What is Focused Care at Hamilton's Medicare star rating?

CMS rates Focused Care at Hamilton 5 out of 5 stars overall, with 5 for health inspections, 1 for staffing and 5 for quality measures (CMS data as of September 1, 2026).

How many deficiencies did Focused Care at Hamilton get at its last inspection?

0 health deficiencies at the standard inspection on September 30, 2025. The Texas average is 9.4.

Has Focused Care at Hamilton been fined?

CMS lists no fines in the last three years.

Does Focused Care at Hamilton 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 Focused Care at Hamilton?

CMS lists 30 owners and managers, and links the home to Focused Post Acute Care Partners. Legal business name: HAMILTON COUNTY HOSPITAL DISTRICT.

Focused Care at Hamilton: Inspections, Staffing & Ratings

The record in brief

At its most recent standard inspection, on September 30, 2025, inspectors cited 0 health deficiencies (the Texas average is 9.4, the national average 9.2).

None of its 8 health citations since July 2023 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 2.77 hours per resident per day, against 3.39 across Texas and 3.86 nationally. Registered nurses accounted for 0.27 of those hours.

41.4% of nursing staff left within the year CMS measured (Texas average 55.3%).

CMS links it to Focused Post Acute Care Partners, an affiliated group of 25 nursing homes.

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.

507/23

112/23

209/24

009/25

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

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 8 health citations on file.

Severity

Isolated

Pattern

Widespread

Immediate jeopardy

Actual harm

Potential for more than minimal harm

Potential for minimal harm

September 30, 2025Standard inspection · 0 citations

September 27, 2024Standard inspection · 2 citations

E

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

F812 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) October 10, 2024

Inspectors wroteBased on observations, interviews, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for one of one kitchen and one of one nourishment room reviewed for sanitation. 1. The facility failed to properly store closed and dated food in the refrigerator. 2. The facility failed to ensure the Nourishment Room was properly cleaned and items were correctly labeled and dated. These failures could place residents who were served from the kitchen at risk for health complications and foodborne illnesses, and decreased quality of life.
E

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

F925 · Environmental · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) October 10, 2024

Inspectors wroteBased on observations, interviews, and record review, the facility failed to maintain an effective pest control program so that the facility was free of pests and rodents for one of one kitchen and one of one common areas (common area near the nurse's station) reviewed for pests. 1. Houseflies, spiders, and crickets were seen in the common area by the nurse's station. 2. Insects and spiderwebs were present in the kitchen. This failure could place residents at risk of infection, discomfort, and diminished quality of life.

December 4, 2023Complaint inspection, Infection control · 1 citation

F

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

F812 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, widespread · found on a complaint visit · infection control inspection · Corrected (the home has a date of correction) December 5, 2023

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure the cleanliness of kitchen equipment, per manufacturer's instructions, for 1 of 1 ice machines reviewed for food safety requirements. The facility failed to ensure the ice machine was descaled and failed to ensure a plastic bin that held an ice scooper was free from scale buildup. This failure placed all residents at risk for illnesses related to prolonged exposure to scale.

July 26, 2023Standard inspection · 5 citations

F

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

F812 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, widespread · Corrected (the home has a date of correction) July 31, 2023

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 one of one kitchen reviewed for food safety. Several items in and from the kitchen (salad, salad dressing, croutons, milk, juice, pudding, and a diabetic bedtime snack) were not labeled or dated. The MAINT walked through the kitchen twice without a hair restraint. Kitchen equipment (deep fryer, refrigerator, freezer, sneeze guard)) was not clean. Insect pests (fruit flies, house flies, crickets, and a cockroach) were present in the kitchen. These failures placed residents at risk of food-borne illness.
E

Provide activities to meet all resident's needs.

