Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around February 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 Meridian Care Of Alice during CMS and state inspections, most recent first.
Failure to Protect Residents From Sexual Abuse: A resident with severe cognitive impairment and a history of sexually inappropriate behavior was found in another resident’s room with his penis exposed and reportedly in her mouth. The other resident also had severe cognitive impairment, dementia, and wandering behaviors. Staff gave conflicting accounts of the event and could not clearly determine whether either resident had the capacity to consent, yet the facility did not treat the incident as sexual abuse.
Failure to Investigate Suspected Sexual Abuse Between Two Cognitively Impaired Residents: A facility did not follow its abuse policy after a male resident with severe cognitive impairment was observed in a female resident’s room engaging in sexually inappropriate conduct, including reported oral-genital contact. Both residents had significant cognitive impairment and a history of wandering, and the male resident had repeated prior incidents of exposing himself and entering female residents’ rooms. Leadership did not treat the event as sexual abuse because neither resident appeared distressed, despite the MD and PA stating neither resident had capacity to consent.
A facility failed to report an alleged sexual abuse incident involving two severely cognitively impaired residents to law enforcement and HHSC within the required timeframe. Staff found a male resident in a female resident’s room with inappropriate sexual contact, but leadership treated the event as a gray area because neither resident appeared distressed and both had cognitive impairment. The DON and ADM did not classify it as sexual abuse for reporting purposes, even though the physician and PA stated it should have been reported and neither resident had capacity to consent.
Failure to Care Plan Inappropriate Sexual Behaviors: A resident with severe cognitive impairment, dementia, and intellectual disabilities had repeated documented inappropriate sexual behaviors toward female residents, including exposure and entering rooms with his pants down. His care plan did not reflect this history or include interventions to address the behaviors, and staff interviews showed the MDS and ADON were not aware the behaviors had been incorporated into the care plan.
Unattended Medication Left on Cart During Pass: During medication pass, an RN left a cup containing Levothyroxine on top of the med cart while entering a resident’s room to put on a gown. The resident had hypothyroidism and severe cognitive impairment. The RN said she forgot to take the medication into the room, and the DON stated scheduled meds should not be left unattended. Facility policy stated no medications are kept on top of the cart.
An RN left a cup containing a resident’s levothyroxine on top of the med cart while she went into the room to don a gown during med pass. The resident had hypothyroidism and severe cognitive impairment. The RN said she forgot to take the medication into the room, and the DON confirmed scheduled meds should not be left unattended. The facility policy stated no medications are kept on top of the cart.
Unlocked Medication and Wound Care Carts: A medication cart by the nurse’s station and a wound care cart by a room were observed unlocked and unattended, with drawers accessible and medications/supplies available for removal. An RN stated she forgot to lock the cart after stepping away, and an LVN stated the wound care cart should always be locked and that charge nurses were responsible for wound care. The DON confirmed both carts should always be locked, and the facility policy required medications and biologicals to be stored in locked compartments.
The facility failed to follow its own medication administration and labeling policies for a multidose vial of Ativan used for two residents with dementia-related behavioral symptoms and anxiety. The vial, which should have been dated and discarded within 28 days of opening, was not labeled with an open date and remained in use beyond the allowable period. Multiple nurses, including an LVN and an RN, administered IM Ativan doses from this vial without checking for an open date or expiration, despite facility policy requiring verification of expiration/beyond-use dates before administration. The DON and ADON confirmed that multidose vials must be dated and are only valid for 28 days once opened, and the narcotic log showed the vial had been opened earlier than permitted for the documented administrations.
A resident with multiple chronic conditions was addressed by an LVN in the dining room, in front of other residents, about wearing underwear instead of pants. The LVN asked the resident to change clothes due to the presence of female residents, causing the resident to feel embarrassed and withdraw from the activity. Staff interviews confirmed the interaction was not handled privately, and the resident reported feeling belittled by the public discussion.
A resident with dementia and unsteadiness on feet was at risk for falls, and the care plan required two beveled mats for fall prevention. However, observations revealed only one mat was in place. Staff interviews confirmed awareness of the requirement but were unsure why it was not followed. The DON acknowledged the lapse in implementing the care plan, which could lead to potential injury.
