F 0761
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted
professional principles; and all drugs and biologicals must be stored in locked compartments, separately
locked, compartments for controlled drugs.
Based on observations, interviews, and record reviews the facility failed to ensure all drugs and biologicals
were stored in locked compartments under proper temperature controls and permitted only authorized
personnel to have access, for 1 of 6 medication carts (300-hall medication cart), reviewed for security. LVN
B left the 300-hall medication cart unattended and unlocked. This failure could place residents at risk for
having their medications uncontrolled. The findings included: During an observation and interview on
9/17/2025 11:28 AM revealed the 300-hall nurse cart was stationed at the end of the 300-hall and was
unattended and unlocked. LVN A locked the cart and stated the cart was assigned to LVN B. During an
interview on 9/17/2025 at 11:32 AM LVN B stated she had left the 300-hall medication cart unattended and
unlocked while she stored a bottle of enteral feeding formula in the facility's resident pantry. LVN B stated
she could not visualize the 300-hall medication cart from within the resident pantry. During an interview on
9/17/2025 at 11:45 AM the Administrator and the DON stated the facility's expectations were for all
medication carts to be secured and locked when not directly attended and the potential risk for residents
was the loss of control of their medications. A record review of the facility's policy dated 2007, titled Security
of Medication Cart revealed, Policy Interpretation and Implementation, The nurse must secure the
medication cart during the medication pass to prevent unauthorized entry. Medication carts must be
securely locked at all times when out of the nurse's view.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other
safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the
date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER
REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Facility ID:
If continuation sheet
Page 1 of 2
Event ID:
676133
Printed: 05/15/2026
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
676133
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/04/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Maverick Nursing and Rehabilitation Center
3106 Bob Rogers Dr
Eagle Pass, TX 78852
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 0812
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve
food in accordance with professional standards.
Based on observations, interviews, and record reviews the facility failed to store, prepare, distribute and
serve food in accordance with professional standards for food service safety, for 1 of 1 residents pantry
refrigerators reviewed for food safety. The facility stored resident's foods in the Resident's pantry refrigerator
without labels and dates to indicate if the foods were safe to serve. These failures could place residents at
risk for food borne illnesses.The findings included:During an observation and interview on 9/17/2025 at
11:34 AM revealed the facility's Resident's Pantry room had a refrigerator. The refrigerator presented with
signage which read, Resident Food Storage . food should have a name, room number, and a date when
placed into storage . refrigerator will be checked daily and disposed of not labeled food . LVN B stated the
refrigerator had unlabeled containers of food which included berries, various desserts stored in small foam
containers, 1 - 1/2 sandwich, and 1 cookie, which all did not have and labeling to reveal if the foods were
safe to serve. During an interview on 9/17/2025 at 11:45 AM the Administrator and the DON stated the
facility's expectation was for the resident's pantry refrigerator to be inspected daily by the nursing staff to
ensure residents' food had labels and dates to ensure foods were safe to eat. The Administrator stated
foods without labels to include dates could be unsafe to serve to residents. The Administrator and the DON
stated the potential negative outcome to residents could be food borne illnesses. A record review of the
facility's policy dated 2022 titled Food Receiving and Storage revealed, Refrigerated/Frozen Storage, .
Foods and Snacks Kept on Nursing Units, All food items to be kept at or below 41 F are placed in the
refrigerator located at the nurses' station and labeled with a use by date.2. All foods belonging to residents
are labeled with the resident's name, the item and the use by date.3. Refrigerators must have working
thermometers and are monitored for temperature according to state-specific guidelines.4. Beverages are
dated when opened and discarded after twenty-four (24) hours.5. Other opened containers are dated and
sealed or covered during storage.6. Partially eaten food is not kept in the refrigerator.
Event ID:
Facility ID:
676133
If continuation sheet
Page 2 of 2