D

Pasadena Post Acute

4006 Vista Rd, Pasadena, TX 77504
Score: 47 / 100

Pasadena Post Acute faces challenges in its CMS ratings, earning a D grade with a score of 47/100. The facility ranks in the 52th percentile among Texas nursing homes, suggesting significant room for improvement.

Staffing at Pasadena Post Acute is near the national average, with 3.46 total nursing hours per resident per day (national average: 3.8 hours).

Recent CMS inspections identified 11 deficiencies at Pasadena Post Acute, including 3 classified as serious — among the most concerning citation levels. The most notable finding involved: coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed..

Score Breakdown

Overall CMS Rating 24 / 40 pts
3 ★ CMS rating
Health Inspections 15 / 25 pts
3 ★ inspection rating
Staffing 8 / 20 pts
2 ★ staffing rating
Quality Measures 12 / 15 pts
4 ★ quality measures

🏥 Staffing Details

Staff Type Hours/Resident/Day National Avg Comparison
Total Nursing 3.46 3.8 Average
Registered Nurses (RN) 0.40 0.7 Below Average
Licensed Practical Nurses (LPN) 1.02 0.7 Above Average
Certified Nursing Assistants (CNA) 2.04 2.4 Below Average
Weekend Total Nursing 3.07 3.8 Below Average
Weekend RN Hours 0.37 0.7 Below Average

🔍 Inspection & Deficiency History

11
Total Deficiencies
Apr 2, 2025
Most Recent Inspection
🟠 8 Moderate 🔴 3 Serious
View recent deficiencies (5 shown)
  • Tag 0644 Severity D
    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
    Apr 2, 2025 · Resident Assessment and Care Planning Deficiencies
  • Tag 0580 Severity K
    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
    Feb 1, 2024 · Resident Rights Deficiencies
  • Tag 0656 Severity K
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    Feb 1, 2024 · Resident Assessment and Care Planning Deficiencies
  • Tag 0689 Severity K
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    Feb 1, 2024 · Quality of Life and Care Deficiencies
  • Tag 0584 Severity E
    Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for d
    Feb 1, 2024 · Resident Rights Deficiencies

📊 Resident Outcome Measures

Based on CMS quality measure data. Lower percentages are better for most metrics.

Measure This Facility Nat'l Avg
Residents with pressure ulcers 4.9% 4.5% Average
Falls with major injury 0.6% 3.0% Better
On antipsychotic medication 21.0% 14.5% Worse
Urinary tract infections 0.3% 2.5% Better
ADL decline (daily activities) 8.8% 14.0% Better
Excessive weight loss 4.2% 7.5% Better
New/worsened incontinence 5.2% 45.0% Better

⚠️ Penalties & Fines

2 penalties recorded by CMS

Total fines: $27,254

How This Grade Was Calculated

This facility's grade of D is based on a score of 47 out of 100, calculated from official CMS Nursing Home Compare data:

  • Overall CMS Rating: 3★ → 24 pts (max 40)
  • Health Inspection Rating: 3★ → 15 pts (max 25)
  • Staffing Rating: 2★ → 8 pts (max 20)
  • Quality Measures Rating: 4★ → 12 pts (max 15)
  • Penalty deductions: -10 pts
  • Fine deductions: -2 pts

Grades: A=85+, B=70–84, C=55–69, D=40–54, F=below 40

Facility Details

Ownership
For profit - Limited Liability company
Certified Beds
116
Provider Type
Medicare and Medicaid
Resident Council
Yes
Family Council
No
Sprinkler System
Yes
Last Inspection
Apr 2, 2025
Deficiencies (Cycle 1)
1