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 Tomball Rehab & Nursing during CMS and state inspections, most recent first.
A resident with multiple chronic conditions, including acute kidney failure, chronic pain, paraplegia, and Type 2 DM, had a new Levaquin 500 mg PO HS order entered by an NP into the EMR, scheduled to start that night. The order was not confirmed within the facility’s expected 2-hour timeframe and was instead confirmed after midnight the following day, resulting in the first dose being given a full day late. The LVN responsible did not recall receiving the order or knowing it required confirmation, and both the DON and Administrator stated that EMR orders were expected to be promptly confirmed and administered as written, consistent with facility policy to administer meds per MD orders.
A resident with severe cognitive impairment, acute kidney failure, and other comorbidities had STAT lab and imaging orders entered into the EMR that were not confirmed in a timely manner, causing delays in further assessment and treatment. One STAT lab order entered in the morning was not confirmed until early afternoon by an LVN, and a STAT KUB imaging order entered by an NP in the morning was not confirmed until late that night. The administrator stated STAT orders should be confirmed immediately, while the LVN reported a high volume of orders and not always being notified when new orders were entered. The facility’s STAT lab policy described time frames for follow-up on lab technician arrival but the delays occurred at the order confirmation stage.
The facility was found deficient in food storage and dishwashing practices. Foods were stored past their use-by dates, and drinks were unlabeled, contrary to policy. The dish machine operated below required temperatures, and the Dietary Aide was inadequately trained, leading to improper sanitization. The Dietary Manager admitted to not conducting competency checks on staff.
A resident with a G-tube did not receive medications as per physician's orders and facility policy. An LVN administered undissolved powder medications directly into the G-tube, leading to a clogged syringe. The facility's policy required medications to be mixed with water before administration, which was not followed, resulting in a deficiency.
A facility failed to administer and document a crucial insulin injection for a resident with type 2 diabetes, leading to a deficiency in pharmaceutical services. Despite the resident's severe cognitive impairment and multiple health issues, the medication was not given or recorded on the specified date. Interviews with nursing staff revealed inconsistencies in documentation practices, with some staff reporting no issues with the electronic systems. The facility's policy mandates immediate documentation of medication administration, which was not followed in this case.
A resident with multiple health conditions was not properly documented for blood sugar levels, vital signs, or adverse drug effects during a shift. LVN A, responsible for the resident's care, failed to document in the electronic records, citing possible service issues. Other staff reported no system problems, highlighting the importance of documentation per facility policy.
The facility failed to accurately assess a resident's hearing loss and use of hearing aids, leading to an incomplete care plan. Despite progress notes indicating the resident had hearing aids, the Admission MDS assessment inaccurately reflected normal hearing. The resident reported poor hearing without his aids, and the DON could not explain the discrepancy.
Delayed Confirmation and Administration of New Antibiotic Order
Penalty
Summary
The deficiency involves the facility’s failure to provide pharmaceutical services that ensured accurate acquiring, receiving, dispensing, and administering of medications for a cognitively intact male resident with multiple diagnoses, including acute kidney failure, major depressive disorder, chronic pain syndrome, paraplegia, insomnia, muscle weakness, and Type 2 diabetes mellitus without complications. The resident’s physician order, entered by a Nurse Practitioner for Levaquin 500 mg PO at bedtime on 04/02/26 at 11:34 AM, was scheduled to begin that same night at 9:00 PM. However, the order was not confirmed in the electronic medical record until 12:39 AM on 04/03/26, and the first dose was not administered until bedtime on 04/03/26, resulting in a missed initial dose on 04/02/26. The LVN responsible for receiving the order on 04/02/26 reported not recalling receiving the order and was unaware that the medication required confirmation that day. The DON stated that physician orders entered into the EMR should be confirmed within two hours and acknowledged there was no justification for the delay in confirming this order. The Administrator similarly stated that orders entered into the EMR were expected to be confirmed within two hours and carried out as prescribed. The facility’s medication treatment administration and documentation policy directed staff to administer medications according to the physician order, which did not occur in this case, as the Levaquin was not administered as prescribed. The facility identified that this failure placed residents at risk of experiencing worsening conditions, infection, and further decline.
