Stonecreek Nursing & Rehabilitation
STONECREEK NURSING & REHABILITATION in SAN AUGUSTINE, TX — inspection on April 1, 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
During an interview on 04/01/2026 at 12:40 p.m., the DON said she expected vaping to be done safely and per policy.
She said they were currently reviewing the policy to make sure they were up to date and meeting requirements.
She said that any risks to residents would be patient specific and could include respiratory effects.
She said it would need to be patient specific, and she would not say what other residents could be exposed to without doing a patient specific assessment.
She said going forward they would be providing education and continue researching the most up to date regulations and scientific evidence and studies.
During an interview on 04/01/2026 at 12:52 p.m., the Administrator said she expected staff to respect the residents' wants and wishes, along with keeping them safe.
She said resident risks could include pressure areas or burns with vape device taped to fingers, and other residents could be exposed to respiratory chemicals from the vape.
She said going forward, she would ensure residents that vape were getting safe smoking assessments completed on them.
Record review of a facility policy titled Electronic Cigarettes dated August 2022 read: .Electronic cigarettes (e-cigarettes) are not considered smoking devices with respect to the risk of ignition, but they are considered a risk for residents related to: .b. second hand aerosol exposure; c. nicotine overdose by ingestion or contact with the skin; and d. explosion or fire caused by the battery . and .to prevent accidents associated with e-cigarettes and to respect the rights of residents who do not want to be exposed to second-hand aerosol, residents are permitted to use e-cigarettes with supervision and in designated smoking areas only . and .3.
Residents who wish to use e-cigarettes are assessed for their ability to safely handle the devices (including batteries and refill cartridges) on an individual basis .
675729 04/01/2026
Stonecreek Nursing & Rehabilitation 451 S El Camino Crossing San Augustine, TX 75972
During the 7 day look back period she received insulin injections.
Record review of a care plan for Resident #38 revised on 2/3/2025 indicated she had diabetes and used insulin.
Interventions included: diabetes medication as ordered by doctor.
During an observation on 3/31/2026 at 8:26 am, LVN A was present at the medication cart for hall C/D. An insulin flex pen of Insulin glargine 35 units subcutaneously at bedtime for Resident #38 with a prescription fill date of 3/25/2026 and did not have an open date present on the label or plastic bag.
Pharmacy directions indicated to discard medication 28 days after the open date.
During an interview on 3/31/2026 at 8:50 am, LVN A said when insulin was opened and accessed it should be dated with an open date and insulin would be discarded 28-30 days following when it was opened depending on the type of insulin.
She said Resident #38 received insulin glargine 35 units at bedtime and the flex pen of insulin glargine had been used.
She said the insulin should be discarded if it did not have an open date.
She said it could be old and less effective if not dated and the staff would not know how old it was.
During an interview on 4/1/2026 at 12:41 pm, the DON was made aware of the insulin pen that belonged to Resident #38 that was not dated with an open date.
She said the staff should follow facility policy and depending on the medication they would need to follow manufacturing recommendations as it applied to open, discard, and expiration dates.
She said staff should put an open date once it was used.
She said there could be a risk of using expired medication if it was not dated.
She said all staff should audit carts every shift and prn along with the DON/ADON and Pharmacy Consultant.
During an interview on 4/1/2026 at 12:52 pm, the Administrator said the nurses should check their carts daily and the administrative nurses and Pharmacy consultants conducted audits randomly.
She said the nurse that opened the vial should have labeled it with an open date so staff would know how long it would be good for.
She said she expected her staff to put an open date or expiration date on medications.
She said there could be a risk of expired medications being given to residents or medications being used past their expiration dates.
Record review of a facility policy titled Medication Labeling and Storage revised February 2023 indicated, .5.
Multi-dose vials that have been opened or accessed (e.g., needle punctured) are dated and discarded within 28 days unless the manufacturer specifies a shorter or longer date for the open vial .
During an interview on 03/30/26 at 11:45 AM, the Maintenance Supervisor said he was made aware of the burner on the stove was not working properly this morning.
The maintenance supervisor said he had not looked at it. He said he would call the professional technician to service the stove.
During an interview on 3/31/26 at 1:50 PM, the Administrator said the burners not lighting on the stove were reported to her yesterday.
She said the technician came to the facility today for a service call and made repairs to the stove.
She said if the burners did not light properly, it could take longer to cook or have a gas leak.
Record review on 03/31/26 of policy titled Policy Regarding Gas Appliance in a Nursing Home Setting dated 11/13/22 indicated:IT IS CRUCIAL TO ADHERE TO SAFETY PROTOCOLS WHEN DEALING WITH GAS APPLIANCES1. If the pilot light on the gas stove is not working; it is recommended to use a long match or a lighter to light the pilot.
This method is preferred overusing a striker, as it allows for a direct flame to be applied to the pilot which is more effective in lighting the pilot compared to a striker.2. If the pilot light does not light after multiple attempts, the professional technician must be called for assistance.3. If the pilot light has to be continually lit by the lighter or long match method the professional technician must be called for service to the appliance.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.
For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
675729 04/01/2026
Stonecreek Nursing & Rehabilitation 451 S El Camino Crossing San Augustine, TX 75972
effective pest control program was in place to keep mice out of the kitchen.This failure could place
and interview on 03/30/26 at 9:45 am.
The dry storage area had small rodent droppings on top of a plastic bin containing condiments and below the bottom shelf on the floor there was a plastic container with mouse bait and small droppings.
The DM said maintenance treats the storage area with mouse bait as needed. No mouse traps were noted by this surveyor or live rodents.
The DM she would have the area cleaned and that the rodent droppings were a sanitation issue.
Record review of pest control logs on 03/30/26 revealed pest control was last there on 3/19/26 for monthly service with no additional treatments requested by the facility.
Invoices revealed the kitchen had no treatment for rodents.
Invoice for 2/24/26, 1/27/26 12/31/25 indicated no treatment for mice in the kitchen.
During an interview on 03/30/26 at 11:45 a.m., Maintenance said that pest control had not treated inside the kitchen for rodents, but they treated outside the door of the kitchen. He said he treats the kitchen with pellets when he is made aware that mice are visible. He said the last treatment was about 2 weeks ago for mice when he was made aware of a problem. He said pests and rodents in the kitchen were a sanitation problem.
During an interview on 3/31/26 at 1:45 p.m., the Administrator said she was aware of mice droppings in the pantry.
She said her expectation was for the Dietary Manager to ensure that all sanitation requirements were followed including pest control.
She said pests and rodents in the kitchen were a sanitation problem and could cause food borne illness.
Record review on 03/31/26 of policy titled Pest Control dated 4/28/2017 and revised on 6/8/25 stated .Routine pest control procedures will be in place. If pests are seen in the kitchen, the director of food and nutrition services or designee shall be informed, describing where the pest was seen and when.
Appropriate action will be taken to eliminate any reported pest situation in the department .
675729 04/01/2026
Stonecreek Nursing & Rehabilitation 451 S El Camino Crossing San Augustine, TX 75972