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 San Remo during CMS and state inspections, most recent first.
Surveyors found multiple expired milk products stored in the main kitchen refrigerator, despite facility policies requiring safe food storage and stock rotation using a first-in/first-out method. The cook in charge reported that her usual daily expiration-date check was not completed that day and that the expired items were overlooked by all kitchen staff. Other dietary staff, including another cook and two aides, stated they were unaware of the expired milk but acknowledged that all kitchen staff were responsible for labeling, storing, and checking expiration dates on food items and discarding expired products, as covered in prior in-service training.
Surveyors found that multiple resident rooms were not thoroughly cleaned or sanitized, with air conditioning units and filters covered in black dirt and thick dust, bathroom floors and showers with dark substances, soap scum, and rust-like stains, and carpets and bedside tables visibly stained. Housekeeping staff acknowledged responsibility for cleaning entire rooms, while maintenance was responsible for air filter cleaning, which was done quarterly by a single staff member who could not keep up with the needed frequency. Supervisory staff and the administrator confirmed expectations that rooms be thoroughly cleaned and recognized that unclean rooms and air filters could negatively affect residents and their breathing, contrary to the facility’s policy requiring a safe, clean, comfortable, and homelike environment.
A cognitively intact male resident with bilateral nephrostomy tubes had his urine collection bags consistently positioned outside his pants, visible in his room, hallways, and dining area, without any documented refusal or informed choice. Staff, including a CNA, ADON, DON, and Administrator, acknowledged that the bags should not be visible for dignity reasons, yet no care plan addressed nephrostomy management or non-compliance, and no documented discussion occurred with the resident or family about keeping the bags inside his pants. The resident and his family later reported they had never been consulted and that they preferred the bags to be concealed for dignity, contrary to staff assumptions.
The facility's kitchen was found to have several food safety deficiencies, including unsealed and expired items in the dry storage and freezer areas. Staff members were unaware of these issues despite recent training. The dietician and administrator acknowledged the importance of proper food handling to prevent cross-contamination and illness.
A resident was moved from a private to a semi-private room without receiving the required written notice, violating her rights. Despite being cognitively intact, she was not informed in advance, and staff interviews revealed a lack of clarity and documentation regarding the room change process. The facility's policy mandates a 5-day advance written notice, which was not adhered to, potentially causing distress to the resident.
A facility failed to refer a resident with schizophrenia for a PASARR Level II evaluation, necessary for receiving specialized services. The resident expressed a desire for these services, but staff were unaware of her diagnosis and did not complete the required evaluation. The facility lacked a formal PASARR policy, relying instead on HHSC recommendations.
A resident with a suprapubic catheter did not receive proper care, as a CNA failed to clean the catheter site and tubing during a bath, and the catheter lacked a securement device. Interviews confirmed that these actions were required, and the facility's guidelines specify washing the catheter site and tubing with soap and water.
A facility failed to maintain proper infection control practices when a CNA did not wear appropriate PPE or perform hand hygiene while bathing a resident with a suprapubic catheter. The resident was on enhanced barrier precautions, but the CNA wore gloves with a hole and did not use a gown, nor did they clean the catheter site. Interviews confirmed the failure to follow infection control protocols, highlighting a deficiency in the facility's infection prevention program.
A facility failed to ensure proper management of controlled medications, leading to the loss of 30 Oxycodone tablets. An LVN shared keys to her medication cart with another LVN without counting the medications, violating facility policy. The resident involved did not report any missed doses or increased pain. Both nurses denied taking the medication, and drug tests were negative. The facility's investigation was unable to determine the cause of the missing narcotics.
The facility failed to ensure a safe, clean, comfortable, and homelike environment for a resident with multiple diagnoses, including dementia. The resident's room was frequently found with trash and feces on the floor, despite the family member's repeated requests for cleaning. The Housekeeping Supervisor confirmed that the room required more frequent cleaning due to the resident's behaviors.
A facility failed to update a care plan for a resident with moderately impaired cognition who wanted to change his own brief. Despite the resident's family and staff being aware of the situation, the care plan did not reflect this preference, leading to the resident getting feces on himself and his surroundings. The facility's policy required care plan reviews for changes in condition, but this was not done.
