Above average — CMS composite of the measures below.
A standard survey is most likely before around August 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 On Valley Ranch during CMS and state inspections, most recent first.
A resident with cerebral palsy and depression was denied the choice to eat in the dining room due to a staff shortage, leading to distress and a confrontation with staff. The facility's policy required residents to eat in their rooms or near the nursing station when short-staffed, which contradicted the resident's rights to self-determination and dignity.
A facility failed to recognize a resident's advance directive, resulting in a 15-day delay in entering the resident's full code status into the medical record. Staff interviews revealed confusion about responsibilities, leading to the oversight.
The facility failed to develop and implement accurate care plans for three residents, leading to discrepancies between their documented code status and physician's orders. This could result in inappropriate life-saving measures being provided or withheld.
A resident with severe cognitive impairment and dependence on staff for all ADLs was not provided with necessary services, including a specialized call bell, regular showers, and assistance out of bed. Observations and interviews revealed the resident was often unshaved, with greasy hair, and without required heel protectors, indicating a failure to adhere to the care plan and physician orders.
The facility failed to provide a resident with the prescribed hydrocortisone gel for shin wounds and did not consistently perform tracheostomy stoma care as directed by physician orders. The resident, who had severe cognitive impairment and multiple medical conditions, was observed with uncovered trach stoma and untreated shin wounds. Staff used an incorrect cream and were unaware of the prescribed care requirements.
A facility failed to ensure a resident with limited range of motion received appropriate treatment and services. The resident was often observed without prescribed positioning devices and was not placed in a Geri chair as recommended. Interviews and observations indicated lapses in care, and the facility's policy on range of motion was not adhered to.
A resident with multiple medical conditions did not receive sufficient fluids over a three-day period, despite having a care plan that included monitoring for dehydration. The resident's water pitcher was not refilled regularly, and staff interviews revealed inconsistencies in the frequency of water pitcher refills, leading to potential dehydration risks.
A facility failed to follow physician orders for a resident's enteral water flush, administering 220ml every 4 hours instead of the prescribed 180ml. This discrepancy was observed over several days, and the resident showed signs of fluid overload. The DON acknowledged the error, noting that the nursing staff might not have seen the updated order.
Resident's Dining Preferences Not Respected Due to Staff Shortage
Penalty
Summary
The facility failed to promote and facilitate resident self-determination by not allowing a resident to eat in the dining room during meal times. This deficiency was identified for a resident with a history of cerebral palsy, hypertension, and major depressive disorder. The resident, who uses a wheelchair or walker and requires setup assistance for eating, expressed a preference to eat in the dining room with other residents. However, due to a staff shortage, the resident was instructed to eat either in her room or by the nursing station, which she found distressing. Interviews with staff and the resident revealed that the facility's practice during staff shortages was to have residents eat in their rooms or near the nursing station for safety reasons, as there were no staff available to monitor the dining room. The resident resisted this directive, leading to a confrontation where her food tray was dropped during a struggle with a nurse. The resident was then taken back to her room against her wishes, and although another tray was brought to her, she refused to eat it as it was not what she had ordered. The facility's administration was unaware of this practice and stated that denying residents the right to eat in the dining room due to staff shortages was unacceptable. The facility's policies on resident rights and quality of life emphasize the importance of promoting resident dignity and self-determination, which were not upheld in this instance. Interviews with other residents and staff confirmed that the practice of restricting dining room access during staff shortages was common, although not all residents were affected by it in the same way.
Failure to Recognize Resident's Advance Directive
Penalty
Summary
The facility failed to recognize a resident's right to formulate an advance directive, specifically for a resident admitted with multiple fractures, dyspnea, acute kidney failure, type 2 diabetes, and dementia. The resident's care plan indicated a full code status, but this was not entered into the medical record from the time of admission until 15 days later. Interviews with staff revealed confusion and miscommunication regarding who was responsible for entering the code status into the medical record. The Social Worker (SW) confirmed that the code status should have been entered upon admission, but it was not. The Admissions Director believed it was the nursing staff's responsibility to update the face sheet and enter the code status, while the Director of Nursing (DON) stated that the nursing staff should have updated the face sheet and entered the code status. The facility's policy indicated that the nurse should obtain a physician's order for the code status and update the medical record accordingly, but this was not done, leading to a lapse in recognizing the resident's advance directive wishes.
