Above average — CMS composite of the measures below.
A standard survey is most likely before around September 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 The Heights Of Alamo during CMS and state inspections, most recent first.
A resident with multiple complex medical conditions, including being NPO and requiring enteral feeding, had a care plan and Kardex that incorrectly included a bedtime snack intervention. Staff interviews and documentation confirmed that the resident was never given food by mouth, but the error occurred because the bedtime snack task auto-populated and was not removed as required. The facility's policy mandates individualized care plans, but this was not followed in this case.
A resident with chronic constipation and end stage renal disease was administered a PRN dose of Bisacodyl suppository following a verbal order from a nurse practitioner, but the nurse failed to enter the order and sign off the administration in the eMAR as required by facility protocol. The medication was only documented in a change in condition report and a bowel movement task report, not in the official medication administration record.
Two residents with severe cognitive impairment had their insurance-provided spending account cards used without permission by staff, who made unauthorized purchases for other residents and personal use. The Business Office Manager did not obtain consent from the residents' representatives, and the Activities Director used the cards multiple times, resulting in significant financial loss for both residents. The facility lacked protocols for managing such cards, leading to the misappropriation of resident property.
A resident with severe cognitive impairment and a legal guardian had her spending account card used by the Activities Director, with permission from the Business Office Manager but without authorization from the resident's responsible party. The card was used to purchase food items for multiple residents. The misappropriation was discovered during an unrelated investigation, but the incident was not reported to the state agency or the resident's representative within the required timeframes.
Failure to Individualize Care Plan for NPO Resident
Penalty
Summary
The facility failed to develop and implement a comprehensive, person-centered care plan for a resident who was NPO (nothing by mouth) and required enteral feeding. Despite the resident's medical history, which included Huntington's disease, diabetes, muscle wasting, hypoxia, and aphasia, and the fact that he was unable to eat or drink by mouth, his care plan and Kardex included an intervention for a bedtime snack. This intervention was not appropriate for his condition, as confirmed by multiple staff interviews and record reviews. Observations and interviews revealed that the resident had a feeding tube and was on continuous enteral feeding, with staff consistently aware that he could not have anything by mouth. The Kardex, however, still listed a bedtime snack as a task, which was an error resulting from an auto-populated field that was not removed for this resident. The MDS nurse acknowledged responsibility for ensuring individualized and accurate care plans and admitted to failing to remove the inappropriate task from the resident's Kardex. Documentation showed that CNAs had not provided a bedtime snack to the resident, as indicated by their documentation of 'NA' for the task. Both the MDS nurse and the DON confirmed that the task should have been removed from the Kardex for residents who are NPO, and that the error was due to a failure to update the care plan to reflect the resident's specific needs. The facility's policy requires care plans to be individualized and include measurable objectives and appropriate interventions based on the resident's assessment.
Failure to Accurately Document PRN Medication Administration in Medical Record
Penalty
Summary
A deficiency occurred when the facility failed to maintain complete and accurate medical records for a resident with end stage renal disease, dependence on dialysis, and constipation. The resident had not had a bowel movement in several days, and after being flagged on a daily report, a nurse contacted the resident's nurse practitioner, who verbally ordered a PRN dose of Bisacodyl suppository. The nurse reported administering the medication, and the resident subsequently had a bowel movement. However, the nurse did not enter the Bisacodyl order into the electronic medical record (eMAR), nor did he sign off on the administration of the medication in the eMAR. The facility's protocol required that any new medication order be entered into the resident's electronic record, which would then populate the eMAR for proper documentation and sign-off after administration. Because the order was not entered, the medication did not appear on the eMAR, and there was no electronic record of its administration. Interviews with staff confirmed that the medication was given, but the required documentation steps were not followed. The Director of Nursing acknowledged that the nurse had not inputted the order or signed off on the medication in the eMAR, as required by facility policy. The only documentation of the medication order and administration was found in the resident's change in condition report and bowel movement task report, not in the official medication administration record.
Failure to Safeguard Resident Funds and Prevent Misappropriation
Penalty
Summary
The facility failed to protect two residents from misappropriation and exploitation of their personal funds. Both residents, who had severe cognitive impairments and designated resident representatives, received spending account cards from their insurance providers. These cards were intended for the residents' use on over-the-counter medications and groceries, with monthly deposits accumulating if unused. The Business Office Manager (BOM) did not obtain permission from the residents' representatives before allowing the Activities Director (AD) to use the residents' cards. The AD subsequently used the cards on multiple occasions to purchase snacks and groceries not only for the cardholders but also for other residents, and in one instance, for personal use. The residents' representatives were not informed or consulted prior to these transactions, and the cards were not given to the representatives as required. The investigation revealed that the AD used one resident's card for unauthorized purchases totaling $318.64 and the other resident's card for $313.72. The receipts showed multiple transactions, including one where a 12-pack of energy drinks was purchased for the AD's personal use. The BOM admitted to not knowing that permission from the residents' representatives was required and that the cards could not be used for other residents. The cards were kept in the BOM's office safe and later in the AD's office, without proper tracking or oversight. The lack of a facility protocol for managing residents' spending account cards contributed to the unauthorized use and lack of accountability. Both residents were severely cognitively impaired and unable to provide consent or manage their own funds. Their representatives only became aware of the misuse after noticing the absence of the cards and questioning facility staff. The facility's policies on resident rights and prevention of abuse and exploitation were not followed, as staff failed to protect the residents' property and did not promptly report or prevent the misappropriation. The incident was only investigated after a representative inquired about the missing card, revealing systemic failures in safeguarding resident funds.
Failure to Timely Report Misappropriation of Resident Property
Penalty
Summary
The facility failed to ensure that all alleged violations involving misappropriation of resident property were reported to the State Survey Agency within the required timeframes. Specifically, a resident with severe cognitive impairment and a legal guardian had a spending account card provided by her insurance, which was intended for her use on over-the-counter medications and groceries. The Business Office Manager (BOM) gave the Activities Director (AD) permission to use this card to purchase food items for the resident and other residents, without obtaining permission from the resident's responsible party (RP) or legal guardian. The AD used the card on several occasions, and the BOM kept the card and receipts in her office safe, but at one point allowed the AD to keep the card in her office. The misappropriation was discovered during an investigation into a separate allegation involving another resident. It was determined that the AD had used the resident's spending account card without proper authorization, and the total amount used was $313.72. The Administrator confirmed the misappropriation but failed to report the incident to the state agency as required and did not notify the resident's RP of the allegation or the findings in a timely manner. The RP was only informed months later, after the investigation had concluded and after the AD had been terminated. Facility policy required prompt reporting of all suspected or alleged violations of abuse, neglect, or misappropriation of property to state authorities within specified timeframes. However, in this case, the facility did not adhere to its own policy or regulatory requirements, resulting in a delay in reporting the misappropriation of the resident's property and in notifying the resident's legal representative.
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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 Alamo
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| San Juan Nursing Home Inc | 2.7 mi | ★★★★★ | 11 | 0 |
| Windsor Las Palmas Nursing And Rehabilitation Cent | 5.3 mi | ★★★★★ | 1 | 0 |
| Mcallen Transitional Care Center | 5.4 mi | ★★★★★ | 5 | 0 |
| Alfredo Gonzalez Texas State Veterans Home | 5.9 mi | ★★★★★ | 14 | 2 |
| Mcallen Nursing Center | 6.3 mi | ★★★★★ | 4 | 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.