Lone Star Rehabilitation & Wellness Center

In the surveyor’s words

From the most serious findings on record at Lone Star Rehabilitation & Wellness Center, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF656Aug 22, 2026

  Based on interviews and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident that included measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment for 4 of 5 residents (Resident #1, Resident #2, Resident #3, Resident #4) reviewed for care plans.The facility failed to ensure the comprehensive care plans for Resident #1, Resident #2, Resident #3, Resident #4 described the resident's goals for admission and desired outcomes, preference and potential for future discharge, and assessment of their desire to return to the community. […]

• No harm, potential for more than minimal, patternF607Sep 4, 2025

  Based on interviews and record reviews, the facility failed to implement written policies and procedures that prohibit and prevent abuse, neglect, exploitation of residents and misappropriation of resident property for 4 of 16 employees (SW, ADMN, CNA C and CNA D) reviewed for employability.The facility failed to ensure record of criminal history check and/or an EMR/NAR check prior to hire were maintained for the SW.The facility failed to ensure record of annual EMR/NAR checks were maintained for the (SW, ADMN, CNA C and CNA D).These findings placed residents at risk of receiving care by someone that was unemployable.The findings included:Record review of the SW's employee file revealed a hire date of 03/28/2022 and no evidence of a criminal history or an EMR/NAR check were completed prior… […]

• No harm, potential for more than minimal, patternF804Sep 4, 2025

  Based on observation, interview and record review, the facility failed to ensure that each resident received food that was palatable, attractive and at a safe and appetizing temperature of 1 of 1 lunch meal in 1 of 1 kitchen tested for nutritive value, flavor, and appearance. The facility failed to provide palatable food served at an appetizing temperature to residents, during lunch on 09/03/2025. This failure could affect the residents who ate food from the facility kitchen by placing them at risk of poor food intake and/or dissatisfaction of meals served.The findings included: During an observation on 09/03/2025 at 12:37 PM the DM obtained food temperatures for noon meal that consisted of Jambalaya, Boiled okra, Cornbread. […]

• No harm, potential for more than minimal, patternF809Sep 4, 2025

  Based on observation, interview and record review, the facility failed to ensure that residents receive meals at regular times comparable to normal mealtimes in the community, for 1 of 1 meal observed for meal service. The facility failed to ensure meals were consistently served at posted mealtimes (lunch meal on 09/02/2025). Posted meal times: Breakfast-Assisted dining room [ROOM NUMBER]:00 PM, Main Dining room [ROOM NUMBER]:05 PM, Hall Trays 12:40 PM This failure could affect all residents who received meals served from the facility's only kitchen by placing residents at risk for decreased meal satisfaction, decreased intake, loss of appetite, unplanned weight loss, and side effects from medication given without food, and diminished quality of life.Findings included: During an… […]

• No harm, potential for more than minimal, patternF803Aug 29, 2024

  Based on observation, interview, and record review the facility failed to follow menus for 1 of 1 lunch meal reviewed. This facility failed to follow the menu when preparing lunch meal on 08/27/2024. This failure could place residents at risk for a decline in health status due to inadequate or inappropriate nutritional intake. The findings included: Review of Resident #50's face sheet reflected a [AGE] year-old female who was admitted on [DATE] with diagnoses included Alzheimer's Disease, Hyperlipidemia (an excess of lipids or fats in your blood), Type II Diabetes Meletus. During an observation on 08/27/2024 at 12:22 PM revealed Resident #50's pureed diet at the lunch mealtime did not have a dessert or mixed vegetables on her tray. […]