Paradigm At The Oak
Paradigm at the Oak in Schulenburg, TX — inspection on May 28, 2026.
Found 2 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
documented on the participation records every day.
The Administrator stated the Activity Director
documented after the group activity to reflect if the resident was active or passive during the group
especially on the secure unit. I want all staff to be involved in the activity plans of the residents on secure unit to ensure the residents are receiving the activities to promote their cognition, socialization or overall psychosocial needs.
Record review of the Facility's Activities Policy, revised 05/2024, revealed, The Facility's activity program shall provide meaningful, person-centered activities to meet each resident's physical, mental, and psychosocial well-being, per their comprehensive care plan.
Collaborate with the interdisciplinary team to develop an activities section in the care plan.
Include goals and interventions tailored to the resident's interests, abilities, and care needs.
Identify barriers to participation and adjust activities or approaches as needed.
Ensure activities are adaptable for residents with physical or cognitive limitations.
Record review of the facility's job description of the Activity Director, signed by Activity Director on 10/03/2024, revealed, In keeping with our organizations goals, this position is responsible for planning, implementing, and evaluating activities and programs for residents.
The Activity Director designs programs to encourage socialization, entertainment, relaxation, and fulfillment, as well as improve daily living skills.Job Duties:Plan, create, and implement meaningful and engaging facility activities for the residents.Design programs to encourage socialization, entertainment, relaxation, and fulfillment, as well as improve daily living skills.Engage in one-on-one visits, care plan meetings, and assessments as needed.Keep accurate records of activities attendance and calendar.Ensure that responsibilities are performed consistent with all applicable federal, state, and local rules and regulations as well as facility policies and procedures.
Record review of the facility's policy titled, Activity Documentation-General Guidelines, dated 05/26/2025, revealed, A qualified Activity professional will complete all required medical record documentation per state and federal regulations.
The Activity Director shall coordinate and supervise all documentation and be responsible for all areas of documentation, according to required time limits and practice guidelines.
The following areas are considered documentation responsibilities of the Activity Director and staff and should be completed in a comprehensive and timely manner .1.
Interdisciplinary team will assess the need for activities and reflect on the resident care: Problems, Goals and Appropriate approaches to related problems.2.
Progress Notes at least quarterly.3.
Resident Participation records.General guideline when completing any of the above areas of required documentation include:1.
Documentation is maintained in the residents' clinical medical records.2.
Only approved medically related abbreviations are used.3.
All entries in the medical record are to be signed (including the author's signature and title) and dated by a qualified Activity professional.4.
All documentation is completed consistent with health care center policy and applicable state and federal laws.
675971 05/28/2026
Paradigm at the Oak 507 West Ave Schulenburg, TX 78956
Findings included:During an observation on 05/28/2026 at 10:30 a.m., Housekeeping Cart #1 was located at the end of west hall.
The compartment where chemicals were stored was not locked.
The compartment had disinfectant cleaner, tub and tile cleaner, and bio waste degrader.
Housekeeper A was not on west hall, and no other staff was near the unlocked housekeeping cart.
Housekeeper A entered the west hall from near the nurses desk located beside the west hall. He was unable to view Housekeeping Cart #1.During an interview on 05/28/2026 at 10:40 a.m., Housekeeper A stated the housekeeping cart was expected to be locked anytime the housekeeper walked away from the cart.
Housekeeper A stated he could not see Housekeeping Cart #1 from where he was standing near the nurses desk. He stated there was a possibility that if a resident drank some of the chemicals the resident may become sick with stomach issues or have an allergic reaction. He stated it was possible a resident may need to be evaluated at the hospital.
Housekeeper A stated he was in-serviced to lock the chemicals in the housekeeping cart.
He did not recall the date or the time of the in-service.
During an interview on 05/28/2026 at 10:50 a.m., the Housekeeping Supervisor stated if a resident swallowed the chemical the nurse would not know what type of care to give the resident without knowing the name of the chemical. He stated all housekeeping carts were expected to be locked anytime the housekeeper was not standing in front of the cart.
The Housekeeping Supervisor stated if a resident ingested some chemicals there was a potential for an allergic reaction, such as burning their throat, stomach and may need to be assessed at the hospital. He stated all housekeeping staff were in-serviced on locking housekeeping carts. He stated there was a possibility that if a resident spilled chemical on their skin it may cause irritation to the skin.
During an interview on 5/29/2026 at 2:50 p.m., the Administrator stated he expected the housekeeping cart to be locked at all times when the housekeeper was not obtaining an item from the housekeeping cart.
The Administrator stated all housekeeping staff was in-serviced on locking the housekeeping carts.
The Administrator stated if a resident drank a chemical there was a possibility a resident may become ill with nausea and vomiting. He stated there was a possibility a resident may need to be transported to the emergency room for further evaluation.
Record review of the facility's policy titled, Chemical Usage, not dated, reflected, Secure Chemical Storage: Each housekeeping cart is equipped with a lockbox for storing chemicals.
Employees must ensure that all chemicals are securely stored in the lockbox and never leave their cart unattended, especially during breaks.
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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.