Based on observation, interview, and record review, the facility failed to promptly notify the ordering physician, physician assistant, nurse practitioner, or clinical nurse specialist of results that fall outside of clinical reference ranges in accordance with facility policies and procedures for notification of a practitioner or per the ordering physician's orders for 1 (Resident #1) of 4 residents reviewed for quality of care. LVN A failed to read an abnormal x-ray result, resulting in Resident #1 experiencing pain with a hip fracture for 2 days before Resident #1 was hospitalized for evaluation. A past noncompliance Immediate Jeopardy was determined to have existed from 4/8/2025 to 4/10/2025. …
F777 citations in Texas
Administration Deficiencies
Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Texas cites F777 more often than its own record predicts
1.67 times the share F777 takes of citations nationally.
Of every deficiency written in Texas in 2025, this is the portion that was F777.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Texas surveyors wrote
F777 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.
Based on interview and record review, the facility failed to promptly notify the ordering physician, results that fall outside of clinical reference ranges in accordance with facility policies and procedures for notification of a practitioner for 1 of 7 residents (Resident #8) reviewed for diagnostic services. The facility failed to ensure LVN K notified the physician/ NP of the Resident #8's femur fracture using the facility's approved notification methods leaving Resident #8 with an undiagnosed/untreated femur (longest bone in th body that extends from the hip to the knee) fracture and in pain documented up to 5 out of 10 for 18 hours before she was transported to the hospital on [DATE]. …
Based on observation, interview and record review, the facility failed to promptly notify the resident's physician when there was radiology results outside of clinical reference range for 1 of 5 residents (Resident #17) reviewed for physician notification of radiology results. The facility failed to promptly notify Resident #17's physician by phone per facility protocol on 02/12/25 when x-ray results falling outside of clinical reference ranges reflected Resident #17 had a right femur fracture This failure could place residents at risk of a delay in medical treatment and could result in not receiving appropriate care and interventions. …
The short window
Recent years
| Year | Share of Texas citations | vs expected |
|---|---|---|
| 2023 | 0.05% | 2.25× |
| 2024 | 0.08% | 2.74× |
| 2025 | 0.04% | 1.67× |
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