LVN was on break. The RN stated she informed the LVN when the LVN returned from break at 3:30 p.m., and the LVN acknowledged this. Later, at about 5:30 p.m., another CNA again reported to the LVN that the resident’s feeding pump needed to be changed, and the LVN again acknowledged the report. Despite these reports, the LVN did not replace the feeding bag before the end of her shift. She stated she was on her way to change the bag after the 5:30 p.m. report but was diverted to assist another resident and did not complete the task. At shift change at 6:00 p.m., she told the oncoming LVN that the resident’s feeding pump needed to be changed, and he said he would take care of it. Review of the medication administration record showed the resident’s enteral feeding was documented as given on the night shift, and a one-time bolus feeding was ordered later that evening due to an extended period without feeding. The facility’s enteral nutrition policy stated that adequate nutritional support through enteral nutrition is to be provided as ordered and that nursing staff and providers monitor for signs and symptoms of inadequate nutrition. The facility determined that the resident did not receive enteral feeding for approximately two hours, which failed to ensure continuous enteral nutrition as ordered.
Delayed Meal Service at Shared Tables
Penalty
Summary
The facility failed to treat residents with respect and dignity during lunch service for 2 residents reviewed for resident rights. During observation on 8/26/25 at 12:05 PM, Resident #53 was seated at a table with 2 other residents. The other 2 residents were served and began eating, while Resident #53 waited until 12:18 PM, 13 minutes later, as staff continued serving other tables. During interview, Resident #53 stated he was hungry and thought he might have to eat by himself if staff did not serve him soon, and said this sometimes happens when he must wait after his table partners have been served. During the same observation, Resident #25 was seated with 1 other resident. The other resident was served at 12:07 PM and started eating, while Resident #25 waited until 12:25 PM, 18 minutes later, while staff served other tables. Resident #25 stated he had to be patient and wait until staff got around to serving him, and said he would like to eat with his table partner when she gets her food. The charge nurse stated both residents had no special orders and should have been served with their table, and that residents should not have to wait to be served while others are eating at their table. The dietary manager stated dietary should pay more attention to who is in the dining room and where they are seated so each resident at a table can be served before moving on to the next table.
Kitchen Sanitation Deficiencies
Penalty
Summary
The dietary kitchen was observed to have multiple sanitation issues during surveyor observation. The food fryer was left in an unsanitary condition, with food crumbs dried to the fryer baskets and inside the fryer walls. A cart holding clean bowls and plates was also observed to be unclean, with food particles present on the cart. In addition, the floor behind the stove, fryer, and oven was not swept, and food particles and trash were found on the floor. During interview, the Dietary Manager stated that the fryer and fryer baskets should have been cleaned after the last use, the clean dish cart should be cleaned before clean dishes are placed on it, and the floors behind equipment should be swept and mopped daily. Record review showed the facility's Kitchen Sanitation policy required utensils, counters, shelves, and equipment to be kept clean, fixed equipment to be routinely cleaned and maintained, and food contact equipment to be cleaned and sanitized after every use.
Missing Required Staff Training
Penalty
Summary
The facility failed to implement and maintain an effective training program for 1 of 16 existing staff members whose training records were reviewed. Record review showed that an LPN hired on 1-13-2021 did not receive initial and/or annual training or in-services in multiple required areas, including Communication, Resident Rights, Infection Control, Compliance and Ethics, Abuse Neglect and Exploitation, QAPI, Behavioral Health, Dementia, HIV, Restraint Reduction, and Prevention of Falls. The facility policy titled In-Service Training, All Staff stated that all staff are required to participate in initial orientation and annual in-service training and that required topics include communication, resident rights, abuse neglect exploitation, dementia management and resident abuse prevention, QAPI, infection prevention and control, behavioral health, and compliance and ethics. During interviews, the ADMN stated that staff training was intended to encompass all employees and all resident care areas, and that employees should have education to provide appropriate care to residents. The HR Coordinator stated that the LPN had been employed as PRN staff since 1/13/21 and had not completed trainings in Communication, Resident Rights, Infection Control, Compliance and Ethics, Abuse Neglect and Exploitation, QAPI, Behavioral Health, HIV, Prevention of Falls, Restraint Reduction, or Dementia. The HR Coordinator also stated that she was responsible for monitoring staff training and that the LPN's most current shift worked was 8-16-2025.
