Solera at West Houston

In the surveyor’s words

From the most serious findings on record at Solera at West Houston, in the surveyor’s own words.

• Immediate jeopardy, patternF686Nov 17, 2025

  Based on observation, interview, and record review, the facility failed to ensure that residents with pressure ulcers receive necessary treatments and services, consistent with professional standards of practice, to promote healing, prevent infection, and prevent new ulcers from developing for 1 (CR #1) of 5 residents reviewed for wound care. The facility failed to properly identify the pressure ulcer and provide immediate oversight by a wound care specialist when the wound was first identified as a Stage 2 Pressure Ulcer on 10/15/25. CR#1 was admitted to the hospital on [DATE] with a necrotic pressure ulcer to the right heel and the need for possible amputation of the lower right extremity. […]

• Immediate jeopardy, isolatedF600Dec 30, 2024

  Based on observation, interview, and record review, the facility failed to ensure each resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation for 1 of 8 (Resident #1) residents reviewed for abuse and neglect. The facility failed to ensure that Resident #1 was free from sexual abuse when staff observed Resident #1 being touched inappropriately by CR #2 on 12/26/2024. The noncompliance was identified as Past Non-Compliance. The IJ began on 12/26/2024 and ended on 12/27/2024. The facility corrected the noncompliance before the survey began. This failure placed residents at risk of experiencing abuse and neglect. […]

• Actual harm, isolatedF600Mar 22, 2024

  Based on interview and record review the facility failed to ensure the resident's right to be free from abuse for 1 of 6 residents (Resident #1), in that:. CNA C was seen on camera being verbally abusive aggressive towards Resident #1 which resulted in the resident feeling unsafe at the facility. This failure could place residents receiving care at risk of experiencing continued psychological distress and declining mental health. Findings included: Record review of Resident #1's clinical notes dated 3/20/24 at 1:29am by the Social Worker, resident is alert and oriented x4 (a measure indicating an individual is aware of their surroundings, knows who they are, where they are and what time it is, a positive sign of cognitive function). […]

• Actual harm, isolatedF755Apr 22, 2021

  Based on record review and interviews, the facility failed to provide pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals) to meet the needs of 1 of 4 residents (CR#1) reviewed for pharmaceutical services. The facility failed to acquire and dispense [MEDICATION(S)] 550 mg tablets, a medication used to lower the risk of reduced brain function for individuals with liver [CONDITION(S)], as ordered on 03/30/21 through 04/04/21 . CR#1 missed 10 doses of this medication resulting in her increased [MEDICATION(S)] levels, increased confusion, altered mental status in CR #1 and subsequent hospitalization . […]

• No harm, potential for more than minimal, patternF655Jul 25, 2025

  Based on observation, interview, and record review, the facility must develop and implement a baseline care plan that included the instructions needed to provide effective and person-centered care of the resident that meet professional standards of quality care and include the minimum healthcare information necessary to properly care for residents for 3 (Residents #139,#140, and #143) of 5 residents reviewed for baseline care plans -Resident #139 had a tracheostomy and an enteral feeding tube that were not baseline care planned. -Residents 139, #140, and #143's baseline care plans did not designate the code status of the residents. The failures could place the residents at risk for not receiving the care and services needed and placed them at risk for deteriorating health. […]