Expired Milk Products Found in Kitchen Refrigerator
Penalty
Summary
Surveyors identified a deficiency in the facility’s food service operations when, during an initial kitchen tour, they observed multiple expired milk products stored in the main kitchen refrigerator. Specifically, they found one half-pint of 2% reduced-fat milk and three containers of fat-free skim milk with “best use by” dates that had already passed. The facility’s written Food Storage policy, revised in 2019, requires that food be stored safely, that stock be rotated using a first-in/first-out method, and that food be kept safe, wholesome, and appetizing. The FDA Food Code was also cited regarding proper labeling and protection of food from contamination. During interviews, the cook who was in charge in the absence of the Nutrition Services Director stated she was responsible for cooking and performed daily morning checks for expiration dates but acknowledged that this check did not occur that day and that the expired milk had been overlooked by all kitchen staff. Another cook/assistant cook, a dietary aide with four years of employment, and a nutritional aide employed for one month each reported they were unaware of the expired milk in the refrigerator at the time of the survey. They all indicated that kitchen staff were responsible for labeling, storing, and checking expiration dates on food items and that expired items should be discarded, consistent with prior in-service training on food preparation, storage, and expired food dates. The presence of expired milk in the refrigerator despite these responsibilities and policies constituted the cited deficiency.
Failure to Maintain Clean and Homelike Resident Rooms
Penalty
Summary
The deficiency involves the facility’s failure to provide a safe, clean, comfortable, and homelike environment for residents, specifically related to room cleanliness and sanitation. Surveyor observations on multiple resident rooms showed that air conditioning units in numerous rooms had black dirt and dust on the front of the units and between the vents, with air filters covered in thick dust. In several bathrooms, floors had thick dark substances near or behind toilets, disposable gloves left on the floor, and shower floors with thick soap scum, rust-like stains, or thick grayish substances. Some carpeted room floors had large dark or white stains, and bedside tables had visible stains on their lower frames. Housekeeping staff interviews confirmed that they were responsible for cleaning entire rooms, including bathrooms, and that air conditioning units were expected to be cleaned, though one housekeeper stated she did not clean air filters. One housekeeper acknowledged that he was responsible for cleaning a specific hall and that floor technicians were supposed to clean carpets; he reported having pointed out carpet issues to the floor techs, but the carpets had not been cleaned. Another housekeeper stated that rooms not being thoroughly cleaned could negatively impact residents. The floor technician reported he was responsible for cleaning floors and that he typically walked around to check carpets for spots, receiving a list of floors to clean from his supervisor and being notified when stains were reported. The housekeeping supervisor stated housekeeping was responsible for cleaning entire rooms, while maintenance was responsible for cleaning air filters, and he was unsure how often filters were cleaned. The maintenance supervisor stated he alone was responsible for cleaning air filters on a quarterly basis and could not get to them as frequently as needed. The administrator acknowledged that he expected housekeeping to thoroughly clean rooms and that failure to do so would not provide a homelike environment, and that not cleaning air conditioning filters could impact residents’ breathing. The facility’s policy on a safe and homelike environment required providing a safe, clean, comfortable, and homelike environment and ensuring residents could receive care and services safely.
Failure to Maintain Dignity and Privacy for Resident With Nephrostomy Bags
Penalty
Summary
The deficiency involves the facility’s failure to ensure a resident’s right to dignity and privacy related to visible nephrostomy urine collection bags. The resident, an older male with malignant neoplasm of the prostate and bilateral nephrostomy tubes, was cognitively intact with a BIMS score of 13. On observation, he was seen in his room with two nephrostomy bags hanging outside his pants, visible from the hallway, and staff reported that the bags had always been outside his pants since admission, including when he walked in the hallways and went to the dining area. The facility’s own staff, including a CNA and the Administrator, acknowledged that the bags should not be visible to others for dignity reasons. Record review showed there was a physician’s order for daily nephrostomy care but no care plan addressing the nephrostomy tubes or any non-compliance with keeping the bags inside the pants. Progress notes contained no documentation that the resident refused to have the bags covered. The resident stated he never told anyone he wanted the bags exposed and that no one had discussed with him the need to keep them inside his pants. His family member similarly reported that no staff had spoken with them about placing the bags inside the pants and expressed a preference for the bags to be concealed for dignity. The ADON stated she only added a care plan for non-compliance after questions were raised about the exposed bags and admitted she had not discussed bag placement with the resident or family. The DON acknowledged the resident’s right to refuse but did not respond when informed that no such discussion or documentation had occurred. The facility’s resident rights policy states that residents have the right to a dignified existence, which was not upheld in this situation.
