Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Bronte Health And Rehab Center during CMS and state inspections, most recent first.
A resident sustained an unwitnessed fall resulting in a fracture, which was initially reported through the Facility Reported Incident and CII Self‑Report Template. However, the Administrator did not submit the required 5‑day Provider Investigation Report (Form 3613‑A) to the State Survey Agency within the mandated timeframe, as confirmed by review of the TULIP system and the completed report date. In interview, the Administrator stated he did not remember completing the 5‑day report and believed he had simply forgotten to do it despite facility policy requiring investigation results to be reported to government agencies within 5 working days.
A resident with vascular dementia, impaired vision, unilateral weakness, and wheelchair dependence was identified as high risk for falls and had a general fall care plan in place. After the resident was found on the bathroom floor following a fall from the wheelchair while attempting to use the toilet, nursing notes documented a resulting right humerus fracture and transfer to the ER. Despite this event, staff interviews confirmed that no new, specific fall-prevention interventions were added to the care plan to address falls from or attempts to get out of the wheelchair, and the care plan was not revised in accordance with facility policy requiring modification when goals are not achieved.
A resident with CKD stage 4, chronic diastolic HF, morbid obesity, moderate cognitive impairment, and frequent bowel and bladder incontinence, care-planned as totally dependent on two staff for toileting and to be checked for incontinence at least every 2 hours, requested to be changed using the call light. A CNA responded quickly, was told the resident needed changing, turned off the call light, stated she would get help, but did not return or seek assistance from other available staff. Over the next several hours, the resident continued to report needing to be changed, and when the CNA later delivered the lunch tray, she still did not provide incontinence care. This conduct did not follow the resident’s care plan or facility policies on perineal care and call light response, resulting in a failure to provide necessary ADL and incontinence care.
A resident with dementia, diverticulosis, and heart failure, who was cognitively intact and independent in ADLs, experienced a fall while reaching for an item on her bedside table, later determined to have caused a rib fracture. Although she was already identified as a fall risk, her care plan did not document this fall event or include fall-prevention interventions. Investigation notes, staff interviews, and clinical documentation confirmed the fall circumstances and subsequent injury, and the DON acknowledged that the fall with injury had not been added to the electronic care plan as required by the facility’s comprehensive, person-centered care plan policy.
The facility did not coordinate assessments with the PASRR program and failed to refer a resident for necessary services, resulting in noncompliance with assessment and referral requirements.
The facility failed to ensure a safe environment for a resident with Alzheimer's by allowing hazardous chemicals in her room, and did not provide adequate supervision for another resident with severe cognitive impairment by not using a gait belt during assistance. These actions violated the facility's safety policies, compromising resident safety.
Two CNAs failed to change contaminated gloves during incontinent care for residents with severe cognitive impairments, risking cross-contamination. Despite training on infection control, the CNAs did not adhere to facility policies, which emphasize glove changes and hand hygiene to prevent infection spread.
A CNA failed to change gloves during incontinent care for a resident with dementia and COPD, risking cross-contamination. Despite training, the CNA did not adhere to infection control policies, as observed during care. The facility's policies require changing gloves to prevent infection spread, which was not followed in this instance.
A facility failed to report alleged abuse involving two cognitively impaired residents to HHSC and law enforcement within the required timeframe. The incidents involved inappropriate touching and kissing, which were not reported due to differing staff opinions on the intent behind the actions. The facility's ADM and DON did not believe the incidents constituted abuse, leading to a failure to follow the facility's abuse prevention and reporting policy.
The facility failed to provide sufficient nursing staff in the memory care unit, resulting in multiple falls and inadequate assistance for residents with severe cognitive impairments. Staff interviews and observations revealed that the current staffing model, which includes only one CNA and a floater, is insufficient to ensure resident safety and proper care.
A resident received ABH gel, an antipsychotic medication, without a proper diagnosis documented. The medication was administered 11 times over a month, and the discrepancy was not identified by facility staff or the hospice nurse. The DON acknowledged the oversight and the facility lacked a policy on unnecessary drugs without adequate indication.
A resident was found to have quarter bed rails in use without a completed side rail assessment. The necessary processes, including a PT evaluation and physician order, were not followed, contrary to the facility's policy. This failure had the potential to cause injury due to improper use of bed rails.
A high fall-risk resident with severe cognitive impairment experienced multiple falls, including a significant unwitnessed fall resulting in a hematoma. Staff interviews revealed understaffing and lack of bed alarms in the memory care unit, contributing to inadequate supervision.
