Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around January 2027
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 Heritage House At Paris Rehab & Nursing during CMS and state inspections, most recent first.
A facility failed to provide a resident with an ongoing program of activities tailored to her interests and well-being. The resident, diagnosed with vascular dementia, expressed a desire to be read to due to poor vision, but this preference was not fulfilled. The Activities Director acknowledged not reading to the resident and incorrectly completing the Activity Evaluation. The Administrator confirmed the importance of fulfilling the resident's preferences to maximize quality of life.
The facility failed to provide palatable, attractive, and properly cooked meals at a safe temperature for several residents during a lunch meal. Residents reported issues such as bad taste, improper cooking, and cold food. The dietary manager did not taste the meal on the day of the survey, and despite previous in-services on recipe adherence, complaints persisted. The administrator acknowledged receiving complaints but could not recall the last in-service on menu adherence.
The facility failed to maintain effective infection control practices, as observed in the care of three residents. A resident received improper incontinent care, with staff using the same wipe multiple times and neglecting hand hygiene. Another resident's bathroom contained bagged, dirty briefs, creating an unsanitary environment. Additionally, a third resident did not receive proper catheter care, and staff failed to follow enhanced barrier precautions. These deficiencies highlight significant lapses in infection control measures.
A resident with impaired vision did not receive proper meal setup assistance during lunch, as the Treatment Nurse failed to remove the meal from the tray or uncover the plate. The resident's care plan required supervision and setup for eating, but the nurse was unaware of the resident's vision issues and uncertain about meal service protocols. The DON and Administrator confirmed that staff should assist with meal setup to meet residents' nutritional needs.
A resident reported missing pink pants to a laundry aide, but no grievance was filed, and the resident was not informed of any progress. The Environmental Services Manager was unaware of the issue, and the Administrator confirmed a grievance should have been filed. The facility's grievance policy was not followed, leading to a deficiency in addressing resident concerns.
A resident with severe cognitive impairment and multiple medical conditions did not receive adequate nail care, as black material was observed under her fingernails over three consecutive days. Despite the care plan requiring regular nail maintenance, staff interviews confirmed that CNAs were responsible for this task, yet it was not performed, posing a risk of infection.
A resident with an indwelling urinary catheter did not receive proper catheter care, as observed when a CNA failed to clean the right peri area and catheter tubing. The resident, who had severe cognitive impairment and required full assistance, was seen holding her catheter tubing, which was not promptly addressed. Interviews with facility staff confirmed the expectation for thorough cleaning to prevent infections, but the observed care did not meet these standards.
A facility failed to document an oxygen order for a resident with vascular dementia and shortness of breath, despite the resident being placed on oxygen by a hospice nurse due to low saturation levels. The lack of documentation and communication between hospice and facility staff led to the absence of a formal order, risking the resident's respiratory care.
The facility failed to provide trauma-informed care for two residents with histories of trauma. One resident's trauma history was not documented or addressed in her care plan, while another resident's PTSD triggers were not identified. The facility's policy on trauma-informed care was not followed, potentially leading to severe psychological distress for the residents.
Two residents in the facility were administered blood pressure medications outside of the ordered parameters, leading to significant medication errors. One resident received Metoprolol and Hydralazine despite a diastolic blood pressure below the threshold, while another was given Hydralazine with a systolic blood pressure below the specified limit. The staff involved acknowledged the errors, and the facility's policy required adherence to physician orders to prevent adverse effects.
A medication cart in the 100 Hall was left unlocked and unattended by an LVN while she went to the restroom, posing risks of unauthorized access to medications. The cart was later locked by ADON N, who acknowledged the associated risks. Interviews with staff, including the DON and Administrator, confirmed the responsibility of charge nurses to ensure carts are locked when unattended, as per facility policy.
The facility failed to comply with food safety standards, as dietary staff did not label and date all food items and failed to dispose of expired items in the kitchen's refrigerator and freezer. Observations revealed expired catfish and celery, and unlabeled tomato juice. The Dietary Manager and Administrator were unaware of these issues, despite policies requiring proper labeling and disposal of expired food.
