520 Se 8th St., Paris, TX 75460 · Lamar County · (903) 737-9820
120 certified beds, about 80 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 2005
CMS Care Compare ratings, data as of September 1, 2026 · CCN 676049 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on February 5, 2026, inspectors cited 14 health deficiencies (the Texas average is 9.4, the national average 9.2).
Of 43 health citations since September 2023, 1 was rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 1 fine totaling $16,149 in the last three years; the largest was $16,149, and the latest is dated November 20, 2024.
Nurses and nurse aides worked 3.19 hours per resident per day, against 3.39 across Texas and 3.86 nationally. Registered nurses accounted for 0.67 of those hours.
CMS links it to The Ensign Group, an affiliated group of 344 nursing homes.
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 43 health citations on file.
Inspectors wroteBased on observation, interview, and record review the facility failed to immediately consult with the resident's physician when there was significant change in the resident's physical, mental, or psychosocial status for 2 of 6 residents (Resident # 4 and Resident #30) reviewed for notification of changes. 1. The facility failed to notify the physician for Resident #4's blood sugars above 401 on 01/08/26, 01/16/26, 01/18/26, 01/22/26, and 01/31/26 2. The facility failed to notify the physician for Resident #30's blood sugars above 401 on 01/09/26, 01/17/26, 01/16/26, and 01/22/26. These failures could place residents at risk of their physicians not being aware of the resident conditions and delay treatments for the residents' conditions.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that it was free of medication error rate of 5 percent or greater. The facility had a medication error rate of 10%, based on 4 errors out of 40 opportunities, which involved 4 of 7 residents (Resident #74, Resident #46, Resident #40 and Resident #3) reviewed for medication administration. The facility failed to ensure LVN E administered Resident #74 Humalog KwikPen (insulin medication) according to the manufacturer's instructions. The facility failed to ensure LVN F primed Resident #46 Novolog KwikPen (insulin medication) according to the manufacturer's instructions. The facility failed to ensure LVN F administer 4 units of Novolog KwikPen to Resident #46 on 02/05/26 according to physician orders. [...]
Inspectors wroteBased on observation, interviews, and record review the facility failed to ensure that residents were free of significant medication errors for 3 of 7 residents review for pharmacy services (Resident #74, Resident #46, and Resident #40. ) 1. The facility failed to ensure LVN E administered Resident #74 Humalog KwikPen (insulin medication) according to the manufacturer's instructions.2. The facility failed to ensure LVN F administered Resident #46 Novolog KwikPen (insulin medication) according to the manufacturer's instructions.3. The facility failed to ensure LVN E administered Resident #V Vancomycin (infection medication) according to the manufacturer's instructions. This failure could place residents at risk of medical complications and not receiving the therapeutic effects of their medications.1. [...]
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, in that: 1. There was an open can of soda, an uncovered Styrofoam cup, an energy drink and a plastic drink container from unapproved sources observed on a food prep counter in the kitchen. This failure could place residents who received meals and/or snacks from the kitchen at risk for food borne illness.
Inspectors wroteBased on interviews and record review, the facility failed to ensure the facility assessment was reviewed and updated as necessary, and at least annually for 1 of 1 facility. 1. The facility did not update the facility assessment to include Resident #38 gastrostomy (surgical procedure that creates an opening in the stomach, allowing for the insertion of a feeding tube (G-tube) for nutritional support). 2. The facility failed to include on the facility assessment the care of bariatric residents. These failures could affect residents by not having the necessary resources to ensure appropriate care is provided.
Inspectors wroteBased on observation, interview and record review the facility failed to, based on the comprehensive assessment of a resident, ensure that residents receive treatment and care in accordance with professional standards of practice for 3 of 13 residents (Residents #5, 6, and 15) in that: Residents #5, Resident #6 and Resident #15 had pacemakers/defibrillator and had no specific guidelines for maintenance, precautions and care. The practice guidelines related to the maintenance, precautions and care were not clearly communicated in the EMR. These 3 residents had no specific care plan for pacemaker and defibrillator care or documentation of coordination of care with a cardiologist. These failures could result in residents experiencing cardiovascular problems, improper cardiac monitoring/transmission and follow up care.