Failure to Submit Required 5‑Day Investigation Report After Unwitnessed Fall With Fracture
Penalty
Summary
The deficiency involves the facility’s failure to submit the required 5‑day Provider Investigation Report (Form 3613‑A) to the State Survey Agency following an allegation of neglect related to an unwitnessed fall with fracture. A resident experienced an unwitnessed fall on 3/30/26 that resulted in a fracture, and the facility submitted the initial Facility Reported Incident and CII Self‑Report Template on 3/31/26. However, review of the TULIP (Texas Unified Licensure Information Portal) system on 04/13/26 showed that no Provider Investigation Report (Form 3613‑A) had been filed for this allegation at that time, despite state requirements and the facility’s own policy that the administrator report investigation results within 5 working days of the incident. Record review later showed that the Provider Investigation Report for the 3/30/26 incident was not completed until 4/14/26, beyond the required 5‑day timeframe. During an interview on 4/13/26, the Administrator stated he did not remember doing a 5‑day report, acknowledged they had done the original report documenting assessment and actions for the resident, but did not recall anything about the 5‑day report. He confirmed that the form in question was the 3613 and stated he “just forgot to do it” due to having many things going on in the building. The Administrator also reported that not completing the 3613 or 5‑day results of an investigation could have the potential for neglect of resident care because the process was not completed. The facility’s policy titled “Prevention of Abuse, Neglect, Exploitation etc.” states that the administrator will follow up with government agencies to report the results of the investigation within 5 working days of the incident, as required by HHS.
Failure to Revise Fall Care Plan After Bathroom Fall and Fracture
Penalty
Summary
Surveyors identified a deficiency in the facility’s failure to develop and implement a comprehensive, person-centered care plan with measurable objectives and timeframes to address a resident’s fall risk and actual fall. The resident was an elderly female admitted with diagnoses including a healing right humerus fracture and vascular dementia without behavioral disturbance. Her quarterly MDS showed moderate cognitive impairment (BIMS 9), unclear but usually understood speech, impaired vision, delusions, verbal behavioral symptoms, rejection of care, unilateral upper and lower extremity functional limitations, wheelchair use for mobility, dependence for transfers, and total bowel and bladder incontinence. She was care planned as high risk for falls due to generalized muscle weakness and unsteadiness, with goals to remain free from falls and injury. The existing fall risk care plan, revised in late December, included general interventions such as anticipating and meeting needs, keeping the call light within reach, ensuring appropriate footwear, following the facility fall protocol, PT evaluation and treatment, and maintaining a safe environment. However, the care plan did not include any specific interventions related to the resident’s fall from her wheelchair in the bathroom on a later date. Nursing progress notes documented that the resident was found lying on her right side on the bathroom floor, initially denying pain, then later screaming that her shoulder hurt during care, leading to an X-ray order and subsequent transfer to the emergency room for a right humerus fracture. The resident later stated she fell in the bathroom while trying to use the toilet. Interviews with staff revealed that no new or revised interventions were added to the care plan after this fall to address the circumstances of the incident or to prevent future falls, including falls from or attempts to get out of the wheelchair without assistance. LVN B stated she was not aware of any interventions implemented to decrease the risk of another fall and noted the resident typically used the call light and had not previously attempted self-transfers. The MDS Coordinator reported she initiates care plans and that the IDT meets weekly to discuss interventions but was unaware of any interventions added after the fall and was unsure why none were put in place. The ADON confirmed the resident had been care planned for the fracture but that no specific fall-prevention interventions were added, and the Administrator stated he was unaware that no interventions had been implemented and that the MDS Coordinator was responsible for updating care plans. The facility’s own care plan policy required revising goals and objectives when desired outcomes were not achieved, but the resident’s care plan was not modified following the fall and injury.