A facility failed to ensure proper antibiotic stewardship for a resident prescribed Doxycycline for cellulitis without documented signs or symptoms of infection. Despite awareness from the ADON and DON, the facility relied on doctor's orders without meeting criteria for antibiotic use. The facility's policy emphasized the importance of an antibiotic stewardship program, but implementation was lacking.
A resident with dementia and other conditions was roughly handled by a CNA during incontinent care, causing fear and a sense of unsafety. The incident was reported by the resident and his family, with video evidence provided. Despite this, the facility's administration failed to view the videos and did not adequately investigate the abuse allegations.
A facility failed to report an allegation of abuse involving a resident to the appropriate authorities within the required timeframe. The incident involved a CNA providing rough care to a resident with dementia and other conditions, causing fear and discomfort. Despite a family member's report and video evidence, the facility did not report the incident to the HHSC. Interviews revealed that the care was aggressive, but the facility did not follow its policy on reporting and investigating abuse.
A CNA failed to follow proper infection control procedures during incontinent care for a resident, including not changing gloves or performing hand hygiene after removing a soiled brief. The resident, with multiple health conditions, was at risk due to these actions. The DON and Administrator acknowledged the failure to adhere to infection control policies.
Failure to Provide Resident-Specific Activities
Penalty
Summary
The facility failed to provide an ongoing program of activities tailored to meet the interests and well-being of a resident diagnosed with vascular dementia and shortness of breath. The resident, who had cognitive impairments and was at risk for isolation, was supposed to participate in activities of choice 1-3 times weekly. However, the facility did not ensure that the resident's Activities Evaluation was accurately completed, and no in-room activities were documented for August, September, and October 2024. The resident expressed a desire to be read to, as she could no longer see the books, but this preference was not fulfilled. The Activities Director, who started in August 2024, acknowledged that she had not read to the resident and had incorrectly filled out the Activity Evaluation, assuming the resident read on her own. The Administrator confirmed that if the resident liked to be read to, it should have been done, and the Activities Director was responsible for ensuring activities and assessments were completed. The facility's policy emphasized the importance of recreational services in enhancing residents' quality of life, but the lack of adherence to this policy led to the deficiency.
Deficiency in Food Quality and Temperature
Penalty
Summary
The facility failed to provide food that was palatable, attractive, and at a safe and appetizing temperature for eight residents during a lunch meal. Residents reported that the food tasted bad, was not cooked properly, and was served cold. Specific complaints included food being consistently bad, meals being improperly prepared, and a lack of variety. One resident mentioned receiving food items they could not eat, such as rice and corn, and another noted that the dinner roll was raw inside. These issues were observed during a lunch meal where the dietary manager and surveyors noted deficiencies in the taste and appearance of the food. The dietary manager, who has been employed at the facility for several years, admitted to not tasting the lunch meal on the day of the survey due to being occupied with other kitchen duties. The dietary staff had completed in-services on following recipes earlier in the year, but the exact timing was unclear. The dietary manager handled food complaints by communicating with residents and allowing families to make food choices for residents who frequently complained. Despite these efforts, the issues persisted, as evidenced by the residents' complaints and the surveyors' observations. The administrator, who has been in the role for 14 months, stated that he oversees the dietary manager and occasionally orders test trays from the kitchen. He acknowledged receiving food complaints and mentioned that the dietary manager would address these by speaking with residents. However, the administrator could not recall when the last in-service on following the menu was conducted. The facility's policy on menus and nutritional adequacy, revised in 2012, indicates that menus are planned to meet average resident nutritional needs, yet the observed deficiencies suggest a failure to adhere to this policy.
