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 The Center At Parmer during CMS and state inspections, most recent first.
A resident with paraplegia and other complex conditions did not receive scheduled catheter care for over two hours past the ordered time, resulting in significant pain and discomfort. The delay occurred because staff prioritized other residents' needs, and there was a lack of timely communication and delegation. The resident repeatedly requested assistance, and the procedure was eventually performed by an LPN, but not documented at the correct time. Facility policy requiring prompt response to toileting needs was not followed.
A resident with paraplegia and other complex conditions did not receive scheduled catheter care on time, resulting in significant pain and a request for pain medication. Nursing staff provided the care approximately 2.5 hours late, but inaccurately documented the time in the MAR. Multiple staff interviews confirmed the delay, lack of communication during shift change, and failure to document the actual time of care.
The facility did not promptly report suspected abuse, neglect, or theft, nor did it communicate the results of its investigation to the proper authorities as required.
A resident with severe cognitive impairment and multiple medical conditions was discharged without receiving a written 30-day notice, reasons for discharge, or information about appeal rights. The resident's representative and the Ombudsman were also not notified in writing, and staff interviews confirmed a lack of compliance with facility policy and regulatory requirements.
The facility failed to implement comprehensive care plans for three residents, specifically regarding transfer assistance. One resident with a hip fracture and cognitive impairment required substantial assistance, but the care plan lacked details. Another resident, post-stroke, needed total dependence for transfers, yet the care plan did not specify the use of a mechanical lift. A third resident, with intact cognition but medical conditions affecting mobility, experienced inconsistent staff support during transfers due to unclear care plan documentation.
A facility failed to transmit a Discharge MDS assessment for a resident within the required timeframe. The resident, who had conditions including intervertebral disc disorder and hyponatremia, was discharged, but the MDS was not encoded or transmitted due to the MDS coordinator's absence. This oversight affected recently discharged residents at risk of untimely assessment transmission.
A facility failed to provide a comprehensive activity program tailored to residents' preferences, leading to boredom and dissatisfaction among residents. The activity calendars for September and October 2024 were limited, and residents reported not receiving them. The facility lacked an activity director for a period, contributing to the deficiency. Residents expressed a need for more engagement and stimulation, which was not being met.
A facility failed to provide aseptic tracheostomy care for a resident. An LVN contaminated the sterile field by improperly handling normal saline and did not clear the resident's airway before inserting the inner cannula. The facility's care plan lacked specific guidance on tracheostomy care frequency, contributing to the deficiency.
A facility failed to maintain an effective infection control program during tracheostomy care for a resident with encephalopathy, HIV, and tracheostomy status. The LVN did not follow aseptic techniques, using non-sterile saline and failing to clear a mucus plug before inserting the inner cannula. The DON confirmed the breach in procedure, which could risk resident infections.
Delayed Catheter Care Resulting in Resident Discomfort and Pain
Penalty
Summary
A deficiency occurred when a resident with paraplegia, major depressive disorder, and ankylosing spondylitis did not receive scheduled in-and-out catheter care for approximately 2.5 hours past the ordered time. The resident was care planned for self-catheterization, but facility staff were responsible for performing the procedure as the resident was unable or unwilling to do it independently. Medical orders specified catheterization every six hours, but on the day in question, there was no documentation of the 4:00 pm catheterization, and the next recorded care was at 10:00 pm, with staff interviews confirming the procedure was actually performed around 6:30 pm. The resident reported significant discomfort and pain due to the delay, stating he requested catheter care multiple times without timely response. He described being in 'massive pain' and required a pain pill for relief. Staff interviews corroborated that the resident expressed discomfort and that the delay in catheter care was due to staff attending to other residents in pain. The ADON acknowledged being informed of the resident's request but was occupied with other urgent care needs, and there was a lack of communication and delegation to ensure the resident's catheter care was completed as ordered. Documentation was inconsistent, with the LPN who performed the catheterization not recording the actual time of care, instead documenting it at the next scheduled time. Multiple staff members, including the DON and RNs, recognized that orders should be followed and that delays could result in resident discomfort and pain. The facility's policy emphasized prompt response to resident requests for toileting assistance to promote dignity and quality of life, which was not adhered to in this instance.