Failure to Provide Timely Incontinence and ADL Care After Call Light Request
Penalty
Summary
The deficiency involves the facility’s failure to provide necessary ADL and incontinence care to maintain good personal hygiene for a resident who was dependent on staff. The resident was an older female with chronic kidney disease stage 4, chronic diastolic heart failure, morbid obesity, moderate cognitive impairment (BIMS score 12), and was frequently incontinent of bowel and bladder. Her admission MDS and care plan documented that she required maximum assistance for toileting, was totally dependent on two staff members for toilet use, and had a history of UTIs related to poor hygiene and incontinence, with an intervention to be checked for incontinence at least every two hours. During an observation, the resident, while lying in bed, stated she believed she needed to be changed and activated her call light. A CNA responded promptly, was informed by the resident that she needed to be changed, turned off the call light, and stated she would find help and return. From 10:30 a.m. to 12:45 p.m., the CNA did not return to check or change the resident, despite two other staff members being present and working on the hall. The resident continued to state that she needed to be changed, and when the CNA later delivered the resident’s lunch tray, she did not offer assistance with incontinence care at that time. Interviews revealed that the CNA did not seek help from a nurse or any other staff member, explaining that her partner had gone to lunch, and another CNA confirmed she had been on break earlier and was not asked to assist upon her return. Facility policies required perineal care in accordance with standards of practice to prevent skin breakdown and infection, and the call system policy required calls for assistance to be answered as soon as possible and no later than five minutes, with urgent requests addressed immediately. The failure to provide timely incontinence care and to follow the resident’s care plan and facility policies constituted the deficiency.
Failure to Update Care Plan After Resident Fall With Injury
Penalty
Summary
The deficiency involves the facility’s failure to update a resident’s comprehensive care plan with fall-related interventions following a fall with injury. The resident was an older female admitted with diagnoses including dementia, diverticulosis of the intestine, and heart failure. An MDS dated 2/26/26 documented a BIMS score of 14, indicating she was cognitively intact and independent in all ADLs. Her care plan, dated 2/9/26, identified her as a fall risk but contained no entry for a fall incident on 2/6/26 and no fall interventions, as she had no previous falls documented. On 2/6/26, during shift change, a CNA heard the resident’s roommate express concern and found the resident on the floor by her bed, sitting on her buttocks and holding her lower right side. The nurse assessed the resident and noted redness to the right side of the waist, intact skin, no bruising, no head injury symptoms, equal and reactive pupils, equal and strong grips, and maintained active range of motion. The resident reported she had been trying to get something from her bedside table, lost her balance, and fell. She complained of pain/discomfort to the right side of her waist and was given PRN tramadol. The environment was documented as free of clutter, with proper footwear in use and the call light within reach but not utilized. Subsequent documentation showed that the resident later complained of continued abdominal discomfort, was evaluated, and was ultimately found to have a right posterior 11th rib fracture and was admitted to the hospital before returning to the facility. Interviews and investigation notes confirmed the fall circumstances, including the roommate’s account of hearing a noise and seeing the resident on the floor with her head near the nightstand and feet toward the wheelchair. On review of the electronic care plan, the DON stated that the fall with injury was not present in the care plan and acknowledged that the fall should have been added when the resident returned from the hospital. The facility’s care plan policy required a comprehensive, person-centered care plan with measurable objectives and timetables to meet each resident’s needs, but the resident’s care plan was not updated to reflect the fall event and related interventions.
Failure to Coordinate PASRR Assessments and Referrals
Penalty
Summary
The facility failed to coordinate assessments with the pre-admission screening and resident review (PASRR) program and did not refer residents for services as needed. This deficiency indicates that required assessments and referrals for appropriate services were not completed in accordance with regulatory requirements.
Failure to Ensure Resident Safety and Supervision
Penalty
Summary
The facility failed to ensure a safe environment for Resident #42, who was moderately cognitively impaired and resided in a secured unit due to Alzheimer's Disease. During an observation, it was found that Resident #42 had two bottles of nail polish remover in her room, which were easily accessible and posed a risk of ingestion. The Director of Nursing (DON) acknowledged that such chemicals should not be present in a resident's room, especially in a secured unit, and that it was the staff's responsibility to ensure hazardous items were not accessible. The facility's policy required hazardous chemicals to be secured, but this was not adhered to, placing Resident #42 at risk. Additionally, the facility did not provide adequate supervision and assistance to Resident #13, who had severe cognitive impairment and was at risk for falls. During an observation, two CNAs were seen assisting Resident #13 without using a gait belt, despite having one available. The CNAs hooked their arms under the resident's arms, which the DON later stated could cause injury and was not a safe method of assistance. The facility's policy emphasized the use of gait belts for safe resident movement, but this was not followed, compromising Resident #13's safety. The facility's policies on hazardous areas and resident safety were not effectively implemented, as evidenced by the presence of hazardous chemicals in Resident #42's room and the improper assistance provided to Resident #13. These deficiencies highlight a lack of adherence to established safety protocols, which are crucial for preventing accidents and ensuring resident safety in the facility.
