The Atrium of Bellmead

In the surveyor’s words

From the most serious findings on record at The Atrium of Bellmead, in the surveyor’s own words.

• Immediate jeopardy, patternF687Jun 18, 2026

  Based on interview, and record review, the facility failed to provide foot care and treatment, in accordance with professional standards of practice, including to prevent complications from the resident's medical condition for 8 of 8 resident.The facility failed to provide continued care for 8 of 8 residents (Resident #1, Resident # 2, Resident # 3, Resident #4, Resident #5, Resident #6, Resident #7, Resident #8) after being treated by podiatry.This failure resulted in Resident #1 developing Gangrene which lead to toe amputation.An Immediate Jeopardy (IJ) was identified on 06/17/2026 at 5:14PM. The initial IJ template was provided to the facility on [DATE] at 5:14PM. […]

• Actual harm, isolatedF697Jul 28, 2021

  Based on interview and record review, the facility failed to ensure that pain management was provided to a resident who required such services, consistent with professional standards of practice, the comprehensive person-centered care plan and the resident's goals and preferences for 1 of * resident reviewed for pain management. (Resident #54) The facility failed to ensure a triplicate prescription was completed timely to avoid a lapse in pain medication for Resident #54. The facility failed to ensure Resident #54's pain medication was available when she needed it. […]

• No harm, potential for more than minimal, widespreadF812Nov 6, 2024

  Based on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for dietary services in that: 1) Dietary staff failed to effectively reseal, label and date items in the walk-in refrigerator. 2) Dietary staff failed to effectively label items in in freezer. These failures could place residents at risk for food contamination and foodborne illness. The findings include: During the initial tour of the kitchen on 11/04/2024 at 09:11 AM the following was observed: The walk-in refrigerator contained what appeared to be cabbage in a clear opened plastic bag that was exposed to air and not labeled or dated. […]

• No harm, potential for more than minimal, patternF580Jul 22, 2026

  Based on observation, interview, and record review, the facility failed to consult with the resident's physician when there is an accident involving the resident which results in injury and has the potential for requiring physician intervention for 1 (R#1) of 5 residents.The facility failed to ensure staff notified R#1's Physician, Hospice Physician and NP when R#1 fell during a 1-person transfer without a gait belt on 7/14/26, 7/19/26, and 7/20/26. R#1 cried, said her buttocks was hurting, and complained of right hip pain after the fall on 7/19/26. R#1 also cried and said her right hand was hurting and she hit her leg after the fall on 7/20/26. […]

• No harm, potential for more than minimal, patternF657Jul 22, 2026

  Based on observation, interview, and record review, the facility failed to review and revise 1 (R#1) of 5 residents' care plans.The facility failed to review and revise R#1's care plan to reflect she required a gait belt and 2-person assistance with transfers after she fell during a 1-person transfer without a gait belt on 7/14/26, 7/19/26, and 7/20/26.This failure could place residents at risk of not having their care and service needs met.Findings include:Review of R#1's admission Record, dated 7/21/26, reflected she was admitted to the facility on [DATE]. […]