State Formally Investigating Nursing Home Leadership

The Texas Health and Human Services Commission (HHSC) confirmed last week that they are conducting an investigation into the administration at Paradigm at the Oak nursing home in Schulenburg.

Earlier this year the Record began reporting on the unusually large number of convicted sex offenders who live at the Paradigm facility in Schulenburg after learning about a sexual assault that took place there in November 2024. We obtained several HHSC inspection reports through an open records request. Those reports detailed an alleged coverup by the facility administrator at the time, Pamela Noell. Earlier this month, a Fayette County Grand Jury indicted Noell on three felony charges related to the coverup.

Following Noell’s indictment, we asked HHSC whether it shares disciplinary information about nursing home administrators with potential future employers. According to the inspection reports we were able to obtain, Paradigm terminated Noell over the coverup. But she was able to get another job just a few months later at another nursing home just up the road in La Grange - Care Inn.

The Record contacted the owners of Care Inn back on April 24 after learning that Noell was the new administrator there. We told them about the allegations in Schulenburg. The owners were quite shocked and said nothing negative appeared on any of the multiple background checks they conducted. The following day they informed us that Noell was no longer working there.

The Care Inn owners speculated that perhaps the allegations in Schulenburg had not yet appeared on her record at the time they conducted the background checks.

Thomas Vazquez, Assistant Press Officer with HHSC. told us the following last week: “HHSC shares information regarding past disciplinary actions and imposed sanctions with potential employers. HHSC enters final disciplinary actions and imposed sanctions into the National Practitioners Data Bank (NPDB), which providers may access before hiring.”

Vasquez said HHSC could not comment further on this case due to the ongoing investigation.

“HHSC cannot release information on ongoing Nursing Facility Administrator (NFA) investigations,” Vasquez said. “HHSC may only release investigation findings once the investigation is closed and all due process is offered and exhausted. In the specific case you’re referencing, the NFA investigation is ongoing. However, information regarding Ms. Noell’s past disciplinary actions is currently available for nursing facilities to review through existing data in the NPDB.”

The public cannot access NPDB. It is only accessible by state officials and medical providers.

We also asked HHSC a number of questions related to the sex offenders living at Paradigm in Schulenburg. Do nursing homes get additional compensation for housing sex offenders? HHSC did not respond to that question.

We asked whether there are any special rules for housing sex offenders in nursing homes.

“Our top priority is protecting the health, safety and well-being of people served by the facilities and providers we regulate,” Vasquez stated. “Nursing facility rules require each facility to determine the person-centered care necessary for the safety and well-being of every resident. Facilities are responsible for meeting the needs of all residents; maintaining adequate staffing, staff training, and qualifications; equipment; and any other protections to ensure that safety, rights, and quality of care are maintained for all residents. As part of this responsibility, a facility must determine what level of supervision is necessary, including whether a secure unit is needed because of a resident’s clinical need.”

Finally, we asked at what point, if any, does HHSC “shut down” a nursing home for repeated instances of abuse or neglect.

“HHSC may revoke a nursing facility license under several circumstances outlined in Texas Health and Safety Code Section 242.061, Vasquez said. “These situations include where HHSC found the facility had engaged in abuse or neglect in a repeated or substantial manner, or where HHSC found three violations within a 24-month period that constitute an immediate threat to the health and safety related to the abuse or neglect of a resident. Each violation is connected to a separate survey, inspection or investigation visit that occurred on separate entrance and exit dates. Additionally, this action is taken after providing notice and an opportunity for a hearing to the license holder.”

The Record recently learned about another sexual assault that took place in 2022 at Paradigm in Schulenburg.

Since we began reporting on this story at the beginning of the year, numerous family members, medical professionals, and former and current employees have reached out to us with alarming stories about Paradigm Healthcare. The Illinois-based company owns more than a dozen nursing homes in Texas along with a few in Ohio. Almost all of the people we’ve spoken with have refused to be quoted or identified over fear of retaliation.

But one family member has agreed to share her story publicly: Sunday Kennedy, the daughter of the late Donald Garner, who used to live at a Paradigm at the Creek, a nursing home in Wharton. Kennedy alleges that her father witnessed another man choke to death inside the nursing home. No nursing staff were in the hall at the time, she alleges. Kennedy said a janitor tried reporting it to the nursing station, but the nurse on duty only got up to respond after multiple pleadings. By the time nurses got to the man, it was too late.

Prior to this incident, Kennedy said her father had mobility issues but his mind was in good health. She said he quickly deteriorated after witnessing a fellow resident die in such a manner. She alleges the medical treatment her father received resulted in him being unable to communicate. After this, Kennedy got her father transferred to another nursing home. He passed away last September at the age of 80.

The Record has since filed another open records request with HHSC for documents pertaining to the 2022 sexual assault at Paradigm in Schulenburg and the choking death that occurred at the Paradigm facility in Wharton.