The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

CENTRAL TEXAS MEDICAL CENTER 1301 WONDER WORLD DRIVE SAN MARCOS, TX 78666 April 29, 2015
VIOLATION: ORGANIZATION OF NURSING SERVICES Tag No: A0386
Based on review of documentation and interview, it was determined that facility nursing staff failed ensure the safety of its patients at time of discharge.

Findings were:

Patient # 1 was discharged from Central Texas Medical Center on 1/20/15. At 11:22 am that day, he recieved 3 units of fast acting insulin and 5 units of "basil" (routine) insulin for a blood glucose reading of 226. There is no documented record of Patient # 1's intake that day--including breakfast and lunch. Patient # 1 was discharged to a skilled nursing facility at 4pm that afternoon and was found unresponsive after arrival. His blood glucose was measured at 21.

In an interview with the RN Risk Manager on 4/29/15, the above senerio was confirmed. She acknowledged that there was no documented evidence of Patient #1's food or liquid intake that day.
VIOLATION: IMPLEMENTATION OF A DISCHARGE PLAN Tag No: A0820
Based on a review of documentation and interview, it was determined that the facility failed to notify family members of Patient # 1 of his pending discharge.

Findings were:

On 1/20/15, Patient # 1 was discharged from Central Texas Medical Center. Family members requested notification of discharge from patient's primary nurse. The patient was discharged without family notification.

In an interview with the primary nurse of Patient # 1 on 4/29/15, the failed communication was confirmed.