Delayed Confirmation of STAT Lab and Imaging Orders
Penalty
Summary
The facility failed to ensure timely processing and communication of STAT laboratory and imaging orders for a resident, resulting in delays in further medical assessment and treatment. The resident was an elderly female admitted with diagnoses including urinary tract infection, acute kidney failure, cognitive communication deficit, and delusional disorder. Her Quarterly MDS showed a BIMS score of 1, indicating severe cognitive impairment, and she required supervision and one-person assistance with multiple ADLs, including bed mobility, transfers, toileting, dressing, and personal hygiene. She was care planned for falls with interventions such as keeping the bed in the lowest position and using a fall mat. Record review showed a STAT laboratory test entered into the electronic medical record on one date at 10:21 a.m. was not confirmed until 1:30 p.m. by an LVN. In a separate incident, a NP reported issuing a STAT KUB imaging order at 10:29 a.m. on another date, which was not confirmed until 10:09 p.m., representing a significant delay in processing a STAT order. The administrator stated that STAT physician orders should be confirmed right away and acknowledged that the delay in confirming the STAT KUB order was not acceptable. The LVN involved stated she did not recall the NP issuing the STAT order and reported receiving a high volume of orders and not always being notified when orders were entered into the electronic medical record. The facility’s policy on STAT laboratory services outlined specific time frames for follow-up when a lab technician does not arrive, but the documented delays occurred at the order confirmation stage in the electronic medical record.
Deficiencies in Food Storage and Dishwashing Practices
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, as observed during a survey of the kitchen. Foods were found stored past their use-by dates, with mandarin oranges and butterscotch pudding dated well beyond the recommended storage period. Additionally, a tray of drinks was found without proper labeling, which is against the facility's policy that requires all ready-to-eat foods to be labeled with preparation and use-by dates. The Dietary Manager admitted to not knowing the appropriate storage duration for these items and acknowledged that the drinks should have been labeled, attributing the oversight to a dietary staff member in training. Further deficiencies were noted with the facility's dishwashing practices. The low-temperature dish machine was observed operating below the required temperature for effective sanitization, with the wash cycle at 98 F and the rinse cycle at 104 F, contrary to the facility's policy that mandates a minimum of 120 F. The Dietary Aide responsible for operating the machine was found to be inadequately trained, as she was unaware of how to properly check and record the machine's temperature. The Dietary Manager confirmed that the aide had not been in-serviced on the dish machine's operation, despite her six years of employment, and had never conducted a competency check or audit on the staff's use of the dishwasher.
Failure in Proper Medication Administration via G-tube
Penalty
Summary
The facility failed to provide appropriate pharmaceutical services for a resident with a gastrostomy tube (G-tube), specifically in the administration of medications. The resident, a male with a history of difficulty swallowing, dementia, and gastrostomy status, was observed receiving medications in a manner that did not comply with the physician's orders or facility policy. The Licensed Vocational Nurse (LVN) responsible for administering the medications poured dry powder medication directly into the resident's G-tube, followed by water, instead of mixing the medications with water as required. The resident's medical records indicated that medications should be crushed or opened and mixed with at least 5 milliliters of water before administration through the G-tube. Additionally, the G-tube was to be flushed with 10 to 15 milliliters of water between each medication. However, during the observation, the LVN continued to administer undissolved powder medication directly into the G-tube, which led to the syringe becoming clogged. This method was contrary to the facility's policy and the physician's orders, which were designed to prevent blockages and ensure the resident received the therapeutic effects of the medications. Interviews with the LVN and other staff members, including the Director of Nursing (DON), confirmed that the facility's procedure was not followed. The DON stated that medications should be dissolved in water before administration to prevent clogging of the G-tube. The LVN admitted to not following the correct procedure and acknowledged having been in-serviced on the proper method within the last 60 days. The facility's policy on medication administration via enteral tube feeding was clear in its requirements, yet the failure to adhere to these guidelines resulted in a deficiency in the care provided to the resident.
