Inspiration Hills Rehabilitation Center
Inspection Findings
F-Tag F0656
F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
stated This nurse was doing treatment; resident was combative with this nurse and CNA that was helping.
Resident scratched, hit and bit this nurse, and was hitting CNA. Dressing was changed and intact. Told residents nurse to monitor behaviors. Written by Treatment Nurse B. During an interview on 11/26/25 at 2:32 p.m. Treatment Nurse B stated Resident #1 was sometimes not calm during care and would fight staff.
She stated 2 staff went into the residents room for care. She stated the aides would call the nurse to come talk to the resident if she was refusing care like a shower and if she became combative they would stop care and return at a later time to try again. She stated the resident had recently bit and scratched her. The nurse raised her arm to show a purplish raised area on her forearm. During an interview on 11/26/25 at 3:00 p.m. Resident #1's RP stated she was a difficult patient because she will scratch and lash out at staff.
Resident #1's RP stated she does a lot of self-inflicting scratches due to her long nails and behaviors.
Resident #1's RP stated she experienced trauma in the past, had anxiety, and would pick at herself or lash out. The RP stated they would redirect Resident #1 and ask her to rub her hands to warm them up instead.
During an observation on 11/26/25 at 3:16 p.m. Resident #1 was laying in bed scratching her arm, constantly rubbing her arms together, and picking under her nails. During a joint interview on 11/26/25 at 4:15 p.m. The SW and the MDS Coordinator stated they would normally complete a care plan meeting and comprehensive care plan for residents within 21 days of them being admitted to the facility. They stated they added a focus area on 11/26/25 day for the resident resistance to care and behaviors because they had not done it prior and should have. They stated there was an incident on 11/12/25 where the resident was being combative and hit herself in the face while her nails were being trimmed. The SW stated she was busy working between two buildings and just had not had a chance to add the focus area. They stated the care plan should be updated to help staff know what the interventions were to care for the resident. During an
interview on 11/26/25 at 4:27 p.m. the DON stated Resident #1 was known to be combative with staff
during care. The DON stated they had psychiatry visit the resident and she was on anti-anxiety medication for about 1 week. The DON stated the care plan should have been updated after the incident on 11/12/25.
The DON stated it was important to update the care plan so the interdisciplinary team would all be on the same page of how to care for the resident. Record review of the facility's policy, titled Care Plans, Comprehensive Person-Centered, dated 12/2020, stated Policy Statement: A comprehensive, person-centered care plan that includes measurable objectives and timetables to meet the resident's physical, psychosocial and functional needs is developed and implemented for each resident. 8.The comprehensive, person-centered care plan will: g. Incorporate identified problem areas; h. Incorporate risk factors associated with identified problems. 13. Assessments of residents are ongoing and care plans are revised as information about the residents and the residents' conditions change.
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INSPIRATION HILLS REHABILITATION CENTER in SAN ANTONIO, TX inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 SAN ANTONIO, 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 INSPIRATION HILLS REHABILITATION CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.