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 Royse City Medical Lodge during CMS and state inspections, most recent first.
The facility failed to maintain proper nail care and hygiene for several residents, leading to unclean and untrimmed nails. This deficiency was observed in residents with varying levels of cognitive and physical impairments, who were dependent on staff for assistance with activities of daily living. Despite the facility's policy requiring regular nail care, staff inconsistencies and lack of training contributed to the oversight, posing a risk of infection and decreased quality of life.
The facility failed to properly store and label food items in their kitchen and storage areas, as observed in the walk-in refrigerator and freezer. Multiple food items, including foiled covered items, a container labeled 'chicken', fruit cups, and sandwiches, were found without proper labeling or use-by dates. The external trailer freezer also contained opened boxes of food items lacking proper labeling and secure closure. Interviews with staff revealed a lack of adherence to labeling protocols, posing a risk of food contamination and potential illness for residents.
A LTC facility failed to maintain an effective infection control program, with CNAs not performing hand hygiene or using appropriate PPE during care for three residents. One resident was frequently incontinent, another was on droplet precautions for COVID-19, and the third was on enhanced barrier precautions due to a pressure ulcer. Staff acknowledged lapses in protocol, recognizing the risk of infection spread.
A resident with moderate cognitive impairment was transferred without a gait belt, contrary to facility policy, resulting in the resident experiencing pain. The CNA involved acknowledged the requirement for gait belt use, which was confirmed by the DON, but the orientation checklist lacked specific gait belt training.
A resident with a urinary catheter was at risk for UTIs due to improper catheter care during a transfer. CNA C placed the catheter bag on the bed, causing urine to back up in the tubing. The resident's care plan required the catheter bag to be below the bladder, a protocol not followed during the incident.
A facility failed to provide appropriate respiratory care for a resident on hospice requiring oxygen therapy. The resident's room lacked 'Oxygen in Use' signage, which is essential for safety in a smoking facility. Staff interviews confirmed this oversight, acknowledging it as a deviation from policy and a potential risk to care quality.
A facility failed to ensure proper pharmaceutical services for a resident requiring G-tube medication administration. The resident, with severe cognitive impairment and dependent on tube feeding, had physician orders for water flushes between medications to prevent tube obstruction. RN B did not follow these orders, administering medications without the prescribed flushes, and admitted to not reviewing the orders beforehand. The DON confirmed the importance of following orders to prevent complications.
Deficiency in Resident Nail Care and Hygiene
Penalty
Summary
The facility failed to provide necessary services for residents who were unable to carry out activities of daily living, specifically in maintaining good grooming and personal hygiene. This deficiency was observed in five residents who were dependent on staff for assistance with activities of daily living. The residents' nails were found to be unclean and untrimmed, which could lead to a risk of infection and a decrease in quality of life. The facility's policy required nail care to be performed during bathing or as needed, but this was not consistently followed. Resident #39, a woman with severe cognitive impairment and hemiplegia, had nails that were overgrown and untrimmed. She could not recall the last time her nails were cut, indicating a lack of regular nail care. Similarly, Resident #36, a male with severe cognitive impairment and limited mobility, had nails with dark brown residue underneath, suggesting neglect in personal hygiene. The staff, including CNAs and nurses, were responsible for nail care, but there was a lack of training and awareness among CNAs regarding their responsibilities. Resident #76, a male with intact cognition but limited physical mobility, also had long and dirty nails. Despite being aware of the expectation to report nail care needs to the charge nurse, the staff failed to address this issue. Additionally, Resident #34 and Resident #55, both with substantial assistance needs, had untrimmed and dirty nails. There was no documentation of nail care refusal, and the staff interviews revealed inconsistencies in understanding and executing nail care responsibilities. The facility's policy emphasized the importance of nail care to prevent infections, but this was not adequately implemented, leading to the observed deficiencies.
Improper Food Storage and Labeling in Facility Kitchen
Penalty
Summary
The facility failed to adhere to professional standards for food service safety by not properly storing and labeling food items in their kitchen and storage areas. Observations in the facility's kitchen walk-in refrigerator revealed multiple food items, including foiled covered items, a container labeled 'chicken' with an open lid, fruit cups, and sandwiches, all without proper labeling or use-by dates. Additionally, the walk-in freezer contained an open box of cut carrots without a secure closure or date label. The facility's external trailer freezer also had several opened boxes of food items, such as chicken, burritos, dinner rolls, and lasagna rolls, all lacking proper labeling and secure closure. Interviews with the Dietary Manager and staff members highlighted a lack of adherence to labeling protocols. The Dietary Manager acknowledged that cooks were responsible for labeling items in the freezer and that all kitchen staff should label items in other storage areas. She emphasized the importance of sealing food items to prevent contamination and illness. Staff members confirmed the difficulty in labeling items in the trailer freezer due to poor lighting and cold smoke, which hindered proper labeling and closure of food items. The facility's Food Receiving and Storage Policy, revised in July 2014, mandates that all food stored in refrigerators and freezers be covered, labeled, and dated. The Food and Drug Administration Food Code also requires that food storage containers be identified with the common name of the food and marked with a date if held for more than 24 hours. The facility's failure to comply with these standards poses a risk of food contamination and potential illness for residents consuming meals from the facility's kitchen.