Failure to Implement Accurate Care Plans for Residents
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights for three residents reviewed for care plans. Specifically, Resident #24's care plan reflected a DNR status despite having orders to be full-code, while Resident #40's and Resident #213's care plans reflected they were full-code despite having orders and an active DNR on file. These discrepancies could lead to confusion related to life-saving measures, potentially resulting in life-saving measures being provided to a resident with a DNR status or not providing life-saving measures to a resident with a full-code status. Resident #24, a woman with severe cognitive impairment and multiple diagnoses including spinal stenosis, depression, and dementia, had a care plan dated 2/22/2024 that focused on her DNR status. However, her physician's orders report dated 3/19/2024 indicated she was to have a full-code status. Similarly, Resident #40, a man with no cognitive impairment and multiple diagnoses including acute hematogenous osteomyelitis, type 2 diabetes, and heart failure, had a care plan dated 2/15/2024 that indicated he was full-code, despite having a DNR form signed on 8/31/2023 and a physician's order for DNR status dated 9/8/2023. Resident #213, a woman with no cognitive impairment and multiple diagnoses including a pelvis fracture and hypertension, had a care plan dated 3/16/2024 that indicated she was full-code, despite having a DNR form signed on 3/8/2024 and a physician's order for DNR status. Interviews with facility staff, including the Corporate MDS Nurse, Social Worker, DON, ADON, and WCN, revealed systemic issues in updating and maintaining accurate care plans. The Corporate MDS Nurse acknowledged that the care plans for Residents #24, #40, and #213 were incorrect and highlighted the potential for miscommunication and inappropriate life-saving measures. The DON and other staff members confirmed that discrepancies between care plans and physician's orders could lead to serious consequences, including the provision of life-saving measures to residents with a DNR status or the failure to provide such measures to residents with a full-code status. The facility's policies on care plans and advanced directives were not followed, leading to these deficiencies.
Failure to Provide Necessary ADL Assistance and Personal Hygiene
Penalty
Summary
The facility failed to ensure that a resident who was unable to carry out activities of daily living (ADLs) was provided with the necessary services to maintain good personal hygiene. Specifically, Resident #42, who had severe cognitive impairment and was dependent on staff for all ADLs, was not provided with a specialized call bell, was not showered or dressed in his own clothes, and was not assisted out of bed between 3/19/24 and 3/21/24. Observations revealed that the resident was often found lying flat on his back in bed, unshaved, with greasy hair, and without the required heel protectors or floated heels on pillows. Additionally, the resident had a regular call bell pinned to the sheets instead of the specialized blow light call bell that was indicated in his care plan. Interviews with the resident's family member and staff confirmed these observations and highlighted a lack of adherence to the resident's care plan and physician orders during this period. Resident #42's medical history included anoxic brain damage, chronic heart failure, gastrostomy, dysphagia, aphasia, hypertension, GERD, duodenal ulcer, and muscle weakness. The resident's care plan specified the use of a Geri chair for safety, a specialized blow light call bell, and assistance with all ADLs, including bathing, dressing, grooming, and hygiene. Despite these detailed interventions, the facility failed to implement them consistently, as evidenced by the resident's unkempt appearance and lack of appropriate equipment and assistance. The Director of Nursing (DON) and other staff members acknowledged the deficiencies during interviews, with the DON stating that she and the Assistant Director of Nursing (ADON) made rounds to ensure interventions were in place. However, the observations and interviews indicated that these rounds were not effective in ensuring the resident's needs were met. The facility's policy on routine resident care emphasized the importance of maintaining good grooming and personal hygiene, but this policy was not followed for Resident #42 during the specified period.
Failure to Provide Prescribed Wound and Tracheostomy Care
Penalty
Summary
The facility failed to ensure that Resident #42 received treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the resident's choices. Specifically, the facility did not treat Resident #42's wounds on his shins with the prescribed hydrocortisone gel and did not provide the required tracheostomy stoma care as directed by the physician orders. These failures were observed during multiple instances where the resident's trach stoma was uncovered and the prescribed ointment was not applied to the resident's shins, despite the presence of deep red excoriations. Resident #42, a [AGE] year-old male with severe cognitive impairment and multiple medical conditions including anoxic brain damage, chronic heart failure, and a tracheostomy, was dependent on staff for all activities of daily living. The resident's care plan included specific interventions for tracheostomy stoma care and skin integrity management, which were not followed. The resident's medical records indicated that the hydrocortisone gel was not administered throughout February and March 2024, and the trach stoma care was inconsistently documented. Observations and interviews with staff revealed that the nurses were using an oily barrier cream instead of the prescribed steroid cream for the resident's shin wounds, and the trach stoma was often left uncovered. The Director of Nursing (DON) and Licensed Vocational Nurse (LVN) were unaware of the reasons for these deviations from the prescribed care. The facility's policies on professional standards of care, medication administration, and skin and wound management were not adhered to, resulting in inadequate treatment and care for Resident #42.
