The nursing assistant, identified as CNA A in federal inspection records, had worked at the facility for over 20 years and been certified for more than 30 years. Her certification expired while she continued working on the floor caring for residents.
During a November interview, CNA A told inspectors she wasn't aware her certification had expired. She said that around the expiration date, she provided paperwork about her certificate to the previous assistant director of nursing, who told her "she would take care of it."
She received an email notifying her that her certificate had expired. When she told the director of nursing, "she told her she would help her to renew it."
The nursing assistant said she worked the night shift and came to the facility after waking up to try getting her certificate renewed. "She stated she was not told she could not work while waiting to get her certificate renewed."
But administrators told a different story.
The administrator said she was sure CNA A didn't work the night shift because "they told CNA A she could not work until her certificate was renewed." When pressed by inspectors, the administrator said she would check time punch details.
Then she changed her account.
The administrator admitted CNA A "did clock in and work last night." She told inspectors she informed the director of nursing that CNA A had worked the night shift, but the director of nursing said no, "because CNA A was told last week she could not work."
The administrator maintained that CNA A "was made aware she could not work until her certificate was renewed."
The facility's own quality assurance meeting documents revealed the scope of the breakdown. An off-cycle meeting identified "a system failure" after discovering "a CNA license had lapsed while still working on the floor."
The facility initiated an immediate plan of correction. Human resources would complete a full audit of all nursing licenses. The director of nursing would maintain a binder of all nursing licenses and review them monthly. Staff would receive 60-day advance notice before license expiration.
The nursing director would "provide any assistance needed to renew license or certification."
But the system had already failed.
Facility policy required nursing personnel to present verification of licenses or certifications "prior to or upon employment." The policy stated clearly that nursing personnel "are not permitted to perform direct resident care services until all licensing/background checks have been completed."
Annual license renewals had to be presented to the director of nursing "no later than February 1st each year."
The director of nursing told inspectors she completed an audit of all certified nursing assistant certificates and confirmed no one else had expired credentials.
She said CNA A "could not be at the facility or working" and that she would have to get CNA A's shifts covered.
The confusion over whether CNA A could work extended to the night she actually did work. The administrator initially insisted CNA A hadn't worked, then admitted she had clocked in and worked after checking time records.
CNA A described the situation differently. She said the previous assistant director of nursing had told her the paperwork would be handled. When her certification expired, she said the current director of nursing offered to help with renewal.
She maintained she wasn't told she couldn't work while waiting for renewal.
The 30-year nursing veteran had "never had any issues with getting her certificate renewed" during her two decades at the facility.
The quality assurance committee's emergency meeting reflected the seriousness of allowing unlicensed staff to provide direct resident care. Their corrective action plan included monthly monitoring and immediate escalation if the system failed again.
Federal regulations require nursing homes to ensure all staff providing direct care maintain current licenses and certifications. The facility's own policies echoed these requirements, mandating verification before employment and annual renewal submissions.
The inspection found the facility had violated federal standards for ensuring qualified staff provide resident care. CNA A continued working night shifts while her certification had lapsed, despite facility policies prohibiting unlicensed personnel from providing direct resident services.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Levelland Nursing & Rehabilitation Center from 2025-11-05 including all violations, facility responses, and corrective action plans.
Additional Resources
- View all inspection reports for Levelland Nursing & Rehabilitation Center
- Browse all TX nursing home inspections