The Terrace at Crystal LLC violated federal requirements for at least two residents in January 2026, according to inspection records. Staff failed to document offering non-pharmacological interventions before administering PRN medications, which are given as needed for pain or other symptoms.
The director of nursing confirmed during a January 30 interview that the facility's medical records contained no evidence that staff offered alternatives to medication before every PRN administration for the affected residents.
Federal regulations require nursing homes to try non-drug approaches that might reduce pain without medication or lower pain levels so residents become less reliant on narcotics. These interventions should be offered before giving PRN medications and documented in progress notes.
The facility's own pain management policy, dated March 2020, outlined numerous non-drug options staff should consider. Environmental adjustments include changing room temperature, smoothing bed linens, providing pressure-reducing mattresses, or repositioning residents. Physical interventions range from ice packs and warm compresses to baths, massage, or transcutaneous electrical nerve stimulation.
The policy also specified exercise interventions like range of motion exercises to prevent muscle stiffness, and cognitive or behavioral approaches including relaxation techniques, music, diversions, and activities.
The policy stated the facility maintained "a facility-wide commitment to appropriate assessments and treatment of pain, based on professional standards of practice, the comprehensive care plan, and the resident's choices related to pain management." It noted that non-pharmacological interventions may work alone or alongside medications.
Inspectors classified the violation as causing minimal harm or potential for actual harm, affecting few residents.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for The Terrace At Crystal LLC from 2026-01-30 including all violations, facility responses, and corrective action plans.