Based on interview and record review the facility failed to ensure a nursing facility must notify the state mental health authority or state intellectual disability authority, as applicable, promptly after a significant change in the mental or physical condition of a resident who has mental illness or intellectual disability for resident review for 1 of 8 (Resident #8) residents reviewed for PASARR services in that:Resident #8 was positive for PASARR services, but the PASARR staff were not notified of the significant change of a feeding tube. …
F646 citations in Texas
Resident Assessment and Care Planning Deficiencies
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Texas cites F646 less often than its own record predicts
0.32 times the national share — cited less often here than elsewhere.
Of every deficiency written in Texas in 2025, this is the portion that was F646.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Texas surveyors wrote
F646 findings written in Texas, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
The short window
Recent years
| Year | Share of Texas citations | vs expected |
|---|---|---|
| 2023 | 0.07% | 1.33× |
| 2024 | 0.03% | 0.63× |
| 2025 | 0.02% | 0.32× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Texas surveyors cite →
Deficiency Index is independent and is not affiliated with, endorsed by, or approved by CMS, Medicare, or any government agency. About this data · Report a correction