Northgate Health and Rehab: Smoking Policy Violation - TX
Federal inspectors visited Northgate Health and Rehabilitation Center at 5757 N Knoll on November 25, 2025, responding to a complaint. What they documented under deficiency tag F0689, which covers accident hazards and supervision, was a smoking safety failure affecting a small number of residents.
The facility had a smoking policy. It was detailed. It ran to at least twelve numbered provisions. Residents' ability to smoke or chew tobacco safely had to be evaluated quarterly, and again after any significant physical or cognitive change. Smoking articles, including cigarettes, tobacco, and lighters, were not permitted in residents' possession except under direct supervision. Residents were not allowed to give smoking materials to other residents. Staff caring for any resident with smoking privileges or restrictions were supposed to be alerted to those issues through the care plan. The facility reserved the right to confiscate anything found in violation.
The policy existed. The inspection found the policy had not been followed.
Inspectors rated the level of harm as minimal harm or potential for actual harm. The number of residents affected was listed as few. Those are the lowest tiers on CMS's harm scale, but they are not the same as no harm. Unsupervised access to lighters and cigarettes in a nursing home, among residents who may have physical or cognitive limitations, is the kind of situation the policy was written to prevent. The policy described exactly the risk. The failure was in the execution.
Northgate Health and Rehabilitation Center is a licensed skilled nursing facility operating in northwest San Antonio. The inspection was a complaint survey, meaning someone, a resident, a family member, or a staff member, had contacted regulators before inspectors arrived. The report does not identify who filed the complaint or what specifically prompted it. What it shows is that when inspectors looked at how the facility was managing smoking safety, they found a gap between the written rules and what was actually happening on the floor.
The facility's plan of correction was not included in the portion of the report made available. CMS directs anyone seeking that information to contact the nursing home or the Texas state survey agency directly.
What the report leaves behind is a policy document that reads like a serious attempt to manage a genuine risk, and an inspection finding that says the attempt fell short. Somewhere between the written rule that residents may not keep lighters except under direct supervision and the moment an inspector documented a deficiency, the system broke down. The report does not say how. It does not name a resident who was burned, or a staff member who looked the other way, or a supervisor who signed off on a care plan that missed the smoking restriction entirely.
It says only that the rules were there, and that for at least a few residents, they were not enforced.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Northgate Health and Rehabilitation Center from 2025-11-25 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: August 25, 2026 · Our methodology
NORTHGATE HEALTH AND REHABILITATION CENTER in SAN ANTONIO, TX was cited for violations during a health inspection on November 25, 2025.
Federal inspectors visited Northgate Health and Rehabilitation Center at 5757 N Knoll on November 25, 2025, responding to a complaint.
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.