Park Manor Bee Cave: PASRR Therapy Delay Violation - TX
The inspection at Park Manor Bee Cave, conducted August 18, 2025, centered on a single resident, identified in records only as Resident #1. She is a woman whose age was redacted in the report, admitted to the facility with a list of diagnoses that made the delay especially stark: aphasia, which stripped her of the ability to communicate normally; dysphagia, which made swallowing difficult and dangerous; chronic kidney disease; malnutrition; anemia; and the lingering effects of past strokes. Her score on the Brief Interview for Mental Status, a standard cognitive assessment, was zero, indicating the most severe level of cognitive impairment possible.
A resident who cannot speak for herself, cannot advocate for herself, and scored at the floor of every cognitive measure available. She needed someone at the facility to navigate the paperwork on her behalf. Nobody did.
The process that failed her is called the Preadmission Screening and Resident Review program, known as PASRR, a federal and state requirement designed to ensure that nursing home residents with developmental disabilities or mental illness receive specialized services beyond what a standard nursing facility provides. In Resident #1's case, a Level I screening in September 2024 flagged evidence of a developmental disability. A more detailed Level II evaluation, completed in April 2025, confirmed she qualified for Nursing Facility Specialized Services, specifically physical therapy, occupational therapy, and speech therapy, including specialized assessments in all three.
After that evaluation, the facility's interdisciplinary team was required to meet and then submit a formal request for those services through a state online portal within 20 business days. The facility's own Director of Rehabilitation told inspectors the internal expectation was even tighter, 14 days, and acknowledged that missing the deadline could result in the resident losing access to therapy services and limiting health improvement.
The submission didn't happen for 217 days.
The facility's Habilitation Service Plan, dated March 2025, had already identified the need for specialized physical, occupational, and speech therapy services in its outcome action plan. The recommendation was documented. The evaluation was complete. The need was established on paper. The form still wasn't filed until May 14, 2025, more than 10 times past the required window.
When inspectors interviewed the facility's administrator the same afternoon, she expressed uncertainty about what the submission timeframe even was.
State health officials with the HHSC PASRR Unit confirmed the violation, citing Texas Administrative Code requirements that the facility submit a complete and accurate request within the required period. Inspectors classified the harm level as minimal harm or potential for actual harm, the lower end of the scale, but noted the failure could diminish a resident's quality of life and her ability to reach the highest practical level of functioning.
For a woman who cannot speak, cannot swallow without difficulty, and whose muscles have already begun to waste, the distance between minimal harm on a regulatory form and what those 217 days meant in practice is harder to measure.
The inspection report does not say whether Resident #1 received any of the approved therapy services during the months the paperwork sat unsubmitted. It does not say whether her condition changed. It notes only that the evaluation recommended the services, the deadline passed, and the facility's top administrator didn't know when the clock was supposed to stop.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Park Manor Bee Cave from 2025-08-18 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 22, 2026 · Our methodology
Park Manor Bee Cave in Bee Cave, TX was cited for violations during a health inspection on August 18, 2025.
The inspection at Park Manor Bee Cave, conducted August 18, 2025, centered on a single resident, identified in records only as Resident #1.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.