Nursing homes › Texas › Focused Care at Pasadena
3434 Watters Rd, Pasadena, TX 77504 · 7139419155 · 125 certified beds
Per CMS filings, this facility is affiliated with Focused Post Acute Care Partners, a group operating 25 facilities in 1 states. Group record: average rating 1.9/5, 8 abuse citation icons, 2 facilities on the Special Focus list, $1,840,773 in federal fines. This facility rates below its group average (1.9/5).
Total nurse staffing: 2.95 (Texas median: 3.27). RN hours: 0.40. Weekend total: 2.53. Nursing staff turnover: 77%.
All-time on record: 32 deficiency citations, including 6 at immediate-jeopardy level. Below: citations from 2023 onward (severity letters explained in methodology).
| Survey date | Deficiency | Sev. | Type | Status |
|---|---|---|---|---|
| 2026-03-18 | Ensure that residents are free from significant medication errors. | E | complaint | corrected 2026-04-10 |
| 2026-03-18 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | complaint | corrected 2026-04-24 |
| 2026-02-13 | Ensure each resident receives an accurate assessment. | E | Health | corrected 2026-03-27 |
| 2026-02-13 | PASARR screening for Mental disorders or Intellectual Disabilities | E | Health | corrected 2026-03-27 |
| 2026-02-13 | Ensure medication error rates are not 5 percent or greater. | E | Health | corrected 2026-03-27 |
| 2026-02-13 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Health | corrected 2026-03-27 |
| 2026-02-13 | Provide and implement an infection prevention and control program. | D | Health | corrected 2026-04-13 |
| 2024-11-20 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Health | corrected 2024-11-21 |
| 2024-10-16 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | E | complaint | corrected 2024-11-12 |
| 2024-10-16 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | E | complaint | corrected 2024-11-12 |
| 2024-10-16 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | complaint | corrected 2024-11-12 |
| 2024-10-16 | Dispose of garbage and refuse properly. | E | complaint | corrected 2024-11-12 |
| 2024-08-28 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | J | complaint | corrected 2024-11-12 |
| 2024-08-28 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | complaint | corrected 2024-08-29 |
| 2024-08-08 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | complaint | corrected 2024-08-10 |
| 2024-08-08 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | complaint | corrected 2024-08-10 |
| 2024-08-08 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | complaint | corrected 2024-08-10 |
| 2024-02-20 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | complaint | corrected 2024-03-15 |
| 2024-02-20 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | K | complaint | corrected 2024-03-15 |
| 2023-12-01 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | complaint | corrected 2023-12-06 |
| 2023-12-01 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | complaint | corrected 2023-12-06 |
| 2023-11-12 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | J | complaint | corrected 2023-11-30 |
| 2023-11-12 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | complaint | corrected 2023-11-30 |
| 2023-10-13 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | E | Health | corrected 2023-10-27 |
| 2023-10-13 | Ensure each resident receives an accurate assessment. | E | Health | corrected 2023-10-27 |
| 2023-10-13 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | E | Health | corrected 2023-10-27 |
| 2023-10-13 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | E | Health | corrected 2023-10-27 |
| 2023-10-13 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Health | corrected 2023-10-27 |
| 2023-10-13 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Health | corrected 2023-10-27 |
| 2023-10-13 | Hire a qualified full-time social worker in a facility with more than 120 beds. | E | complaint | corrected 2023-10-27 |
| 2023-10-13 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Health | corrected 2023-10-27 |
| 2023-10-13 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Health | corrected 2023-10-27 |
| Date | Type | Amount |
|---|---|---|
| 2024-08-28 | Fine | $40,699 |
| 2024-08-28 | Payment Denial | 46 days payment denial |
| 2024-02-20 | Fine | $77,458 |
| 2023-11-12 | Fine | $12,855 |
| Name | Role | Type | % | Since |
|---|---|---|---|---|
| ABERNATHY, MARY | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 05/01/2024 |
| HUMPHREY, ERIC | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 05/01/2024 |
| LEGG, STEPHEN | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 01/01/2024 |
| MCKENZIE, MARK | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 04/01/2021 |
| NEWTON, ELIZABETH | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 02/22/2024 |
| TINNERMAN, LINDA | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 01/01/2024 |
| TURNER, LESLIE | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 03/15/2017 |
| COOPER, KIMBERLY | Corporate Officer | Individual | NOT APPLICABLE | since 01/29/2024 |
| NEWTON, ELIZABETH | Corporate Officer | Individual | NOT APPLICABLE | since 02/22/2024 |
| CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO. 1 | Operational/Managerial Control | Organization | NOT APPLICABLE | since 04/01/2022 |
| FOCUSED POST ACUTE CARE PARTNERS LLC | Operational/Managerial Control | Organization | NOT APPLICABLE | since 04/01/2022 |
| FOCUSED POST ACUTE CARE PARTNERS MANAGEMENT, LLC | Operational/Managerial Control | Organization | NOT APPLICABLE | since 04/01/2022 |
| FPACP PASADENA LLC | Operational/Managerial Control | Organization | NOT APPLICABLE | since 04/01/2022 |
| CONLEY, SHAWN | Operational/Managerial Control | Individual | NOT APPLICABLE | since 04/01/2021 |
| MCKENZIE, MARK | Operational/Managerial Control | Individual | NOT APPLICABLE | since 04/01/2021 |
| SPARROW, BRITNEY | Operational/Managerial Control | Individual | NOT APPLICABLE | since 12/01/2024 |
| STRUBBE, LORETTA | Operational/Managerial Control | Individual | NOT APPLICABLE | since 04/01/2021 |
| VILLARREAL, JOHN | Operational/Managerial Control | Individual | NOT APPLICABLE | since 04/22/2025 |
| WILSON, KATRINA | Operational/Managerial Control | Individual | NOT APPLICABLE | since 02/10/2025 |
Source: CMS Provider Data Catalog (July 2026 release) — provider file, deficiency file, ownership file, penalty file. CCN 676050. Corrections: data@carerecords.org.