Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around November 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 Lubbock Health Care Center during CMS and state inspections, most recent first.
A facility failed to ensure accurate accounting of a controlled substance when nursing staff did not physically count Lorazepam stored in the refrigerator during shift change, resulting in four missing syringes. The discrepancy was discovered after a review of the narcotic count sheet and interviews revealed that staff relied on paper records instead of conducting a full physical count as required by policy. The involved nurse could not account for the missing doses and refused to complete a required drug test after an initial abnormal sample.
A resident with multiple medical conditions was improperly restrained by an LVN who tied the resident's hand to the bed to prevent him from pulling out his dialysis port. The LVN did not notify the physician or obtain an order for the restraint, violating the facility's policy. The resident had a history of pulling at his port, posing a risk of severe bleeding, but the facility's policy requires a physician's order for any restraint use.
A resident in a long-term care facility was restrained without a physician's order to prevent him from pulling out his dialysis port. The LVN failed to notify the physician or the Director of Nursing about the resident's change in condition and the use of restraint, violating facility protocols. This lack of communication and adherence to procedures compromised the resident's care.
The facility failed to inform residents and their representatives about the grievance process, resulting in six residents being unaware of how to file grievances or who the grievance official was. The Activity Director and Social Worker were also unaware of the grievance procedures, leading to a lack of written documentation and confusion about roles and responsibilities.
A facility failed to maintain proper infection control practices during medication administration. An LVN did not sanitize a multi-use wrist blood pressure device between residents and neglected hand hygiene between medication administrations. Despite training, the LVN admitted to not following procedures, risking cross-contamination. Interviews with facility administration confirmed the expectation for proper sanitization, but the LVN's actions did not align with the facility's infection control policy.
A resident's Out-of-Hospital Do Not Resuscitate (OOH-DNR) form was found incomplete, missing the physician's license number and printed name. The social worker, responsible for ensuring the accuracy of these forms, acknowledged the error. The resident, a 5-year-old female with multiple health issues, was listed as DNR, but the incomplete form could lead to her end-of-life wishes not being honored.
The facility failed to ensure a safe environment as multiple toilets were found unsecured and unstable, posing a risk of injury. Two residents, both cognitively intact, reported issues with their toilets, with one noting it was loose and the other finding it too short. Maintenance and housekeeping procedures were inadequate, as regular checks for toilet stability were not conducted, and repairs were not completed in a timely manner.
A resident with a history of emphysema, CHF, and hypertension fell in the bathroom due to an unstable toilet in the facility. The toilet wobbled, causing the resident to fall and sustain a wrist laceration and bruises. The facility's investigation found that a bolt securing the toilet had stripped from the floor, leading to the instability. Despite the resident's complaints of pain, x-rays showed no fractures. The incident highlighted concerns about the toilet's condition and potential injury risks.
Failure to Accurately Account for Controlled Substance Due to Incomplete Narcotic Count
Penalty
Summary
The facility failed to provide pharmaceutical services that ensured the accurate accounting of a resident's narcotic medication, specifically Lorazepam Intensol Oral Concentrate. The resident, a male with diagnoses including depression, anxiety, acute systolic heart failure, and respiratory failure, had an active physician order for Lorazepam to be administered four times daily. On a specific date, the narcotic count sheet for this medication showed a discrepancy: four syringes were missing from the count, and the count was subsequently corrected by administrative staff after the discrepancy was discovered. Interviews with nursing staff revealed that at the shift change, the outgoing and incoming nurses did not physically count the Lorazepam stored in the refrigerator, instead relying on the paper record. Both nurses admitted to not counting the medication in the refrigerator, which led to the failure to account for the missing syringes. One nurse stated she had taken all four syringes at the start of her shift and kept two in her pocket for later administration, but could not account for the missing doses. The facility's policy required all controlled substances, including those in the refrigerator, to be counted at each shift change by two staff members, but this procedure was not followed. The incident was further complicated when one of the nurses involved refused to complete a required drug test after providing a urine sample with an abnormal temperature, as per facility protocol for missing narcotics. The missing medication was not located despite a search of all medication carts and interviews with involved staff. The resident did not miss any doses of Lorazepam as the medication was replaced, but the failure to properly account for and secure controlled substances constituted a deficiency in pharmaceutical services.
