Above 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 Prairie Acres during CMS and state inspections, most recent first.
A resident with severe cognitive impairment and total ADL dependence was present when a CNA argued loudly with other staff in the hallway over whether the resident should be bathed before lunch. The CNA raised her voice, approached the resident, and stated she would do it herself while pushing the resident’s Geri-chair, and the exchange continued until an RN intervened. Interviews confirmed staff knew verbal altercations in front of residents were not acceptable, and the facility policy required residents to be treated with dignity and respect at all times.
Incomplete Person-Centered Care Plan: A resident with dementia, psychotic disorders, depression, and moderate cognitive impairment had a care plan that addressed disturbed thought process and pain, but omitted several triggered CAA areas including cognitive loss/dementia, communication, urinary incontinence, pressure ulcers, and Alzheimer’s disease. The MDS nurse, DON, and ADM all stated that triggered care areas should have been included on the resident’s care plan, and the facility policy required a comprehensive person-centered care plan with measurable objectives and timetables.
Failure to Wash Hands During Food Prep: A cook was observed preparing puree food, changing gloves, handling dirty dish items, and moving between prep and storage areas without washing hands between glove changes or task changes. The DM and ADM stated handwashing was required with each glove change and task change, and the facility policy stated gloves do not replace handwashing.
A resident with severe cognitive impairment and a history of falls suffered a broken hip due to inadequate supervision and the absence of a required mobility alarm. Despite being assessed as a moderate fall risk and having a care plan that included increased supervision and mobility alarms, these measures were not implemented, leading to the incident.
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety. Observations revealed multiple instances of improperly stored, labeled, and dated food items in the walk-in pantry, refrigerator, and freezer. Interviews with kitchen staff confirmed the importance of labeling and dating food to prevent serving outdated or potentially harmful food to residents.
The facility failed to maintain an infection prevention and control program, with staff not adhering to proper hygiene and PPE protocols. An LVN did not don PPE or perform hand hygiene during medication administration and wound care. CNAs and NAs did not perform hand hygiene during incontinent care and mealtime assistance. Interviews revealed a lack of awareness about infection control practices.
The facility failed to implement written policies and procedures to prevent abuse, neglect, and exploitation. A CNA was hired and allowed to work without completing the required training, which was against the facility's policy. The Administrator admitted to making this decision due to a shortage of CNAs.
A resident with severe cognitive impairment and high fall risk fell and broke his left hip due to the facility's failure to implement his care plan, which included a chair alarm and 1:1 monitoring. Staff were too busy to transfer the alarm to his wheelchair, and there was a misunderstanding about the monitoring requirements.
A facility failed to ensure proper treatment for a resident with a PEG tube by not checking tube placement before administering medication. The resident had severe medical conditions, and the LVN admitted to not following the correct procedure, which could lead to severe complications. The DON acknowledged the risks involved, and the facility's policies emphasized the importance of confirming tube placement.
A resident with dementia and muscle weakness had a physician's order for oxygen at 2-3 lpm but was observed receiving oxygen at 5 lpm on multiple occasions. Staff interviews confirmed the discrepancy, and facility policies emphasized the need to follow physician orders.
A facility failed to ensure residents were free from significant medication errors when an LVN attempted to administer expired insulin to a resident without verifying the open date on the vial. The resident, who had multiple diagnoses including Type 2 diabetes mellitus, was dependent on staff for most ADLs. The facility's policies on medication administration and labeling were not followed, leading to a significant medication error.
The facility failed to ensure proper storage and labeling of medications, including undated insulin vials, a medication refrigerator out of temperature range, and an unlocked treatment cart left unattended. These deficiencies were observed in two medication carts, one medication room, and one treatment cart.
The facility failed to provide necessary training on abuse, neglect, exploitation, misappropriation of resident property, and dementia management to two CNAs. The administrator admitted to hiring these employees without proper training due to staffing shortages, potentially placing residents at risk of harm.