A facility failed to administer Latanoprost eye drops as prescribed for a resident with dementia and glaucoma. The physician ordered the drops to be given at bedtime, but they were administered in the morning. The medication aide did not notice the discrepancy between the label and the physician's order. Interviews with the RN and DON highlighted the importance of verifying medication orders and reporting discrepancies.
Failure to Protect Residents From Sexual Abuse
Penalty
Summary
The facility failed to ensure the right to be free from abuse for two residents when one resident with severe cognitive impairment and a documented history of sexually inappropriate behavior was found in another resident’s room with his penis exposed and reportedly placed in the other resident’s mouth. The resident involved had diagnoses including moderate intellectual disabilities, frontotemporal neurocognitive disorder, cognitive communication deficit, and dementia with psychotic disturbance, and his quarterly MDS reflected a BIMS of 00. His record also showed repeated prior incidents of sexually inappropriate behavior, including entering female residents’ rooms, exposing his genitals, and being found with his pants down or hands in his pants around female residents. The other resident involved had Alzheimer’s disease, dementia, major depressive disorder, delusional disorder, anxiety disorder, and unspecified psychosis, and her annual MDS reflected a BIMS score of 3. Her care plan documented wandering into other residents’ rooms and included routine checks and reorientation interventions. During interview, she could not recall how old she was and could not answer whether she felt fearful. Her responsible party stated he would not have consented to any sexual activity and said she had dementia and was incapacitated. Staff interviews and record review showed the incident was observed by a CNA who reported seeing the male resident in the female resident’s room making thrusting movements and believed his penis was in her mouth. The ADON, DON, ADM, LVN, PA, and MD gave differing accounts of the event and whether it was consensual, but multiple staff acknowledged that both residents had severe cognitive impairment and could not clearly determine whether either resident had the capacity to consent. The facility did not treat the event as sexual abuse, despite the resident histories, the observed sexual contact, and the inability of the residents to explain what occurred.
Failure to Investigate Suspected Sexual Abuse Between Two Cognitively Impaired Residents
Penalty
Summary
The facility failed to implement and follow its abuse, neglect, exploitation, mistreatment, and misappropriation policy when a suspected sexual abuse incident involving two residents was not investigated as abuse. The policy stated that suspected abuse must be promptly and thoroughly investigated, that the Administrator or designee must begin the investigation immediately, and that sexual abuse is non-consensual sexual contact of any type with a resident. The report identified an Immediate Jeopardy related to this failure. Resident #94 was an elderly female with diagnoses including Alzheimer's disease, dementia, major depressive disorder, delusional disorder, anxiety disorder, and unspecified psychosis. Her MDS reflected a BIMS score of 3, indicating severe cognitive impairment. Her care plan documented wandering into other residents' rooms and cognitive loss with impaired decision-making. Resident #15 was an elderly male with diagnoses including moderate intellectual disabilities, frontotemporal neurocognitive disorder, cognitive communication deficit, and dementia with psychotic disturbance. His quarterly MDS reflected a BIMS of 00, indicating severe cognitive impairment. His care plan documented wandering into other residents' rooms, socially unacceptable behavior, and inappropriate sexual behaviors, including exposing himself to female residents. On the morning of the incident, CNA A reported seeing Resident #15 in Resident #94's room with his pants down, making thrusting movements, and observed Resident #94 in bed. CNA A stated she saw Resident #94 with her hands raised in a grabbing position and reported that Resident #15's penis was in Resident #94's mouth. The ADON stated she was called to the room, saw Resident #15 with his pants up standing next to the head of Resident #94's bed, and was told by CNA A what she had witnessed. The ADON, DON, and ADM stated Resident #94 did not appear distressed and that the event was not treated as sexual abuse because they believed both residents appeared willing and neither showed fear or distress. The MD and PA stated neither resident had the capacity to consent to sexual activity, and the MD stated the incident should have been reported to the state. The report also documented that the facility had a history of Resident #15 entering female residents' rooms and exposing himself, with multiple prior notes describing similar inappropriate sexual behaviors.
