River Pointe of Trinity Healthcare and Rehabilitat

In the surveyor’s words

From the most serious findings on record at River Pointe of Trinity Healthcare and Rehabilitat, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Jul 29, 2025

  Based on observation, interview, and record review, the facility failed to ensure the residents' environment remained free from accident hazards and the residents received adequate supervision and assistance to prevent accidents for 1 of 11 residents (Resident #2) reviewed for accidents. The facility failed to ensure a safe transfer of Resident #2 using a mechanical lift with two staff. On 6/21/2025 Resident #2 was being transferred from her bed to a wheelchair and CNA A failed to ensure all 4 straps were secured and Resident #2 flipped out of the mechanical lift to the floor and hit her head that resulted in a golf ball sized bump to the back of her head. Hospitality aide B sat in a recliner in the room and talked on a phone during the transfer. […]

• Actual harm, isolatedF607May 13, 2024

  Based on observation, interview, and record review the facility failed to implement their written policies and procedures regarding prohibiting and preventing abuse for one (Resident #1) of 4 residents reviewed for developing and implementing abuse and neglect policies, in that: Resident #1 was provided a discharge notice on 03/05/24 after reporting CNA A shook her shoulders in the shower room on 02/29/24 and alleged MA B gave her medications she did not recognize that made her sick in January 2024. The facility failed to provide Resident #1 safety after CNA A was allowed to return to the facility on [DATE], one day after abuse allegations were made by Resident #1. […]

• Actual harm, isolatedF755Aug 16, 2021

  Based on interview and record review, the facility failed to provide pharmaceutical services to ensure the accurate acquiring, receiving, dispensing, administering and securing of medications for 1 of 11 residents reviewed for pharmacy services. (Resident #1) Med Aide A administered Resident #1 the wrong medications resulting in the resident being found unresponsive, sent to hospital for evaluation and treatment, where she tested positive for the narcotics opioids, benzodiazepines (sometimes called benzos- work to calm or sedate a person), and tricyclic antidepressants and required [MEDICATION(S)] (for the emergency treatment of known or suspected opioid overdose) intravenously. […]

• No harm, potential for more than minimal, widespreadF837May 13, 2024

  Based on observation, interview, and record review, the governing body failed to appoint an Administrator who is licensed by the State for 1 of 4 Facility Administrators reviewed for governing body. The Interim Administrator was not licensed in Texas. This failure could place residents at risk of not being provided care and services by licensed and unlicensed staff being overseen by an Administrator who was not licensed by the State of Texas and familiar with Texas rulles and regulations for nursing facilities. Findings include: Observations and interview between 5/8/24 at 9:10 a.m. and 5/9/24 at 6:30 p.m. revealed the CO was the only acting Administrator. During entrance conference the CO identified himself as the Administrator. During an interview on 5/8/24 at 3:48 p.m. […]

• No harm, potential for more than minimal, widespreadF812Mar 20, 2024

  Based on observation, interview, and record review, the facility failed to store and distribute food in accordance with professional standards for food service safety in the facility's only kitchen. The facility failed to date opened items, remove expired and rotten foods from the refrigerator and walk in cooler. These failures could place residents who ate the food from the kitchen at risk for food-borne illness. Findings include: During an observation on [DATE] at 9:54 AM the refrigerator contained a pitcher of tea, a plate with a sandwich, and celery that was not dated. […]