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 August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Sylan Shores Health And Wellness during CMS and state inspections, most recent first.
Two residents with significant cognitive and physical impairments experienced falls that were not incorporated into their care plans, despite documentation of the incidents in assessments and progress notes. Although both residents had prior falls that were care-planned and had interventions in place for fall risk, the most recent falls were not addressed in their care plans, as confirmed by staff interviews.
The facility failed to ensure that residents were protected from all forms of abuse and neglect, including physical, mental, and sexual abuse, as well as physical punishment, due to insufficient protective measures and oversight.
Several residents with complex medical conditions had their MDS assessments inaccurately coded, listing bed rails used for positioning and turning as physical restraints. Care plans and resident interviews confirmed the rails were used as mobility aids, not restraints, but the assessments did not reflect this, resulting in inaccurate documentation.
The facility did not ensure pharmaceutical services were provided to meet each resident's needs and failed to employ or obtain a licensed pharmacist, resulting in noncompliance with regulatory requirements.
A resident with multiple impairments was not treated with dignity during incontinence care when a CNA allegedly placed a bedsheet over her face while she was crying. The resident, who is dependent on staff for daily living activities, communicated the incident to her family member through sign language. The facility's administrator suspended the CNA and conducted an assessment, finding no physical injuries. The incident violated the facility's policy on resident rights.
A resident with severe cognitive impairments experienced an unwitnessed fall resulting in a left femur fracture. The incident was not reported to the state agency until four days later, despite facility policy requiring immediate reporting. Interviews revealed a lack of timely documentation and discrepancies in incident report dates.
A resident with moderate hearing difficulties reported that her hearing aids stopped working after a shower, but her complaint was not documented or addressed by the facility. The resident expressed frustration over communication issues, and interviews revealed a lack of awareness and documentation by staff, violating the resident's right to voice grievances without fear of reprisal.
The facility failed to ensure accurate MDS assessments for three residents, leading to discrepancies in their care plans. A resident with Multiple Sclerosis was not coded for falls despite a documented history, another with dementia had unrecorded falls, and a third resident's cognitive assessment was inaccurate despite her ability to communicate. These inaccuracies could result in unmet medical needs.
A medication aide in a LTC facility administered incorrect doses of Famotidine and Tylenol to a resident, resulting in an 8% medication error rate. The resident, with multiple health conditions, received a 10 mg dose of Famotidine instead of 20 mg and a 325 mg dose of Tylenol instead of 650 mg. The errors were observed during a medication pass and confirmed through interviews and record reviews.
Failure to Update Care Plans After Resident Falls
Penalty
Summary
The facility failed to ensure that two residents who experienced falls had these incidents incorporated into their individualized care plans. For one resident, who had a history of Alzheimer's disease, repeated falls, and other significant medical conditions, a fall that occurred in October was not added to her care plan. Although previous falls had been care-planned with specific interventions, the most recent fall was only documented in a change in condition assessment, with no corresponding update to the care plan. Similarly, another resident with Alzheimer's disease, schizophrenia, diabetes, COPD, and muscle weakness experienced an unwitnessed fall in the hallway, resulting in a forehead injury and subsequent transfer to the emergency room. Despite this event being documented in progress notes and a change in condition assessment, the fall was not added to the resident's care plan. This resident had prior falls that were care-planned, and interventions for fall risk were in place, but the most recent incident was not addressed in the care plan. Interviews with facility staff, including the MDS nurse responsible for care plans, revealed that falls should be documented and care plans updated accordingly. The MDS nurse indicated that care plans are typically updated the day after a fall unless the resident is sent out, in which case updates occur upon return. The administrator and DON confirmed that the falls should have been care-planned and acknowledged that failure to do so could result in staff not knowing how to care for the residents following such incidents.
Failure to Protect Residents from Abuse and Neglect
Penalty
Summary
A deficiency was identified regarding the facility's failure to protect each resident from all types of abuse, including physical, mental, sexual abuse, physical punishment, and neglect by any individual. The report notes that residents were not adequately safeguarded from these forms of mistreatment, indicating lapses in the facility's protective measures and oversight. Specific details about the actions or inactions leading to the deficiency, as well as information about the residents involved or their conditions at the time, are not provided in the report.
Inaccurate MDS Coding of Bed Rails as Physical Restraints
Penalty
Summary
The facility failed to ensure that resident assessments accurately reflected the residents' status for several individuals. Specifically, for three residents with complex medical histories including Alzheimer's disease, Parkinson's disease, dementia, and other chronic conditions, the Minimum Data Set (MDS) assessments incorrectly coded bed rails used for positioning and turning as physical restraints. Record reviews showed that the care plans for these residents identified the bed rails as mobility or enabler bars used to assist with bed mobility, not as restraints. Observations and interviews confirmed that the residents used the side rails to help reposition themselves in bed, and staff interviews acknowledged that the MDS coding was inaccurate. The MDS nurse and the DON both confirmed that the bed rails were not being used as restraints and should not have been coded as such. The facility's policy and the RAI manual specify that bed rails are only considered restraints if they are used to intentionally prevent a person from getting in and out of bed. The incorrect coding on the MDS assessments did not reflect the actual use of the bed rails as described in the care plans and by the residents themselves.
Failure to Provide Required Pharmaceutical Services
Penalty
Summary
The facility failed to provide pharmaceutical services to meet the needs of each resident and did not employ or obtain the services of a licensed pharmacist. This deficiency was identified during the survey process, indicating that the required pharmaceutical oversight and services were not in place for residents as mandated by regulations.