Failure to Report Alleged Sexual Abuse
Penalty
Summary
The facility failed to ensure that an alleged sexual abuse incident involving two residents was reported to local law enforcement and to HHSC Complaint and Incident Intake immediately, and no later than 2 hours after the allegation was made. The deficiency involved a male resident with diagnoses including moderate intellectual disabilities, frontotemporal neurocognitive disorder, cognitive communication deficit, and dementia with psychotic disturbance, and a female resident with diagnoses including Alzheimer’s disease, dementia, major depressive disorder, delusional disorder, anxiety disorder, and unspecified psychosis. Both residents had severe cognitive impairment on MDS assessments, and both were described by facility staff and clinicians as lacking the capacity to consent to sexual activity. The record showed that staff had a long history of documenting the male resident’s inappropriate sexual behaviors, including entering female residents’ rooms, exposing his genitalia, and needing frequent redirection and monitoring. On the incident date, a CNA reported finding the male resident in the female resident’s room with his pants down, making thrusting movements, and believed his penis was in the female resident’s mouth. The CNA intervened and called for the ADON, who removed the male resident from the room. The female resident was described as calm, without visible distress, and unable to explain what occurred. The ADON, DON, ADM, and other staff interviewed later stated they were aware of the event and notified the physician, psychiatric services, and family members, but the incident was not treated as sexual abuse for reporting purposes. During interviews, the DON and ADM stated they believed the event was a gray area because both residents had similar cognitive impairments and neither appeared fearful or distressed. The DON stated the facility did not believe the incident constituted sexual abuse, and the ADM stated it appeared both residents were willing participants. In contrast, the physician and PA stated the incident should have been reported to the state, and the physician stated neither resident had the capacity to consent. The facility’s abuse policy stated that alleged abuse must be reported immediately, but no later than 2 hours after the allegation is made, and that local law enforcement must be notified of suspected crime or alleged sexual abuse. The report identified this failure as an Immediate Jeopardy.
Failure to Care Plan Inappropriate Sexual Behaviors
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for a resident with a documented history of inappropriate sexual behaviors. The resident was a male admitted with moderate intellectual disabilities, frontotemporal neurocognitive disorder, cognitive communication deficit, and dementia with psychotic disturbance. His quarterly MDS reflected a BIMS of 00, indicating severe cognitive impairment, and he required varying levels of assistance with toileting and bathing while also having a wandering behavior noted. Record review showed multiple progress notes documenting inappropriate sexual behaviors toward female residents over several months. These included entering a female resident’s room with his pants down, exposing his penis in a TV room with a female resident present, exposing his genitals to female residents several times, being in another female resident’s room with his hands in his pants while she slept, pulling his pants down in front of a female resident, and repeatedly attempting to enter a female resident’s room with his penis exposed. The resident’s care plan, revised on 09/25/25, did not reflect this history of inappropriate sexual behaviors. During interviews, the ADON stated the resident did not have a prior history of inappropriate sexual behaviors with other residents and acknowledged that behaviors should be care planned because care plans are individualized to address resident needs. The PA stated she was aware of the resident’s sexual inappropriate behaviors and reported the behaviors escalated after a GDR of aripiprazole. The MDS stated he was responsible for care plans, was not aware of the sexual behaviors prior to the incident, and acknowledged that if the behaviors were not care planned, staff would not have clear guidance on what to monitor or how to respond. The DON stated the resident had a history of inappropriate sexual behaviors, including exposing himself and self-stimulatory behaviors in his room, and that failure to care plan these behaviors could allow them to continue without appropriate monitoring or staff guidance.
Unattended Medication Left on Cart During Pass
Penalty
Summary
The facility failed to provide pharmaceutical services to ensure accurate administration of medications for one of two residents observed during medication pass. During observation of Resident #4’s room, RN T left a medication cup containing Levothyroxine on top of the medication cart while she went into the resident’s room to put on a gown. The medication was not administered at that time and was left unattended on the cart. Resident #4 was an [AGE]-year-old female admitted on 6/25/21 with hypothyroidism and had a BIMS score of 2, indicating severe cognitive impairment. During interview, RN T stated she did not normally leave medications on top of the cart but forgot to take the medication into the room with her, and said any resident could grab the medication and take it. The DON stated scheduled medications should not be left unattended and that any resident or visitor could take the medication and have an adverse reaction. The facility policy stated no medications are kept on top of the cart and that the cart must be clearly visible to the personnel administering medications, with all outward sides inaccessible to residents or others passing by.
