Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around October 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 Rowlett Health And Rehabilitation Center during CMS and state inspections, most recent first.
The facility's kitchen failed to meet professional standards for food service safety, with unlabeled and undated food items in the refrigerator and freezer, and unsanitary conditions observed in the ice machine scoop holder and storage bins. These deficiencies could risk cross-contamination and airborne illnesses.
The facility failed to provide a clean and safe environment in several resident rooms, with issues such as dirty air conditioning units, dusty air filters, and grime in bathrooms. Interviews revealed a lack of coordination between housekeeping and maintenance staff regarding cleaning responsibilities.
A resident with mobility and cognitive impairments was unable to access her call light due to it being pinned between the bed and the wall, contrary to her care plan and facility policy. Staff interviews revealed a lack of awareness and adherence to ensuring call lights are within reach, resulting in the resident relying on her roommate's call light for assistance.
Two residents with COPD and respiratory failure experienced deficiencies in respiratory care due to improper storage of nebulizer masks and nasal cannulas, and lack of physician's orders for oxygen administration. Observations showed equipment was left unbagged, risking contamination, while interviews confirmed the absence of necessary orders and care plans, violating facility policies.
A CNA in an LTC facility failed to follow proper infection control procedures while providing incontinent care to two residents with hemiplegia and cognitive impairments. The CNA did not wash hands before donning gloves, failed to change gloves or sanitize hands after cleaning the residents, and used a brief that fell on the floor. These actions were against the facility's infection control policies, which emphasize hand hygiene to prevent cross-contamination.
A resident with severe cognitive impairment was found to have a scoop mattress without physician orders or assessment, contrary to facility policy. Staff interviews revealed the mattress was left in place after the resident changed rooms, and the oversight was acknowledged by the DON.
Deficiencies in Food Storage and Sanitation
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, as observed in their only kitchen. During an inspection, it was noted that food items in the refrigerator and freezer were not labeled and dated according to guidelines. Specifically, a large bag of breadsticks and a bag of pretzels were found with incomplete labeling, missing the year, which is against the facility's policy. Additionally, ten large frozen tubes of meat were found unlabeled and undated, lacking any visible indication of the type of meat or the date they were received. Further observations revealed unsanitary conditions in the kitchen, including an ice machine scoop holder with black stains and storage bins for sugar and flour with black dirt stains and black particles in the sugar. Medium storage bins for brown sugar and rice also had black dirt stains. These deficiencies in food storage, labeling, and kitchen sanitation could potentially place residents at risk for cross-contamination and airborne illnesses.
Failure to Maintain Clean and Safe Environment
Penalty
Summary
The facility failed to maintain a safe, clean, comfortable, and homelike environment for residents in several rooms, as observed during a survey. Specifically, rooms #511, #513, #515, #517, #519, and #522 were found to have air conditioning units with dirt particles and grime, thick layers of dust on air filters, and bathroom floors with built-up dirt and grime. Additionally, some rooms had other issues such as non-functional lights, calcium deposits on faucets, and stained nightstands. These conditions were identified through observations and interviews with staff, indicating a lack of proper cleaning and maintenance. Interviews with housekeeping and maintenance staff revealed a lack of clarity and coordination regarding responsibilities for cleaning air conditioning units and filters. Housekeeping staff mentioned that they were instructed to clean the outer parts of the units, while maintenance was responsible for changing air filters quarterly. However, both departments acknowledged the need for better coordination to ensure thorough cleaning. The facility's policy on maintaining a safe and comfortable environment was not effectively implemented, as evidenced by the unsanitary conditions observed in the resident rooms.
Inaccessible Call Light System
Penalty
Summary
The facility failed to ensure that the call light system in a resident's room was accessible, which is a violation of the resident's right to reasonable accommodation of needs and preferences. The resident, an elderly female with difficulty walking, unsteadiness, and weakness, was observed to have her call light pinned between the bed and the wall, making it inaccessible. Despite the resident's limited range of motion and moderate cognitive impairment, the call light was not repositioned to be within her reach, as required by her care plan. Interviews with staff, including a CNA and the DON, revealed that the staff did not notice the call light's inaccessibility, and the CNA admitted responsibility for ensuring call lights are accessible. The facility's policy mandates that call devices be within the resident's reach before leaving the room, but this was not adhered to, leading to the deficiency. The resident expressed reliance on her roommate's call light due to the inaccessibility of her own, highlighting the oversight in ensuring her needs were met.