Resident Dignity Violated During Incontinence Care
Penalty
Summary
The facility failed to ensure that a resident was treated with respect and dignity during incontinence care. A resident, who was dependent on staff for various aspects of daily living due to multiple physical and cognitive impairments, was subjected to an incident where a CNA allegedly placed a bedsheet over her face while she was crying. This action was reported by the resident's family member, who communicated with her through sign language, as she was born deaf and had a muscle disease. The family member reported that the resident indicated the CNA was lying about the incident. The resident's medical history included abnormalities of gait and mobility, muscle weakness, contractures in multiple joints, cognitive communication deficit, and oropharyngeal dysphagia. She was assessed to have moderate cognitive impairments and was dependent on staff for toileting hygiene, dressing, eating, and personal hygiene. The incident was reported to the facility's administrator, who took immediate action by suspending the CNA involved and conducting an assessment of the resident, which showed no physical injuries. Interviews with the facility's administrator and DON revealed that the CNA denied the allegations but was not cooperative with the investigation. The family member expressed frustration over the repeated incidents and the inability of the resident to communicate directly with the state. The facility's policy on resident rights emphasizes the importance of treating residents with dignity and respect, and the incident was a clear violation of these rights.
Failure to Timely Report Resident Fall and Injury
Penalty
Summary
The facility failed to report an incident of neglect involving a resident who experienced an unwitnessed fall in her room, resulting in a left femur fracture. The incident occurred on 6/21/24, but it was not reported to the state agency until 6/25/24, four days later. This delay in reporting was identified during a review of the resident's records and interviews with facility staff. The resident, a female with severe cognitive impairments and multiple health conditions, was found on the floor by a CNA during the night shift. An LVN assessed the resident and suspected a hip fracture, which was later confirmed by an x-ray. The LVN notified the DON and the resident's family, and the resident was sent to the hospital. However, the incident was not entered into the system promptly, and there were discrepancies in the incident report dates. Interviews with the ADON, LVN, and DON revealed a lack of timely documentation and reporting to the state agency. The facility's policy requires incidents to be reported immediately, but not later than 24 hours after occurrence or suspicion. The delay in reporting could potentially place residents at risk of injury of unknown origin, abuse, and neglect.
Failure to Address Resident Grievance Regarding Hearing Aids
Penalty
Summary
The facility failed to ensure that residents could voice grievances without fear of discrimination or reprisal, as evidenced by the case of a resident who experienced issues with her hearing aids. The resident, who had moderate hearing difficulties and relied on hearing aids, reported that her hearing aids stopped working after a shower. She informed a nurse about the incident, but the complaint was not documented or reported to the Director of Nursing (DON) or the Administrator. The resident expressed frustration over her inability to communicate effectively due to the malfunctioning hearing aids. Interviews with the DON and other staff revealed a lack of awareness and documentation regarding the resident's grievance. The facility's grievance policy, which designates the Administrator as the Grievance Official responsible for investigating and resolving complaints, was not followed. The failure to document and address the resident's complaint about her hearing aids not only violated her right to voice grievances but also placed her at risk of harm by not having her concerns addressed.
Inaccurate MDS Assessments for Three Residents
Penalty
Summary
The facility failed to ensure accurate assessments for three residents, leading to deficiencies in their care. Resident #6, a female with multiple diagnoses including Multiple Sclerosis and intellectual disability, was not accurately coded for falls in her Minimum Data Set (MDS) assessment. Despite having a history of falls documented in the facility's accident and incidents log, her MDS indicated no falls since admission. This discrepancy suggests a failure to accurately assess and document her fall history, which is crucial for her care planning. Resident #61, a female with dementia and repeated falls, also had inaccuracies in her MDS assessment. Her quarterly MDS indicated no falls, despite documentation of multiple falls in the facility's records. This inconsistency highlights a failure to accurately reflect her fall history, which is essential for addressing her care needs and preventing future incidents. The resident herself acknowledged having multiple falls, although she could not recall specific details. Resident #66, a female with chronic conditions including hypertension and diabetes, was inaccurately assessed for her cognitive patterns in her admission MDS. Despite being able to communicate and understand others, her MDS indicated she was unable to answer questions. Observations and interviews revealed she was hard of hearing but capable of communication, contradicting the MDS assessment. These inaccuracies in the MDS assessments for all three residents could lead to unmet medical needs and inadequate care planning.
Medication Administration Errors Lead to 8% Error Rate
Penalty
Summary
The facility failed to maintain a medication error rate of less than 5%, resulting in an 8% error rate during a medication administration review. This deficiency involved a resident who was administered incorrect doses of Famotidine and Tylenol by a medication aide (MA A). Specifically, MA A gave the resident a 10 mg dose of Famotidine instead of the prescribed 20 mg, and a 325 mg dose of Tylenol instead of the prescribed 650 mg. These errors were observed during a medication pass and were confirmed through interviews and record reviews. The resident involved was an elderly female with multiple diagnoses, including allergic rhinitis, gastro-esophageal reflux disease (GERD), hemiplegia, and cerebral infarction due to thrombosis. The medication errors were identified during an observation of the medication administration process, where MA A failed to administer the correct dosages as per the physician's orders. The facility's Director of Nursing (DON) acknowledged the need for staff training and adherence to medication administration policies, which require verifying the right medication and dosage before administration.
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 466 citations issued within 25 miles in the last 12 months — including the 36 immediate-jeopardy cases — 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 La Porte
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Baywood Crossing Rehabilitation & Healthcare Cente | 3.6 mi | ★★★★★ | 3 | 0 |
| The Courtyards At Pasadena | 4.1 mi | ★★★★★ | 8 | 0 |
| Bay Ridge Healthcare Center | 4.4 mi | ★★★★★ | 7 | 3 |
| Hca Houston Healthcare Southeast | 4.7 mi | ★★★★★ | 0 | 0 |
| The Suites Pasadena | 4.8 mi | ★★★★★ | 21 | 1 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Sylan Shores Health And Wellness.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.