Infection Control Deficiencies in LTC Facility
Penalty
Summary
The facility failed to maintain an effective infection control program, as evidenced by several observed deficiencies involving three residents. For Resident #5, a CNA did not perform hand hygiene between glove changes during incontinence care, despite the resident being frequently incontinent of bladder and bowel. The CNA acknowledged the lapse in protocol, recognizing the risk of infection due to improper hand hygiene practices. In the case of Resident #69, who was on droplet precautions due to COVID-19, a CNA interacted with the resident without wearing a mask and failed to perform hand hygiene before entering another resident's room. The CNA admitted to not following the facility's expectations for PPE use and hand hygiene, understanding the potential risk of infection to the resident and others. For Resident #199, who was on enhanced barrier precautions due to a pressure ulcer, two CNAs provided incontinence care without wearing gowns, despite signage indicating the need for PPE. Both CNAs acknowledged their oversight, with one citing nervousness and the other misunderstanding the signage. The Director of Nursing confirmed the expectation for staff to perform hand hygiene and use appropriate PPE to prevent infection spread.
Failure to Use Gait Belt During Resident Transfer
Penalty
Summary
The facility failed to ensure adequate supervision and use of assistance devices during a resident transfer, which was observed with one resident. The resident, who had a moderately impaired cognition and required moderate one-person assistance for transfers, was transferred from her bed to a wheelchair without the use of a gait belt. Instead, the CNA lifted the resident by her armpits, causing the resident to express pain. This action was contrary to the facility's policy and the resident's care plan, which required the use of a gait belt for safe transfers. Interviews with the CNA and the Director of Nursing (DON) confirmed that the expectation was to use a gait belt during transfers to prevent injury. The CNA acknowledged the requirement and admitted to not using the gait belt, despite having been trained on its use. The facility's policy on safe lifting and movement of residents emphasized the use of appropriate techniques and devices, such as gait belts, to ensure the safety of both staff and residents. However, the CNA's orientation checklist did not specifically mention gait belt training, indicating a possible gap in the training process.
Inadequate Catheter Care Leads to Potential UTI Risk
Penalty
Summary
The facility failed to provide appropriate catheter care for a resident who was incontinent of bladder, leading to a potential risk for urinary tract infections. During an observation, CNA C was seen transferring a resident from bed to wheelchair without keeping the urinary catheter bag below the level of the bladder. This resulted in urine backing up in the tubing towards the resident's bladder. The resident's care plan specifically required the catheter bag to be positioned below the bladder to prevent such occurrences. The resident involved had a moderately impaired cognition with a BIMS score of 10 and required moderate assistance for transfers. The resident's medical history included conditions such as abnormal posture, unsteadiness on feet, retention of urine, and muscle weakness. Despite CNA C's skills verification indicating competence in catheter care, the failure to maintain the catheter bag below the bladder was acknowledged by both CNA C and the Director of Nursing, who confirmed that this oversight could increase the risk of urinary tract infections.
Failure to Provide Appropriate Respiratory Care
Penalty
Summary
The facility failed to provide appropriate respiratory care for a resident on hospice who required oxygen therapy. The resident, an elderly female with severe cognitive impairment and multiple diagnoses including dementia and hypertensive chronic kidney disease, was observed to be on oxygen therapy via nasal cannula. However, there was no signage indicating 'Oxygen in Use' on the resident's room door, which is necessary to ensure safety and alert staff in case of emergencies or evacuations. Interviews with facility staff, including a CNA, an LVN, and the DON, confirmed that the absence of the oxygen signage was a deviation from the facility's policy and professional standards of practice. The staff acknowledged that the signage is crucial in a smoking facility to prevent smoking or open flames near oxygen, and its absence could lead to decreased quality of care by not meeting the resident's care needs. The facility's policy on oxygen administration, revised in October 2010, also required 'No smoking/Oxygen in Use' signs as part of the necessary equipment and supplies for oxygen therapy.
Failure to Follow G-Tube Medication Administration Protocol
Penalty
Summary
The facility failed to provide adequate pharmaceutical services for a resident who required medication administration via a G-tube. The resident, a severely cognitively impaired female with multiple diagnoses including dysphagia and cerebral infarction, was dependent on tube feeding for more than half of her caloric intake. The physician's orders specified that the G-tube should be flushed with 15 to 30 ml of water between each medication to prevent tube obstruction and ensure proper hydration. However, during an observation, RN B did not follow these orders and failed to flush the G-tube between medications, administering them consecutively without the prescribed water flushes. RN B admitted to not reviewing the physician's orders prior to administering the medications and acknowledged the potential consequences of not flushing the G-tube as prescribed. The Director of Nursing confirmed that staff are required to follow physician orders and that failing to do so could lead to a clogged G-tube, necessitating hospital intervention, and could decrease the resident's hydration. Despite RN B's competency assessment indicating proficiency in G-tube medication administration, the failure to adhere to the prescribed procedure was observed.
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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 Royse City
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Greenville Health & Rehabilitation Center | 10.8 mi | — | 2 | 0 |
| Briarcliff Health Center Of Greenville | 11.2 mi | — | 15 | 1 |
| Greenville Gardens | 11.7 mi | — | 0 | 0 |
| Legend Healthcare And Rehabilitation - Greenville | 11.7 mi | — | 0 | 0 |
| Highland Meadows | 12.8 mi | — | 0 | 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.