801 South Loop 250 West, Midland, TX 79703 · Midland County · (432) 689-2100
144 certified beds, about 132 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 2017
CMS Care Compare ratings, data as of September 1, 2026 · CCN 676430 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on April 10, 2026, inspectors cited 5 health deficiencies (the Texas average is 9.4, the national average 9.2).
Of 25 health citations since December 2023, 1 was rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 1 fine totaling $13,397 in the last three years; the largest was $13,397, and the latest is dated December 21, 2023.
Nurses and nurse aides worked 3.39 hours per resident per day, against 3.39 across Texas and 3.86 nationally. Registered nurses accounted for 0.38 of those hours.
49.6% of nursing staff left within the year CMS measured (Texas average 55.3%).
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 25 health citations on file.
Inspectors wroteBased on observation, interview, and record review the facility failed to store all drugs and biologicals in locked compartments for 1 of 4 nurse medication carts reviewed for medication storage and for 2 of 4 nurse medication carts (hall 1 cart and hall 4 cart) observed for medications stored and properly labeled. LVN A failed to ensure her nurse medication cart was secured when it was left unattended on [DATE]. The hall one nurse medication cart had one insulin pen that belonged to Resident #100 that had been opened but not dated when it was placed into use. This these failures could place clients at risk for drug diversion or accidental ingestion and could place residents at risk of receiving medications that were expired and not produce the desired effect.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that each resident received adequate supervision and assistance devices to prevent accidents for 1 of 4 residents (Resident #64) reviewed for transfers. CNA H and CNA I performed an incorrect two-person transfer on Resident #64 on 4/6/26. This failure could place residents who required assistance during transfers at risk of pain and injury.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure one Resident (Resident #16) of two reviewed for Percutaneous Endoscopic Gastrostomy (PEG-a tube inserted through the abdomen into the stomach for the purpose of administering liquid nutrition and medications) received the appropriate treatment and services to prevent complications and aspiration. LVN E failed to check PEG tube placement by auscultating (Listening with stethoscope) and checking for residual prior to administering Resident #16's medication as ordered by the physician. This failure placed residents who had a PEG tube at risk for complications, aspiration, and pneumonia.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents who needed respiratory care were provided such care, consistent with professional standards of practice for 1 of 7 residents (Resident #51) reviewed for respiratory care in that: Residents #51's oxygen nasal cannula tube was not bagged when not in use. This failure could place the residents at risk of infection.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide pharmaceutical services for 1 (Resident #8) of 1 resident reviewed for expired medications. The hall four nurse medication cart had one insulin pen that belonged to Resident #8 that had expired. This these failures could place clients at risk for drug diversion or accidental ingestion and could place residents at risk of receiving medications that were expired and not produce the desired effect.
Inspectors wroteBased on interview and record review, the facility failed to ensure the right to be free from abuse was provided for 1 (Resident #1) of 15 residents reviewed for abuse, in that: The facility failed to protect Resident #1 from abuse on 4.24.25 when Resident #1 was handled roughly by CNA A. These failures could place residents at risk of abuse, injury, intimidation, fear, agitation, and psychological harm.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the resident's right to be free from misappropriation of resident property for 1 of 16 residents (Resident #3), reviewed for drug diversion. The facility failed to prevent the misappropriation of an unknown number of Resident #3's Lorazepam Oral Concentrate 1MG/0.5ML (Controlled Substance requiring double lock and count every shift) on 08/03/2024 from the medication cart that was never found. This failure could place residents at risk of misappropriation, and could result in increased pain, and poor quality of life.
Inspectors wroteBased on interviews and record reviews the facility failed to have evidence that all allegations of abuse, neglect, exploitation, or mistreatment, were thoroughly investigated, for 1 (Resident #4) of 8 residents reviewed for investigating alleged verbal abuse. On Tuesday 4.15.25 Resident #4 reported that she was hit by an employee at night. The Facility did not investigate the allegation of physical abuse. The failure could place residents at risk for abuse.