Infection Control Lapses During Incontinent Care
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program, as evidenced by the actions of two CNAs during incontinent care for two residents. CNA A did not change her gloves after they became contaminated while providing care to a resident with Alzheimer's disease and muscle weakness. This resident was totally incontinent and required regular checks and care to prevent skin breakdown. Despite being aware of the need to change gloves to prevent cross-contamination, CNA A admitted to forgetting this step during the care process. Similarly, CNA C also failed to change her gloves after they became contaminated while providing incontinent care to another resident with dementia and chronic obstructive pulmonary disease. This resident also had severe cognitive impairment and was always incontinent. CNA C stated that she typically only changes gloves if they are visibly soiled, indicating a misunderstanding of proper infection control practices. Interviews with the Director of Nursing (DON) and Assistant Director of Nursing (ADON) revealed that the facility had conducted training on infection control and incontinent care. However, the ADON admitted to not always documenting proficiency observations, and the DON acknowledged that the CNAs' failure to change gloves could lead to cross-contamination. The facility's policies on diaper handling, perineal care, standard precautions, and hand hygiene emphasize the importance of changing gloves and washing hands to prevent the spread of infections, but these were not adhered to during the observed incidents.
Inadequate Glove Use During Incontinent Care
Penalty
Summary
The facility failed to ensure that nurse aides demonstrated competency in providing nursing and related services, as evidenced by an incident involving a certified nursing assistant (CNA) who did not change her gloves during incontinent care for a resident. The resident, who was admitted with diagnoses of dementia and chronic obstructive pulmonary disease, required assistance due to bowel and bladder incontinence. During an observation, the CNA was seen performing incontinent care without changing her gloves after they became contaminated, which could lead to cross-contamination and infection. The resident's care plan indicated the need for regular checks for incontinence and proper hygiene to prevent skin breakdown. However, during the care process, the CNA failed to change gloves after wiping the resident's bottom, which had bowel movement, and proceeded to handle a clean brief without changing gloves. This action was contrary to the facility's policies on infection control and standard precautions, which require changing gloves to prevent cross-contamination. Interviews with the CNA, Director of Nursing (DON), Assistant Director of Nursing (ADON), and the Administrator revealed that the CNA was aware of the potential for cross-contamination but did not change gloves unless they were visibly soiled. The DON and Administrator confirmed that the expectation was for CNAs to change gloves when contaminated. The ADON had conducted proficiency training, but documentation of these observations was inconsistent. The facility's policies emphasized the importance of hand hygiene and glove use to prevent the spread of infections, which was not adhered to in this instance.
Failure to Report Alleged Abuse in a Timely Manner
Penalty
Summary
The facility failed to report alleged violations related to abuse in a timely manner, as required by state law. Specifically, the facility did not report incidents involving two residents, who were both severely cognitively impaired, to the Health and Human Services Commission (HHSC) and law enforcement. The incidents involved inappropriate touching and kissing between the residents, which were not reported within the mandated two-hour window for abuse allegations. Interviews with staff revealed differing opinions on whether the incidents constituted abuse, with some staff believing there was no sexual intent, while others felt the actions were abusive. Resident #1, a female with severe cognitive impairment, was involved in an incident where Resident #2, a male with similar cognitive impairments, allegedly touched her inappropriately and kissed her neck. Despite the cognitive impairments of both residents, which rendered them unable to consent, the facility's administration did not report the incidents as abuse. The Director of Nursing (DON) and Administrator (ADM) believed the actions were accidental and lacked sexual intent, leading to their decision not to report the incidents. The facility's policy on abuse prevention and reporting was not followed, as the incidents were not reported to the appropriate authorities. The ADM and DON were responsible for reporting such incidents but failed to do so, citing a lack of intent or malice. This failure to report could place residents at risk of further abuse, as the facility did not take immediate action to prevent potential abuse as required by state regulations.