Food Safety Deficiencies in Kitchen
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, as observed during a survey of the kitchen. In the dry storage area, several food items were found unsealed, including a box of baking soda, a bag of powdered sugar, and containers of breadcrumbs and sugar. Additionally, expired items were discovered, such as bottles of thickened orange juice and a bag of egg noodles. The freezer also contained unsealed items like chopped collard greens, broccoli florets, and a lemon meringue pie. These practices could potentially lead to cross-contamination and pose a risk of foodborne illnesses to residents. Interviews with staff members revealed a lack of awareness regarding the presence of expired and unsealed items in the kitchen. One staff member, employed for six years, admitted to not knowing about the expired and unsealed food, despite having received recent in-service training on food preparation and storage. Another staff member, with three years of employment, also expressed unawareness of the kitchen's condition and acknowledged the potential for cross-contamination and bacterial growth due to expired and unsealed food. The facility's dietician, who visits weekly, was also unaware of the expired and unsealed items. She emphasized that all staff are responsible for ensuring food safety and that they had been trained on proper food handling procedures. The dietician stated that the expired and unsealed items were discarded, and she believed there was no risk to residents as a result. The facility's administrator was informed of the findings and acknowledged the importance of following proper food storage and preparation protocols to prevent cross-contamination and illness.
Failure to Provide Written Notice for Room Change
Penalty
Summary
The facility failed to provide Resident #92 with written notice prior to a room change, violating her right to be informed in advance of such changes. Resident #92, a cognitively intact female with a BIMS score of 14, was moved from a private room to a semi-private room without receiving any written or verbal explanation. The resident expressed that she was abruptly informed of the move without any prior notice or reason, and she did not believe the change was related to insurance issues. Interviews with facility staff, including the Unit Manager, Social Worker, Administrator, and DON, revealed a lack of clarity and communication regarding the room change process. The Unit Manager and Social Worker were unable to confirm if any written notice was provided, and the Administrator admitted uncertainty about whether residents received written documentation for room changes. The DON acknowledged conversations with the resident and her family about transitioning from skilled therapy to private pay but could not confirm if written notice was given. The facility's policy requires a 5-day advance written notice for room changes, but no documentation was found to support compliance with this policy. Interviews with LVNs involved in the resident's care indicated that they were either unaware of the room change or did not see any written notice. The lack of documentation and communication highlights a failure to adhere to the facility's policy, potentially causing distress to the resident by not allowing her to prepare for the move.
Failure to Refer Resident for PASARR Level II Evaluation
Penalty
Summary
The facility failed to refer a resident for a PASARR Level II evaluation to the State-designated authority, which is necessary for residents with serious mental disorders to receive specialized services. The deficiency was identified during a review of records and interviews, where it was found that a resident with a diagnosis of schizophrenia was not referred for the necessary evaluation. The resident's quarterly MDS Assessment indicated that her cognition was intact, and she expressed a desire to receive PASARR services, which she was not receiving. Interviews with facility staff revealed a lack of awareness and oversight regarding the resident's mental health diagnosis and the need for a PASARR Level II evaluation. The LVN responsible for PASARR services was unaware of the resident's schizophrenia diagnosis and admitted that the resident was at risk of not receiving qualified services. The DON, who was responsible for ensuring the accuracy of PL-1 screenings, also did not know why a new PL-1 was not completed for the resident's diagnosis. It was noted that the facility did not have a formal PASARR policy but followed recommendations from HHSC.
Inadequate Catheter Care for Resident
Penalty
Summary
The facility failed to provide appropriate care for a resident with a suprapubic catheter, leading to a deficiency in preventing urinary tract infections. The resident, who was cognitively intact and required partial assistance for bathing, was observed with a suprapubic catheter that had crusty, brown drainage at the site and on the tubing. During a bath, a CNA did not clean the catheter site or tubing, which is a necessary step in catheter care. Additionally, the resident's catheter lacked a securement device, which is essential to prevent the catheter from pulling out and potentially causing complications. Interviews with the CNA, Unit Manager, and DON confirmed that the catheter site and tubing should have been cleaned, and a securement device should have been in place. The facility's in-service guidelines for suprapubic catheter care, revised in October 2010, specify the need to wash around the catheter site and the outer part of the catheter tube with soap and water. The failure to adhere to these guidelines and provide the necessary care could place the resident at risk of cross-contamination and the development of urinary tract infections.
