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Complaint Investigation

Silver Tree Nursing And Rehabilitation Center

October 10, 2025 · Schertz, TX · 930 Roy Richard Dr
Citations 3
CMS Rating 2/5
Beds 120
Provider ID 676121
Healthcare Facility
Silver Tree Nursing And Rehabilitation Center
Schertz, TX  ·  View full profile →
Inspection Summary

SILVER TREE NURSING AND REHABILITATION CENTER in SCHERTZ, TX — inspection on October 10, 2025.

Found 3 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.

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Inspection Findings

FF0656
Resident Assessment and Care Planning Deficiencies
Potential for More Than Minimal Harm

PM, Resident #3's RP revealed Resident #3 could be manipulative when she got mad and did not get her way.

She revealed Resident #3 had a history of making up stories about her care in order to make it seem like Resident #3 had to come home instead of staying at the facility.

Interview on 10/10/25 at 04:37 PM, the ADM and DON revealed they should have documented Resident #2 refused wound treatments in his care plan because care plans were person centered and reflected what care resident received.

They further revealed for Resident #3 they did not document in her care plan that she made accusations and allegations of her care. (The ADM revealed these accusations and allegations were not reportable events.) They revealed Resident #3 had a history of making allegations about staff, and they had been working on helping this resident with these behaviors through psychiatric and psychological services.

Interview on 10/13/25 at 03:54 PM, [Mental Health Organization] counselor revealed Resident #3 did not like being in the facility because she wanted to go home.

She revealed Resident #3 had a history of making up accusations about care.

She revealed if Resident #3 got into a bad mood, anything bothered her.

She revealed the facility and she had been working on these behaviors with her.

Record review of the facility's policy, titled Comprehensive Care Planning, undated, reflected The comprehensive care plan will describe the followingThe services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being; and the right to refuse treatment

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

10/10/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Silver Tree Nursing and Rehabilitation Center

930 Roy Richard Dr Schertz, TX 78154

SUMMARY STATEMENT OF DEFICIENCIES

jeopardy to resident health or safety

had these behaviors.

They further revealed they would report elopements to the ADM immediately.

The noncompliance was identified as PNC.

The Immediate Jeopardy began on 08/28/25 and ended on 08/29/25.

The facility had corrected the noncompliance before the investigation began.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

10/10/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Silver Tree Nursing and Rehabilitation Center

930 Roy Richard Dr Schertz, TX 78154

SUMMARY STATEMENT OF DEFICIENCIES

The facility failed to ensure Resident #2's wound treatment was accurately documented from 10/01/25 to 10/06/25.

These failures could place residents at risk of not receiving the care and services needed due to inaccurate or incomplete clinical records.

The findings included:

Record review of Resident #2's admission record, dated 10/10/25, revealed resident was an [AGE] year-old male resident admitted [DATE] with diagnoses to include protein-calorie malnutrition.

Record review of Resident #2's admission MDS assessment, dated 09/11/25, revealed Resident #2's had a BIMS score of 06 out of 15, indicating severe cognitive impairment.

Record review of Resident #2's care plan reflected a focus The resident has a potential for pressure ulcer development., initiated 09/10/25, with interventions . [Resident #2] with hx of wound care refusal, initiated 10/07/25.

Record review of Resident #2's October 2025 Wound Administration Record reflected WOUND CARE: unstageable PI to right buttock. one time a day for WOUND HEALING for Lib A (liberal in the AM shift meaning wound treatment could be done any time during the morning shift) did not have anything documented for 10/01/25 to 10/06/25.

Interview on 10/09/2025 at 11:59 AM, LVN AD revealed in the last 2 weeks, Resident #2 had a history of refusing wound care and had to get Resident #2's family member to help Resident #2 agree to wound treatment.

Interview on 10/09/25 at 02:50 PM, RN C revealed she did wound treatment for Resident #2 from 09/30/25 to 10/03/25 and 10/06/25.

She revealed Resident #2 had a history of refusing wound care.

She revealed she tried 2 or 3 times for wound treatment, but he continued to refuse wound treatment.

She revealed they had to educate family member and Resident #2 every day about importance of wound treatment.

Interview on 10/10/25 at 04:37 PM, the ADM and DON revealed Resident #2 refusing wound treatment should be documented in his administration record.

They revealed this was important, so his records were accurate.

Record review of the facility's policy Wound Treatment Management, dated 2021, reflected 7.

Treatments will be documented on the Treatment Administration Record.

Record review of facility's policy Documentation, undated, reflected 1.

The facility will maintain complete and accurate documentation for each resident on all appropriate clinical record sheets.

Facility ID:

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 SCHERTZ, 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 SILVER TREE NURSING AND REHABILITATION CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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