401 Swift Street, Refugio, TX 78377 · Refugio County · (361) 526-9223
90 certified beds, about 41 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 2020
CMS Care Compare ratings, data as of September 1, 2026 · CCN 676491 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on February 26, 2026, inspectors cited 5 health deficiencies (the Texas average is 9.4, the national average 9.2).
Of 25 health citations since August 2023, 3 were rated as actual harm or immediate jeopardy to residents (2 immediate jeopardy).
CMS lists 3 fines totaling $37,698 in the last three years; the largest was $15,216, and the latest is dated September 11, 2025.
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 0.72 of those hours.
96.9% of nursing staff left within the year CMS measured (Texas average 55.3%).
CMS links it to Creative Solutions in Healthcare, an affiliated group of 149 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 25 health citations on file.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure drugs and biologicals used in the facility were secured and stored in accordance with current accepted professional principles for 1 of 1 treatment carts observed for medication and treatment storage. The facility failed to ensure the treatment cart was locked and secured. This failure could place residents at risk of gaining access to unlocked medications and supplies which could cause them harm.
Inspectors wroteBased on interview and record review, the facility failed to ensure residents were free from any significant medication errors for 4 of 10 residents (Resident #2, Resident #5, Resident #8, and Resident #16) reviewed for medication errors in that:1. The facility failed to ensure Resident #2's blood pressure altering medications were administered and/or documented as ordered on 02/04/26 and 02/25/26. 2. The facility failed to ensure Resident #5's blood pressure altering medication was administered and/or documented as ordered on 22 of 76 opportunities from 02/01/26 to 02/26/26.3. The facility failed to ensure Resident #8's blood pressure altering medications were administered, and/or documented as ordered on 02/08/26.4. The facility failed to ensure Resident #16's blood pressure altering medications were administered, and/or documented as ordered on 02/17/26. [...]
Inspectors wroteBased on observation, interviews and record review, the facility failed to distribute and serve food with proper accordance with professional standards for food service safety. The kitchen staff member failed to wear the beard restraint properly to prevent hair from contacting food. The facility staff member failed to wear gloves during lunch and handled Resident #4's food bare handed. These failures could place residents who receive meals and/or snacks from the kitchen at risk for food contamination and food borne illness. Findings Include: Observations during the lunch hour in the dining room revealed on 02/25/26 at 12:30 PM revealed the MR who was helping to serve residents was in line to receive a tray from the kitchen to give to the residents proceeded to touch Resident #4's biscuit and push it back onto her plate and then to try to open the biscuit for her without wearing gloves. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility for 1 of 5 residents (Resident #3) reviewed for resident rights. The facility failed to place a privacy cover over Resident #3's catheter bag while she was in bed at 10:16 AM on 02/25/26 This failure could place residents at risk of feeling embarrassed or exposed.
Inspectors wroteBased on interview and record review the facility failed to coordinate to obtain and document a physician's order for an existing advanced directive of DNR status for 1 of 6 (Resident #2) residents reviewed for advance directives. The facility failed to ensure Resident #2's DNR was ordered and scanned into his EMR when it was signed by his RP on [DATE]. This failure could place residents at risk of not having their advance directives followed.
Inspectors wroteBased on observations, interviews, and record reviews, 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 of 6 residents (Resident #5) reviewed for infection control.1. The facility failed to ensure Resident #5 had an order for EBP (Enhanced Barrier Precautions) due to her right chest dialysis catheter. This failure could place residents at risk of cross-contamination and development or spread of infection. Record review of Resident #5's admission record reflected an [AGE] year-old female originally admitted to the facility on [DATE] with most recent admission on [DATE]. [...]
Inspectors wroteBased on interviews, and record reviews, the facility failed to protect the rights of one (Resident #1) of four residents reviewed for resident rights. The facility staff took a picture of Resident #1 without her permission. This failure could place residents at risk for an infringement of fundamental rights and a dignified existence. Review of Resident #1's face sheet dated [DATE] revealed Resident #1 was last admitted on [DATE]. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident received adequate supervision and assistance devices to prevent accidents for one (Resident #1) of 2 residents reviewed for accidents and hazards. The facility failed to ensure CNA A provided adequate supervision and used a 2-person assist while providing incontinent care to Resident #1. CNA A left Resident #1's bedside, while she lay on her right side. Due to her positioning, Resident #1 fell off the bed. Resident #1 sustained a rib fracture and contusions (bruising) to her right cheekbone, forehead, and back on 06/02/25. A PNC (Past Non-Compliance) Immediate Jeopardy (IJ) situation was identified on 06/02/25. The PNC IJ was removed on 06/30/25. The facility had corrected the noncompliance before the investigation began. [...]
Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure residents received treatment and care in accordance with professional standards of practice for 1 of 2 residents (Resident #2) reviewed for quality of care and dignity. The facility failed to ensure staff were providing adequate incontinent care for Resident #2 and that staff knew not to photograph the scenario on 02/27/25. The failures could affect residents residing in the facility, resulting in not receiving needed care and affecting their dignity.