Insufficient Staffing in Memory Care Unit
Penalty
Summary
The facility failed to have sufficient nursing staff with the appropriate competencies and skill sets to provide nursing and related services to assure resident safety and maintain the highest practicable physical, mental, and psychosocial wellbeing for five residents on the memory care unit. Specifically, the facility did not ensure there were enough staff to prevent falls and provide the necessary assistance for residents requiring two-person assistance for tasks such as transfers, locomotion, and toileting. This deficiency was observed through multiple incidents and interviews with staff members who expressed concerns about the inadequate staffing levels and the resulting risks to resident safety and care quality. Resident #1, an elderly female with severe cognitive impairment and a high fall risk, sustained two falls within a short period, one of which resulted in a laceration to her left eyebrow. Despite care plan interventions requiring increased supervision and appropriate footwear, the facility's staffing levels were insufficient to provide the necessary oversight. Similar issues were noted for Residents #2, #3, #4, and #5, all of whom required significant assistance with daily activities and were at risk of falls due to their severe cognitive impairments and other medical conditions. Interviews with CNAs and other staff members revealed that the memory care unit typically had only one CNA on duty, with a floater CNA who was not always available promptly. This staffing model was implemented following a corporate decision to reduce staff based on census data, which led to increased falls and injuries among residents. Staff members consistently reported that the current staffing levels were inadequate to ensure resident safety and that the previous model with two CNAs on the memory care unit was more effective in preventing falls and providing necessary care.
Failure to Ensure Correct Diagnosis for Psychotropic Medication
Penalty
Summary
The facility failed to ensure that a resident on psychotropic drugs had the correct diagnosis in place. Specifically, a resident received ABH gel, an antipsychotic medication, without having a proper diagnosis documented. The resident's care plan did not indicate any need for antipsychotic medications, yet the medication was administered 11 times over a period of approximately one month. This discrepancy was not identified by the facility staff or the hospice nurse responsible for the resident's care. Interviews with the hospice nurse, the facility's Director of Nursing (DON), and other staff revealed that there was a lack of proper review and verification of the medication orders against the resident's diagnoses. The DON acknowledged that it was the facility's responsibility to ensure that all medications matched the resident's documented diagnoses, and this oversight could potentially harm the resident. The facility did not have a policy related to unnecessary drugs without adequate indication at the time of the survey exit.
Failure to Assess Bed Rail Risk
Penalty
Summary
The facility failed to accurately assess a resident for the risk of entrapment from bed rails prior to their use. Resident #1, a male admitted with diagnoses including surgical aftercare, anemia, muscle weakness, and unsteadiness on feet, had quarter bed rails in use without a completed side rail assessment. The annual MDS assessment and care plan for Resident #1 did not indicate the use of bed rails. During an observation, it was noted that Resident #1's bed had quarter bed rails, and the Director of Nursing (DON) confirmed that the necessary processes, including a PT evaluation and physician order, were not completed before the bed rails were installed. The DON admitted that the side rail assessment should have been done before moving Resident #1 to a bed with side rails, but this process was not followed. Interviews with the DON, the Director of Physical Therapy (DPT), and Physician A revealed that no PT evaluations were completed, and the physician was not contacted regarding bed rail orders for Resident #1. The facility's policy on the proper use of side rails, which includes assessing the resident's symptoms, risk of entrapment, and reasons for using side rails, was not adhered to. This failure had the potential to cause injury to the resident due to the improper use of bed rails.
Failure to Prevent Falls for High-Risk Resident
Penalty
Summary
The facility failed to ensure adequate supervision to prevent falls for a resident identified as a high fall risk. The resident, an elderly female with severe cognitive impairment and other medical conditions, experienced multiple falls, including a significant unwitnessed fall that resulted in a hematoma on her forehead. Despite being identified as a high fall risk, the resident was found on the floor with a bleeding injury, indicating a lack of adequate supervision and preventive measures. Interviews with staff revealed that the memory care unit was often understaffed, with only one aide present, making it difficult to monitor all residents effectively. The staff also mentioned the absence of bed alarms and the reluctance of other CNAs to assist in the memory care unit, further contributing to the inadequate supervision. The resident's care plan and medical records indicated a history of multiple falls, yet the facility's measures, such as a lowered bed and fall mat, were insufficient to prevent further incidents. The resident's family expressed concerns about the frequent falls and the potential for more severe injuries. The Director of Nursing acknowledged the resident's fall risk and the challenges in ensuring constant supervision. The facility's policy on fall risk assessment emphasized the need for a resident-centered fall prevention plan, but the implementation appeared inadequate, as evidenced by the repeated falls and the significant injury sustained by the resident.
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What surveyors actually found near you
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Bronte
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Robert Lee Care Center | 11.8 mi | — | 7 | 0 |
| Winters Healthcare Residence | 20.2 mi | — | 0 | 0 |
| Ballinger Healthcare And Rehabilitation Center | 21 mi | — | 7 | 0 |
| Central Texas Nursing & Rehabilitation | 21.1 mi | — | 2 | 0 |
| Sagecrest Alzheimers Care Center | 29.1 mi | — | 0 | 0 |
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