Inspectors wrote1. The facility failed to ensure RN P wore PPE (gown) while performing wound care on 02/04/26.2. The facility failed to ensure CNA S wore PPE (gown) while performing care on 02/03/26.3. The facility failed to have Personal Protective Equipment, also known as PPE, (is specialized clothing or equipment worn to protect individuals from hazards in various settings, such as the workplace, and includes items like gloves, safety helmets, masks, and eye protection) outside Resident #64's and Resident #5's rooms, who required enhanced barrier precautions also known as EBP (an infection control strategy that uses gowns and gloves during high-contact care activities to reduce the transmission of multidrug-resistant organisms (MDROs). These failures could place any resident at the facility at risk for cross-contamination and the spread of infection.
Inspectors wroteBased on interviews and record reviews, the facility failed to treat each resident with respect and dignity and provided care in a manner that promotes maintenance or enhancement of his or her quality of life for 1 of 26 residents (Resident #44) reviewed for resident rights. The facility did not ensure Resident #44 had the correct size briefs to go to dialysis. This failure could place residents at an increased risk of embarrassment, isolation, and diminished quality of life.
Inspectors wroteBased on interviews, observation, and record review, the facility failed to ensure the resident had the right to be informed in advance, by the physician or other practitioner or professional, of the risks and benefits of proposed care, of treatment and treatment alternatives or treatment options and to choose the alternative or option he or she prefers for 1 of 26 (Resident #44) residents reviewed for psychoactive medications. The facility did not ensure Resident #44 had signed a psychotropic consent for Prozac (antidepressant) 40 mg. This failure could place residents at risk for receiving unnecessary psychotropic medications without informed consent.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure the resident environment remained as free of accident hazards as possible, and each resident received adequate supervision and assistance devices to prevent accidents for 1 of 1 resident (Resident #60) reviewed for accident hazards and supervision. The facility did not ensure Resident #60 wore a smoking apron on 02/03/26 at 9:30 a.m. smoke break. This failure could place residents who smoke at risk of physical harm.
Inspectors wroteBased on observation, interview and record review, the facility failed to establish a system of receipt and disposition of all controlled drugs in sufficient detail to enable accurate reconciliation and determine that drug records were in order and that an account of all controlled drugs were maintained and periodically reconciled for 2 of 6 residents (Resident #59 and Resident #54) reviewed for pharmacy services. The facility failed to ensure Resident #59's discontinued wrapped in the back of the narcotic box Diazepam (controlled medication used to treat anxiety) was being accurately reconciled on 02/04/26. The facility failed to ensure Resident #54's discontinued wrapped in the back of the narcotic box Lyrica (controlled medication used for pain) was being accurately reconciled on 02/04/26. [...]
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that all drugs and biologicals used in the facility were labeled and stored in accordance with professional standards for 2 of 4 medication storage areas (300 hall Medication Cart and medication refrigerator) observed for storage and security. 1. The facility failed to ensure MA H secured the 300 hall Medication Cart, when it was not in use and unattended on 02/02/2026. 2. The facility did not ensure Resident #14's medication named Lorazepam (used for anxiety) was secure in the unlocked refrigerator on 02/04/26. These failures could place residents at risk of not receiving drugs and biologicals as needed, medication errors, medication misuse, and drug diversion.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide food that was palatable and served at an appetizing temperature for 2 of 2 residents (Resident #43, Resident #62) and 1 of 1 lunch meal reviewed for palatability. The facility did not provide palatable food served at an appetizing temperature or taste to Resident #43 and #62 who complained the food was served cold and did not taste good. 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 observations, interviews, and record review, the facility failed to follow established policy regarding smoking areas, and smoking safety for 1 of 1 facility. 1. The facility failed to provide a metal container with a self-closing cover device. 2. The facility did not ensure smoked cigarettes were extinguished in a fire-retardant receptacle. These failures could place residents and staff at risk of unsafe smoking and injury.
Inspectors wroteBased on interview, and record review, the facility failed to ensure in accordance with professional standards and practices, the medical records on each resident were accurately documented for 1 of 7 residents (Resident #1) reviewed for accurate medical records. The facility failed to ensure LVN A accurately documented on Resident #1's medical record the time of physician notification in the progress note dated 7/15/25. This failure could place residents at risk of emergency situations not being accurately documented, leading to confusion on what occurred when.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident received adequate supervision and assistance to prevent accidents and injury from hot liquid spills for 1 of 6 resident's (Resident #173) reviewed for accident and supervision. Resident #173 sustained a thermal burn from spilling hot coffee on her leg, served by CNA A without obtaining the temperature of the liquid on 11/12/2024. The noncompliance was identified as past non-compliance (PNC). The Immediate Jeopardy (IJ) began on 11/12/2024 and ended on 11/14/2024. The facility had corrected the non-compliance before the survey began. This failure could place residents served hot liquids at risk for thermal burns if spilled.
