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Autumn Winds Living & Rehabilitation

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About Autumn Winds Living & Rehabilitation

General Information

Legal Business NameSchertz Nursing Operations, LLC
Ownership TypeFor Profit - Partnership
Changed Ownership In The Last 12 MonthsNo
First Accepted MedicareDecember 11, 2011 (6 years)
Capacity96
Residents92
Percent Occupied96%
Program ParticipationMedicare And Medicaid
Resident And Family CouncilsBoth
In HospitalNo
Continuing Care Retirement CommunityNo
Special Focus FacilityNo
Auto Sprinkler System In Required AreasYes

Ratings for Autumn Winds Living & Rehabilitation

Autumn Winds Living & Rehabilitation
was reviewed by Medicare to have a rating of 2 out of 5. About Medicare Ratings
Overall Rating
Health Inspections Rating
Quality Measures Rating
Staff Rating
RN Staff Rating

Overall Ratings of Texas Nursing Homes

Fines, Complaints, and Inspection Problems in the Past 3 Years

Compare The Number of Problems

Types of Problems at Nursing Homes

Some issues within a nursing home are much more severe than others. Medicare evaluates each problem based on 2 scales: the number of residents affected by a problem and the severity of the potential or actual harm to residents based on the problem. We have color coded the matrix below to make it easier to pick out the more severe problems. In general, orange and red issues related to the treatment of a resident are considered substandard quality of care.

  Residents Affected
Severity of the Deficiency Few Some Many
Immediate jeopardy to resident health or safety J K L
Actual harm that is not immediate jeopardy G H I
No actual harm with potential for more than minimal harm that is not immediate jeopardy D E F
No actual harm with potential for minimal harm A B C

October 17, 2016 - 8 months ago

 Residents AffectedSeveritySource/TypeDescription
KSomeImmediate JeopardyComplaintMake sure that the facility is administered in an acceptable way that maintains the well-being of each resident .
KSomeImmediate JeopardyComplaintEnsure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
KSomeImmediate JeopardyComplaintDevelop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property.
KSomeImmediate JeopardyComplaintProtect each resident from mistreatment, neglect and misappropriation of personal property.
FManyPotential for HarmComplaintMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
ESomePotential for HarmComplaintKeep accurate, complete and organized clinical records on each resident that meet professional standards.
ESomePotential for HarmComplaintMake sure that nurse aides show they have the skills and techniques to be able to care for residents' needs.
ESomePotential for HarmComplaintHave a program that investigates, controls and keeps infection from spreading.
ESomePotential for HarmComplaintEnsure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions.
ESomePotential for HarmComplaintKeep residents' personal and medical records private and confidential.
ESomePotential for HarmComplaintKeep each resident free from drugs that restrain them, unless needed for medical treatment.
ESomePotential for HarmComplaintProvide necessary care and services to maintain or improve the highest well being of each resident .
ESomePotential for HarmComplaintLet residents refuse treatment, refuse to take part in an experiment, or formulate advance directives.
ESomePotential for HarmComplaintEnsure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being.

August 30, 2016 - 10 months ago

 Residents AffectedSeveritySource/TypeDescription
KSomeImmediate JeopardyComplaintGive or get quality laboratory services/tests in a timely manner to meet the needs of residents.
KSomeImmediate JeopardyComplaintEnsure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being.
KSomeImmediate JeopardyComplaintDevelop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property.
KSomeImmediate JeopardyComplaintProtect each resident from mistreatment, neglect and misappropriation of personal property.
ESomePotential for HarmComplaint1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.
ESomePotential for HarmComplaintEnsure services provided by the nursing facility meet professional standards of quality.
ESomePotential for HarmComplaintProtect each resident from all abuse, physical punishment, and involuntary separation from others.

February 18, 2016 - 16 months ago

 Residents AffectedSeveritySource/TypeDescription
FManyPotential for HarmHealth InspectionStore, cook, and serve food in a safe and clean way.
FManyPotential for HarmHealth InspectionTrain all employees on what to do in an emergency, and carry out unannounced staff drills.
ESomePotential for HarmHealth InspectionMake sure there is a pest control program to prevent/deal with mice, insects, or other pests.
ESomePotential for HarmHealth InspectionDevelop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
CManyPotential for Minimal HarmHealth InspectionKeep accurate, complete and organized clinical records on each resident that meet professional standards.
BSomePotential for Minimal HarmHealth InspectionMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
BSomePotential for Minimal HarmHealth InspectionProvide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.