Failure to Develop and Update Person-Centered Care Plan
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for Resident #8 that included measurable objectives and timeframes to meet his medical, nursing, mental, and psychosocial needs identified in the comprehensive assessment. Record review showed the resident was admitted with diagnoses including Alzheimer's disease, chronic kidney disease stage 3, hypertension, hearing loss, bilateral nuclear cataracts, osteoporosis, right femur fracture, low back pain, chronic pain syndrome, dysphagia, and atherosclerosis of the left leg. The Activity Participation Note documented that he preferred independent in-room activities, watching TV and movies, going outside in the sunshine with a blanket, and enjoying hunting and fishing. The resident's significant change MDS assessment documented a BIMS score of 1 out of 15 and activity preferences that included doing favorite activities, keeping up with the news, going outside for fresh air, and participating in religious services or practices. However, the comprehensive care plan initiated on 12/03/2024 and revised on 6/30/2025 did not include a care plan to address his activity interests or need for one-on-one in-room activities, and it was not revised to address his bedbound status. Observations on 8/26/2025 and 8/27/2025 showed the resident lying in bed with his eyes closed, and the Activity Director stated the resident did not like group activities, liked music, and had not had a documented activity progress note since 2/03/2025.
Failure to Provide Individualized Activity Programming
Penalty
Summary
The facility failed to provide an ongoing activity program based on the comprehensive assessment, care plan, and preferences of Resident #8, including facility-sponsored group activities, individual activities, and independent activities. Resident #8 was a [AGE]-year-old male with Alzheimer’s disease, chronic kidney disease stage 3, hypertension, hearing loss, bilateral nuclear cataracts, osteoporosis, a right femur neck fracture, low back pain, chronic pain syndrome, dysphagia, and atherosclerosis of the left leg. His activity preferences documented in the record included independent in-room activities, watching TV and movies, going outside in the sunshine with a blanket, hunting, fishing, keeping up with the news, and participating in religious services or practices. Observation showed Resident #8 lying in bed with his eyes closed on multiple occasions, with the room door open to the hallway and no observed visitors or in-room activity programs offered during the survey period. On one observation, the TV was on but the volume was low, and the resident was not wearing his eyeglasses, which were on the bedside nightstand. Staff interviews indicated that he had been staying in bed for about 2 months after a fall and hip fracture, that family did not want him transferred because of pain and injury concerns, and that he was visited by family and friends at times. The Activity Director stated the resident did not like group activities, liked music, and had been shown YouTube live music videos, but the resident did not really like the tablet. Record review showed the last documented activity progress note was dated 2/03/2025, and the Activity Director stated she was supposed to document a progress note every 3 months and with each MDS assessment but had not done so for Resident #8. The Activity Director also stated Resident #8 did not have an individual in-room activities program developed to meet his interests. The MDS Coordinator reviewed the record and stated there was no activity care plan until one was added after the issue was discussed. The facility’s policy stated one-on-one wellness visits should be provided for residents whose impairments prevent or limit group participation or who prefer not to attend group programs, and that the resident’s individual care plan must include the identified need, interventions, and number of visits per week.
Failure to Provide Ordered Wheelchair Pressure Cushion
Penalty
Summary
Provide appropriate pressure ulcer care and prevent new ulcers from developing. Resident #34, a male with diagnoses including hypertension, hemiplegia and hemiparesis, cerebral infarction, and muscle wasting, had a Quarterly MDS showing a BIMS score of 00 and indicating he was at risk for pressure ulcers/injuries, skin and ulcer/injury treatments, and use of a pressure reducing device for the wheelchair. His comprehensive care plan dated 08/07/2025 identified risk factors for pressure ulcer/injury development including frequent urinary and/or bowel incontinence, immobility, poor nutrition, a Braden risk score of 11, and sheering/friction. His consolidated orders dated 4/30/25 included a pressure redistribution cushion to the wheelchair. During observation on 8/26/25 at 12:05 PM, Resident #34 was seated in his wheelchair in the dining room for lunch and there was no cushion on the seat. During interview, the resident stated he did not have a cushion in his wheelchair but thought he would like one because it would make the wheelchair more comfortable. The RN stated the wheelchair cushion was on the resident’s order but did not know whether he had one, and the CNA stated she did not know about the order and had never placed a cushion on residents’ wheelchairs. The DON and Administrator stated staff were responsible for ensuring residents at risk for skin breakdown had the appropriate pressure reduction cushion in their wheelchairs, and the facility policy stated residents at risk for developing pressure injuries would have pressure reduction cushion devices in their wheelchairs.
