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Complaint Investigation

Harmony Care At Brookshire

February 14, 2025 · Brookshire, TX · 710 Hwy 359 S
Citations 1
CMS Rating 2/5
Beds 130
Provider ID 675700
Healthcare Facility
Harmony Care At Brookshire
Brookshire, TX  ·  View full profile →
Inspection Summary

Harmony Care at Brookshire in Brookshire, TX — inspection on February 14, 2025.

Found 1 citation. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF755
Immediate of rights as well as repeating back to prescriber for accuracy. Few 2/17/2025. affected

Resident was administered 100mg of Midodrine instead of the verbally ordered amount of 10mg.

Resident assessed by LVN and sent to ER for evaluation. (returned 2/11/2025)

Family called

MD/NP notified.

Audit all Midodrine orders by DON 2/10/2025

Resident #1 medication clarified/fixed 2/10/2025 (ultimately discontinued upon hospital return)

Notify Medical Director 2/10/2025 11:03am brief QAPI discussion to establish plan (this)

New orders will be reviewed by DON/designee daily to ensure accurately transcribed and that the computerized order matches the medication card.

Results of these audits will be discussed in morning meeting and any discrepancies will be rectified immediately.

LVN disciplinary action and 1:1 education 2/10/2025 related to transcription and medication administration to ensure the computerized order matches the medication card.

MA disciplinary action and 1:1 education 2/10/2025 related to medication administration to ensure the computerized order matches the medication card.

MA removed from MA role as of 2/10/2025 until further education and training occurs and she successfully completes 3 competency checks by DON.

Facility MAs and nurses re-educated on medication administration started 2/10/2025 by the DON.

Education was completed on 2/11/2025 and staff not allowed to work without training completion.

The education consisted of right person, right time, right dosage, right route, right drug.

Also included matching computerized order to medication card.

Nurses and MAs were provided education and post-test for Midodrine administration specifically by the DON on 2/10/2025 and no one can return to work unless education has been completed.

675700

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 675700 B.

Wing 02/14/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Harmony Care at Brookshire 710 Hwy 359 S Brookshire, TX 77423

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Brookshire, TX, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Harmony Care at Brookshire or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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