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Complaint Investigation

Avir At Rose Trail

November 18, 2025 · Tyler, TX · 930 S Baxter
Citations 2
CMS Rating 1/5
Beds 172
Provider ID 455429
Healthcare Facility
Avir At Rose Trail
Tyler, TX  ·  View full profile →
Inspection Summary

Avir at Rose Trail in TYLER, TX — inspection on November 18, 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

FF0655
Resident Assessment and Care Planning Deficiencies
Potential for More Than Minimal Harm

During an interview on 10/13/2025 at 12:30 PM resident #2 was observed up in his specialized wheelchair, with hydraulics up high in air, he did not response to verbal stimuli with first attempt, after much encouragement he responded and stated he had no current issues with the facility.

During an interview on 10/14/2025 at 12:18PM, the administrator and the Social Worker both said they were not aware of issues of residents #1 & #2's care plans, and the MDS nurses were responsible for these, and the DON should have overseen that the care plans were completed appropriately and timely.

Both admitted the care plans were an issue due to transition of interim DON and new MDS Nurse who was out sick and only been with the facility for a couple of weeks.

The administrator said they were addressing this issue in the daily morning meetings to be informed of changes to be care planned but did not know what happened.

During an interview on 10/14/2025 at 2:00 PM, the ADON said the care plans were the responsibility of the MDS Nurse (RN) she was an LVN, and it is the responsibility of the RN.

Record review of an undated care planning policy dated March 2022 indicated the care planning/interdisciplinary team shall develop a comprehensive care plan for each resident.

The policy indicated a comprehensive care plan included measurable objectives and timetables to meet the resident's medical, nursing, mental, and psychological needs which shall be developed for each resident.

The policy indicated implementation included the resident's comprehensive care plan was to be developed within 7 days of the completion of the resident's comprehensive MDS assessment (Admission, Annual or Significant Change in Status), and no more than 21 days after admission.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

11/18/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Rose Trail Nursing and Rehabilitation Center

930 S Baxter Tyler, TX 75701

SUMMARY STATEMENT OF DEFICIENCIES

During an interview on 10/15/2025 at 10:18AM, the Wound Care nurse said, after the mother's arrival to facility late in the afternoons after 6:00PM, it had been discovered that the resident's mother had changed the Pressure Ulcer dressing on several occasions.

She said it was discussed verbally with the mother to not change the dressing, and to notify the nursing staff if the Pressure Ulcer dressing had been soiled and needed changed.

She said she informed the mother that the nursing staff will change the dressing daily and as needed PRN.

The wound care nurse stated that she understood that after speaking with the MD and Social Worker that an IDT meeting would be scheduled, and care plans would be updated.

During an interview on 10/15/2025 at 10:30AM, the Social Worker said, she only documented that the IDT meeting was scheduled for 07/30/2025 at 4:45PM, but no additional notes were added to progress notes or care plans.

During an interview on 10/15/2025 at 1:30PM, the ADON LVN said, that Resident #3 was receiving Hospice care with a skilled nurse once a week and a hospice aide care three times a week. ADON LVN said, Resident #3 hospice care plans should had been added, and Resident #4 IDT care plans should had been added to the comprehensive care plans.

The ADON LVN said, she had been with this facility for only 3 to 4 weeks but was informed by the corporate nurse, it is the responsibility of the DON RN to complete, update, and sign the admission base line care plans, and comprehensive care plans.

During an interview on 10/15/2025 at 2:00pm the DON RN said, she was just hired as the interim DON RN due to the recent transition of the previous DON, and the new MDS nurse had been out sick. DON RN said, the team were addressing care plans issue in the daily morning meetings.

During an interview on 10/15/2025 at 2:30PM the Administrator said that the RN, DON, and the MDS nurse were responsible for reviewing the admission care plans and updating the current care plans.

The Admin. said, the DON and the MDS Coordinator were responsible for ensuring the MDS assessments were accurate and said the RAI manual was used as the guideline for the MDS's assessment.

She said the policy would be to follow the Resident Assessment Instrument (RAI).

The Administrator confirmed that the care plans did not address or document Hospice Care for Resident #3, nor did the care plans address IDT meeting with Resident # 4 mother's on requesting the nursing staff to change the PU dressing when soiled.

Record review of an undated care planning policy dated March 2022 indicated the care planning/interdisciplinary team shall develop a comprehensive care plan for each resident.

The policy indicated a comprehensive care plan included measurable objectives and timetables to meet the resident's medical, nursing, mental, and psychological needs which shall be developed for each resident.

The policy indicated implementation included the resident's comprehensive care plan was to be developed within 7 days of the completion of the resident's comprehensive MDS assessment (Admission, Annual or Significant Change in Status), and no more than 21 days after admission.

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 TYLER, 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 Avir at Rose Trail or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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