Failure to Accurately Document and Timely Provide Catheter Care
Penalty
Summary
The facility failed to ensure that the medical record for a resident was complete and accurately documented, specifically regarding the timing and documentation of catheter care. The resident, a forty-one-year-old male with paraplegia, major depressive disorder, and ankylosing spondylitis, was care planned for self-catheterization with nursing staff monitoring and documenting intake and output. Physician orders required in-and-out catheterization every six hours at set times. On the date in question, the Medication Administration Record (MAR) reflected catheter care at 4:00 am, 10:00 am, and 10:00 pm, but there was no entry for the 4:00 pm scheduled time. Interviews and record reviews revealed that the resident actually received catheter care at approximately 6:30 pm, not at the documented 10:00 pm time. The resident reported experiencing significant pain due to the delay in catheter care, stating that he requested assistance multiple times and only received care about 2.5 hours after the scheduled time. He also reported needing pain medication due to the discomfort. Multiple staff interviews confirmed the delay, with one LPN stating she provided catheter care at 6:30 pm after the resident complained of pain. The Assistant Director of Nursing (ADON) and other staff acknowledged that the resident's care was delayed due to attending to other residents in pain, and that the catheter care was not documented as a late entry but instead was inaccurately recorded as being performed at 10:00 pm in the MAR. Further interviews with nursing and administrative staff confirmed that the delay in catheter care was not communicated during shift change, and that the nurse responsible did not document the actual time of care. Staff also discussed the potential for discomfort and pain when catheter care is delayed, and acknowledged that orders should be followed and documentation should be accurate. The facility's policy emphasized the importance of prompt response to resident needs and maintaining dignity, but the events described showed a failure to meet these standards in this instance.
Failure to Timely Report Suspected Abuse, Neglect, or Theft
Penalty
Summary
The facility failed to timely report suspected abuse, neglect, or theft and did not report the results of the investigation to the proper authorities. This deficiency was identified based on the facility's lack of prompt action in notifying the appropriate agencies when an incident of suspected abuse, neglect, or theft occurred. The report indicates that the required notifications and investigation results were not communicated as mandated.
Failure to Provide Required Written Discharge Notice and Appeal Rights
Penalty
Summary
The facility failed to provide a written notice of discharge, including the reasons for the move and the right to appeal, to a resident and her representative at least 30 days prior to discharge. The resident, who had severe cognitive impairment and multiple medical diagnoses including hemiplegia, hemiparesis, dysphagia, and depression, was dependent on assistance for health literacy and functional cognition. Despite care plan requirements for communication and involvement in discharge planning, there was no documentation in the resident's progress notes or electronic health records indicating that a written discharge notice was given to the resident, her representative, or the Ombudsman. Interviews with facility staff revealed a lack of understanding and compliance with the regulatory requirement to provide a 30-day written discharge notice. The care manager (CM) and assistant director of nursing (ADON) both acknowledged that the notice was not provided, and the CM admitted to not knowing the requirement to notify the resident, representative, and Ombudsman in writing. The resident's representative reported learning about the discharge from a medical equipment provider rather than the facility and stated that neither she nor the resident received information about the right to appeal the discharge or the appeal process. Facility policy reviews confirmed the requirement for a 30-day written notice of discharge, including information on the reason for discharge, effective date, location, contact information for the Ombudsman, state survey agency, appeal rights, and resources for assistance. The policy also specified that the Ombudsman must be notified before discharge is initiated. Despite these policies, the facility did not provide the required notifications or documentation, resulting in a deficiency related to discharge planning and resident rights.
Deficiency in Comprehensive Care Planning for Resident Transfers
Penalty
Summary
The facility failed to implement a comprehensive care plan to meet the medical and nursing needs of three residents, specifically regarding the assistance required during transfers. This deficiency was identified through observations, interviews, and record reviews. For Resident #235, the care plan did not specify the level of assistance needed for transfers, despite the resident's cognitive impairment and physical limitations due to a right hip fracture. The resident required substantial assistance with activities of daily living and was dependent on others for transfers, yet the care plan lacked detailed interventions. Resident #242's care plan also failed to indicate the necessary assistance for transfers. The resident, who had moderate cognitive impairment and physical limitations following a stroke, required total dependence for transfers. However, the care plan did not specify the use of a mechanical lift or the level of assistance needed, which was crucial given the resident's condition and reliance on a wheelchair for mobility. Similarly, Resident #289's care plan did not accurately reflect the assistance needed for transfers. Although the resident had intact cognition, he required assistance from one or two staff members for transfers due to his medical conditions, including acute congestive heart failure and unsteadiness on feet. The care plan lacked specific details on the transfer assistance required, leading to inconsistencies in staff support during transfers. Interviews with staff revealed a lack of clear communication and documentation regarding transfer status, which could result in negative outcomes such as falls.
