Premier SNF of Alice: Skin Assessment Failures - TX
The inspection, conducted November 29, 2025, was a complaint survey. It identified one deficiency, tagged under F0842, concerning medical records. The level of harm was listed as minimal harm or potential for actual harm. A few residents were affected.
The resident at the center of the finding is identified in the report only as Resident 1. She uses a wheelchair. At some point before November 17, 2025, skin irregularities appeared on her body. The facility's protocol called for a licensed or registered nurse to conduct a skin assessment and document what was found, including any redness, bruising, rashes, blisters, skin tears, open areas, or lesions. That assessment, for whatever reason, was not documented on November 17.
The director of nursing acknowledged it during the inspection. She told inspectors that documentation should have occurred on that date, and that the reason it mattered was straightforward: without a written record, staff cannot accurately monitor changes in a resident's skin over time. A bruise that is tracked can be compared. One that isn't documented simply exists, unanchored, with no baseline and no trail.
The director of nursing also offered an explanation for where the bruising may have come from. She said the discoloration could have stemmed from Resident 1 passing through doorways in her wheelchair. That is the entirety of what the inspection report captures about the possible cause.
She added that Resident 1's well-being was not compromised, that the skin irregularities had resolved by the time inspectors arrived, and that there was no evidence of malice.
The facility's own skin assessment policy, reviewed by inspectors during the survey, was undated. It laid out clear expectations: a full body assessment upon admission or readmission, documentation after any change in condition or newly identified skin issue, and written observations of anything found. The gap between that policy and what actually happened on November 17 was the basis for the citation.
As a corrective step, the director of nursing told inspectors the facility planned to conduct an as-needed in-service focused on documenting skin assessments.
What the inspection report does not answer is how long the skin irregularities were present before anyone considered documenting them, or whether anyone noticed them before November 17. It does not say who first observed the bruising, or whether Resident 1 or her family were told about it. The report does not describe the size, location, or appearance of the discoloration beyond the word "irregularities."
What it does establish is that a resident who uses a wheelchair showed signs of skin changes, that those changes went undocumented in violation of the facility's own written protocol, and that the director of nursing learned of the documentation failure and acknowledged it directly to inspectors.
Skin documentation in nursing homes exists for a specific reason. A bruise recorded with its size, location, and date gives the next nurse a reference point. Without that record, a wound that is worsening looks the same on paper as one that is healing, because neither one appears on paper at all. The director of nursing said as much herself: the documentation was needed to ensure accurate monitoring and prevent further progression of any compromising skin integrity issue.
The irregularities, she said, had resolved. Resident 1, she said, was not harmed.
The record, though, cannot confirm any of that. There was nothing written down on November 17 to measure the resolution against.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for The Premier Snf of Alice from 2025-11-29 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 22, 2026 · Our methodology
THE PREMIER SNF OF ALICE in ALICE, TX was cited for violations during a health inspection on November 29, 2025.
The inspection, conducted November 29, 2025, was a complaint survey.
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.