Failure to Prevent and Report Verbal Abuse of Resident by LVN
Penalty
Summary
The facility failed to implement its written policies and procedures prohibiting and preventing abuse, resulting in a resident not being free from abuse. A female resident with a history of autistic disorder, fetal alcohol syndrome, epilepsy, and other complex medical needs was subjected to verbal abuse by an LVN. The incident occurred in the presence of other staff, residents, and a police officer, and included the LVN making disparaging remarks, using obscene gestures, and escalating the situation with the resident. The LVN made statements such as 'Y'all need to take her ass somewhere,' 'Her family member needs to come get her,' and 'She needs to go to jail,' while also flipping off the resident and inviting her to physical confrontation. The resident became visibly upset, threatened to punch the LVN, and was further agitated by the LVN's continued comments and gestures. Multiple staff members, including CNAs and other nurses, witnessed the incident but did not report the abuse to the Director of Nursing (DON) or the abuse coordinator as required by facility policy. Interviews revealed that staff assumed others would report the incident, or were unsure of the reporting process, despite having received training on abuse and neglect. The DON and administration were unaware of the incident until informed by surveyors two weeks later. The LVN involved continued to work shifts at the facility after the incident, as the administration had not been notified and no investigation was initiated at the time. The failure to report and address the abuse resulted in the resident not being protected from further abuse, and the administration remained unaware of the situation until external intervention. The incident was corroborated by police body camera footage, staff interviews, and resident accounts. The facility's lack of timely response and failure to follow abuse prevention and reporting protocols led to the identification of Immediate Jeopardy by surveyors.
Failure to Timely Report Verbal Abuse Incident
Penalty
Summary
The facility failed to immediately report an allegation of verbal abuse involving a resident with complex medical and behavioral needs, including autism, fetal alcohol syndrome, epilepsy, and tachycardia. The incident occurred when a nurse engaged in a verbal altercation with the resident, using derogatory language, making inappropriate gestures, and escalating the situation in the presence of other staff, residents, and a police officer. The nurse made statements such as 'Y'all need to take her ass somewhere,' 'Her [family member] needs to come get her,' and 'You don't scare me none,' and also flipped off the resident, which further agitated the resident and led to a confrontation that required staff and police intervention to prevent escalation. Multiple certified nursing assistants (CNAs) and other staff witnessed or were aware of the incident but failed to report the abuse to the administrator or the Director of Nursing (DON) as required by facility policy and state law. Interviews revealed that staff were trained on abuse and neglect reporting procedures, but several CNAs assumed others would report the incident or delayed reporting due to absence of the DON or other reasons. As a result, the administrative staff, including the DON, were not made aware of the incident until it was brought to their attention by surveyors two weeks later. The failure to report the incident immediately prevented timely investigation and intervention by facility leadership. The nurse involved continued to work multiple shifts following the incident, and the lack of prompt reporting compromised the facility's ability to ensure resident protection and oversight. The deficiency was identified as Immediate Jeopardy due to the risk posed to residents' safety and well-being.
Failure to Prevent and Report Verbal Abuse by Nursing Staff
Penalty
Summary
The facility failed to protect a resident from verbal abuse by a licensed vocational nurse (LVN). The incident involved a female resident with a history of autistic disorder, fetal alcohol syndrome, epilepsy, and other complex medical and behavioral needs. During a period of behavioral escalation, the resident was subjected to derogatory and confrontational language by LVN B, who made statements such as, "Y'all need to take her ass somewhere," and "Her [family member] needs to come get her!" in the presence of the resident and others. LVN B further engaged in inappropriate behavior by flipping off the resident, making taunting gestures, and inviting the resident to physically confront her. These actions were witnessed by staff, other residents, and a police officer who was present at the time. Multiple staff members, including CNAs and other nurses, observed the incident but failed to immediately report the abuse to the Director of Nursing (DON) or the abuse coordinator as required by facility policy and training. Some staff assumed others would report the incident, while others were unsure of the reporting process or believed the situation was being handled by the police. The DON and Assistant DON were not made aware of the incident until much later, and the abuse coordinator was not notified in a timely manner. The lack of prompt reporting delayed the facility's response and investigation into the abuse. The resident involved was visibly upset during and after the incident, exhibiting behaviors such as yelling, making threats, and attempting to harm herself. The police and staff intervened to de-escalate the situation and prevent further escalation between the resident and LVN B. The incident was corroborated by body camera footage, staff interviews, and the resident's guardian, confirming that the resident was subjected to verbal abuse and inappropriate gestures by LVN B in the presence of others.