Unattended Medication Left on Cart During Pass
Penalty
Summary
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist was not met when RN T left a cup containing Resident #4’s medications on top of the medication cart while she went into the room to don a gown. The medication cup was observed on the cart during the medication pass and contained levothyroxine, which had been ordered for treatment of hypothyroidism. Resident #4’s face sheet identified her as an [AGE]-year-old female admitted to the facility on 6/25/21, and her MDS dated 12/30/25 documented severe cognitive impairment. During interview, RN T stated she did not normally leave medications in the top of the medication cart, but she forgot to take the medication into the room with her. She stated the negative outcome could be that any resident could grab the medication and take it. The DON confirmed that medications scheduled to be administered should not be left unattended and stated that any resident or visitor could take the medication and could have an adverse reaction. The facility policy titled Administering Medications, revised April 2019, stated that no medications are kept on top of the cart and that the cart must be clearly visible to the personnel administering medications, with all outward sides inaccessible to residents or others passing by.
Unlocked Medication and Wound Care Carts
Penalty
Summary
The facility failed to store drugs and biologicals in locked compartments on 2 of 8 medication carts reviewed: RN C’s medication cart and the wound care cart. During an observation on 03/24/26 at 2:23 PM, the medication cart by the nurse’s station in the 300 hall was unlocked and unattended. The surveyor opened the drawers and found bulk bottles and blister packs accessible for removal. RN C approached from a nearby hall and identified herself as responsible for the cart, then stated she had walked away briefly and forgot to lock it. During an observation on 03/25/26 at 9:20 AM, the wound care cart by room [ROOM NUMBER] was also unlocked and unattended. LVN D was able to open the drawers without unlocking the cart and stated the cart was supposed to always be locked, that there was no designated wound care nurse, and that charge nurses were responsible for wound care. The DON later stated the medication and wound care carts should always be locked to prevent others, including residents, from getting medications and supplies. The facility policy dated February 2023 stated that medications and biologicals are stored in locked compartments and that carts used to transport such items are not left unattended if open or otherwise potentially available to others.
Expired, Undated Multidose Ativan Vial Administered to Residents
Penalty
Summary
The deficiency involves the facility’s failure to provide pharmaceutical services that ensured accurate acquiring, receiving, dispensing, and administering of medications, specifically related to a multidose vial of Ativan. A multidose vial of Ativan 20 mg/10 mL, used for treating anxiety and aggression, was opened on a documented date but was not labeled with the date opened or initials on the vial or its packaging. Despite the facility’s policy requiring multidose vials to be dated and discarded within 28 days of opening, the vial remained in use beyond this period. The Ativan narcotic count log showed the vial had been opened on a specific date, but the vial itself lacked any open date, and the expiration/beyond-use dating process required by policy was not followed. Resident #1, a male resident with dementia with behavioral disturbances, had physician orders for intramuscular Ativan 2 mg/mL in varying one-time doses for aggression, combativeness, and severe aggression. The February 2026 MAR documented that IM Ativan was administered to this resident on three separate dates by different nurses (LVN-C, RN-D, and LVN-E). Resident #2, a female resident with dementia with anxiety and generalized anxiety disorder, had a physician order for Ativan 2 mg/mL, 0.5 mL one time only for aggression and combativeness, and the February 2026 MAR showed Ativan 0.5 mL was administered on one date. These administrations corresponded with the same multidose vial of Ativan that had been opened more than 28 days earlier and was not properly dated on the vial. During observation, the Ativan vial was approximately one-third full, with no written open date or initials, and staff interviews confirmed that the vial had been opened on a date that made it expired under facility policy at the time it was administered to both residents. The ADON stated that multidose vials should be dated and initialed when opened and are only good for 28 days, and acknowledged that ADONs audit controlled medication logs only every couple of weeks. LVN-C, RN-D, and LVN-E each stated they did not check the vial for an open date or expiration prior to administration, despite acknowledging that nurses are supposed to verify that medications are not expired before giving them. The DON confirmed that the vial, opened on the documented date, should have been discarded 28 days later and that every nurse administering the medication should have checked when it was opened and whether it was expired. Facility policies on Medication Administration and Medication Labeling and Storage required dating of multidose vials when opened and discarding them within 28 days, which was not done in this case.