Failure in Medication Administration and Documentation
Penalty
Summary
The facility failed to provide adequate pharmaceutical services for a resident, specifically in the administration of a 6:30 am Lantus Solution-Insulin injection. This medication was crucial for managing the resident's type 2 diabetes, a condition that affects glucose metabolism. The resident, who had severe cognitive impairment and multiple health issues including hypertension, chronic kidney disease, and peripheral vascular disease, did not receive the prescribed insulin injection on the morning of June 8, 2024. This lapse in medication administration was not documented in the resident's electronic medical records, indicating a failure in both the administration and documentation processes. Interviews with the nursing staff revealed discrepancies in the documentation process. LVN A, who was responsible for administering the medication on the specified date, acknowledged the importance of following physician orders and documenting medication administration but could not explain the lack of documentation. She suggested there might have been an issue with the electronic system in the 500 hall area. However, other staff members, including LVN B and LVN C, reported no issues with the electronic systems during their shifts and emphasized the necessity of proper documentation to ensure continuity of care. The facility's policy on medication administration and documentation requires that medications be administered according to physician orders and documented immediately in the electronic medical records. The failure to document the administration of the insulin injection, as well as the absence of vital signs and adverse medication effect monitoring on the specified date, highlights a significant deficiency in the facility's pharmaceutical services. This deficiency could potentially place residents at risk for medication errors and adverse health outcomes.
Failure to Document Resident Care and Monitoring
Penalty
Summary
The facility failed to maintain clinical records in accordance with accepted professional standards and practices for one resident, leading to incomplete and inaccurate documentation. Specifically, the facility did not document the resident's blood sugar levels, vital signs, or monitoring for adverse drug effects during a specific shift. The resident, who has a history of type 2 diabetes mellitus, hypertension, chronic kidney disease, and peripheral vascular disease, was not properly monitored or documented for various medical needs, including insulin therapy, anticoagulant monitoring, and catheter care. Interviews with staff revealed that LVN A, who was responsible for the resident's care during the shift in question, did not document the necessary medical information in the electronic medical records. LVN A acknowledged the importance of documentation and monitoring for adverse reactions but could not explain the lack of documentation, suggesting a possible issue with service in the area. However, other staff members, including LVN B and LVN C, reported no issues with the electronic systems and emphasized the critical nature of documentation in nursing practice. The facility's policy on medication and treatment administration requires immediate documentation following administration, and any medications or treatments not administered should be documented with a reason. The absence of documentation for the resident's care during the specified shift represents a significant deviation from these guidelines, potentially affecting the quality of care provided to the resident.
Inaccurate Assessment of Resident's Hearing Status
Penalty
Summary
The facility failed to complete an accurate assessment for a resident, specifically regarding the resident's hearing loss and use of hearing aids. The resident, an elderly male with a primary diagnosis of a left femur fracture and other conditions including diabetes type 2, anemia, and anxiety, was admitted to the facility. Despite progress notes indicating the resident had hearing aids in both ears, the Admission MDS assessment inaccurately reflected that the resident had normal hearing and did not use hearing aids. This discrepancy was further compounded by a care plan that noted a communication problem but did not specify the nature of the problem or include hearing aids as an intervention. During an interview, the resident reported poor hearing without his hearing aids and mentioned that one hearing aid was lost and the other had a dead battery. The Director of Nursing (DON) was unable to explain the inaccuracies in the MDS assessment, as the nurse responsible for MDS accuracy was on bereavement leave. The failure to accurately document the resident's hearing status and use of hearing aids placed the resident at risk of not receiving appropriate care and services to meet his needs.
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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 Tomball
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Park Manor Of Tomball | 1.3 mi | — | 13 | 0 |
| Lawrence Street Health Care Center | 1.3 mi | — | 0 | 0 |
| The Heights Of Tomball | 1.9 mi | — | 0 | 0 |
| Willow Creek Lodge | 5.4 mi | — | 1 | 0 |
| The Broadmoor At Creekside Park | 6.8 mi | — | 11 | 1 |
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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.