Failure to Implement Range of Motion Interventions
Penalty
Summary
The facility failed to ensure a resident with limited range of motion received appropriate treatment and services to increase range of motion and/or to prevent further decrease in range of motion. The resident, a male with severe cognitive impairment and multiple medical conditions including anoxic brain damage and muscle weakness, was observed multiple times without the prescribed positioning devices such as hand rolls, heel protectors, and posey palm pad. Additionally, the resident was not placed in a Geri chair as recommended, which is crucial for his condition to prevent further decline in mobility and skin integrity. Observations revealed that the resident was often left lying flat on his back in bed without the necessary devices. Interviews with the resident's family member and roommate indicated that the resident was not being bathed or taken care of properly, and was rarely moved out of bed. The facility's Director of Nursing (DON) and other staff members acknowledged the lapses in care, noting that the interventions were not consistently implemented despite being documented in the resident's care plan and physician orders. The facility's policy on range of motion, which mandates that residents should reach and maintain their highest level of range of motion and prevent avoidable decline, was not adhered to. The DON admitted that the staff should have been more diligent in ensuring the prescribed interventions were in place. Despite the care plan and physician orders being accessible in the electronic medical records, the staff failed to consistently implement the necessary interventions to maintain the resident's range of motion and overall quality of care.
Failure to Ensure Adequate Fluid Intake for Resident
Penalty
Summary
The facility failed to ensure that a resident received adequate fluid intake to maintain proper hydration and health. Specifically, Resident #8, who had multiple medical conditions including polyosteoarthritis, muscle wasting, peripheral neuropathy, hypertension, and atherosclerotic heart disease, did not receive sufficient fluids from 3/19/24 to 3/21/24. Despite having a care plan that included monitoring for dehydration and encouraging fluid intake, the resident's water pitcher was not refilled regularly, leading to potential dehydration risks. The resident reported that her water pitcher was not changed for two days at a time and was only a quarter full during observations on 3/19/24 and 3/21/24. She also mentioned that she did not know who her aide was and that her requests for water refills were not fulfilled promptly. Interviews with staff members revealed inconsistencies in the frequency of water pitcher refills, with some staff stating they filled pitchers once per shift and others claiming to do so more frequently. The Director of Nursing (DON) and other staff members confirmed that water pitchers should be filled at least once per shift, but this standard was not consistently met. The facility's policies on Certified Nurse Aide Standards of Clinical Practice and Routine Resident Care were reviewed, indicating that CNAs should assist residents with drinking and ensure essential items like water pitchers are within reach. However, these policies were not adequately followed, leading to the deficiency in providing sufficient fluid intake for Resident #8.
Failure to Follow Physician Orders for Enteral Water Flush
Penalty
Summary
The facility failed to ensure that Resident #42, who was fed by enteral means, received the appropriate treatment and services to prevent complications. Specifically, the facility did not follow the physician's orders for the resident's enteral water flush, which was changed on 3/15/24 to 180ml every 4 hours. Instead, the staff continued to administer 220ml every 4 hours, as observed on multiple occasions between 3/19/24 and 3/20/24. This discrepancy was confirmed by the Director of Nursing (DON) and Licensed Vocational Nurse (LVN) D during an observation and interview on 3/20/24, where the resident's feet were noted to be moderately swollen, indicating potential fluid overload. The DON acknowledged that the nursing staff might not have seen the updated order and incorrectly assumed that no harm would come from the excess fluid administration. Resident #42, a [AGE] year-old male with severe cognitive impairment and multiple medical conditions, including anoxic brain damage, chronic heart failure, and dysphagia, was dependent on staff for all activities of daily living (ADLs) and received more than 51% of his total calories through the feeding tube. The resident's care plan and physician orders emphasized the need for precise administration of enteral feedings and water flushes to maintain adequate hydration and prevent complications. However, the facility's failure to adhere to these orders placed the resident at risk for fluid overload and other potential complications. The facility's policy on enteral nutrition, which includes monitoring for signs of fluid overload and ensuring adherence to physician orders, was not followed in this case, leading to the identified deficiency.
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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 Porter
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Kingwood Rehabilitation And Healthcare Center | 3.8 mi | ★★★★★ | 0 | 0 |
| Crimson Heights Health & Wellness | 8.1 mi | ★★★★★ | 15 | 0 |
| Deerbrook Skilled Nursing And Rehab Center | 8.1 mi | ★★★★★ | 14 | 3 |
| Park Manor Of Humble | 8.3 mi | ★★★★★ | 9 | 0 |
| Focused Care At Humble | 8.5 mi | ★★★★★ | 1 | 0 |
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