F679 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) July 31, 2023

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide, based on the comprehensive assessment and care plan and the preferences of each resident, an ongoing program to support residents in their choice of activities, both facility-sponsored group and individual activities and independent activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident, encouraging both independence and interaction in the community for six of 16 residents (Residents #9, 18, 19, 23, 26, and 43) reviewed for activities. 1. Residents #9, 18, 19, 23, 36, and 43 spent nearly all their waking hours in the common area near the nurse's station, not receiving activities. 2. Residents #9, 18, 19, 23, 26, and 43 had no person-centered activity program or activities tailored to their specific needs and preferences. [...]
E

Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

F805 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) July 31, 2023

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident received and the facility provided food prepared in a form designed to meet individual needs for 3 of 16 residents (Residents #12, 18, and 19) reviewed for pureed diets. Residents #12, 18, and 19 all received pureed meals not prepared according to professional standards or the recipe. This failure placed residents at risk of weight loss and aspiration.
E

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

F925 · Environmental · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) July 31, 2023

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an effective pest control program so that the facility was free of pests and rodents for one of one kitchen and one of two common areas (common area near the nurse's station) reviewed for pests. 1. Houseflies were seen in the common area by the nurse's station, landing on residents and their food. 2. Insect pests (fruit flies, house flies, crickets, and a cockroach) were present in the kitchen. This failure placed residents at risk of infection, discomfort, and diminished quality of life.
D

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

F657 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) July 31, 2023

Inspectors wroteBased on interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with resident rights, that include measurable objectives and time frames to meet resident's mental and psychosocial needs for 2 of 8 residents (Residents #7 and 13) reviewed for care plans. The facility failed to update care plans as evidenced by: 1. Resident # 7's care plan did not reflect goals and interventions for a new onset of behaviors 2. Resident #13's care plan did not reflect current needs or preferences related to the behavior of wandering. This Failure placed residents at risk of not receiving the appropriate care and services to maintain the highest practical well-being.

Fire safety inspections

8 fire safety citations on file: 2 on September 27, 2024, 6 on July 26, 2023.

Every fire safety citation8 citations

F
Have generator or other power source capable of supplying service within 10 seconds.

K 918 · September 27, 2024 · Corrected (the home has a date of correction)
D
Ensure precautions for handling oxygen cylinders and equipment are correctly followed.

K 929 · September 27, 2024 · Corrected (the home has a date of correction)
F
Develop and maintain an Emergency Preparedness Program (EP).

E 4 · July 26, 2023 · Corrected (the home has a date of correction)
F
Conduct testing and exercise requirements.

E 39 · July 26, 2023 · Corrected (the home has a date of correction)
F
Inspect, test, and maintain automatic sprinkler systems.

K 353 · July 26, 2023 · Corrected (the home has a date of correction)
F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

K 372 · July 26, 2023 · Corrected (the home has a date of correction)
F
Have generator or other power source capable of supplying service within 10 seconds.

K 918 · July 26, 2023 · Corrected (the home has a date of correction)
E
Have properly installed electrical wiring and gas equipment.

K 511 · July 26, 2023 · Corrected (the home has a date of correction)

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)	2.77	3.39	3.86
Registered nurses	0.27	0.43	0.69
All nursing staff on weekends	2.23	2.98	3.42
Nurse aides	1.49
Licensed practical nurses	1.01
Nursing staff turnover (share who left in a year)	41.4%	55.3%	45.8%
Registered nurse turnover	not reported	54.6%	42.9%
Administrators who left	0

CMS expects 3.72 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 2.99 on weekdays and 2.23 on weekends, 25% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.4% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 2.53 in April to June 2025 to 2.77 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	2.77	0.27	2.99	2.23	0.4%	0 of 90	44
Oct to Dec 2025	3.51	0.23	3.66	3.15	0.1%	0 of 92	44
Jul to Sep 2025	3.75	0.21	3.92	3.33	0.0%	0 of 92	44
Apr to Jun 2025	2.53	0.21	2.69	2.13	0.0%	0 of 91	45
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.

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	3.5	15.8	13.9
Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1	0.0	0.3	0.8
Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1	0.6	0.8	1.6
Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1	3.0	3.3	3.2
Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1	0.0	1.5	1.6
Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1	5.9	14.0	14.1
Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1	3.6	3.8	4.6
Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1	8.5	9.6	15.4
Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231	1.3	2.2	1.9
Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231	1.6	2.1	1.8

Owners and operators

Legal business name: HAMILTON COUNTY HOSPITAL DISTRICT. CMS links this home to Focused Post Acute Care Partners, a group of 25 nursing homes averaging 2 stars overall.