February 6, 2015 - 2 years ago

 Residents AffectedSeveritySource/TypeDescription
ESomePotential for HarmHealth InspectionKeep accurate, complete and organized clinical records on each resident that meet professional standards.
CManyPotential for Minimal HarmHealth InspectionGive residents a notice of rights, rules, services and charges.
BSomePotential for Minimal HarmHealth InspectionProvide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.

Staffing Levels Per Resident per Day

Medicare determines the expected staffing time per resident per day depending on level of care the residents of Autumn Winds Living & Rehabilitation require. It is important to compare the reported time to expected time for a single facility instead of comparing the amount of time per resident of two facilities. Learn why.

2hr 10min
2hr 30min
ReportedExpected
CNA
30min
40min
ReportedExpected
LPN
20min
1hr 5min
ReportedExpected
RN
2hr 55min
4hr 15min
ReportedExpected
Total Nursing

This facility also provides approximately 10min per resident per WEEK of physical therapist time.

Quality Measures for Long Stay Residents

100.0%
100.0%
100.0%
100.0%
91.6%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
95.2%
94.4%
80.5%
89.8%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine
-
39.1%
57.1%
79.2%
48.3%
Q4 2015Q1 2016Q2 2016Q3 2016TX
* The data for this facility for some quarters is unavailable.
Percentage of low risk long-stay residents who lose control of their bowels or bladder
24.3%
32.9%
32.9%
37.2%
27.1%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents who received an antianxiety or hypnotic medication
15.4%
23.9%
10.0%
26.2%
20.7%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents whose ability to move independently worsened
8.4%
10.1%
10.6%
10.0%
19.1%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents who received an antipsychotic medication
16.2%
10.8%
10.1%
32.0%
19.1%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents whose need for help with daily activities has increased
10.8%
9.1%
4.5%
0.0%
7.0%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents who self-report moderate to severe pain
2.3%
6.0%
4.5%
8.0%
6.0%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents who lose too much weight
1.7%
1.9%
3.7%
1.9%
6.3%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of high risk long-stay residents with pressure ulcers
1.2%
0.0%
0.0%
0.0%
4.9%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents who have depressive symptoms
5.7%
1.2%
2.3%
0.0%
4.4%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents with a urinary tract infection
9.1%
7.2%
6.7%
5.7%
3.6%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents experiencing one or more falls with major injury
5.9%
5.6%
2.0%
1.9%
2.7%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents with a catheter inserted and left in their bladder
5.7%
2.4%
1.1%
0.0%
0.4%
Q4 2015Q1 2016Q2 2016Q3 2016TX
Percentage of long-stay residents who were physically restrained

Quality Measures for Short Stay Residents

-
86.4%
-
-
74.0%
Q4 2015Q1 2016Q2 2016Q3 2016TX
* The data for this facility for some quarters is unavailable.
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine
-
86.4%
86.4%
86.4%
71.0%
Q4 2015Q1 2016Q2 2016Q3 2016TX
* The data for this facility for some quarters is unavailable.
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine
-
-
-
-
55.7%
Q4 2015Q1 2016Q2 2016Q3 2016TX
* The data for this facility for some quarters is unavailable.
Percentage of short-stay residents who made improvements in function
-
-
-
-
14.2%
Q4 2015Q1 2016Q2 2016Q3 2016TX
* The data for this facility for some quarters is unavailable.
Percentage of short-stay residents who self-report moderate to severe pain
-
-
-
-
3.1%
Q4 2015Q1 2016Q2 2016Q3 2016TX
* The data for this facility for some quarters is unavailable.
Percentage of short-stay residents who newly received an antipsychotic medication
-
0.0%
-
-
1.0%
Q4 2015Q1 2016Q2 2016Q3 2016TX
* The data for this facility for some quarters is unavailable.
Percentage of short-stay residents with pressure ulcers that are new or worsened