Infection Control Deficiencies in Resident Care
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program, as evidenced by several deficiencies observed during the survey. For Resident #2, the facility did not ensure proper incontinent care was provided. During an observation, LVN E and CNA F were seen using the same wipe multiple times to clean the resident's peri area, which is against infection control practices. Additionally, they failed to perform hand hygiene between glove changes, which is crucial to prevent cross-contamination. Both LVN E and CNA F acknowledged their lapses in following proper procedures during interviews. Resident #53's care was also compromised due to the presence of bagged, dirty briefs left in her bathroom, which emitted a strong urine odor. This oversight was attributed to the CNAs being too busy to remove the waste, as stated by CNA F. The resident expressed discomfort and dissatisfaction with the situation, indicating that her complaints to the nursing staff were not addressed. This neglect in maintaining a sanitary environment poses a risk of infection and affects the resident's quality of life. For Resident #72, the facility failed to provide adequate catheter care and adhere to enhanced barrier precautions. CNA H did not clean the resident's right peri area or the catheter tubing, and she touched the resident's sheets without gloves, which is against the enhanced barrier precautions protocol. The ADON and DON confirmed the importance of proper catheter care and the need to follow infection control practices to prevent urinary tract infections and other complications. These deficiencies highlight significant lapses in the facility's infection control measures, potentially endangering residents' health.
Failure to Accommodate Resident's Meal Needs
Penalty
Summary
The facility failed to reasonably accommodate the needs and preferences of a resident, identified as Resident #76, during a lunch meal service. The Treatment Nurse served the resident her lunch but did not remove the meal from the tray or uncover the plate, leaving it on the warmer with a lid. This oversight occurred despite the resident's impaired vision and her care plan indicating a need for supervision and setup for eating. The resident expressed difficulty seeing her meal due to blindness in one eye, and another resident had to assist by removing the lid and positioning the plate for her. Interviews revealed that the Treatment Nurse was unfamiliar with the resident's vision issues and was uncertain about the protocol for uncovering meals. The nurse admitted to being new and under the impression that plates should not be uncovered, although she acknowledged the importance of assisting residents with meal setup. The Director of Nursing (DON) and the Administrator both stated that staff are expected to set up meal trays and provide necessary assistance to ensure residents' nutritional needs are met. The facility's policy on resident rights emphasizes the right to reasonable accommodation of needs and preferences, which was not upheld in this instance.
Failure to Address Resident Grievance Regarding Missing Clothing
Penalty
Summary
The facility failed to ensure prompt efforts were made to resolve grievances for a resident who was missing a pair of pink pants from the laundry. The resident, who had intact cognition and was dependent on staff for dressing and personal hygiene, reported the missing pants to a laundry aide. The laundry aide acknowledged the report but did not file a grievance or inform the resident of any progress toward resolution. The aide mentioned notifying the Environmental Services Manager, who was responsible for filing grievances, but the manager was unaware of the issue and had not taken any action. Interviews with the Environmental Services Manager and the Administrator revealed a lack of communication and follow-through in the grievance process. The Environmental Services Manager stated that grievances should be filed to ensure lost items are recovered, but was not informed of the missing pants. The Administrator confirmed that a grievance should have been filed and that any staff member could initiate the process. The facility's grievance policy emphasized the importance of addressing resident concerns promptly, but this was not adhered to in this case.
Failure to Provide Adequate Nail Care for Resident
Penalty
Summary
The facility failed to provide adequate nail care for a resident who was unable to perform activities of daily living independently. The resident, a female with severe cognitive impairment and multiple medical conditions including lung cancer and chronic respiratory failure, required assistance from two persons for dressing, bathing, and personal hygiene. Despite the care plan indicating the need for regular nail care, observations on three consecutive days revealed black material under the resident's fingernails, indicating a lack of proper hygiene maintenance. Interviews with facility staff, including a CNA and the DON, confirmed that it was the responsibility of CNAs to ensure residents' fingernails were clean, particularly during showers. The CNA acknowledged the importance of keeping fingernails clean to prevent bacterial infections, especially since the resident had a habit of putting her hands in her mouth. The DON and the Administrator both recognized the risk of infection and the need for maintaining the resident's dignity through proper hygiene, yet the deficiency persisted over the observed period.