Inspectors wroteBased on observations, interviews, and record reviews the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in 1 of 1 kitchen reviewed for kitchen sanitation and food storage. -The facility failed to keep a plastic bottle of barbeque sauce free of dried drippings around sides of the bottle. -The facility failed to keep spice bottles completely sealed. These failures could place residents at risk of food borne illnesses.
Inspectors wroteBased on observations, interviews and record review the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for the residents during lunch service observation. -The Director of Rehabilitation did not don gloves or properly disinfect resident's bodily fluids observed on the floor of the main dining room. This failure could place the residents at risk for communicable diseases or viruses.
Inspectors wroteBased on observations, interview, and record review the facility failed to ensure that the resident has a right to a dignified existence and treat each resident with respect and dignity for 1 (Resident #45) of 8 residents reviewed. Resident #45's nephrostomy bag (a sterile disposable bag used to collect urine that is drained from the kidney through a tube) was not placed in a privacy bag. This failure could place residents at risk of diminished quality of life and compromise residents' dignity.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure residents were provided services with reasonable accommodation of needs and preferences for 2 (Resident #20, Resident #38) of 8 residents. Resident call lights were not kept within reach for Resident #20 and Resident #38 This failure places residents at risk of having needs unmet when they are unable to contact staff.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure a resident who is unable to carry out activities of daily living receives the necessary services to maintain personal hygiene for 1 of 6 residents (Resident #18) reviewed for ADL s. The facility failure to provide nail trimming for Resident #18. This failure placed the resident at risk for injury, infection and decreased quality of life.
Inspectors wroteBased on observations, interview, and record review the facility failed to ensure that a resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections for 1 (Resident #45) of 8 residents reviewed. Resident #45's urinary catheter nephrostomy bag bag was not placed below the bladder. This deficient practice could place the residents at risk of urinary tract infections.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident who is fed by enteral means receives the appropriate treatment to prevent complications for 1 of 1 residents (Resident #83) reviewed who received their feeding through a percutaneous endoscopic gastrostomy (PEG) feeding tube. The facility failed to ensure CNA C and CNA E did not lower the head of the bed flat while the PEG (A PEG tube is a thin, flexible tube inserted through the abdominal wall and into the stomach. It is used to provide nutrition and medications to patients who cannot eat or drink normally) pump was still infusing the formula, during personal care performed for Resident #83. This failure could affect residents with PEG tubes and could result in unwanted outcomes such as aspiration pneumonia.
Inspectors wroteBased on observations, interviews, and record reviews the facility failed to ensure that a resident who neededs respiratory care was provided such care, consistent with professional standards of practice for 1 (Resident #29) of 17 residents observed for oxygen management. - The facility failed to ensure Resident #29's oxygen tank was not empty behind her wheelchair while she was in the dining area. These failures could place residents on oxygen therapy at risk of receiving incorrect or inadequate oxygen support and decline in health.
Inspectors wroteBased on observations, interviews, and record review the facility failed to provide pharmaceutical services, including procedures that ensure the accurate administering of all drugs to meet the needs of the residents, for 1 (Hall 5 nurse cart) of 4 medication carts inspected for medication reconciliation. RN A did not document the administration of a controlled medication (Tramadol) on the individual controlled medication records after she had administered the medication on 02/04/2025. This failure could place residents at risk of under dose, overdose, and drug diversion.
Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure drugs and biologicals used in the facility were labeled in accordance with currently accepted professional principles, included the appropriate accessory and cautionary instructions, and the expiration date when applicable for 1 of 4 medication carts (Hall 500 Nurse Med Cart) reviewed for medication storage. The facility failed to ensure the Hall 500 Nurse Medication Cart contained an insulin pen with an open date. This failure could place residents at risk of not receiving the therapeutic benefit of medications or adverse reactions to medications.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide food that was palatable and served at an appetizing temperature for 3 of 3 diet test trays reviewed for food temperatures. -The facility failed to maintain hot food on the served test trays. -This failure could place residents who ate food from the kitchen at risk of weight loss, altered nutritional status, and diminished quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to treat each resident with respect and dignity and provide care in a manner that promoted maintenance or enhancement of his or her quality of life for 3 of 6 residents (Residents #1, #2, and #3) observed for resident rights. The facility failed to ensure staff assisting Residents #1, #2, and #3 did not stand while feeding them. This failure could place residents at risk for decreased meal satisfaction.