Verbal Altercation in Resident’s Presence
Penalty
Summary
The facility failed to ensure residents were treated in a respectful manner that maintained or enhanced dignity for one resident reviewed for dignity. The resident involved was a female with diagnoses including Alzheimer’s disease, major depressive disorder, generalized anxiety disorder, and delusional disorders. Her MDS assessment reflected severe cognitive impairment, and she was dependent on staff for eating, oral hygiene, toileting, bathing, dressing, personal hygiene, and all transfers. Her care plan indicated she required assistance with all decision-making and total assistance with ADLs, including use of a Geri-chair for positioning and safety and a Hoyer lift for transfers. During an observation, CNA C was heard arguing with CNA A and CNA B in the hallway near the resident’s bedroom while the resident was present. CNA C stated she had not bathed the resident yet and became upset when CNA A and CNA B transferred the resident to a Geri-chair to prepare her for lunch. CNA C raised her voice, approached the resident, and loudly stated, “I will do it myself. I always do everything by myself,” while pushing the resident’s Geri-chair. CNA C continued arguing in a loud and aggressive tone with staff, including statements about always having issues with CNA B. RN D intervened and instructed CNA C to stop fussing and finish patient care with another resident, while CNA A and CNA B took the resident back to bed so she could receive her bed bath. Interviews with CNA A, CNA B, RN D, the DON, and the ADM confirmed the exchange occurred in the resident’s presence and that staff understood verbal altercations in front of residents were not acceptable. CNA A and CNA B stated they did not observe any physical or emotional reaction from the resident after the altercation. CNA C stated she was aware the resident was present and acknowledged she had been trained not to engage in confrontations in front of residents, though she denied yelling or being confrontational. The facility policy on dignity stated residents shall be treated with dignity and respect at all times and that dignity means assisting residents in maintaining and enhancing self-esteem and self-worth.
Incomplete Person-Centered Care Plan
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for Resident #5 that included measurable objectives and timeframes to meet her identified medical, nursing, mental, and psychosocial needs. Resident #5 was an elderly female admitted with diagnoses including unspecified dementia, psychotic disorder with hallucinations, psychotic disorder with delusions, and major depressive disorder. Her admission MDS, dated 02/03/2025, showed a BIMS score of 08, indicating moderate cognitive impairment, and the CAA summary identified care planning revision areas for cognitive loss/dementia, communication, ADL functional/rehabilitation potential, urinary incontinence and indwelling catheter, falls, nutritional status, pressure ulcer, psychotropic drug use, and pain. Record review of the current care plan showed focus areas for disturbed thought process related to psychotic disorder with hallucinations and delusions, with interventions to administer medications as ordered and monitor and record signs and symptoms of non-verbal pain. The care plan did not include focus areas for Cognitive Loss/Dementia, Communication, Urinary Incontinence, Pressure Ulcers, or the diagnosis of Alzheimer’s disease with late onset. The resident’s active physician orders included tramadol and acetaminophen for pain, quetiapine for psychotic disorder with hallucinations, and sertraline for major depressive disorder. During interviews, the MDS nurse stated she was responsible for completing and updating care plans and that all CAA areas should have been included on Resident #5’s care plan because they applied to her current care. The DON stated all triggered care areas should have been listed as focus areas on the care plan, and the ADM stated critical areas should have been addressed. The facility policy stated that a comprehensive, person-centered care plan with measurable objectives and timetables is developed and implemented for each resident based on the comprehensive assessment.
Failure to Wash Hands During Food Preparation
Penalty
Summary
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for dietary services. During observation on 07/29/2025 at 10:30 AM, [NAME] E placed a piece of fish into a puree processor bowl and removed gloves, took a sheet pan to the dirty dish room, returned to the prep area, put on gloves, and continued the puree process. [NAME] E then added water to the fish in the puree processor bowl, removed gloves, went to the dry storage room, picked up a container of thickener from the bottom shelf, placed it on the prep table across from the steam table, and scooped thickener into a Styrofoam cup. [NAME] E then returned to the puree prep area, put on gloves, and poured a small amount of thickener into the puree processor bowl with fish. He removed the puree fish from the processor into a bowl and placed it in the microwave, then removed gloves and took the puree processor bowl, lid, and blade to the dirty dish area before washing his hands. No handwashing was observed between glove changes or task changes. During interview, [NAME] E stated he should have washed his hands between glove changes and anytime he changed tasks and said he was nervous and forgot. The DM and ADM stated hands should be washed with any glove change and task change, and both acknowledged [NAME] E had been trained on handwashing. The facility policy stated employees are to wash hands between handling dirty and clean dishes, equipment/utensils, and food, and that gloves or hand sanitizer do not replace handwashing.