Inspectors wroteBased on interview and record review, the facility failed to conduct initially and periodically a comprehensive, accurate, standardized reproducible assessment of each resident's functional for 2 of 4 residents (Resident #13 and Resident #28) reviewed for comprehensive assessments and timing. The facility did not ensure Resident #13's Annual MDS assessment was completed within 14 days of admission. The facility did not ensure Resident #28's admission MDS assessment was completed within 14 days of admission. This failure could place residents at risk of not having their needs identified and met.
Inspectors wroteBased on interview and record review, the facility failed to complete a resident assessment within the required time frame for 4 of 18 residents (Resident #9, Resident #16, Resident #26, and Resident #31) reviewed for quarterly assessments. The facility did not ensure Resident #9, Resident #16, Resident #26, and Resident #31's quarterly MDS assessments were completed within 14 days of the ARD. This failure placed residents at risk of not having their assessments completed timely which could result in not having their individually assessed needs met.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure residents who were unable to carry out activities of daily living received necessary services to maintain personal hygiene for 3 of 16 residents (Resident #173, Resident #16, and Resident #61) reviewed for ADLs. The facility failed to provide scheduled showers and/or bed baths to Resident #173, Resident #16, and Resident #61 at least 3 times per week. These failures could place residents at risk of not receiving services/care and decreased quality of life.
Inspectors wroteBased on interview and record review, the facility failed to ensure each resident's drug regimen was free from unnecessary medications (is a medication used: In excessive doses (including duplicate therapy); or For excessive duration; or Without adequate monitoring; or Without adequate indication for its use; or In the presence of adverse consequences which indicate the dose should be reduced or discontinued) for 1 of 6 residents (Resident #66) reviewed for unnecessary medications in that: The facility failed to ensure Resident #66 had documented diagnoses for the use of Humulin R (Regular insulin, also known as neutral insulin and soluble insulin, is a type of short-acting medical insulin. It is used to treat type 1 diabetes, type 2 diabetes, gestational diabetes, and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states). [...]
Inspectors wroteBased on interviews and record reviews, the facility failed to ensure a gradual dose reduction was attempted for 3 of 6 residents (Resident #1, Resident #13, and Resident # 37) reviewed for unnecessary medications/ gradual dose reduction in that: 1. The facility failed to ensure a gradual dose reduction (GDR) was attempted or document contraindication for a gradual dose reduction for Resident #1's ordered Risperdal (antipsychotic medication used to treat certain disorders by changing how the brain uses neurotransmitters) 4mg orally twice daily ordered 04/17/2024. 2. The facility failed to ensure a GDR was attempted or document contraindication for a GDR for Resident #13's Risperdal/risperidone 0.5 mg by mouth two times daily ordered on 3/09/23. 3. [...]
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 1 of 18 residents (Resident #40) reviewed for infection control practices. The facility failed to ensure LVN T performed hand hygiene after blood sugar was taken from a resident. LVN T entered Resident #40's room and did not perform hand hygiene prior to obtaining Resident #40's blood sugar and gave insulin on 11/19/24. These failures could place residents at risk of exposure to communicable diseases, cross-contamination, and infections.
Inspectors wroteBased on interview and record review, the facility failed to maintain an antibiotic stewardship program that included a system to monitor antibiotic use, for 1 (Resident #37) of 18 residents reviewed for antibiotic use. The facility failed to conduct appropriate monitoring of antibiotic use for Resident #37 by not including the resident in the Tracking and Trending Log when he was treated for a urinary tract infection. These failures could place residents receiving antibiotics at risk for unnecessary antibiotic use, inappropriate antibiotic use, and increased antibiotic-resistant infections.
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 in (1 of 1) kitchen reviewed for dietary services. 1) The facility failed to label and date all food items. 2) Dietary staff failed to dispose of expired foods items. 3) Dietary Staff failed to store (1) dented can in a separate area. 4) Dietary Staff failed to effectively reseal, label and date frozen food items. These failures could place residents at risk for food contamination and foodborne illness.
