Terrell Healthcare Center: PASRR Filing Delay - TX
The paperwork in question is called a Notification of Specialized Services, or NFSS. When a resident is identified during an interdisciplinary team meeting as needing a specialized service, the facility is supposed to submit that form within 25 to 29 days, with a physician's signature. The form exists for a specific reason: to make sure residents actually receive the care and support they need, including any specialized equipment they qualify for.
For Resident 1, that meeting happened on June 10, 2025. The resident's interdisciplinary team identified a new specialized service that day: a specialized mattress, the kind used to prevent or manage pressure wounds. Under the timeline a corporate nurse described to inspectors, the NFSS should have been submitted no later than early July 2025.
It wasn't submitted until November 19, 2025, the same day inspectors arrived.
The corporate nurse confirmed the sequence directly. The meeting was June 10. The NFSS should have started that day and been submitted in June. Instead, the facility submitted it five months late, on the morning of the inspection itself.
The corporate nurse was clear about what the delay means in practice. The whole point of the NFSS requirement, she told inspectors, is to ensure a resident receives the care and support needed and any specialized service they require and are eligible for. When the paperwork isn't filed, that assurance breaks down. Whether Resident 1 had the specialized mattress during those five months, or went without it while the form sat unfiled, the inspection report does not say. What it says is that the documentation meant to formalize and protect that care was missing for the better part of a year.
The violation was cited under F0644, which covers PASRR, the Pre-Admission Screening and Resident Review process. PASRR is the federal system designed to identify nursing home residents with serious mental illness or intellectual disabilities and connect them with specialized services beyond what a standard nursing facility provides. The NFSS is how a facility formally documents and pursues those services once a need is identified. CMS rated the harm level as minimal harm or potential for actual harm, with some residents affected.
Inspectors noted the NFSS for Resident 1's specialized mattress was submitted by the facility on 11/19/25, the day of the inspection. The corporate nurse confirmed it should have been submitted in June 2025.
Terrell Healthcare Center is located in Terrell, Texas, roughly 30 miles east of Dallas.
The five-month gap between when the paperwork was due and when it was filed raises a question the inspection report leaves open: what happened to Resident 1's care during that time. The specialized mattress was identified as a needed service at the June meeting. The form that was supposed to ensure the resident received it, and received the support tied to it, wasn't submitted until a federal inspection was already underway.
The corporate nurse put it plainly. The importance of ensuring an NFSS was submitted timely, she said, was to ensure a resident received the care and support needed and any specialized service they required and were eligible for.
For Resident 1, that assurance arrived five months late.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Terrell Healthcare Center from 2025-11-19 including all violations, facility responses, and corrective action plans.
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 7, 2026 · Our methodology
Terrell Healthcare Center in Terrell, TX was cited for violations during a health inspection on November 19, 2025.
The paperwork in question is called a Notification of Specialized Services, or NFSS.
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.