The Highlands Guest Care Center: Staffing Post Failures - TX
When a federal inspector walked into The Highlands Guest Care Center on the morning of December 28, 2025, the daily nurse staffing posting hanging at the receptionist desk was dated December 26. The sheet telling families how many nurses and aides were assigned to care for their loved ones that day had not been updated since Friday. It was Sunday morning.
The posting had been sitting there, unchanged, through two full days of shifts.
The director of nursing told inspectors she had no idea the weekend postings had never gone up. She said the staffing coordinator was responsible for filling out the daily sheet, and the weekend supervisor was supposed to put it up on Saturdays and Sundays. The staffing coordinator, for her part, said she had done her job: she created the postings for December 27 and 28, placed them in the 24-hour turnover binder, and left them for the weekend supervisor to handle. The completed sheets were still sitting in that binder when inspectors reviewed it on December 29.
The weekend supervisor did not answer the phone when inspectors tried to reach her on December 30.
What the posting is supposed to tell families is specific: the number of licensed nurses, meaning registered nurses, licensed practical nurses, and licensed vocational nurses, and the number of certified nursing aides directly responsible for resident care, updated within two hours of the start of every shift. The director of nursing described the purpose plainly. It is, she said, about transparency. It tells each family member how many staff members are assigned each shift to provide care for their loved one. The negative effect of not posting, she acknowledged, is that visitors would not have the nursing staff hours for that day.
That transparency was missing for the entirety of Saturday and Sunday.
The gap matters because the posting is one of the few tools families have to verify, in real time, whether the facility is adequately staffed on any given shift. A family visiting a parent on a Sunday afternoon has no other way to know whether the floor is running with a full complement of aides or whether it is short. The posted number does not guarantee good care, but its absence removes even the baseline check.
The inspection found the violation affected many residents and their families, as well as facility visitors. Inspectors classified the level of harm as potential for minimal harm, the lowest tier on the federal scale.
The Highlands Guest Care Center's own policy, revised in August 2022, requires the staffing data to be posted in a prominent location accessible to residents and visitors, in a clear and readable format, within two hours of the beginning of each shift. The facility had the paperwork. The staffing coordinator had filled it out. It never made it to the wall.
The breakdown here was not a failure of documentation. It was a failure of follow-through, a gap between the person who prepared the information and the person responsible for displaying it, with no one in between checking whether it had actually been done. The director of nursing, by her own account, was unaware the postings had lapsed until inspectors told her.
For families who came through that lobby on Saturday or Sunday, the sheet at the desk showed December 26 and nothing more. Whether they noticed, whether they asked, whether anyone told them it was out of date, the inspection report does not say.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for The Highlands Guest Care Center from 2025-12-30 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 17, 2026 · Our methodology
THE HIGHLANDS GUEST CARE CENTER in DALLAS, TX was cited for violations during a health inspection on December 30, 2025.
The sheet telling families how many nurses and aides were assigned to care for their loved ones that day had not been updated since Friday.
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.