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Matlock Place: Wound Care Missed, Odor Develops - TX
The resident suffered from chronic wounds with poor healing prospects due to her debilitated condition....
Latest reports, citations, and penalties from CMS data
The resident suffered from chronic wounds with poor healing prospects due to her debilitated condition....
The November 23 complaint inspection found systemic failures in basic nursing care protocols that put residents at immediate risk....
Resident #6 was discovered on the hallway floor at 10 a.m....
The resident, identified only as Resident #1, required intermittent catheterization according to doctor's orders....
The violation occurred in the facility's main kitchen where food is prepared for residents....
The resident, identified in inspection records as Resident #1, made multiple statements about sexual assault to nursing staff over several months....
"I have not worn them since I got them," she told inspectors during a September 23 interview....
Resident #1 fell on October 16, 2025, breaking her right humerus....
The violation occurred on October 16 at 12:34 PM on Hall 500 at Pflugerville Care Center....
Federal inspectors found staff transferring residents without gait belts during a September complaint investigation....
The investigation began when corporate auditors discovered the manager was not following proper procedures for distributing resident funds....
The incident occurred on the evening of October 19 when Resident #2 stomped or kicked Resident #1's foot at Avir at Overton....
But when federal inspectors reviewed the records in November, they found gaps in documentation and a facility that couldn't produce basic intake records....
The patient experienced shortness of breath during exertion, at rest, and while lying flat....
Instead, the nursing assistant known as "CNA A" left the resident unattended....
The November 9 assault was the second documented incident in two weeks....
At 11:13 a.m., 4:15 p.m., and 4:45 p.m., they found the same brown and yellow removable substance on the toilet seat and metal safety rail....
But when she fell again on October 30, staff discovered they had been disregarding the safety protocols entirely....
The resident said the guard "curls his lips and mean mugs" them, and "puts hand on the gun in front of" them as intimidation....
Four additional days had no documentation recorded for the evening shift at all....