Not rated by CMS — ratings are suppressed for new or low-volume facilities.
Past the typical resurvey interval — a standard survey could occur at any time
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 Highland Meadows during CMS and state inspections, most recent first.
A facility failed to complete a baseline care plan within 48 hours for a newly admitted resident with joint replacement, diabetes, and heart failure. An LVN initiated but did not complete the plan, and the DON acknowledged the lapse, citing staff communication to meet care needs.
A facility failed to prevent complications for a resident with a g-tube. A CNA did not inform the nurse to pause the feeding before providing care and lowered the resident's bed to a flat position while the feeding continued. This oversight could lead to complications such as aspiration. The resident had multiple diagnoses, including dementia and gastro-esophageal reflux disease, and required tube feeding due to dysphagia and weight loss. The facility lacked a specific policy for care during continuous g-tube feeding.
A resident with multiple health conditions had a PRN order for Lorazepam that exceeded the 14-day limit without re-evaluation by a physician. Facility staff, including ADONs and the DON, failed to follow up on the re-evaluation requirement, and the facility's policy on PRN psychotropic medication was not adhered to.
Two CNAs failed to perform proper hand hygiene during incontinent care for two residents, leading to potential cross-contamination and infection spread. One CNA did not wash hands after changing gloves following a bowel movement, while the other did not change gloves or wash hands after cleaning urine. Interviews with the DON and ADON confirmed that staff are expected to follow hand hygiene protocols, which are emphasized in the facility's infection control policies.
A resident with multiple health issues was found to have an open wound in the groin area, which was not reported to the primary care physician as required. The facility's staff assumed it was a moisture-related incident and only notified the wound care doctor. This oversight in communication and reporting could delay medical intervention and affect the resident's health.
A resident with multiple medical conditions was found to have a wound in the lower abdominal/groin area, which was not reported to HHSC as required. The facility's DON assumed the wound was moisture-related and did not consider it an injury of unknown origin, despite staff observations suggesting otherwise. This failure to report deviated from the facility's policy and could place residents at risk.
The facility failed to maintain an effective infection control program, with staff observed touching medications without gloves, not cleaning equipment between uses, and neglecting hand hygiene during incontinent care. Staff admitted to forgetting protocols despite recent training.
The facility failed to follow its policy on food storage, leading to unlabeled and undated items in the nourishment room refrigerator and lack of temperature documentation for personal refrigerators. Staff interviews revealed confusion over responsibilities, placing residents at risk of foodborne illness.
Failure to Complete Baseline Care Plan for New Resident
Penalty
Summary
The facility failed to develop and implement a baseline care plan for a newly admitted resident within the required 48-hour timeframe. The resident, a female with a history of joint replacement surgery, type 2 diabetes mellitus, and heart failure, was admitted to the facility. Although a baseline care plan was initiated by an LVN, it was not completed, leaving the resident without a comprehensive plan to address her immediate health and safety needs. Interviews with facility staff, including the LVN responsible for the care plan and the Director of Nursing, confirmed the oversight. The LVN admitted to forgetting to complete the baseline care plan, while the Director of Nursing acknowledged the requirement but downplayed the risk, citing close communication among staff to meet care needs. The facility's policy mandates the completion of a baseline care plan within 48 hours of admission, which was not adhered to in this case.
Failure to Prevent Complications in G-Tube Feeding
Penalty
Summary
The facility failed to provide appropriate care and services to prevent complications for a resident with a gastrostomy tube (g-tube). A certified nursing assistant (CNA) did not inform the nurse to turn off the resident's g-tube feeding prior to providing incontinent care. The CNA lowered the head of the resident's bed to a flat position while the g-tube feeding continued to infuse, which could place the resident at risk for complications such as aspiration and pneumonia. The resident involved was an elderly female with multiple diagnoses, including hypertension, dementia, and gastro-esophageal reflux disease, and was dependent on staff assistance for activities of daily living. The resident's care plan indicated a need for tube feeding due to dysphagia and weight loss, with a goal to remain free of complications related to tube feeding. Despite this, the CNA was unaware of the need to pause the feeding or keep the head of the bed elevated during care, and the facility lacked a specific policy regarding providing care to residents on continuous g-tube feeding.