Inspectors wroteBased on interview, and record review, the facility failed to ensure the right to formulate an advance directive was provided for 3 of 22 residents (Residents #124, #5 and #33) reviewed for advanced directives. 1. The facility did not ensure Resident #124's full code status was discontinued after Resident #124 signed a DNR. 2. The facility did not ensure Resident #5's OOH-DNR was signed by the responsible party. 3. The facility failed to obtain a signature from the attending physician and resident representative on Resident #33's DNR form. These failures could place residents at risk of not receiving care and services to meet their needs.
Inspectors wroteBased on interview, and record review the facility failed to ensure assessments accurately reflected the resident status for 4 of 22 residents (Resident # 3, Resident #27, Resident #44, and Resident #60) reviewed for MDS assessment accuracy. The facility failed to accurately reflect Resident #60's need for dialysis on the MDS assessment. The facility failed to accurately document smoking for Residents #27 and #3 on the MDS assessment. The facility failed to accurately reflect Resident #44's weight loss on the MDS assessment. This failure could place residents at risk for not receiving care and services to meet their needs.
Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure a resident who is incontinent of bladder received appropriate treatment and services to prevent urinary tract infections for 1 of 1 residents (Resident #32) reviewed for treatment of urinary tract infections and 3 of 4 residents (Resident #12, #64, and #51) reviewed for incontinent care and 1 of 2 residents (Resident #36) reviewed for treatment and services related to indwelling catheters. The facility failed to ensure CNA C used a clean wipe after each stroke while providing catheter care to Resident #12. The facility did not ensure NA Y cleaned Resident #64 peri-anal area before placing a clean brief underneath her and applying barrier cream. The facility did not ensure NA O cleaned Resident #51 front peri area prior to cleaning the peri anal. [...]
Inspectors wroteBased on interview and record review, the facility failed to provide pharmaceutical services, including procedures that assure the accurate dispensing and administering of all drugs and biologicals to meet the needs of each resident for 5 of 22 residents (Residents #2, Resident #33, Resident #47, Resident #52, and Resident #55) reviewed for pharmacy services. The facility failed to keep a record of receipt of controlled medications awaiting disposition to allow accurate and periodic reconciliation. The facility failed to ensure the witnesses signed with the Pharmacy Consultant when drugs were destructed. These failures could place the residents at risk of not having medications available for use and drug diversion.
Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure that all drugs and biologicals used in the facility were labeled and stored in accordance with professional standards for 3 of 4 medication carts (MA 100 hall, Nurse 200 and even rooms on 300 hall, and Nurse 500 hall), 1 of 2 medication storage rooms (Medication room at the beginning of 200 hall) reviewed for drugs and biologicals and for 3 of 22 residents (Residents #59, #14, and #67 ) reviewed for storage of medications. 1. The facility failed to ensure bisacodyl (medication used for constipation) and hydrocortisone acetate (medication used for hemorrhoids) suppositories in the refrigerator in the medication storage room at the beginning of the 200 hall were discarded when they expired. [...]
Inspectors wroteBased on observation, interview and record review, the facility failed to provide food that was palatable, attractive and at a safe and appetizing temperature for 2 of 6 meals (10/10/23 lunch meal and 10/11/23 lunch meal) reviewed for palatability and temperature. The facility failed to provide food that was palatable for 1 of 3 meal observed on 10/10/23 (lunch) meal. The facility failed to provide food that was palatable and appetizing temperature for 1 of 3 meal observed on 10/11/23 (lunch) meal. These failures could place residents at risk of decreased food intake, hunger, and unwanted weight loss.
Inspectors wroteBased on interview and record review, the facility failed to collaborate with hospice representatives and coordinate the hospice care planning process for each resident receiving hospice services, to ensure quality of care for the resident, ensuring communication with the hospice medical director, the resident's attending physician, and others participating in the provision of care for 3 of 3 residents (Resident #33, Resident #36, and Resident #43) reviewed for hospice services. The facility did not ensure Resident #33's hospice records were a part of their records in the facility. The facility did not ensure Resident #36's hospice records were a part of their records in the facility. The facility did not ensure Resident #43's hospice records were a part of their records in the facility. [...]
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 and to help prevent the development and transmission of communicable diseases and infections for 4 of 6 staff (CNA C, MA S, NA Y, and NA O) reviewed for infection control. The facility failed to ensure CNA C performed hand hygiene in between glove changes. The facility failed to ensure CNA C used a clean wipe after each stroke while providing catheter care. The facility did not ensure NA Y cleaned Resident #64's peri-anal area before placing a clean brief underneath her and applying barrier cream. The facility did not ensure NA Y performed hand hygiene and changed gloves while providing incontinent care to Resident #64. [...]