Name	Role	Type	Since
Hamilton County Hospital District	Direct ownership interest	Organization	04/01/2019
Collett, Michael	Managing control - governing body	Individual	05/29/2019
Craig, Karen	Managing control - governing body	Individual	01/12/2022
Forrest, William	Managing control - governing body	Individual	05/20/1992
Muxworthy, Neil	Managing control - governing body	Individual	05/20/1996
Witzsche, Robert	Managing control - governing body	Individual	12/28/1998
Hooper, Grady	Corporate officer	Individual	12/01/2015
Focused Post	Operational/managerial control	Organization	04/01/2019
Focused Post Acute Care Partners II LLC	Operational/managerial control	Organization	04/01/2019
Focused Post Acute Care Partners Management, LLC	Operational/managerial control	Organization	04/01/2019
Fpacp Hamilton LLC	Operational/managerial control	Organization	04/01/2019
Hamilton County Hospital District	Operational/managerial control	Organization	04/01/2019
Conley, Shawn	Operational/managerial control	Individual	04/01/2019
English, Jon	Operational/managerial control	Individual	04/01/2019
English, Tiffany	Operational/managerial control	Individual	07/30/2020
Lee, James	Operational/managerial control	Individual	04/01/2019
McKenzie, Mark	Operational/managerial control	Individual	04/01/2019
Pratt, Carrie	Operational/managerial control	Individual	04/01/2017
Strubbe, Loretta	Operational/managerial control	Individual	04/01/2019
Focused Post	Adp of the SNF	Organization	03/10/2025
Focused Post Acute Care Partners II LLC	Adp of the SNF	Organization	03/10/2025
Focused Post Acute Care Partners Management, LLC	Adp of the SNF	Organization	03/11/2025
Fpacp Hamilton LLC	Adp of the SNF	Organization	02/18/2025
Hamilton County Hospital District	Adp of the SNF	Organization	03/10/2025
Conley, Shawn	Adp of the SNF	Individual	04/01/2019
English, Jon	Adp of the SNF	Individual	04/01/2019
English, Tiffany	Adp of the SNF	Individual	07/30/2020
Lee, James	Adp of the SNF	Individual	04/01/2019
McKenzie, Mark	Adp of the SNF	Individual	04/01/2019
Pratt, Carrie	Adp of the SNF	Individual	02/18/2025

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.

Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 4 problems in this area, most recently on September 27, 2024: "Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards."
Can we see a resident room, a shower room and the dining room on this visit?Inspectors cited 2 problems in this area, most recently on September 27, 2024: "Make sure there is a pest control program to prevent/deal with mice, insects, or other pests."
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 26, 2023: "Provide activities to meet all resident's needs."
When is the care plan meeting, and can family attend it?Inspectors cited 1 problem in this area, most recently on July 26, 2023: "Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals."
Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.23 hours per resident per day, below the Texas average of 2.98.

Other nursing homes nearby

Pecan Creek Healthcare Center
Hamilton, 0.6 mi · 4 of 5 stars · 12 citations
Hico Nursing and Rehabilitation
Hico, 19.8 mi · 2 of 5 stars · 23 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 Focused Care at Hamilton's Medicare star rating?: CMS rates Focused Care at Hamilton 5 out of 5 stars overall, with 5 for health inspections, 1 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did Focused Care at Hamilton get at its last inspection?: 0 health deficiencies at the standard inspection on September 30, 2025. The Texas average is 9.4.
Has Focused Care at Hamilton been fined?: CMS lists no fines in the last three years.
Does Focused Care at Hamilton 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 Focused Care at Hamilton?: CMS lists 30 owners and managers, and links the home to Focused Post Acute Care Partners. Legal business name: HAMILTON COUNTY HOSPITAL DISTRICT.

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.