Cedar Creek Nursing: PASARR Screening Failure - TX
The May 2026 inspection, a standard health review, turned up five separate deficiencies at Cedar Creek. One of them was a failure under what regulators call PASARR, the Preadmission Screening and Resident Review program. It is the mechanism designed to catch residents with mental disorders or intellectual disabilities and connect them to appropriate services. The inspectors rated the violation at Level D, meaning no actual harm was documented but real potential for more than minimal harm existed.
That distinction matters less than it might sound. A Level D finding does not mean nothing went wrong. It means inspectors could not point to a specific resident who suffered a measurable injury at the time they were standing in the building. The resident who never received a proper screening, who never got evaluated for whether their mental health needs exceeded what Cedar Creek could provide, may still be living there. The harm may be ongoing and quiet.
PASARR failures tend to stay invisible precisely because the person most affected often cannot easily identify what they're missing. A resident with a serious mental illness who needed referral to a specialized facility, or who needed additional psychiatric services layered into their care plan, may simply not be getting those things. No alarm goes off. No chart note flags the gap. The absence of care rarely announces itself.
What makes Cedar Creek's situation harder to explain away is the correction status attached to this deficiency. As of the inspection date, the provider had filed no plan of correction. Not an inadequate plan. Not a plan under review. No plan at all.
Facilities cited for deficiencies are expected to respond with a written plan describing what went wrong, what they will do to fix it, and when the fix will be complete. That response is a basic part of how the inspection process works. Cedar Creek had not provided one for the PASARR violation.
The other four deficiencies cited during the same inspection are not detailed in the available inspection materials. What is documented is that this facility, in a small town in the Texas Hill Country, left a federal screening requirement unmet and then did not tell regulators how it planned to address that.
Cedar Creek is not a large urban system with layers of compliance staff and legal teams managing inspection responses. It is a single facility in Bandera, a community of a few thousand people where residents and their families may have limited options for comparison or transfer. That context does not excuse the failure. It does mean that residents there have fewer obvious places to turn.
The PASARR process was built after years of evidence that nursing homes were warehousing people with serious mental illness who belonged in different settings, or who needed services the facility was never equipped to provide. The screening is supposed to be the check on that. When it does not happen, the system that was designed to protect some of the most vulnerable nursing home residents simply does not function.
At Cedar Creek, it did not function. And as of the last documented inspection, nobody at the facility had put in writing what they intended to do about it.
The residents who were admitted without proper screening are still residents. Their needs have not paused while the paperwork catches up.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Cedar Creek Nursing and Rehabilitation Center from 2026-05-08 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: August 4, 2026 · Our methodology
Cedar Creek Nursing and Rehabilitation Center in Bandera, TX was cited for violations during a health inspection on May 8, 2026.
The May 2026 inspection, a standard health review, turned up five separate deficiencies at Cedar Creek.
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.