Resident Dignity Compromised by Public Discussion of Attire
Penalty
Summary
A deficiency occurred when a licensed vocational nurse (LVN) addressed a male resident in the dining room, in the presence of other residents, regarding his attire. The resident, who had diagnoses including muscle wasting, heart failure, type 2 diabetes, hypertension, and chronic obstructive pulmonary disease, was observed sitting in the dining room wearing underwear briefs. The LVN asked the resident, in front of others, if he knew he was not wearing pants and requested that he put on clothes over his underwear, citing the presence of female residents. This interaction was witnessed by staff and reported by the resident as embarrassing and belittling. The resident was cognitively intact, independent in functional abilities, and typically outgoing and social. Following the incident, he expressed feeling upset and withdrew to his room, not returning to the dining area that day. Staff interviews confirmed that the LVN acknowledged she should have addressed the matter privately rather than in front of other residents. Other staff and residents did not express concern about the resident's attire, and some believed he was wearing shorts. The resident later reported feeling embarrassed by the public nature of the interaction. Documentation and interviews indicated that the resident did not experience ongoing distress after the incident, and no similar incidents involving the LVN were reported. The facility's policy requires residents to be treated with dignity and respect at all times, but in this instance, the resident's right to dignity and respect was not upheld due to the manner in which the LVN addressed his attire in a public setting.
Failure to Implement Comprehensive Care Plan for Fall Prevention
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for a resident, which included measurable objectives and time frames to meet the resident's medical and nursing needs. The resident, an elderly male with dementia, hypertension, and unsteadiness on feet, was identified as being at risk for falls. The care plan dated October 25, 2024, specified the use of two beveled mats as an intervention to prevent falls. However, during observations on January 14 and 15, 2025, it was noted that only one floor mat was present at the resident's bedside. Interviews with facility staff, including an LVN and a CNA, revealed that they were aware of the requirement for two floor mats but were unsure why only one was in place. The Director of Nursing confirmed that the care plan was not followed, which could potentially lead to injury if the resident were to fall. The facility's policy on comprehensive person-centered care plans emphasizes the need for measurable objectives and timetables to meet residents' needs, which was not adhered to in this case.
Failure to Administer Eye Drops as Prescribed
Penalty
Summary
The facility failed to ensure the accurate administration of Latanoprost Ophthalmic Solution for a resident with dementia and glaucoma. The resident's physician had ordered the eye drops to be administered at bedtime, but during an observation, a medication aide was seen administering the drops in the morning. The medication aide admitted to not noticing the discrepancy between the label instructions and the physician's order, stating that she had been administering the drops in the morning for as long as she could remember. The aide confirmed that she usually compared the resident's name, drug name, and dosage on the label with the computer records, but did not notice the timing error. Interviews with the RN and DON revealed that the facility's protocol required staff to verify medication orders against the label and to report any discrepancies to a nurse. The RN stated that in the event of a discrepancy, the medication should be held, and the physician should be contacted for clarification. The DON emphasized the importance of administering medications as prescribed to ensure their effectiveness. The facility's policy on administering medications required staff to check the label three times to verify the correct resident, medication, dosage, time, and route before administration.
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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 Alice
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| The Premier Snf Of Alice | 2.4 mi | — | 9 | 0 |
| Windsor Nursing And Rehabilitation Center Of Alice | 2.4 mi | — | 11 | 0 |
| Windsor Nursing And Rehabilitation Center Of San D | 9.8 mi | — | 0 | 0 |
| Lone Star Ranch Rehabilitaion And Healthcare Cente | 21.8 mi | — | 3 | 0 |
| Kingsville Nursing And Rehabilitation Center | 22.6 mi | — | 5 | 0 |
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