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Complaint Investigation

The Crescent

October 23, 2025 · Sugar Land, TX · 11353 Sugar Park Lane
Citations 2
CMS Rating 2/5
Beds 112
Provider ID 676323
Healthcare Facility
The Crescent
Sugar Land, TX  ·  View full profile →
Inspection Summary

The Crescent in Sugar Land, TX — inspection on October 23, 2025.

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.

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Inspection Findings

FF0609
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Potential for More Than Minimal Harm

Review of facility's Abuse, Neglect, Exploitation, and Misappropriation Prevention Program dated April 2021 reflected: 1.

Identify and investigate all possible incidents of abuse, neglect, mistreatment, or misappropriation of resident property.2.

Investigate and report any allegations within timeframes required by federal requirements.

Record review of the Long-Term Care Regulation Provider Letter Title Abuse, Neglect Exploitation, Misappropriation of Resident Property and Other Incidents that a Nursing Facility Must Report to the Health and Human Services Commission reflected:Type of Incident to Report Neglect (Incident with or without serious bodily injury) When to report:Immediately, but not later than two hours after the incident occurs or is suspected.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

10/23/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

The Crescent

11353 Sugar Park Lane Sugar Land, TX 77478

SUMMARY STATEMENT OF DEFICIENCIES

jeopardy to resident health or safety

passing score.In an interview on 10/23/2025 at 4:15 PM, the DON stated she was in serviced by the RVP on Policy for Hot liquids and safely handling hot liquids with the resident. DON stated she and ED/ADM completed in-services with the nurse managers, nursing staff, 2 ADON, Unit Manager, Department Heads to include Dietary, Social Worker, MDS Coordinator, Business Office, Human Resources, Housekeeping, Medical Records, Activity Director, and Admissions Coordinator. DON stated 2 Monitor Hot Liquids Risk Binders were placed at each nurse's station. DON stated assessments will be completed at admission and quarterly. DON stated the DON, ADON, Nurse Unit Manger and weekend supervisor will monitor.Interviews conducted on 10/23/2025 with nurses from 6/2, 2/10, and 10/6 shifts between 4:35 PM -5:40 PM [LVN C, LVN D, LVN E, LVN G, LVN H, and RN I] indicated they participated in the mandatory in service training about Policy for Hot liquids and safely handling hot liquids with the resident.

Each stated they completed quizzes following the in-services.

They stated they received training on the Hot Liquid Safety Binder of at risk and not at risk binder located at the two nurse's stations.

Interviews conducted on 10/23/2025 with 9 CNAs who worked the 6/2, 2/10, and 10/6 shift between 4:00PM-5:48 PM [CNA J, CNA K, CNA L, CNA M, CNA N, CNA O, CNA P, CNA Q, CNA R] indicated they participated in an in-service training on Policy for Hot liquids and safely handling hot liquids with the resident.

The CNAs summarized the topic of discussion stating understanding handling of hot liquids and safety.

Each CNA stated they completed the post test with passing scores.Interviews attempted via outbound calls to additional 5 CNAs and 1 RN the calls were unanswered and forwarded to an automated service that prompted to leave a voicemail. A return call was not received prior to the exit on 10/23/2025.Record Review of QAPI meeting attendance sheet (ED/ADM, RVP, DON, Unit Manager, ADON, and Regional Director of Clinical Services).Record Review on 10/23/2025 of the In-Service Training Sheets dated 10/23/2025 reflected all facility staff had been in-serviced on all training topics listed on the plan of removal.

About 3 percent of signatures were still needed as those employees had not worked a shift, those employees will reconfirm understanding of the training and sign off prior to working their shift.

Record Review on 10/23/2025 of Hot Liquid Evaluation dated 10/23/2025 reflected all 73 residents of the facility had been completed.Record Review of care plans on 10/23/2025 reflected the 38 residents considered at risk from hot liquid evaluation was updated in the comprehensive care plan.The ED/ADM and DON were informed the Immediate Jeopardy was removed on 10/23/25 at 7:20 PM.

The facility remained out of compliance at a severity level of no actual harm with a potential for more than minimal harm that is not immediate jeopardy and scope of isolated.

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 Sugar Land, 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 The Crescent or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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