Inadequate Catheter Care for Resident
Penalty
Summary
The facility failed to provide appropriate catheter care for a resident who was incontinent of the bladder and had an indwelling urinary catheter. During an observation, CNA H did not clean the resident's right peri area or the foley catheter tubing while providing incontinent care. The resident, who had a severely impaired cognition and was dependent on staff for all activities of daily living, was observed holding her catheter tubing, which was not addressed promptly by the CNAs. This oversight in care could lead to potential risks such as urinary tract infections and injury. The resident's care plan indicated the need for catheter care every shift and highlighted the risk of urinary tract infections and injury. The care plan also required enhanced barrier precautions during high-contact resident care activities. Despite these guidelines, the CNAs did not adhere to the proper catheter care procedures, as evidenced by the incomplete cleaning of the peri area and catheter tubing. Interviews with the ADON and DON revealed that the CNAs were expected to clean both sides of the peri area and the catheter tubing to prevent infections and skin breakdown. The facility's policy on urinary catheter management emphasized the importance of proper catheter care to prevent complications. However, the CNAs did not follow these protocols during the observed care, leading to the identified deficiency.
Failure to Document Oxygen Order for Resident
Penalty
Summary
The facility failed to ensure that respiratory care was provided consistent with professional standards of practice for a resident requiring oxygen therapy. The resident, an elderly female with vascular dementia and shortness of breath, was observed without an active order for oxygen despite having been placed on oxygen by a hospice nurse due to low oxygen saturation levels. The resident's care plan and MDS assessment did not reflect the use of oxygen, and there was a lack of documentation in the facility's records to support the administration of oxygen. Interviews with facility staff and hospice personnel revealed a breakdown in communication and documentation regarding the resident's need for oxygen. The hospice nurse had given a verbal order for oxygen, but it was not properly documented or communicated to the facility staff, leading to the absence of a formal order in the resident's records. This oversight was acknowledged by the facility's nursing staff and the Director of Nursing, who emphasized the importance of having a documented order to ensure the resident received the necessary care and to prevent potential respiratory complications.
Failure to Provide Trauma-Informed Care for Residents
Penalty
Summary
The facility failed to provide trauma-informed and culturally competent care for two residents, both of whom had histories of trauma. Resident #46, a female with major depressive disorder, generalized anxiety disorder, and mild cognitive impairment, did not have an accurate trauma screen identifying possible triggers despite having a history of trauma. Her care plan did not reflect her trauma history, and the current social worker was unaware of her past trauma. Interviews revealed that Resident #46 had communicated her traumatic experiences to staff, but this information was not documented or addressed in her care plan. Resident #15, diagnosed with bipolar disorder, PTSD, and generalized anxiety disorder, also did not have her PTSD triggers identified in her care plan. The social worker was unsure who was responsible for updating PTSD triggers and had not conducted a trauma assessment for Resident #15. Despite being seen by psychiatric services, the lack of identified triggers in her care plan meant that appropriate care could not be provided to mitigate potential re-traumatization. The facility's policy on trauma-informed care, which mandates the identification of triggers and the inclusion of trigger-specific interventions in care plans, was not followed. This oversight in both residents' cases could lead to severe psychological distress due to re-traumatization, as the facility did not adequately account for their trauma histories and preferences in their care plans.
Failure to Adhere to Blood Pressure Medication Parameters
Penalty
Summary
The facility failed to ensure that two residents were free from significant medication errors. Resident #15, a female with a history of hypertension and other mental health conditions, was administered Metoprolol and Hydralazine despite her diastolic blood pressure being below the ordered parameters. On a specific date, her blood pressure was recorded as 143/55, yet she received both medications, which were supposed to be held if the diastolic blood pressure was less than 60. The medication aide responsible for administering the medication acknowledged the error and mentioned that she was not allowed to contact the doctor when the blood pressure was out of parameter, although she was supposed to notify the charge nurse. Resident #68, a male with chronic heart failure and pulmonary hypertension, was also administered Hydralazine when his blood pressure was outside the ordered parameters. His blood pressure was recorded as 99/60, and the medication was given despite instructions to hold it if the systolic blood pressure was less than 100. The LVN involved stated that she did not administer the medication on that day, but acknowledged the importance of adhering to the parameters to prevent adverse effects. Interviews with the Director of Nursing (DON) and the Administrator revealed that it was the responsibility of the nurse or medication aide to contact the doctor if a resident's blood pressure was out of the specified parameters. The facility's policy required medications to be administered according to physician orders, and the failure to adhere to these orders could result in significant risks to the residents. The DON and Administrator emphasized the importance of following the physician's orders and the potential consequences of administering medication outside of the prescribed parameters.