Failure to Provide Adequate Supervision and Assistance Devices
Penalty
Summary
The facility failed to ensure adequate supervision and assistance devices for Resident #35, leading to an unwitnessed fall that resulted in a broken left hip. Resident #35, a male with severe cognitive impairment and multiple diagnoses including dementia and Alzheimer's, was dependent on staff for mobility and had a history of falls. Despite being assessed as a moderate fall risk and having a care plan that included the use of mobility alarms and increased supervision, these measures were not adequately implemented on the day of the incident. On the day of the fall, Resident #35 had been transitioned from a geri chair to a wheelchair for therapy and a haircut. The mobility alarm, which was supposed to be transferred to the wheelchair, was not in place. Staff members, including the Director of Nursing (DON) and Licensed Vocational Nurse (LVN), admitted that the alarm was not moved because they were busy and believed the resident was under supervision. However, the resident was left unattended in the hallway, leading to the fall. Interviews with staff and the resident's family revealed that the lack of the mobility alarm and inadequate supervision were critical factors in the incident. The family expressed concern over the repeated falls and the failure to follow the care plan. Staff members acknowledged that the care plan was not followed and that this lapse could have detrimental effects on the resident's safety. The facility's policies on comprehensive, person-centered care plans and fall risk management were not adhered to, contributing to the deficiency.
Improper Food Storage and Labeling in Kitchen
Penalty
Summary
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety. Observations revealed multiple instances of improperly stored, labeled, and dated food items in the walk-in pantry, refrigerator, and freezer. Specific findings included an opened package of bread, a tray of brownies, and various containers of spices and pantry foods without labels or dates. Additionally, the walk-in refrigerator contained bags of lettuce, a whole watermelon, trays of juice and tea, yogurts, and puddings, all without proper labeling or dating. The freezer also had an open box of breadsticks, a large package of ground beef, and a tray of brownies, none of which were labeled or dated. These deficiencies were confirmed through interviews with kitchen staff who acknowledged the importance of labeling and dating food to prevent serving outdated or potentially harmful food to residents. Interviews with Cook A, Cook B, and the Dietary Manager (DM) indicated that it was everyone's responsibility to ensure food items were properly labeled and dated. They acknowledged that failing to do so could result in serving outdated food, which could lead to bacterial growth and potential illness among residents. The facility's policies on food storage, both dry and refrigerated/frozen, were reviewed and confirmed the requirement for all food to be stored in properly covered containers with labels and dates. The lack of adherence to these policies was evident in the observations made during the survey, highlighting a significant lapse in food safety practices within the facility's kitchen operations.
Infection Control Deficiencies
Penalty
Summary
The facility failed to maintain an infection prevention and control program, leading to multiple instances of staff not adhering to proper hygiene and PPE protocols. LVN C did not don PPE while administering medication via PEG tube to a resident and failed to perform hand hygiene or change gloves between dirty and clean portions of wound care for another resident. Additionally, LVN C did not perform hand hygiene between assisting different residents with eating during mealtime. These actions were observed on multiple occasions, indicating a pattern of non-compliance with infection control procedures. CNA E and NA G were observed performing incontinent care for a resident without performing hand hygiene before, during, or after the task. They also did not change gloves between cleaning the resident and placing a clean brief on them. This lack of proper hygiene extended to touching various items in the resident's room with soiled gloves. Similarly, CNA F did not perform hand hygiene between assisting different residents with eating during a meal. Interviews with the staff members involved revealed a lack of awareness and understanding of the importance of hand hygiene and PPE use. The Director of Nursing (DON) acknowledged that these practices could lead to an increased risk of infection. Facility policies on hand hygiene, incontinent care, and wound care were reviewed and found to be in place, but not followed by the staff, leading to the observed deficiencies.