Inadequate Infection Control Practices During Resident Care
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program, as evidenced by the improper use of personal protective equipment (PPE) and inadequate hand hygiene by a certified nursing assistant (CNA) while providing care to a resident. The resident, a male with a history of bone infection, diabetes, and urinary tract infection, required partial assistance with bathing and had a suprapubic catheter. During an observation, the CNA was seen wearing gloves but not a gown, despite the resident being on enhanced barrier precautions. The CNA's clothing came into contact with the bed and the resident, and the CNA did not clean the resident's catheter site or tubing. Additionally, the CNA continued to use gloves with a hole, failing to change them or perform hand hygiene after bathing the resident. Interviews with the CNA, Unit Manager, and Director of Nursing (DON) confirmed that the resident was on enhanced barrier precautions, which required the use of a gown and gloves. The CNA admitted to not following proper procedures, including changing gloves and performing hand hygiene. The Unit Manager and DON reiterated the importance of correct PPE usage and hand hygiene to prevent infection spread. The facility's in-service training on infection control emphasized the need for a comprehensive infection prevention and control program, which was not adhered to in this instance.
Failure to Properly Manage Controlled Medications
Penalty
Summary
The facility failed to ensure proper management of controlled medications, leading to the loss of 30 tablets of Oxycodone belonging to a resident. LVN A shared the keys to her medication cart, which contained a separately locked compartment for controlled medications, with LVN B during their shift. This action was against the facility's policy, which requires a count of controlled medications before handing over keys. At the end of her shift, LVN A discovered that the Oxycodone tablets were missing, and the medications were never located. The resident involved was a female with severe cognitive impairment and multiple medical conditions, including a bacterial infection, surgical aftercare, amputation, peripheral vascular disease, and chronic non-pressure ulcers. She was receiving scheduled pain medications and hospice services. Despite the missing Oxycodone, the resident did not report any missed doses or increased pain during the period in question. Interviews with the involved staff revealed that LVN A and LVN B breached facility policy by sharing keys without counting the medications. Both nurses denied taking the missing medication, and drug tests for both were negative. The facility conducted a thorough investigation, including a full medication audit, but was unable to determine the cause of the missing narcotics. The incident highlighted a significant lapse in the facility's procedures for managing controlled substances.
Failure to Maintain a Clean and Homelike Environment
Penalty
Summary
The facility failed to ensure a safe, clean, comfortable, and homelike environment for a resident, leading to unsanitary living conditions. The resident, a male with diagnoses including encephalopathy, hyperlipidemia, type 2 diabetes, and dementia, was observed with a soiled brief on the floor. The resident admitted to changing his own brief and missing the trash can, and had not called staff to clean up. The resident's family member, who visited several times a week, also noted that the room frequently needed cleaning and often had trash on the floor, including broken pieces of a plastic cup and used gauze with feces on it. The family member stated she frequently informed staff about the need for cleaning in the resident's room. The Housekeeping Supervisor confirmed that resident rooms were cleaned once a day or more if needed, and that this particular resident's room was cleaned more frequently due to behaviors of throwing things and issues with feces on the floor. The supervisor stated that CNAs or nurses would inform housekeeping staff if additional cleaning was needed. The facility's policy on resident rights, revised in February 2021, guarantees residents the right to a dignified existence and to be treated with respect, kindness, and dignity. However, the facility failed to uphold this policy for the resident in question.
Failure to Update Care Plan for Resident's Independence in Brief Changing
Penalty
Summary
The facility failed to ensure comprehensive care plans were reviewed and revised by the interdisciplinary team after each assessment for a resident with moderately impaired cognition. The resident, who had diagnoses including encephalopathy, hyperlipidemia, type 2 diabetes, and dementia, expressed a desire to be independent and change his own brief. However, the care plan did not address this preference, leading to the resident changing his own brief and getting feces on himself and his surroundings. Despite the resident's family member and staff being aware of the situation, the care plan was not updated to reflect the resident's needs and preferences. Observations and interviews revealed that the resident often did not call for assistance and waited for staff rounds to be cleaned. The CNA and LVN confirmed that the resident had been attempting to change his own brief for a couple of weeks, and the Director of Nursing acknowledged that the care plan should have included the resident's desire to change his own brief. The facility's policy required changes in the resident's condition to be reported and the care plan to be reviewed, but this was not done, placing the resident at risk for delayed treatment and not maintaining their highest practicable wellbeing.
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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 Richardson
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Collinwood Nursing And Rehabilitation | 1.3 mi | — | 1 | 0 |
| Remington Transitional Care Of Richardson | 2.2 mi | — | 0 | 0 |
| Lindan Park Care Center Lp | 3 mi | — | 0 | 0 |
| The Parks At Garland Healthcare And Rehab | 3.3 mi | — | 3 | 0 |
| Legend Oaks Healthcare And Rehabilitation Garland | 3.6 mi | — | 4 | 0 |
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