Based on interview and record review, the facility failed to designate a registered nurse (RN) to serve as the DON on a full-time basis since 11/3/2024 The facility did not have a DON from 11/3/2024 to currant date. This failure could place residents at risk of lack of nursing oversight and a higher level of care. Findings include: Record review of DON Coverage from Raw Punch Report dated 1/7/2025 indicated last day of DON coverage was 11/3/2024 with punch out time of 2:38pm with a total of 6.70 hours. During Entrance Conference interview on 1/6/2025 at 8:45 AM with the administrator F, she said they currently do not have a DON. …
F731 citations in Texas
Nursing and Physician Services Deficiencies
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Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Texas cites F731 more often than its own record predicts
3.76 times the share F731 takes of citations nationally.
Of every deficiency written in Texas in 2025, this is the portion that was F731.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Texas surveyors wrote
F731 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.
What else Texas surveyors cite →
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