Failure to Re-evaluate PRN Psychotropic Medication
Penalty
Summary
The facility failed to ensure that a resident's PRN order for Lorazepam, a psychotropic medication, was limited to fourteen days, as required by regulations. The resident, a male with multiple diagnoses including chronic systolic heart failure, COPD, and depression, had a PRN order for Lorazepam for anxiety that extended beyond the fourteen-day limit without physician documentation re-evaluating the necessity of the medication. The resident's care plan indicated the use of Ativan for anxiety, with a goal to decrease anxiety symptoms, but there was no evidence of re-evaluation or documentation justifying the continued PRN use of Lorazepam. Interviews with facility staff, including the ADONs and the DON, revealed a lack of awareness and follow-up regarding the re-evaluation of the PRN Lorazepam order. The ADONs acknowledged the requirement for a 14-day re-evaluation of psychotropic medications and admitted to not following up with the primary care provider after the resident was no longer on hospice. The DON was unaware of the pharmacy's recommendation for re-evaluation and could not provide a rationale for the prolonged use of the medication. The facility's policy required that PRN orders for antipsychotic medications not be renewed beyond 14 days without a documented evaluation and rationale, which was not adhered to in this case.
Inadequate Hand Hygiene 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 perform hand hygiene after changing gloves while assisting a resident who had a bowel movement. This oversight was acknowledged by CNA A, who admitted forgetting to complete hand hygiene, despite being aware of its importance in preventing infection spread. Similarly, CNA C did not change gloves or perform hand hygiene after cleaning a resident who was soiled with urine. Instead, CNA C continued to handle the resident's clean brief, linens, and bed remote with the same gloves. CNA C was unaware of the need for hand hygiene between care tasks unless a bowel movement was involved, indicating a gap in understanding of infection control practices. Interviews with the Director of Nursing (DON) and the Assistant Director of Nursing (ADON), who is also the infection preventionist, confirmed that staff are expected to perform hand hygiene during care. The facility's policies emphasize hand hygiene as a primary means to prevent infection spread, and staff are in-serviced on infection control monthly. However, the observed practices of the CNAs did not align with these expectations, leading to potential risks of cross-contamination and infection spread.
Failure to Notify Physician of Resident's Injury
Penalty
Summary
The facility failed to immediately inform a resident's attending physician and the resident's representative of a significant change in the resident's condition, specifically an injury of unknown origin. The resident, a female with multiple diagnoses including hypertension, dementia, and obesity, was found to have an open wound in the groin area. This wound was discovered by a family member and reported to an LVN, who treated the wound but did not notify the primary care physician, assuming it was a moisture-related incident. The facility's Director of Nursing stated that the wound care doctor was notified, which they believed satisfied reporting requirements. However, the primary care physician was not informed of the wound, which was later assessed by another physician as a laceration, not consistent with a moisture-related injury. The facility's policy requires that all injuries of unknown origin be reported to the attending physician, which was not done in this case. Interviews with staff revealed a lack of clarity and communication regarding the wound's origin and the appropriate reporting procedures. The LVN involved did not contact the primary care physician, and the Director of Nursing did not consider the wound an injury of unknown origin. This oversight could potentially delay medical intervention and affect the resident's health, as the primary care physician was unaware of the wound and its implications.
