Mi Casita Nursing: Expired Meds, Loose Pills Found - TX
A nurse's aide eventually explained what it was. LVN D told inspectors he had prepared the miralax for a resident, the resident refused it, and he didn't want to waste it, so he put it back in the cart. It sat there, unlabeled, in a drawer alongside medications being dispensed to other residents.
That was one of the findings when inspectors walked the facility on March 27, 2026. By the time they finished checking two medication carts and one medication room, they had documented loose unidentified pills, an unlabeled powder, skin prep supplies expired more than four months prior, nutritional shakes eight months past their expiration date, and hand sanitizer that had expired in August 2022, nearly four years before the inspection.
The unlabeled cup of white powder wasn't the only problem with Med Cart B. Inspectors also found 32 sureprep skin preparation pads with an expiration date of November 15, 2025, a 2-ounce bottle of aloe vera hand sanitizer expired August 2022, and a 32-ounce bottle of eucalyptus hand sanitizer, also expired August 2022, sitting openly on top of the cart. The hand sanitizers had been expired for roughly four years.
In Med Cart A, inspectors found two loose pills sitting in the second drawer. One was oblong and light gray. One was oblong and yellow-orange. Neither was in any packaging. Neither was labeled.
The director of nursing, present during the inspection, said she believed the light gray pill was memantine, a medication used to treat dementia symptoms, and thought the yellow-orange one was a different dose of the same drug. She believed. She thought. There was no way to confirm it from looking at the pills in the drawer.
Memantine, administered at the wrong dose or to the wrong resident, can cause dizziness, confusion, and in some cases more serious neurological effects. The director of nursing told inspectors that a potential negative outcome from improperly labeled medications was medication errors. The administrator, interviewed separately that afternoon, said the potential negative outcome from unlabeled medications was that residents could be short pills.
In Med Room C, inspectors found four packs of povidone-iodine swab sticks with an expiration date of May 2025 sitting on a shelf, and four bottles of Glucerna nutritional shakes in the refrigerator with an expiration date of July 1, 2025. The inspection took place in late March 2026. The shakes had been expired for nearly nine months.
The director of nursing told inspectors that medication aides and nurses were responsible for making sure expired items and loose pills didn't end up in the carts or medication rooms. She said staff had been trained on medication storage but could not give an exact date for when that training last occurred.
The administrator said she expected expired items to be pulled before their expiration dates. Asked why some medications weren't labeled and why expired supplies were still on the shelves, she said it was maybe an oversight.
The facility's own policy on medication storage, last revised in November 2020, states that discontinued, outdated, or deteriorated drugs are to be returned to the dispensing pharmacy or destroyed. The policy also states that only the issuing pharmacy is authorized to transfer medication between containers, which would include spooning a dose of miralax into an unlabeled medicine cup and returning it to a drawer for later.
What the inspection found was a medication system that had, in multiple locations, stopped being monitored. The expired hand sanitizer alone tells a story. Something with a date of August 2022 does not end up still on a cart in March 2026 because of a single lapse. It stays there because nobody is checking.
The director of nursing acknowledged the expired supplies shouldn't have been there. She said she didn't know why they were. The administrator said the same. Neither offered an explanation beyond the word oversight.
CMS rated the harm level as minimal harm or potential for actual harm. The violation affected few residents. Those are the agency's categories, and by the numeric scale of nursing home citations, this one sits toward the lower end.
But the unlabeled cup of white powder in a medication drawer is not an abstraction. A nurse prepared something for a specific resident, that resident declined it, and rather than discard it, the nurse returned it to a shared cart with no label, no resident name, no indication of what it was or how much. Anyone reaching into that drawer later would have found a cup of white powder and had to guess.
The director of nursing said she didn't know why the expired items were in the carts. The administrator called it an oversight. The facility's policy said expired drugs should be returned to the pharmacy or destroyed.
The hand sanitizer expired in the summer of 2022. It was still there.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Mi Casita Nursing and Rehabilitation Center from 2026-03-27 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 19, 2026 · Our methodology
MI CASITA NURSING AND REHABILITATION CENTER in LUBBOCK, TX was cited for violations during a health inspection on March 27, 2026.
A nurse's aide eventually explained what it was.
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.