Medication Cart Left Unlocked and Unattended
Penalty
Summary
The facility failed to ensure that all drugs and biologicals were stored in locked compartments under proper temperature controls, as required by their policy. This deficiency was observed when a medication cart in the 100 Hall was left unlocked and unattended by LVN M while she went to the restroom. The cart was parked beside the centralized nursing station, and this oversight was noticed during an observation. ADON N later locked the cart and acknowledged the risks associated with leaving it unlocked, including potential theft of medications, poisoning, and overdose. Interviews with staff revealed that LVN P accidentally left the cart unattended after being stopped by someone with a question. Both the DON and the Administrator confirmed that it was the responsibility of the charge nurses to ensure the carts were locked when unattended. They acknowledged the risks posed by this failure, such as unauthorized access to medications by residents, staff, or visitors, which could lead to poisoning, needle sticks, or misuse of medications. The facility's policy on medication storage emphasized the importance of locking all drugs and biologicals and restricting access to authorized personnel only.
Failure to Adhere to Food Safety Standards in Dietary Services
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, as observed during a survey of the kitchen's dietary services. The survey revealed that the dietary staff did not label and date all food items, and they also failed to dispose of expired food items in the refrigerator and freezer. These lapses were identified during observations in the kitchen's walk-in freezer and refrigerator, where expired items such as a zip lock bag of frozen catfish and a container of celery were found, along with a container of tomato juice that was not labeled or dated. Interviews with the Dietary Manager and the Administrator highlighted a lack of awareness and oversight regarding the expired and unlabeled food items. The Dietary Manager, who had been employed at the facility for several years, admitted to conducting daily walk-throughs but failed to notice the issues identified by the surveyor. The Administrator, who had been in the role for 14 months, stated that he conducted weekly walk-throughs but had not done so in the week of the survey. Both acknowledged the importance of labeling, dating, and discarding expired food to prevent potential foodborne illnesses among residents. The facility's policy on food storage and the FDA Food Code were reviewed, indicating requirements for labeling, dating, and discarding expired food items. The policy emphasized the need for proper sealing, labeling, and rotation of food items, while the FDA Food Code outlined specific labeling requirements for food packaged in a food establishment. Despite these guidelines, the facility's failure to comply with these standards was evident in the survey findings, posing a risk of food contamination and illness to residents.
Failure in Antibiotic Stewardship and Documentation
Penalty
Summary
The facility failed to promote antibiotic stewardship by ensuring the appropriate use of antibiotic therapy for a resident reviewed for antibiotic use. The resident, an elderly female with dementia and anxiety, was prescribed Doxycycline Monohydrate for cellulitis in the left lower extremity. However, there was no documented evidence of signs or symptoms of infection to support the use of the antibiotic. The facility's records, including the Revised McGeer Criteria for Infection Surveillance Checklist, indicated that the resident did not meet the criteria for antibiotic use for cellulitis, soft tissue, or wound infection. Interviews with facility staff, including the Assistant Director of Nursing (ADON) and the Director of Nursing (DON), revealed awareness of the issue but a reliance on following doctor's orders despite the lack of documented criteria. The ADON, who was responsible for infection control, acknowledged the absence of proper documentation and education regarding antibiotic use. The facility's policy on infection prevention and control emphasized the importance of an antibiotic stewardship program, yet the implementation and adherence to this policy were lacking, as evidenced by the failure to document necessary signs and symptoms for antibiotic administration.
