Falcon Lake Nursing Home, Llc
Inspection Findings
F-Tag F0628
F 0628 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
said the notice should have had the OMB's information. The ADM said he was not sure if the notice provided to Resident #1 had the OMB's information. The ADM said he just followed the notice letter template. The ADM said he was not sure where the template was from, but the DON provided the template to him. In an interview on 01/30/26 at 5:25 PM, with the DON, she said the ADM asked her for the 30-day discharge notice template. The DON said she was not sure what the notice information was supposed to consist of. The DON said she did a web search for examples, obtained a template, and provided the template to the ADM. Record review of the facility's Transfer and Discharge Notice policy dated December 2016 reflected - Policy: Our facility shall provide a resident and/or the resident's representative with a 30-day written notice of an impending transfer or discharge.3. The resident and/or representative will be notified in writing of the following information: c. The location to which the resident is being transferred or discharged ;f. The name, address, and telephone number of the Office of the State Long-term Care Ombudsman.
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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
01/30/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Falcon Lake Nursing Home, LLC
200 Carla St Zapata, TX 78076
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 F0656
F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
to be individualized and developed accurately so staff knew how to care for the residents. Record review of
the facility's Care Plans, Comprehensive Person-Centered policy dated December 2016 reflected - Policy:
A comprehensive, person-centered care plan that includes measurable objectives and timetables to meet
the resident's physical, psychosocial and functional needs is developed and implemented for each resident.13. Assessments of residents are ongoing and care plans are revised as information about the residents and the residents' condition changes.
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Falcon Lake Nursing Home, LLC in Zapata, 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 Zapata, 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 Falcon Lake Nursing Home, LLC or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.