Improper Respiratory Care and Equipment Storage
Penalty
Summary
The facility failed to provide proper respiratory care for two residents, leading to deficiencies in the storage and administration of respiratory equipment. Resident #321, a female with chronic obstructive pulmonary disease (COPD) and acute respiratory failure, had her nebulizer mask and nasal cannula improperly stored. Observations revealed that the mask was left unbagged on a side table, and the nasal cannula was hanging from the back of her wheelchair, touching potentially contaminated surfaces. Interviews with staff confirmed that these items should have been bagged to prevent contamination and infection. Resident #322, also diagnosed with COPD and chronic respiratory failure, had no physician's order for oxygen administration, which is necessary for ensuring proper respiratory care. The resident's nasal cannula was found hanging unbagged on an oxygen concentrator, and there was no care plan in place for oxygen administration. Interviews with the LVN and DON highlighted the lack of a physician's order, which is crucial for meeting the resident's respiratory needs and ensuring staff are aware of the required care. The facility's policies on oxygen administration and physician's orders were not followed, as evidenced by the improper storage of respiratory equipment and the absence of necessary physician's orders. These failures could lead to respiratory infections and unmet respiratory needs for the residents involved. The staff, including the DON, acknowledged the importance of proper storage and the need for physician's orders to ensure consistent and safe respiratory care.
Infection Control Deficiency Due to Improper Hand Hygiene
Penalty
Summary
The facility failed to maintain an effective Infection Prevention and Control Program, as evidenced by the actions of CNA D during the provision of incontinent care to two residents. Resident #49, a male with hemiplegia and severe cognitive impairment, was observed during a transfer from a shower chair to bed. CNA D did not wash his hands before putting on gloves, failed to change gloves or sanitize hands after cleaning the resident's bottom, and handled clean items such as a new brief without proper hand hygiene. This lack of adherence to infection control protocols could lead to cross-contamination and infection. Similarly, Resident #89, also a male with hemiplegia and severe cognitive impairment, was observed during a transfer to a wheelchair. CNA D again did not wash his hands before donning gloves, failed to change gloves or sanitize hands after cleaning the resident, and used a brief that had fallen on the floor. These actions were contrary to the facility's infection control policies, which emphasize hand hygiene as a primary means to prevent the spread of infections. Interviews with CNA D, the DON, and LVN A confirmed the lapses in infection control practices. CNA D acknowledged the failure to follow proper procedures, while the DON and LVN A reiterated the importance of hand hygiene and glove changes to prevent cross-contamination. The facility's policies clearly outline the necessity of hand hygiene before and after resident contact, after glove removal, and when transitioning from contaminated to clean areas during care.
Failure to Obtain Physician Orders for Scoop Mattress
Penalty
Summary
The facility failed to ensure that a resident received treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the resident's choices. Specifically, the facility did not obtain physician orders or assess a resident for the use of a scoop mattress before its installation. This oversight was identified during a record review and observations, which revealed that the resident, who had severe cognitive impairment and required moderate assistance for activities of daily living, was using a scoop mattress without the necessary physician orders. Interviews with facility staff, including an LVN and the DON, confirmed that the resident had been moved to a new room, and the scoop mattress was inadvertently left in place without proper assessment or orders. The LVN acknowledged that the resident was independent in bed mobility and should not have had a scoop mattress, while the DON admitted that the mattress was not changed when the resident was relocated. The facility's policy on physician orders emphasizes that physical restraints, such as a scoop mattress, should only be used to treat medical symptoms and require prior assessment and orders, which were not obtained in this case.
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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 Rowlett
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Beacon Harbor Healthcare And Rehabilitation | 0.3 mi | — | 2 | 0 |
| Rockwall Nursing Care Center | 3.2 mi | — | 10 | 1 |
| Broadmoor Medical Lodge | 4.2 mi | — | 5 | 0 |
| Highland Meadows | 4.9 mi | — | 0 | 0 |
| Pleasant Valley Healthcare And Rehabilitation Cent | 5.6 mi | — | 1 | 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.