The Hills Nursing & Rehabilitation
THE HILLS NURSING & REHABILITATION in DECATUR, TX — inspection on February 26, 2026.
Found 4 citations. 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.
Inspection Findings
#12's care plan had not been updated to reflect his current plan of care and continued to indicate
plan was that a new nurse could have sent Resident #12 to the ER, causing distress to the family and
plan, but the administrative nursing team held overall responsibility.
Interview on 02/26/26 at 12:14 PM with MDS E revealed the care plans were developed as a team effort and each department completed their respective sections.
She stated care plans were discussed with the IDT quarterly, and during morning meetings when changes were identified. MDS E stated she or the nursing team should have updated Resident #12's care plan to reflect the in-house G-tube replacement. MDS E stated it was important for care plans to be updated to stay current on the residents' needs to ensure they received proper care.
Interview on 02/26/26 at 4:06 PM with the Administrator revealed that MDS and nursing managers were responsible for updating care plans.
She stated it was important that the care plan be updated to accurately reflect the resident's plan of care and individual needs.
The Administrator stated the nursing managers should have updated Resident #12's care plan when the G-tube began being replaced in the facility.
The Administrator stated the care plans were reviewed quarterly and revised as needed.
Record review of the facility's policy, Comprehensive Care Planning, undated, reflected the following: The facility will develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment.
The resident's care plan will be reviewed after each Admission, Quarterly, Annual and/or Significant Change MDS assessment, and revised based on changing goals, preferences, and needs of the resident and in response to current interventions.
676004 02/26/2026
The Hills Nursing & Rehabilitation 201 E Thompson St Decatur, TX 76234
habits.
She also stated it was an infection control risk because the nails could become dirty
Record review of facility Nail Care policy, undated, reflected the following:
Nail management is the regular care of the toenails and fingernails to promote cleanliness, and skin integrity of tissues, to prevent infection, and injury from scratching by fingernails or pressure of shoes on toenails. It includes cleansing, trimming, smoothing , and cuticle care and is usually done during the bath.GoalsNail care with be performed regularly and safely. .
676004 02/26/2026
The Hills Nursing & Rehabilitation 201 E Thompson St Decatur, TX 76234
Findings included:Review of Resident #61's quarterly MDS dated [DATE] reflected the resident was an [AGE] year-old male admitted to the facility on [DATE].
The residents' diagnoses included heart failure, paraplegia, cognitive communication deficit, pressure ulcer of right buttock, and pressure ulcer of right heel. Resident #61 had a BIMS of 6 which indicated his cognition was severely impaired.
The MDS further reflected the resident had a pressure ulcer/injury, a scare over bony prominence.Review of Resident #61's care plan revised on 08/01/25 reflected the resident had a pressure ulcer and was at risk for impaired skin integrity related noncompliance with treatment plan, impaired mobility, and cognitive impairment; right heel-stage 4.
Interventions included to administer treatments as ordered and monitor for effectiveness.
Review of Resident #61's Order Summary Report for February 2026 reflected the following: Cleanse right heel stage IV with wound cleanser, pat dry with gauze 4X4, apply medi honey to slough, collagen to pink tissue and calcium alginate and cover with dry dressing 3x a week and PRN.Mon, Wed, Fri for wound healingObservation on 02/26/26 at 9:25 AM of Resident #61's wound care revealed the resident was alert and lying in bed.
The Wound Care Nurse put on gloves, took/cut off the resident's bandage off the resident's right foot.
The Wound Care Nurse took off her gloves and applied hand sanitizer and put on new gloves.
The Wound Care Nurse cleansed the heel wound and applied gauze on the wound and put the resident's foot on the bed, and the gauze served as a barrier between the wound and the bed.
The Wound Care Nurse picked up the resident's foot and cleansed the wound again and when she placed the foot back on the bed, the barrier gauze slipped up the foot, and the heel wound was placed the drawsheet under the resident.
The Wound Care Nurse proceeded to apply the wound treatment and dress it and did not reclean the wound after it was placed on the drawsheet with no barrier.
Interview on 02/26/26 at 2:15 PM with the Wound Care Nurse revealed she would have a CNA assist her and hold Resident #61's foot during wound care.
The Wound Care Nurse said she put a gauze on the resident's heel to use as a barrier and did not notice the gauze move and thought it was still protecting the heel.
The Wound Care Nurse said it was important for the wound not to touch the bed or drawsheet after it had been cleaned because it would introduce bacteria and cause infection.
Interview on 02/26/26 at 11:00 AM with the ADON revealed open wounds should not touch surfaces until it is clean, treated and bandaged to prevent the introduction of new bacteria and keep the wound free of infection.
Review of the facility's policy titled Pressure Injury: Prevention, Assessment and Treatment revised on 05/05/25 reflected the following: Procedure1.
Nursing personnel will continually aim to maintain the skin integrity, tone, turgor, and circulation to prevent breakdown, injury and infection.
Review of the facility's policy titled Infection Control Plan: Overview updated on 03/2024 reflected the following: Infection ControlThe facility will establish and maintain an Infection Control Program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of disease and infection. .1.
Hand HygieneHand hygiene continues to be the primary means of preventing the transmission of infection.
The following is a list of some situations that require hand hygiene:.Before and after eating or handling food.Before and after assisting a resident with meals.After handling soiled or used linens, equipment, or utensils. .Personal Protective EquipmentHCP who enter the room of a patient with suspected or confirmed SARS-CoV-2 infection should adhere to Standard Precautions and use.N95 filters or higher, gown, gloves, eye protection (i.e., goggles or a face shield that covers the front and sides of the face).
676004 02/26/2026
The Hills Nursing & Rehabilitation 201 E Thompson St Decatur, TX 76234