Inspectors wroteBased on interview and record review, the facility failed to promote antibiotic stewardship by ensuring the appropriate use of antibiotic therapy and providing written rationale, by the provider, when an antibiotic was used despite criteria, to determine the appropriate the use of an antibiotic for 3 of 3 residents (Residents #8, 33, and #125) reviewed for antibiotic use. The facility failed to ensure Residents #8, #33, and #125 had documented signs and symptoms, appropriate lab work, and diagnoses to support the use of prescribed antibiotics. This failure could place residents receiving antibiotics at risk for unnecessary antibiotic use, inappropriate antibiotic use, and increased antibiotic-resistant infections.
Inspectors wroteBased on observations, interviews 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 1 of 1 dining room reviewed for resident rights. The facility did not ensure LVN A treated residents with dignity and respect by referring to them as feeders. This failure could place residents at an increased risk of embarrassment, isolation, and diminished quality of life.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident had the right to make choices about aspects of his or her life in the facility that were significant to the resident for 1 of 22 residents (Resident #12) reviewed for self-determination. The facility failed to ensure Resident #12 was assisted out of bed. This failure could place residents at risk for being denied the opportunity to exercise his or her autonomy regarding things that are import in their life and decrease their quality of life.
Inspectors wroteBased on observations, interviews, and record reviews the facility failed to provide a safe, clean, comfortable, and homelike environment in 1 of 62 Rooms (room [ROOM NUMBER]) reviewed for a clean and homelike environment. The facility failed to ensure room [ROOM NUMBER] was cleaned daily, and in accordance with the facility's Housekeeping Checklist. This deficient practice could place residents at risk of infections and living in an uncomfortable environment leading to a decreased quality of life.
Inspectors wroteBased on interview, and record review, the facility failed to implement a comprehensive person-centered care plan to meet resident's medical, nursing, and mental and psychosocial needs identified in the comprehensive assessment for 1 of 22 residents (Resident #124) reviewed for care plans. The facility did not develop Resident #124's care plan related code status. This failure could place residents at risk for inaccurate care plans not receiving care and services to meet their needs.
Inspectors wroteBased on observations, interviews and record reviews, the facility failed to review and revise the comprehensive person-centered care plan for 2 of 22 residents (Resident #32 and Resident #44) reviewed for comprehensive care plans. The facility failed to ensure Resident #32's care plan was updated to indicate she no longer smoked. The facility failed to ensure Resident #44's care plan was updated to indicate weight loss. These failures could place residents at increased risk of not having their individual needs met and a decreased quality of life.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident who was unable to carry out activities of daily living received services to maintain personal hygiene for 1 of 65 (Resident #46) residents reviewed for ADLs. The facility failed to ensure Resident #46's fingernails were trimmed, clean and free from a black colored material. These failures could place residents at risk of not receiving services or care, decreased quality of life, and decreased self-esteem.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that residents requiring respiratory care were provided such care, consistent with professional standards of practices for 2 of 9 residents (Residents #27 and #60) reviewed for respiratory care. 1. The facility failed to ensure Resident #27's oxygen was set between 3-4 LPM as ordered by the physician. 2. The facility failed to ensure Resident #60 had a physician's order for oxygen. These failures could place residents who receive respiratory care at risk for developing respiratory complications and a decreased quality of care.
Inspectors wroteBased on interview and record review, the facility failed to ensure residents were seen by a physician at least once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter or alternate between personal visits by the physician and visits by a physician assistant, nurse practitioner or clinical nurse specialist for 1 of 22 residents (Resident #16) reviewed for physician services. The facility failed to ensure Resident #16 was seen by the facility's attending physician and/or the physician's extender at least once every 60 days from October 2022 through February 2023. This failure could place the residents at risk for medical conditions not being identified, care needs not being met, and a decline in health status.
Inspectors wroteBased on observation, interview and record review, the facility failed to follow their established smoking policy for 1 of 1 smoking area and 1 of 6 (Resident #27) residents reviewed for smoking. 1. The facility did not ensure Resident #27 had a smoking evaluation completed. 2. The facility did not ensure smoked cigarettes were extinguished in a fire-retardant receptacle. These failures could place residents at risk for smoking-related injuries and fires in the facility.