Inspectors wroteBased on interviews and record reviews, the facility failed to ensure residents received adequate supervision to prevent elopements for 1 (Resident #1) of 7 residents reviewed for accidents and supervision. The facility failed to provide adequate supervision to Resident #1. As a result, Resident #1 eloped from the facility at night along a highway and was located approximately 2 hours later in 44° Fahrenheit weather after he had fallen into a wet drainage ditch. Resident #1 was admitted to the hospital with diagnoses including hypothermia. An Immediate Jeopardy was identified on 01/04/24 at 3:02 PM. While the IJ was removed on 01/05/24 at 6:28 PM, the facility remained out of compliance at a severity level of actual harm that was not Immediate Jeopardy and a scope of isolated due to the facility's need to evaluate the effectiveness of the corrective systems. [...]
Inspectors wroteBased on observation, interview and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen: The facility failed to label and date food items. The facility failed to maintain cleanliness in the kitchen. The kitchen staff did not practice proper hand hygiene. These failures could place residents who received meals prepared in the kitchen at risk for ingesting food borne pathogens resulting in gastrointestinal discomfort or illness and cross-contamination.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide pharmaceutical services including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biological, to meet the needs of 1 of 10 residents (Resident #271), 3 of 8 Medication Carts (400 Hall Nurse Medication Cart, 500 Hall Nurse Medication Cart, and 500 Hall Medication Aide Cart) reviewed for pharmacy services. - The facility failed to ensure the 400 Hall Nurse Medication Cart did not include two loose pills. - The facility failed to ensure the 500 Hall Nurse Medication Cart did not contain expired Tramadol medication. - The facility failed to ensure the 500 Hall Medication Aide Cart did not include three loose pills and an expired ophthalmic solution. [...]
Inspectors wroteBased on observation, interview, and record review the facility failed to store all drugs and biologicals in locked compartments under proper temperature controls and permit only authorized personnel to have access to medications in medication cart 1 of 8 reviewed for label and storage of drugs and biologicals. The facility failed to ensure medication cart #1 was locked when unattended on [DATE]. This failure could place residents at risk of having access to unauthorized medications and/or lead to possible harm or drug diversions.
Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment to help prevent the development and transmission of communicable diseases and infections for 1 (Resident #72) of 4 residents reviewed for infection control. The facility failed to ensure RN A washed or sanitized her hands prior to putting gloves on and administering medication to Resident #72. This failure could place resident's risk for cross contamination and the spread of infection.
2 fire safety citations on file: 2 on April 10, 2026.
| Date | Penalty | Amount or length |
|---|---|---|
| December 21, 2023 | Fine | $13,397 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Texas | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.39 | 3.39 | 3.86 |
| Registered nurses | 0.38 | 0.43 | 0.69 |
| All nursing staff on weekends | 3.00 | 2.98 | 3.42 |
| Nurse aides | 2.12 | ||
| Licensed practical nurses | 0.89 | ||
| Nursing staff turnover (share who left in a year) | 49.6% | 55.3% | 45.8% |
| Registered nurse turnover | 35.7% | 54.6% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.65 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.55 on weekdays and 3.00 on weekends, 15% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.65 in April to June 2025 to 3.39 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.39 | 0.38 | 3.55 | 3.00 | 0.0% | 0 of 90 | 132 |
| Oct to Dec 2025 | 3.29 | 0.31 | 3.43 | 2.93 | 0.0% | 0 of 92 | 135 |
| Jul to Sep 2025 | 3.41 | 0.38 | 3.55 | 3.06 | 0.0% | 0 of 92 | 129 |
| Apr to Jun 2025 | 3.65 | 0.43 | 3.81 | 3.24 | 0.0% | 0 of 91 | 123 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Texas, Jan to Mar 2026 | 3.33 | 0.40 | 3.50 | 2.93 | 2.2% | 0.7% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Texas, all employers | |||
| CNAs (nursing assistants) | $18.03 | $16.97 to $20.71 | 88,680 |
| LPNs and LVNs | $29.92 | $27.46 to $32.89 | 57,560 |
| Registered nurses | $46.14 | $38.06 to $50.53 | 271,380 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Texas | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 11.2 | 15.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.7 | 0.3 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.9 | 0.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 8.1 | 3.3 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.9 | 1.5 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 16.1 | 14.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.8 | 3.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 2.3 | 9.6 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 24.6 | 25.7 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 10.4 | 12.3 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.6 | 2.2 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.1 | 2.1 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Ashton Medical Lodge's Medicare short-stay residents. On returning residents home or to the community, CMS rates it worse than the national rate (43.5% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
43.5% this home
Worse than the national rate
US median of homes 51.5% · Texas: 116 better, 50 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 156 eligible stays.