Food Safety and Sanitation Deficiencies
Penalty
Summary
The facility failed to maintain food storage, preparation, and service areas in accordance with professional standards for food service safety. Observations revealed that appliance surfaces in the kitchen were soiled with dried food, grease, and burned food. Bulk storage container lids were contaminated with food particles and dust, and opened food packages in the refrigerator, freezer, and dry storage room were not sealed, labeled, or dated. Expired milk and prune juice were found stored in the refrigerator and dry food storage room, respectively. Cooking utensils and pans were improperly stored with sanitized surfaces exposed to air contaminants. During the initial tour of the facility's kitchen, several areas were found to be unclean, including the hand washing sink, manual can opener, toaster, and stainless steel counter. The convection oven, steamer, gas ovens, and deep fryer unit were also noted to have accumulated dust, grease, and food debris. The facility's nonperishable food storage room contained expired prune juice, and various opened food items were improperly stored without proper sealing, labeling, or dating. The walk-in refrigerator and freezer contained unlabeled and undated food items, including cheese slices, deli ham, breaded ribs, and raw ground beef. A live fly was observed in the food preparation area during a follow-up visit, indicating a potential risk for contamination. The facility's policies and procedures for sanitization, food receiving and storage, and dry storage were not adhered to, as evidenced by the presence of expired foods, improperly stored utensils, and inadequate labeling and dating of food items. The Dietary Manager acknowledged the issues and stated that cleaning schedules were in place, but the deficiencies persisted.
Failure to Address Resident Council Grievances
Penalty
Summary
The facility failed to promptly address grievances raised by the Resident Council concerning resident care and life within the facility. During the Resident Council Meetings held on April 17, 2024, and May 20, 2024, concerns were voiced but not addressed, and the residents were not informed of any actions taken to resolve these issues. The concerns included unaddressed issues such as beds not being changed, the need for more dental care, larger food portions, and more hamburger toppings. Additionally, the follow-up to these concerns was not documented in the meeting minutes, leaving the residents without a clear understanding of whether their issues were resolved. Interviews with the Social Worker, Resident Council President, and Activity Director revealed a lack of communication and follow-up regarding the grievances. The Resident Council President stated that while concerns were conveyed to the Administrator, there was no feedback on the outcomes, and improvements were only noticed occasionally. The Activity Director confirmed that she did not provide follow-up responses to the Resident Council and was unaware of the actions taken to resolve the grievances. The Administrator and other department supervisors were invited to attend meetings but did not always participate, further hindering the resolution process. The facility's grievance policy outlines that grievances should be addressed and communicated back to the residents, but this was not consistently followed. The Administrator acknowledged meeting with residents to discuss specific issues, such as the smoking policy, but there was no systematic approach to ensure all grievances were addressed and communicated back to the Resident Council. This lack of follow-up and communication placed residents at risk for a decreased quality of life and well-being within their living environment.
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Illustrative
What surveyors actually found near you
We read the 7 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
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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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Wichita Falls
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Senior Care Health & Rehabilitation Center - Wichi | 0 mi | ★★★★★ | 0 | 0 |
| Swan Health At Wichita Falls | 2.1 mi | ★★★★★ | 0 | 0 |
| Courtyard Gardens | 2.5 mi | — | 0 | 0 |
| Advanced Rehabilitation And Healthcare Of Wichita | 3.4 mi | ★★★★★ | 0 | 0 |
| Rolling Meadows | 3.9 mi | — | 0 | 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.