Park Place Nursing & Rehabilitation Center
Inspection Findings
F-Tag F0842
F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
documented other than the nurse saying she worked that day. The DON said LVN A had come to her the other day (date not specified) asking for bigger xeroform as she was using approximately 9 xeroform per leg on Resident #1's legs. The DON said she would ask who documented on the WAR for Resident #1's wound care and how they were able to prove the wound care was performed. During an interview on 10/21/25 at 12:09 p.m. the DON said kb25 was LVN A. The DON said she spoke with LVN A who said she went back in Resident #1's chart this morning (10/21/25) and documented wound care being performed.
The DON said that LVN A said she had to go back in to document the wound care because she forgot to go to the WAR and check it off. The DON said she did not know who the assigned initials MP1 belonged to.
The DON said her assigned initials in the EMR were MP25. The DON said she pulled the facility staff list for
the EMR and could not find any staff member with the initials MP1 assigned to them. During an interview
on 10/21/25 at 1:26 p.m. LVN A said she floated between sides upstairs depending on who was off work.
LVN A said the nurses were responsible for performing wound care. LVN A said she worked out of the TAR
in the EMR and did not check the WAR. LVN A said she did go in this morning and checked off in the WAR that wound care was performed on Resident #1 on the days she had worked. LVN A said she normally documented performing wound care on the 24hr report. During an interview on 10/22/25 at 9:52 a.m.
Resident #1 said she was treated good at the facility. Resident #1 said her legs had to be wrapped today.
Resident #1 said staff at the facility performed wound care on her daily. Resident #1 said she did not have any concerns at the facility. During an interview on 10/22/25 at 10:21 a.m. LVN B said to know if a resident had orders for wound care she would look in the WAR. LVN B said once wound care was completed it was checked off on the WAR. LVN B said most of the time the morning shift performed wound care on residents
in even numbered rooms and the evening shift performed wound care on the odd numbered rooms. LVN B said she had performed wound care on Resident #1. LVN B said she would forget to sign out on the WAR when she completed wound care. LVN B said the importance of accurate documentation was to ensure it could be proved a resident was receiving their ordered care and so other nurses could determine what care had been provided for a resident. During an interview on 10/22/25 at 12:35 p.m. the DON said the facility's Electronic Medical Records policy was the only policy they had regarding medical or clinical records. During
an interview on 10/22/25 at 12:54 p.m. the DON said she was never able to determine what staff member had been assigned initials MP1. The DON said she expected documentation to be done daily and as care was provided, or when medications were administered. The DON said the importance of accurate documentation was to prove care was provided and what was going on with the residents. Record review of
the facility's Electronic Medical Records policy last revised March 2014 indicated, .Only authorized persons who have been issued a password and user ID code will be permitted access to the electronic medical records system.
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
11/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Park Place Nursing & Rehabilitation Center
2450 E Fifth St Tyler, TX 75701
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0880
Federal health inspectors cited PARK PLACE NURSING & REHABILITATION CENTER in TYLER, TX for a deficiency under regulatory tag F-F0880 during a complaint investigation conducted on 2025-11-25.
Category: Infection Control Deficiencies
The facility was found deficient in the following area: Provide and implement an infection prevention and control program.
Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.
While no actual harm was documented, there was potential for more than minimal harm to residents.
This was one of 2 deficiencies cited during this inspection of PARK PLACE NURSING & REHABILITATION CENTER.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-11-26.
PARK PLACE NURSING & REHABILITATION CENTER in TYLER, TX inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 PARK PLACE NURSING & REHABILITATION CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.