Knopp Healthcare And Rehab Center Inc
KNOPP HEALTHCARE AND REHAB CENTER INC in FREDERICKSBURG, TX — inspection on January 9, 2026.
Found 6 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
constitutes an accident/Incident should be Immediately directed to the Director of Nursing or the shift
action.PROCEDURE:9.
Complete an Incident report.10.
Note the location and the time of the Incident.
were on the Incident report.13.
Notify DON/ADON of injuries of unknown cause immediately.14.
When complete the Incident report will be sent to the office where the administrator & Director of Nursing verifies and investigates the contents of the incident report.
The medical records personnel will keep copies of the Incident reports on file in the office.
They will then be reviewed at the quarterly QA meetings which Include the medical director.DON, or designated nurse, will investigate all injuries of unknown cause following DADSguideline. DON will report injuries to DADS based on DADS guidelines.
Record review of facility document titled, Resident Abuse, Neglect or Mistreatment undated reflected the following: Each resident shall be free from abuse, neglect, mistreatment, exploitation and misappropriation of property.
Abuse shall include physical harm, pain, mental anguish, verbal abuse (derogatory terms), sexual abuse or involuntary seclusion.Suspected or substantiated cases of resident abuse, neglect, misappropriation of property or mistreatment shall be thoroughly investigated and documented by the administrator, and reported to the appropriate state agencies.Procedure:Any alleged violation involving mistreatment, misappropriation of property, abuse, exploitation or neglect of a resident shall be reported to the administrator immediately.The administrator shall thoroughly investigate all allegations.The administrator will make initial report to state within 24 hours of the incident.5.
The administrator will take steps to ensure and prevent further potential abuse while investigation is in process.8. An incident report will be completed.10.
The administrator shall take the following actions to assure that investigation is conducted effectively.10.
Results of investigation shall be reported to officials (state agency) in accordance with state law and within five (5) working days.
455278 01/09/2026
Knopp Healthcare and Rehab Center Inc 1208 N Llano Fredericksburg, TX 78624
mistreatment, exploitation and misappropriation of property.
Abuse shall include physical harm, pain,
thoroughly investigated and documented by the administrator, and reported to the appropriate state
exploitation or neglect of a resident shall be reported to the administrator immediately.The administrator shall thoroughly investigate all allegations.The administrator will make initial report to state within 24 hours of the incident.5.
The administrator will take steps to ensure and prevent further potential abuse while investigation is in process.8. An incident report will be completed.10.
The administrator shall take the following actions to assure that investigation is conducted effectively.10.
Results of investigation shall be reported to officials (state agency) in accordance with state law and within five (5) working days.
455278 01/09/2026
Knopp Healthcare and Rehab Center Inc 1208 N Llano Fredericksburg, TX 78624
primary diagnosis. PASRR guidelines for Health and Human Services dated June 2023 state that if a
455278 01/09/2026
Knopp Healthcare and Rehab Center Inc 1208 N Llano Fredericksburg, TX 78624
During an observation and interview on 1/7/2026 at 10:29 AM revealed an exit door which was accessed through wing-4 hallway.
The door gave a person access to the facility exterior courtyard.
The courtyard was not fenced and had a cement sidewalk which had access to state a state highway.
The wing-4 hallway was used by residents to get to the dining room and activities areas.
Observation of the exit door revealed a wander guard system box affixed to the upper right door frame, however the wander guard box had loose wires exposed. LVN D Stated the door allowed access to the kitchen courtyard and had access to the street (state highway). LVN D stated the door had a wander guard system, and the box had loose wires which were not connected and may not be functioning.
During an interview on 1/7/2025 at 2:00 PM the Activities Director (AD) stated he was responsible for ensuring the facility's wander guard system was working.
The AD stated 9 residents were assessed as elopement risk and were supported with wander guard bracelets on the person's right wrist.
The AD stated he checked the wander guard bracelets daily Monday through Friday and maintained a log of the checks.
The AD stated he checked each residents wander guard bracelet with a wander guard hand held device which would indicate if the bracelet was functioning.
