Azalea Trail Nursing and Rehabilitation Center
411 Spring Creek Rd, Grand Saline, TX 75140 · Van Zandt County · (903) 962-4226
72 certified beds, about 62 residents a day · For profit - Individual · Medicare and Medicaid since 1994
CMS Care Compare ratings, data as of September 1, 2026 · CCN 675253 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on July 29, 2026, inspectors cited 1 health deficiency (the Texas average is 9.4, the national average 9.2).
None of its 2 health citations since April 2024 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 3.35 hours per resident per day, against 3.39 across Texas and 3.86 nationally. Registered nurses accounted for 0.29 of those hours.
26.8% of nursing staff left within the year CMS measured (Texas average 55.3%).
Health inspections
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.
Where its citations fall on CMS's grid
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 2 health citations on file.
July 29, 2026Standard inspection · 1 citation
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide an environment free of accident hazards for one (Resident #1) of three residents reviewed for oxygen use. The facility failed to securely store oxygen cylinder when in resident room on 7/27/26. This failure could place residents at risk of living in an unsafe environment.
November 19, 2025Complaint inspection · 1 citation
- D Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan to meet each resident's medical, nursing, mental and psychosocial needs for 1 of 5 residents reviewed for care plans. (Resident #1) The facility failed to care plan the bed alarm being discontinued on 07/21/25 for Resident #1. The facility failed to care plan Resident #1's fall with major injuries on 08/06/25. These failures could place residents at risk of not having individual needs met and not receiving needed services.
May 14, 2025Standard inspection · 0 citations
April 3, 2024Standard inspection · 0 citations
Fire safety inspections
7 fire safety citations on file: 3 on July 29, 2026, 1 on May 14, 2025, 3 on April 3, 2024.
Every fire safety citation7 citations
- E Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- C Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- C Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- E Provide properly protected cooking facilities.
- E Have restrictions on the use of portable space heaters.
- C Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
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) | 3.35 | 3.39 | 3.86 |
| Registered nurses | 0.29 | 0.43 | 0.69 |
| All nursing staff on weekends | 2.94 | 2.98 | 3.42 |
| Nurse aides | 2.24 | ||
| Licensed practical nurses | 0.83 | ||
| Nursing staff turnover (share who left in a year) | 26.8% | 55.3% | 45.8% |
| Registered nurse turnover | not reported | 54.6% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.18 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
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 3.52 on weekdays and 2.94 on weekends, 16% 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 3.64 in April to June 2025 to 3.35 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 | 3.35 | 0.29 | 3.52 | 2.94 | 0.0% | 0 of 90 | 62 |
| Oct to Dec 2025 | 3.06 | 0.27 | 3.23 | 2.61 | 0.0% | 0 of 92 | 63 |
| Jul to Sep 2025 | 3.49 | 0.31 | 3.70 | 2.97 | 0.0% | 0 of 92 | 54 |
| Apr to Jun 2025 | 3.64 | 0.32 | 3.86 | 3.09 | 0.0% | 0 of 91 | 52 |
| 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
Staff pay at this home
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.
Official wage estimates for Texas
| 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.
Quality measures
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 | 32.9 | 15.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.9 | 0.3 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 7.3 | 0.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 9.1 | 3.3 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 1.6 | 1.5 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 37.0 | 14.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.0 | 3.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 8.8 | 9.6 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 22.4 | 25.7 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 21.7 | 12.3 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.1 | 2.2 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.0 | 2.1 | 1.8 |
Owners and operators
Legal business name: EKKLESIA HEALTHCARE, LLC.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Ward, Michael | Direct ownership interest | Individual | 01/01/2007 | |
| Ward, Patricia | Direct ownership interest | Individual | 01/01/2007 | |
| Ward, Patricia | Operational/managerial control | Individual | 01/01/2007 | |
| Ward, Michael | Adp of the SNF | Individual | 01/01/2007 | |
| Ward, Patricia | Adp of the SNF | Individual | 01/01/2007 |
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.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 1 problem in this area, most recently on July 29, 2026: "Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents."
- When is the care plan meeting, and can family attend it?Inspectors cited 1 problem in this area, most recently on November 19, 2025: "Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.94 hours per resident per day, below the Texas average of 2.98.
Other nursing homes nearby
- Avir at Bradburn Grand Saline, 0.3 mi · 1 of 5 stars · 18 citations
- Avir at Grand Saline Grand Saline, 0.5 mi · 2 of 5 stars · 25 citations
- Van Healthcare Van, 11.3 mi · 4 of 5 stars · 11 citations
- Avir at Mineola Mineola, 12.7 mi · 1 of 5 stars · 53 citations
- Mineola Gardens Wellness & Rehabilitation Mineola, 13.2 mi · 1 of 5 stars · 23 citations
- Canton Oaks Canton, 13.3 mi · 4 of 5 stars · 4 citations
- Emory Health and Rehab Emory, 14.6 mi · 3 of 5 stars · 28 citations
- Crestwood Health and Rehabilitation Center Wills Point, 16.8 mi · 5 of 5 stars · 10 citations
Texas contacts for a concern about a nursing home
These are the official offices in Texas. NursingHomeClear cannot take or act on complaints.
- Resident advocate: Texas Office of the State Long-Term Care Ombudsman, 800-252-2412. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
Common questions
- What is Azalea Trail Nursing and Rehabilitation Center's Medicare star rating?
- CMS rates Azalea Trail Nursing and Rehabilitation Center 4 out of 5 stars overall, with 5 for health inspections, 3 for staffing and 1 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Azalea Trail Nursing and Rehabilitation Center get at its last inspection?
- 1 health deficiency at the standard inspection on July 29, 2026. The Texas average is 9.4.
- Has Azalea Trail Nursing and Rehabilitation Center been fined?
- CMS lists no fines in the last three years.
- Does Azalea Trail Nursing and Rehabilitation Center accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Azalea Trail Nursing and Rehabilitation Center?
- CMS lists 5 owners and managers. Legal business name: EKKLESIA HEALTHCARE, LLC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.