Improper Use of Physical Restraint on Resident
Penalty
Summary
The facility failed to ensure that a resident was free from physical restraints, as required by regulations, unless needed for medical treatment. A Licensed Vocational Nurse (LVN) tied a resident's hand to the bed without notifying the physician, Director of Nurses (DON), or the resident's responsible party. The LVN took this action to prevent the resident from pulling out his dialysis port, which could have led to severe bleeding. However, there was no physician's order for this restraint, and the facility's policy requires such an order before applying any restraint. The resident involved was an elderly male with multiple medical conditions, including metabolic encephalopathy, sepsis, acute posthemorrhagic anemia, myocardial infarction, atrial fibrillation, heart failure, and acute kidney failure. He had a history of pulling at his dialysis port, which was a significant concern due to the risk of bleeding. Despite these challenges, the facility's records did not document any order for restraint, nor did they reflect any communication with the physician regarding the use of restraints. Interviews with staff revealed that the LVN believed he was acting in the resident's best interest to prevent a life-threatening situation. However, he did not follow the facility's policy and procedure for restraints, which requires physician notification and an order. The facility's policy emphasizes maintaining a restraint-free environment and only using restraints when medically necessary and with proper authorization. The incident was discovered by the DON, who found the resident's hand tied to the bed and confirmed that no proper procedures had been followed.
Failure to Follow Restraint Protocols and Notify Physician
Penalty
Summary
The facility failed to provide appropriate treatment and care for a resident in accordance with professional standards and the resident's comprehensive person-centered care plan. The Licensed Vocational Nurse (LVN D) did not notify the resident's physician or responsible party about a change in the resident's condition, specifically the resident's behavior of attempting to remove his dialysis port. This lack of communication prevented the physician from exploring alternative interventions to manage the resident's behavior. Additionally, LVN D applied a restraint to the resident's arm without obtaining a physician's order. The restraint was used to prevent the resident from pulling out his dialysis port, which could have led to severe bleeding. However, this action was taken without following the facility's policy and procedure for restraints, which requires notification and approval from the physician, the Director of Nursing (DON), and the resident's responsible party. The incident was discovered when the DON found the resident's hand tied to the bed frame. Interviews with staff revealed that LVN D was aware of the facility's no-restraint policy but chose to restrain the resident temporarily for safety reasons. The failure to follow proper procedures and communicate effectively with the healthcare team and the resident's family compromised the quality of care provided to the resident.
Failure to Inform Residents of Grievance Process
Penalty
Summary
The facility failed to provide residents and their representatives with information on their rights related to filing grievances. This deficiency was identified for six confidential residents who were unaware of the grievance process, including how to file a grievance, who the grievance official was, and their right to obtain a written decision. During a Resident Council meeting, all six residents expressed their lack of knowledge about the grievance process, indicating that they did not know where to obtain or submit a grievance form. The Activity Director (AD) confirmed that she had never discussed grievances in Resident Council meetings and was unaware that residents could file grievances independently or anonymously. The AD, who had been employed for 18 months, stated she had not been trained on the grievance procedure and was unaware of the facility's grievance policy. The AD documented grievances in the facility's electronic records but did not maintain written documentation. The Social Worker also lacked awareness of the requirement to keep grievance documentation for three years and stated that no written grievances were completed by staff, residents, or their representatives. The facility's grievance policy outlines that residents have the right to voice grievances without fear of reprisal and that the facility must make prompt efforts to resolve them. However, the policy was not effectively communicated or implemented, as evidenced by the lack of awareness among residents and staff. The facility's grievance process involved the Social Worker and the Administrator, but there was confusion about the roles and responsibilities, and the grievance forms were not easily accessible to residents.
Inadequate Infection Control Practices During Medication Administration
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program, as evidenced by the actions of LVN A during medication administration. LVN A did not properly clean a multi-use wrist blood pressure device between residents, which was observed during multiple medication passes. Specifically, the device was used on several residents without being sanitized before or after each use, potentially leading to cross-contamination and the spread of infections among residents. Additionally, LVN A did not sanitize her hands between administering medications to different residents. This was observed during several medication passes, where LVN A prepared and administered medications to multiple residents without performing hand hygiene before or after each interaction. This lack of hand sanitization was acknowledged by LVN A, who admitted to not following proper procedures due to being in a routine and not being trained to sanitize medical devices between residents. Interviews with facility administration, including the ADM and DON, revealed that staff training on infection control practices, including hand hygiene and sanitizing medical devices, was conducted quarterly or monthly. However, LVN A's actions during the medication pass indicated a failure to adhere to these training protocols, as confirmed by the facility's policy on infection control, which mandates hand washing after each direct resident contact.