Rough Handling of Resident During Incontinent Care
Penalty
Summary
The facility failed to protect a resident from abuse when a Certified Nursing Assistant (CNA) roughly provided incontinent care. The incident involved a male resident with a history of dementia, congestive heart failure, Parkinson's disease, and other conditions that required assistance with daily activities. During the care, the CNA used excessive force to roll the resident onto his side, causing his legs to come off the bed swiftly. This rough handling was observed in a video and reported by the resident and his family member. The resident expressed feeling scared and unsafe due to the rough care provided by the CNA. The family member of the resident reported the incident to the facility's Assistant Director of Nursing (ADON) and Director of Nursing (DON), providing video evidence of the rough handling. However, the facility's administration, including the DON and ADON, claimed they were unable to view the videos due to technical issues. Despite the family member's attempts to show the videos in person, the facility's leadership declined the offer. Interviews with other staff members, including another CNA present during the incident, confirmed the rough handling of the resident. The facility's staffing coordinator and ADON, upon viewing the video with the state surveyor, identified the actions as aggressive and uncalled for. The facility's policy on abuse and neglect emphasizes the importance of protecting residents from harm and conducting timely investigations, which was not adequately followed in this case.
Failure to Report Alleged Abuse in a Timely Manner
Penalty
Summary
The facility failed to report an allegation of abuse involving a resident to the appropriate authorities within the required timeframe. The incident involved a certified nursing assistant (CNA) who was observed providing rough and aggressive care to a resident during incontinent care. The resident, who had a history of dementia, congestive heart failure, Parkinson's disease, and other conditions, was handled in a manner that caused fear and discomfort. Despite the family member's report and video evidence of the incident, the facility did not report the allegation to the Health and Human Services Commission (HHSC) as required. The resident's family member reported the incident to the Assistant Director of Nursing (ADON) and the Director of Nursing (DON), providing video evidence of the rough handling. However, the facility's administration, including the Administrator, DON, and ADON, failed to view the videos or take appropriate action to report the incident. The family member's attempts to show the videos in person were declined, and the facility did not conduct a proper investigation or report the incident to the state agency. Interviews with staff members revealed that the CNA involved in the incident had been identified and that the care provided was considered aggressive and rough. Despite this, the facility did not follow its policy on reporting and investigating allegations of abuse. The Administrator, who was responsible for reporting such incidents, acknowledged the failure to report and investigate the allegation, which could have prevented further harm to the resident.
Inadequate Infection Control During Incontinent Care
Penalty
Summary
The facility failed to establish and maintain an effective infection prevention and control program, as evidenced by the actions of CNA A during the provision of incontinent care to a resident. CNA A did not change her gloves or perform hand hygiene after removing the resident's soiled brief, and she improperly disposed of the soiled brief by throwing it across the room. These actions were observed in a video dated 06/07/2024, which showed CNA A continuing to touch the resident and other surfaces with contaminated gloves, thereby increasing the risk of cross-contamination and infection. The resident involved was an elderly male with multiple diagnoses, including dementia, congestive heart failure, Parkinson's disease, and hypertension. His comprehensive care plan indicated a need for assistance with activities of daily living and emphasized maintaining his dignity by ensuring he was clean and well-groomed. Despite this, the care provided by CNA A did not adhere to the facility's infection control policies, as she failed to perform proper hand hygiene and glove changes during the care process. Interviews with CNA A, the DON, and the Administrator confirmed that the infection control procedures were not followed. CNA A acknowledged the incorrect practices and identified the risk of infection due to improper cleaning and handling of soiled materials. The DON, who is responsible for infection control, and the Administrator both recognized the failure to adhere to the facility's policies, which are designed to prevent the transmission of communicable diseases and infections.
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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.
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Nursing homes near Paris
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Legend Healthcare And Rehabilitation - Paris | 2.9 mi | — | 14 | 0 |
| Stillhouse Rehabilitation And Healthcare Center | 2.9 mi | — | 0 | 0 |
| Brentwood Terrace Healthcare And Rehabilitation | 3 mi | — | 3 | 0 |
| Avir At Paris | 3.3 mi | — | 5 | 0 |
| Homestead Of Hugo | 22.7 mi | — | 4 | 1 |
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