Failure to Transmit Discharge MDS Timely
Penalty
Summary
The facility failed to transmit a resident assessment within the required time frame for a discharged resident, identified as Resident #61. The resident was admitted with diagnoses including intervertebral disc disorder with radiculopathy, lower back pain, and hypo-osmolality and hyponatremia. Although the Admission MDS was completed and accepted, the Discharge MDS assessment was not initiated, coded, or transmitted by the required date. This oversight was discovered during a record review, which revealed that the Discharge MDS had not been encoded or transmitted as of July 26, 2024. The MDS coordinator, responsible for encoding and timely transmission of the MDS records, was unavailable due to personal reasons, leading to the delay. The facility's policy mandates that MDS assessments, including discharge records, be completed and electronically encoded into the facility's system, with appropriate assessments transmitted to CMS. The failure to adhere to these procedures resulted in the deficiency, affecting residents discharged in the last 30 days who were at risk of not having their assessments transmitted timely.
Deficiency in Resident Activity Program
Penalty
Summary
The facility failed to provide an ongoing program of activities that met the individual preferences and needs of residents, as required by their comprehensive assessments and care plans. This deficiency was identified for three residents who expressed feelings of boredom and dissatisfaction with the activities offered. The activity calendars for September and October 2024 were limited, listing only books, puzzles, and TV time, with minimal variation or engagement opportunities. Interviews with the residents revealed that they were not aware of the activity calendar, and they felt that their preferences and needs were not being met, leading to feelings of boredom and depression. Resident #11, an elderly female with intact cognition, expressed that she had not received an activity calendar and was unaware of any activities being offered. Her care plan indicated a strong preference for various activities, including reading, listening to music, and participating in group activities, yet these preferences were not being addressed. Similarly, Resident #18, who also had intact cognition, reported feeling like she was not given opportunities to demonstrate her abilities and felt like she was being treated as an object. She expressed a need for more stimulation and engagement, which was not being provided by the facility. Resident #285, with moderate cognitive impairment, also reported not having seen an activity calendar and expressed feelings of boredom. The facility had been without an activity director from September 2024 until mid-October 2024, which contributed to the lack of organized activities. The new Activities Director acknowledged the importance of keeping residents engaged to prevent depression but had only recently started working on improving the activity program. The facility's administrator admitted that the lack of an activity director made it challenging to provide adequate activities, and the limited activities offered did not fully meet the residents' needs.
Failure to Provide Aseptic Tracheostomy Care
Penalty
Summary
The facility failed to provide respiratory care consistent with professional standards for a resident with a tracheostomy. The resident, who was cognitively intact and independent in activities of daily living, had a tracheostomy and required care and suctioning. The facility's comprehensive care plan did not adequately address the frequency or specifics of tracheostomy care, which contributed to the deficiency. During an observation, an LVN was seen performing tracheostomy care for the resident. The LVN did not follow aseptic technique as required. She opened a non-sterile bottle of normal saline and poured it into a sterile tray after donning sterile gloves, thereby contaminating the sterile field. Additionally, the LVN failed to clear the resident's airway of a visible mucus plug before inserting the inner cannula, which could have compromised the resident's airway. Interviews with the LVN and the DON confirmed the breach in aseptic technique and the failure to ensure a clear airway before inserting the inner cannula. The facility's policy on tracheostomy care emphasized the use of aseptic technique and the necessity of ensuring a patent airway, which was not adhered to during the observed care.
Inadequate Aseptic Technique in Tracheostomy Care
Penalty
Summary
The facility failed to establish and maintain an effective infection prevention and control program, specifically in the provision of tracheostomy care for a resident. The resident, who was admitted with diagnoses including encephalopathy, HIV, and tracheostomy status, was assessed to be cognitively intact and independent in activities of daily living. The resident's care plan included antibiotic therapy for infection and tracheostomy interventions, but it did not address the specific care or frequency required for tracheostomy maintenance. During an observation, LVN F did not adhere to aseptic techniques while performing tracheostomy care, which included using non-sterile normal saline and failing to clear a mucus plug before inserting the inner cannula. The LVN acknowledged the breach in aseptic technique, admitting to contaminating the sterile field by handling non-sterile items with sterile gloves. The Director of Nursing confirmed that the expected procedure was not followed, leading to cross-contamination. The facility's policy on tracheostomy care, which mandates the use of aseptic techniques and sterile gloves, was not adhered to during the procedure. This failure in maintaining aseptic technique during tracheostomy care could potentially place residents at risk for infections.
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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 Austin
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Ignite Medical Resort Round Rock, Llc | 1.2 mi | — | 12 | 0 |
| Park Valley Inn Health Center | 1.5 mi | — | 7 | 0 |
| Hearthstone Nursing And Rehabilitation | 1.9 mi | — | 3 | 0 |
| Cedar Pointe Health And Wellness Center | 4.3 mi | — | 6 | 0 |
| Trinity Care Center | 4.4 mi | — | 9 | 0 |
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