The AD stated he did not check the facility exit doors for the wander guard system and had not recognized the exit door from the wing-4 hallway to the kitchen courtyard had the wander guard monitor disabled. A policy was requested from the Administrator on 1/7/2026 at 9:51 Am and as of 1/15/2026 the policy was not provided. A record review of The United States of Americas Agency for Healthcare Research website titled Elopement accessed 1/19/2026 revealed, https://psnet.ahrq.gov/web-mm/elopement#:~:text=An%20immediate%20organizational%20response%20should,and%20diversion%20activities.
An immediate organizational response should be initiated when any patient with decreased mental capacity has left the unit or treatment area without authorization.
Health care organizations should have policies and procedures in place indicating the steps that personnel are to follow in any elopement situation, and adequate training should be provided for all staff.
These protocols should include assessment and prevention procedures to reduce the risk of harm for patients with diminished capacity.
Such preventive measures may include placing the patient on an observation protocol (special precautions for patients requiring frequent or constant monitoring).
Such a protocol may include locating the patient close to the desk, placing an electronic monitoring device on the patient when available, partnering the patient with a roommate, or requesting a family member or nursing assistant to sit with the patient.
Additional precautions common in mental health and rehabilitation facilities include automatic door locks, alarms, and diversion activities.
455278 01/09/2026
Knopp Healthcare and Rehab Center Inc 1208 N Llano Fredericksburg, TX 78624
will make regular scheduled visits of (16) sixteen hours each month or (20) twenty hours depending
and will plan therapeutic menus.THERAPEUTIC DIETSTherapeutic diets shall be planned and based
upon admission, will be visited by the Food Service SupervisorThe consultant, when requested by the charge nurse, will visit all patients on therapeutic dietsDietary data pertinent to a patient will be recorded on patients' diet card on file in kitchen or chart by charge nurse or consultantThe dietary consultant is on call to give assistance on diets at the discretion of the staff.
Record review of document titled, Dietary Consultant dated March 1, 2012, reflected the following: Purpose: To maintain a dietary department in compliance with roles and regulations of Federal, State and local authorities. To provide therapeutic diets and meals, as prescribed by the physician, in a well-balanced, attractive and appetizing manner under safe, sanitary conditions for a reasonable cost.Qualifications: Must be a professional dietitian who is a member of the American Dietetic Association and meets the registration requirements, or is a graduate of a baccalaureate degree program with major studies in food service management, or foods and nutrition.
The Chief Nutritionist, Bureau of Long Term Care and Texas Department of Health shall evaluate and determine suitability of this person. A minimum of 15 clock hours of appropriate continuing education per year shall be completed, reported and approved according to instructions issued by the Texas Department of Health, Long [NAME] Care Division.
Performance Requirements:1. To provide continuing liaison with medical and nursing staff2. To advise and provide consultation to the administrator3. To counsel with residents and/or families on special diets4. To provide input and review residents' total health care plans5. To visit regularly with residents and to document these visits on a written report6. To guide the supervisor and staff of the dietetic services7. To participate in development or review of dietetic policies and procedures8. To conduct in-service education programs 11. To develop menus and make individual facility changes as necessary12. To write or check meal patterns for therapeutic diets13.
To review all substitutions on menus14. To inspect all areas of the Dietetic Department-equipment, sanitation and procedural follow-through, etc. and to advise the administrator of the results15.
Though an exit conference on each visit, to apprise the food service supervisor and administrator of any recommendation and to leave a written report16. To schedule time of consultation at the facility with. the food service supervisor
455278 01/09/2026
Knopp Healthcare and Rehab Center Inc 1208 N Llano Fredericksburg, TX 78624
During an observation and interview on 1/7/2026 at 8:00 AM revealed the facility's laundry department had 3 commercial clothes washers and 4 commercial clothes dryers.
One of the 3 commercial clothes washer was not in service and one of the four commercial clothes dryers was not in service.
The Laundry Services Manager (LSM) stated she had been the LSM for the last year and during that time One of the 3 commercial clothes washer was not in service and one of the four commercial clothes dryers was not in service.
The LSM stated laundry services were being provided for the 50-60 average census of residents, however the facility had a license for 119 and if the facility were to receive more residents the laundry services may not be accommodated without the in-operable equipment. A policy review was requested from the Administrator on 1/7/2026 at 9:51 AM and as of 1/15/2026 a policy was not provided prior to exit.
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.