Failure to Report Injury of Unknown Origin
Penalty
Summary
The facility failed to report an injury of unknown origin for a resident, which was discovered on December 27, 2024. The resident, a female with multiple medical conditions including moderate cognitive impairment, was found to have a wound in the lower abdominal/groin area. The wound was initially assessed by an LVN, who treated it and notified the wound care doctor. However, the facility did not report this incident to the Health and Human Services Commission (HHSC) as required by their policy. The Director of Nursing (DON) believed the wound was moisture-related and did not consider it an injury of unknown origin, thus not reporting it to HHSC. The facility's policy mandates that all injuries of unknown origin be reported immediately, but the DON assumed the wound was covered under an existing order for moisture-related incidents. Interviews with staff, including the DON, CNA, and the physician, revealed that the wound did not appear to be pressure or moisture-related, but rather consistent with a laceration. The facility's failure to report the wound as an injury of unknown origin was a deviation from their established procedures. The policy clearly states that all such incidents should be reported to local, state, and federal agencies. Despite the wound being small and not resulting in serious bodily injury, the lack of reporting could place residents at risk for abuse, neglect, and other incidents, as the facility did not follow the required protocol for reporting injuries of unknown origin.
Infection Control Lapses
Penalty
Summary
The facility failed to establish and maintain an effective infection prevention and control program, as evidenced by multiple lapses in protocol by staff members. Specifically, a medication aide (MA A) was observed touching medications without gloves and administering them to a resident. Additionally, MA A did not clean the blood pressure machine between uses for two residents. In an interview, MA A acknowledged awareness of the proper procedures but admitted to forgetting them. The Assistant Director of Nursing (ADON) confirmed that the staff should not touch medications without gloves and should clean the blood pressure machine between residents, regardless of isolation status. Another incident involved a certified nursing assistant (CNA B) who failed to perform hand hygiene while providing incontinent care to a resident. CNA B was observed not washing hands after removing dirty gloves and before donning clean gloves. In an interview, CNA B admitted to forgetting the hand hygiene protocol despite recent in-service training on infection control. The Director of Nursing (DON) reiterated that staff should maintain infection control practices to prevent the spread of infection. The facility's hand washing policy, effective since May 2017, mandates hand hygiene as the primary means to prevent infection spread, requiring hand washing for at least 20 seconds after removing gloves.
Deficient Food Storage Practices in Facility
Penalty
Summary
The facility failed to adhere to its policy regarding the storage and handling of foods brought in by family members and visitors for residents. Observations revealed that nine residents did not have documentation of temperature checks for their personal refrigerators, which is a requirement to ensure food safety. Additionally, the nourishment room refrigerator contained several unlabeled and undated food items, including ice cream, pho, sandwiches, and pizza, along with visible stains, indicating a lack of proper maintenance and oversight. Interviews with facility staff, including the Director of Nursing, Dietary Manager, and Assistant Director of Nursing, highlighted a lack of clarity and responsibility regarding the management of both personal and nourishment room refrigerators. The Director of Nursing stated that the nursing and dietary staff were responsible for cleaning and dating items in the nourishment room, while personal refrigerators were the responsibility of residents and their families. However, the Dietary Manager admitted there was no schedule for cleaning the nourishment room refrigerator, and the Assistant Director of Nursing acknowledged the difficulty in maintaining it due to family access. Further interviews with nursing staff revealed inconsistencies in the understanding of responsibilities for cleaning and maintaining temperature logs. A Licensed Vocational Nurse and a Medication Aide both indicated that cleaning the refrigerators was not part of their job descriptions, and there was confusion about who was responsible for these tasks. This lack of clear procedures and accountability placed residents at risk of foodborne illness due to potential exposure to expired or improperly stored food.
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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 Rockwall
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Rockwall Nursing Care Center | 2.3 mi | — | 10 | 1 |
| Broadmoor Medical Lodge | 2.4 mi | — | 5 | 0 |
| Beacon Harbor Healthcare And Rehabilitation | 4.5 mi | — | 2 | 0 |
| Rowlett Health And Rehabilitation Center | 4.9 mi | — | 0 | 0 |
| Wylie Oaks Healthcare And Rehabilitation | 9.7 mi | — | 2 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.