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 and to help prevent the development and transmission of communicable diseases and infections for 1 of 2 shower rooms (located on Hall 2) and 1 of 17 rooms (room [ROOM NUMBER]) reviewed for infection control. The facility failed to ensure the shower room (located on Hall 2) was clean and the soiled towels were removed promptly after use. The facility failed to ensure soiled briefs were discarded appropriately from a resident room (room [ROOM NUMBER]). These failures could place residents and staff at risk for cross-contamination and the spread of infection.
1 fire safety citation on file: 1 on November 20, 2024.
| Date | Penalty | Amount or length |
|---|---|---|
| November 20, 2024 | Fine | $16,149 |
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) | 3.19 | 3.39 | 3.86 |
| Registered nurses | 0.67 | 0.43 | 0.69 |
| All nursing staff on weekends | 2.74 | 2.98 | 3.42 |
| Nurse aides | 1.85 | ||
| Licensed practical nurses | 0.67 | ||
| Nursing staff turnover (share who left in a year) | not reported | 55.3% | 45.8% |
| Registered nurse turnover | not reported | 54.6% | 42.9% |
| Administrators who left | 1 |
CMS expects 3.65 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 3.37 on weekdays and 2.74 on weekends, 19% 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 3.09 in April to June 2025 to 3.19 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 | 3.19 | 0.67 | 3.37 | 2.74 | 0.0% | 0 of 90 | 80 |
| Oct to Dec 2025 | 3.10 | 0.59 | 3.28 | 2.64 | 0.0% | 0 of 92 | 78 |
| Jul to Sep 2025 | 3.20 | 0.50 | 3.39 | 2.74 | 0.0% | 0 of 92 | 73 |
| Apr to Jun 2025 | 3.09 | 0.47 | 3.30 | 2.57 | 0.0% | 1 of 91 | 72 |
| 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.
Trains nurse aides: this home runs a state-approved CNA program (state list: HHSC Approved NATCEP Providers, as of October 6, 2026). A nursing home cannot charge aides it employs, or has offered a job, for state-approved training (42 CFR 483.152(c)). See Legend Healthcare and Rehabilitation - Paris CNA training on CareerFunded, our sister site for career training.
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. If you work here, your report helps start one.
| 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 | 14.6 | 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 | 0.0 | 0.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 1.5 | 3.3 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 2.9 | 1.5 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 17.3 | 14.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 1.1 | 3.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 8.4 | 9.6 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 23.6 | 25.7 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 15.3 | 12.3 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.1 | 2.2 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.9 | 2.1 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Legend Healthcare and Rehabilitation - Paris's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (44.3% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
44.3% this home
No different from 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. 122 eligible stays.
12.2% 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. 148 eligible stays.
7.4% this home
No different from 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. 95 eligible stays.
82.3% 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. 51 residents counted.
0.0% 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. 98 residents counted.
1.0% 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. 98 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. 24 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: FANNIN COUNTY HOSPITAL AUTHORITY. CMS links this home to The Ensign Group, a group of 344 nursing homes averaging 3.2 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Fannin County Hospital Authority | 5% or greater direct ownership interest | Organization | 100% | 04/01/2017 |
| Burns, Stephen | Managing control - governing body | Individual | 08/01/2022 | |
| Lawrence, Ra | Managing control - governing body | Individual | 04/01/2017 | |
| Burnam, Soon | Corporate officer | Individual | 04/01/2017 | |
| Keetch, Chad | Corporate officer | Individual | 04/01/2017 | |
| Sanderson, Clark | Corporate officer | Individual | 10/29/2012 | |
| Eiffel Healthcare LLC | Operational/managerial control | Organization | 04/01/2017 | |
| Burns, Stephen | Operational/managerial control | Individual | 08/01/2022 | |
| Lawrence, Ra | Operational/managerial control | Individual | 04/01/2017 | |
| Ensign Services Inc | Adp of the SNF | Organization | 05/01/2016 | |
| Sherman Health Holdings LLC | Adp of the SNF | Organization | 01/01/2022 | |
| Standard Bearer Healthcare Op, LP | Adp of the SNF | Organization | 01/01/2022 | |
| The Ensign Group Inc | Adp of the SNF | Organization | 01/01/2022 | |
| Burns, Stephen | Adp of the SNF | Individual | 08/01/2022 | |
| Lawrence, Ra | Adp of the SNF | Individual | 04/01/2017 |
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.
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