Incomplete OOH-DNR Form for Resident
Penalty
Summary
The facility failed to ensure that all residents had the right to formulate an advance directive, specifically for one resident who was listed as Do Not Resuscitate (DNR). The Out-of-Hospital Do Not Resuscitate (OOH-DNR) form for this resident was incomplete, missing the physician's license number and printed name associated with the physician's signature. This oversight was identified during a record review and confirmed through interviews with the facility's social worker and administrator. Both acknowledged that the OOH-DNR form was not valid if not filled out correctly, and the social worker admitted to being responsible for ensuring the accuracy of these forms. The resident in question was a 5-year-old female with multiple diagnoses, including cerebral infarction, muscle weakness, hypertension, major depressive disorder, and type 2 diabetes. The deficiency was attributed to human error, as stated by the social worker, who was responsible for monitoring the accuracy of OOH-DNR forms. The facility's policy required that all validly executed DNR orders be honored, and the social worker was tasked with assisting residents and family members with the execution of these forms. However, the missing information on the OOH-DNR form could potentially lead to the resident's end-of-life wishes not being honored.
Unsecured Toilets Pose Safety Risk
Penalty
Summary
The facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public, as evidenced by unsecured and unstable toilets in multiple rooms. On June 25, 2024, it was observed that toilets in rooms #3, #8, #13, #16, #32, #50, #51, #52, #56, and the rooms of Residents #2 and #3 were not properly secured to the floor, posing a risk of injury and falls. This issue was identified during observations and interviews with staff and residents, revealing that the toilets were loose and unstable. Resident #2, a cognitively intact female with a history of hypoxia, hypertension, anxiety, and seizures, required assistance for toilet use. She reported that her toilet was loose and had not been fixed despite being informed of the issue. Similarly, Resident #3, a cognitively intact male with a history of morbid obesity, lack of coordination, hypertension, and seizures, noted that his toilet was too short but did not comment on its stability. Interviews with staff, including the ADM and maintenance personnel, indicated that the issue had been identified but not adequately addressed, with maintenance staff noting that some toilets could not be tightened further without risking damage. The facility's maintenance and housekeeping procedures were found lacking, as regular checks for toilet stability were not part of the routine maintenance schedule. The maintenance staff had been informed of the issue but had not completed the necessary repairs before leaving the facility. Housekeeping staff were instructed to report any issues, but the process for ensuring repairs was not effectively implemented. The ADM acknowledged the potential for injury due to unsecured toilets and indicated that safety and environmental rounds would be conducted, but these actions were not part of the initial response to the deficiency.
Resident Falls Due to Unstable Toilet
Penalty
Summary
The facility failed to ensure that the resident environment was free from accident hazards, leading to an incident involving a resident. The resident, a cognitively intact female with a history of emphysema, CHF, and hypertension, experienced a fall in the bathroom due to an unstable and loose toilet. The incident occurred when the resident attempted to use the toilet, which wobbled and caused her to fall, resulting in a laceration on her wrist and bruises on her arm and neck. The facility's investigation revealed that one of the bolts securing the toilet had stripped from the floor, causing the toilet to be unstable. The resident was found on the floor by a CNA, with the toilet leaning over but not on top of her. Despite the resident's complaints of aches and pains, x-rays showed no acute fractures. The resident was admitted to the facility on the same day of the incident and was discharged two days later, unrelated to the fall. Interviews with facility staff and the resident's family highlighted concerns about the toilet's condition and the potential for injury. The facility's policy on event reporting requires a thorough investigation of incidents, including documentation of actions taken to prevent recurrence. However, the report does not mention any corrective actions taken by the facility to address the deficiency after the incident.
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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 Lubbock
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Lakeside Rehabilitation And Care Center | 0.1 mi | — | 4 | 0 |
| Southern Specialty Rehab & Nursing | 0.3 mi | — | 2 | 0 |
| Mi Casita Nursing And Rehabilitation Center | 0.6 mi | — | 15 | 0 |
| Mesquite Post Acute Care | 0.7 mi | — | 1 | 0 |
| The Mildred & Shirley L. Garrison Geriatric Educat | 1.3 mi | — | 3 | 2 |
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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.