Failure to Implement Abuse Prevention Policies
Penalty
Summary
The facility failed to implement written policies and procedures that prohibit and prevent abuse, neglect, and exploitation of residents. Specifically, a Certified Nursing Assistant (CNA) was hired and allowed to work without completing the required training on abuse, neglect, and exploitation. The CNA was hired on March 1, 2024, but did not complete the necessary training until March 28, 2024. The Administrator admitted to making a judgment call to hire the CNA without proper training due to a shortage of CNAs. This failure to adhere to the facility's policy could place residents at risk of abuse, neglect, or exploitation.
Failure to Implement Care Plan Leads to Resident Fall and Injury
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for Resident #35, who had a history of severe cognitive impairment, mobility issues, and a high risk of falls. Despite being care planned for a chair alarm in his wheelchair and 1:1 monitoring, these interventions were not implemented, leading to an unwitnessed fall that resulted in a broken left hip. The resident had previously fallen and broken his right hip, indicating a pattern of inadequate fall prevention measures. On the day of the incident, Resident #35 was transitioned from a geri chair to a wheelchair for therapy and later taken for a haircut. During this time, the chair alarm was not transferred to the wheelchair, and 1:1 monitoring was not maintained. Staff members, including the Activity Director and Licensed Vocational Nurse, were unaware or did not ensure the implementation of the care plan interventions. The resident was found on the floor by the Activity Director after wheeling himself down the hall, indicating a lapse in supervision and adherence to the care plan. Interviews with staff and the resident's family revealed that the chair alarm was not in use because staff were too busy to transfer it, and there was a misunderstanding about the requirements for 1:1 monitoring. The Director of Nursing and other staff members acknowledged that the care plan was not followed, which directly contributed to the resident's fall and subsequent injury. The facility's policies on comprehensive person-centered care plans and fall risk management were not adhered to, leading to a significant deficiency in resident care.
Failure to Check PEG Tube Placement Before Administering Medication
Penalty
Summary
The facility failed to ensure that a resident who is fed by enteral means received the appropriate treatment and services to prevent complications. Specifically, the facility did not check for PEG tube placement before administering medication (Cephalexin) to a resident. This failure was observed during an incident where a Licensed Vocational Nurse (LVN) administered the medication without verifying the tube's placement, which is against the facility's policy and standard medical procedures. The resident involved had a history of severe medical conditions, including cerebral infarction, dysphagia, and aspiration of fluid, making the proper management of the feeding tube critical for his care. The resident's care plan included specific interventions to ensure proper tube placement before feeding or medication administration. However, during an observation, the LVN admitted to not following the correct procedure, which involves using a syringe filled with air and listening for a 'whoosh' sound to confirm placement. The Director of Nursing (DON) acknowledged that failing to check the tube placement could lead to severe complications. The facility's policies on enteral feedings and nutrition also emphasized the importance of confirming tube placement to prevent aspiration and other risks.
Failure to Adhere to Physician's Orders for Oxygen Therapy
Penalty
Summary
The facility failed to ensure that a resident requiring respiratory care received such care consistent with professional standards and physician orders. Resident #34, who had diagnoses including unspecified dementia, anxiety disorder, and muscle weakness, had a physician's order for oxygen via nasal cannula at 2-3 liters per minute (lpm). However, observations on multiple occasions revealed that the resident was receiving oxygen at 5 lpm, which was higher than the prescribed amount. This discrepancy was noted during various times of the day over a two-day period. Interviews with facility staff, including CNAs, the Director of Nursing (DON), and Licensed Vocational Nurses (LVNs), confirmed that the oxygen levels were set higher than the physician's orders. The staff acknowledged that they were responsible for setting and checking the oxygen levels according to the physician's orders but could not explain why the resident's oxygen was set at 5 lpm. The facility's policies on administering medications and oxygen also emphasized the importance of adhering to physician orders, which was not followed in this case.