9.9% this home
No different from the national rate
US median of homes 10.7% · Texas: 0 better, 9 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 152 eligible stays.
11.3% this home
Worse than the national rate
US median of homes 7.1% · Texas: 4 better, 11 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 152 eligible stays.
89.7% this home
Median of homes: Texas57.3% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 87 residents counted.
1.6% this home
Median of homes: Texas0.0% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 188 residents counted.
1.5% this home
Median of homes: Texas1.3% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 188 residents counted.
100.0% this home
Median of homes: Texas98.5% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 63 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: MIDLAND COUNTY HOSPITAL DISTRICT.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Bowerman, Stephen | Corporate officer | Individual | 03/01/2023 | |
| David W Miller Gs Trust | Operational/managerial control | Organization | 03/01/2023 | |
| Foursquare Texas 16 LLC | Operational/managerial control | Organization | 03/01/2023 | |
| Jec Gs Trust | Operational/managerial control | Organization | 03/01/2023 | |
| John E Miller Gs Trust | Operational/managerial control | Organization | 03/01/2023 | |
| Kingsbury Capital LLC Series F | Operational/managerial control | Organization | 03/01/2023 | |
| Kjc Gs Trust | Operational/managerial control | Organization | 03/01/2023 | |
| Lion Plaza LP | Operational/managerial control | Organization | 03/01/2023 | |
| Mnh-Inv Series LLC Series D | Operational/managerial control | Organization | 03/01/2023 | |
| Richard M Miller Gs Trust | Operational/managerial control | Organization | 03/01/2023 | |
| Hampton, Broderick | Operational/managerial control | Individual | 03/01/2023 | |
| Lewis, Shane | Operational/managerial control | Individual | 03/01/2023 | |
| Campbell, John | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/06/2026 | |
| Campbell, Kenneth | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/06/2026 | |
| Miller, David | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/06/2026 | |
| Miller, John | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/06/2026 | |
| Miller, Richard | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/06/2026 | |
| Dwm 5x5 Trust | Adp of the SNF | Organization | 03/01/2023 | |
| Fairbrook Partners, LP | Adp of the SNF | Organization | 03/01/2023 | |
| Foursquare Texas 16 LLC | Adp of the SNF | Organization | 04/23/2025 | |
| Jem 5x5 Trust | Adp of the SNF | Organization | 03/01/2023 | |
| Midland Nh Realty Ltd | Adp of the SNF | Organization | 03/01/2023 | |
| Montague Nh, LP | Adp of the SNF | Organization | 03/01/2023 | |
| Rmm 5x5 Trust | Adp of the SNF | Organization | 03/01/2023 | |
| Rockett, LP | Adp of the SNF | Organization | 03/01/2023 | |
| Sdl Gs 5x5 Trust | Adp of the SNF | Organization | 03/01/2023 | |
| Atkins, Jeffrey | Adp of the SNF | Individual | 03/01/2023 | |
| Hampton, Broderick | Adp of the SNF | Individual | 03/01/2023 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
These are the official offices in Texas. NursingHomeClear cannot take or act on complaints.