Failure to Ensure Residents Are Free from Significant Medication Errors
Penalty
Summary
The facility failed to ensure that residents were free from significant medication errors, specifically involving the administration of expired insulin to a resident. The incident involved a Licensed Vocational Nurse (LVN) who attempted to administer insulin to a resident without verifying the open date on the vial. The insulin vial did not have an open date, making it impossible to determine if the insulin was expired. The LVN acknowledged that administering expired medication would not be effective for the resident. The Director of Nursing (DON) also confirmed that expired insulin would not be as effective. The facility's policies on medication administration and labeling were not followed, as they require checking expiration dates and recording the open date on multi-dose containers. The resident involved was a female with multiple diagnoses, including Type 2 diabetes mellitus, cerebral infarction, hypertension, cognitive communication deficit, muscle weakness, and major depressive disorder. The resident was dependent on staff for most activities of daily living (ADLs) except for eating. The resident's care plan included monitoring and documenting the effectiveness and side effects of diabetes medication. Despite this, the resident's insulin was not properly managed, leading to the potential administration of expired medication. The facility's failure to adhere to its own policies and procedures resulted in a significant medication error that could have adversely affected the resident's health.
Medication Storage and Labeling Deficiencies
Penalty
Summary
The facility failed to ensure drugs and biologicals were stored in locked compartments and labeled in accordance with currently accepted professional principles. Specifically, insulin medications were found in a medication cart without a date indicating when the vial was opened. Additionally, the medication refrigerator in the medication room was logged at 30 degrees Fahrenheit on four occasions out of the last 28 days, which is outside the acceptable temperature range. Furthermore, an LVN left a treatment cart unlocked and unattended, which could have allowed unauthorized access to medications. These deficiencies were observed in two medication carts, one medication room, and one treatment cart. During the survey, it was noted that the medication refrigerator contained an emergency kit full of insulins and a narcotic box with Lorazepam oral concentrate for three residents. The treatment cart with the undated Humalog insulin vial was left unattended by the LVN, who was informing the Director of Nursing (DON) about the issue. An agitated resident was present near the unlocked cart, posing a potential risk. Interviews with the LVN and DON confirmed that administering expired insulin could result in ineffective medication, and leaving an unlocked cart unattended could lead to unauthorized access by residents. The facility's policies on medication storage, labeling, and security were reviewed and found to be inconsistent with the observed practices.
Failure to Provide Essential Staff Training
Penalty
Summary
The facility failed to provide necessary training to their staff on abuse, neglect, exploitation, misappropriation of resident property, and dementia management. Specifically, two CNAs (CNA I and CNA J) were found to lack this essential training. CNA I, hired on 03/01/24, had no record of training on these critical areas, while CNA J, hired on 08/07/23, lacked dementia management training. This deficiency was identified through interviews and record reviews, revealing that the facility's administrator allowed these CNAs to work without completing the required training due to staffing shortages. During interviews, the administrator admitted to making a judgment call to hire these employees without proper training, acknowledging it was a mistake. The facility's policy mandates that new hires must complete specific training before starting floor work, including training on abuse prevention, identification, and reporting, as well as dementia management. However, this policy was not followed, potentially placing residents at risk of harm due to being cared for by untrained staff.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 6 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
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Friona
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Hereford Nursing & Rehabilitation | 21.2 mi | ★★★★★ | 0 | 0 |
| Castro County Nursing & Rehabilitation | 22.8 mi | ★★★★★ | 2 | 0 |
| Country View Living | 23.9 mi | ★★★★★ | 4 | 0 |
| Farwell Care And Rehabilitation Center | 25.6 mi | ★★★★★ | 21 | 0 |
| Park View Nursing Care Center | 29.1 mi | ★★★★★ | 24 | 2 |
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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.