Inspectors wroteBased on interview, and record review, the facility failed to ensure that a resident receives treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the resident's choices, for 1 of 3 residents (Resident #48) reviewed for quality of care. 1. The facility staff failed to ensure blood sugar checks were completed per physician's orders. Resident #48's blood sugar level dropped below normal causing him to become unresponsive then subsequently coded while he was in EMS care at the facility. 2. The facility failed to ensure that LVN G documented Resident #48's blood sugar result on the morning of [DATE]. 3. [...]
Inspectors wroteBased on observations, interviews, and record review, the facility failed to maintain an infection prevention and control program, including hand hygiene, designed to provide a safe, sanitary, and comfortable environment, and to help prevent the development and transmission of communicable diseases and infections for two (Resident #16 and Resident #43) of 4 residents reviewed for infection control practices. 1. The facility failed to ensure LVN B kept Resident #16's open wounds from coming in contact with a soiled surface. 2. The facility failed to ensure LVN A utilized EBP while flushing and giving medications through Resident #43's g-tube. These failures could place residents that require wound care at risk for healthcare associated cross-contamination and infections.
Inspectors wroteBased on interviews, and record review, the facility failed to ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source and misappropriation of resident property, were reported immediately, but not later than 2 hours after the allegation was made, if the events that caused the allegation involve abuse or resulted in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury, to the administrator of the facility and to other officials (including to the State Survey Agency and adult protective services where state law provides for jurisdiction in long-term care facilities) in accordance with State law through established procedures for 1 of 3 residents (Resident #48) reviewed for abuse/neglect reporting. [...]
Inspectors wroteBased on interviews, and record reviews, the facility failed to ensure a PASRR evaluation was completed on newly admitted residents prior to admission or after admission for 1 (Resident #5) of 5 residents reviewed for PASRR screenings. The facility failed to ensure Resident #5's PASRR Level 1 screening indicated he was positive for mental illness. This failure could place residents at risk of not receiving or benefiting from specialized therapy and equipment services they may require.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure that the comprehensive care plans were reviewed and revised by the interdisciplinary team after each assessment, for 1 resident (Resident #43) of 5 residents whose care plans were reviewed for timing and revision. Resident #43's care plan was not revised after his diet was changed from mechanical to nothing by mouth. Resident #43's care plan was not revised after returning from a local hospital with a new g-tube (feeding tube). Resident #43's care plan was not revised after enteral feeding was started. Resident #43's most recent care plan dated 10/15/24 was not revised after an actual fall on 10/31/24. This failure could place residents at risk for inadequate care.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure all drugs and biological were stored in locked compartments for one wound care cart of one reviewed for storage, in that: The facility failed to ensure the wound care cart was locked when left unattended. This deficient practice could place residents at risk of misappropriation of medications or harm due to accidental ingestion of unprescribed mediations.
Inspectors wroteBased on interviews and record review, the facility failed to maintain clinical records on each resident that were complete and accurately documented, in accordance with accepted professional standards and practices for 1 (Resident #48) of 3 residents reviewed for clinical records. The facility failed to ensure that LVN G documented Resident #48's blood sugar result on the morning of [DATE]. The facility failed to ensure that LVN D documented Resident #48's blood sugar result on the evening of [DATE] when he was found unresponsive on his bathroom floor. The facility failed to ensure that RN E documented the administration of Glucagon to Resident #48 on the evening of [DATE] when he was found unresponsive on his bathroom floor and his blood sugar was low. [...]
Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure that each resident received adequate supervision to prevent accidents for one (Resident #1) of 10 residents reviewed for supervision. The facility failed to ensure Resident #1 received adequate supervision while Resident #1 was unaccounted for approximately 36 minutes from 5:40 PM to 6:16 PM on 09/04/24 travelling approximately 500 feet while she eloped from the 200 hall exit door. Resident #1 was found approximately 100 feet from the front entrance along the side of the facility. The Immediate Jeopardy (IJ) template was provided to the facility on [DATE] at 4:10 PM. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, that included measurable objectives and time frames to meet the resident's physical, mental and psychosocial needs, for six residents (R#6, R#2, R#3, R#5, R#18, and #19) of sixteen residents reviewed for comprehensive care plans, in that: 1)The facility failed to ensure floor mats were in place for R#6 while in bed as stated in the care plan. 2)The facility failed to ensure R#2's care plans reflected he was eligible to attend special offsite activities/program for senior adults without signing out in the sign-out logs. 3)The facility failed to update R#3's care plans to reflect she was eligible to attend special offsite activities/program for senior adults without signing out in the sign-out logs. [...]
Inspectors wroteBased on interviews and record reviews, the facility failed to send a copy of the notice of transfer or discharge, and the reasons for the transfer or discharge in writing to the resident, resident representative, or the Office of the State Long-Term Care Ombudsman for one of six residents (Resident #8) reviewed for transfer and discharge. The facility failed to notify the Resident and Resident Representative of the transfer or discharge and the reason in writing and in a language or manner they understand. This failure could affect residents at the facility by placing them at risk of being discharged and not having access to available advocacy services, discharge/transfer options, and the appeal processes.
Inspectors wroteBased on interviews and record reviews, the facility failed to revise and review the care plans for 2 of 9 residents (R#4 and R#7) whose care plans were reviewed, in that: 1)The facility failed to ensure R#4's care plans to reflect actual falls. 2)The facility failed to update R#7's care plans to reflect actual falls. These failures could place residents at risk of receiving incorrect care and cause health complications with subsequent illnesses or injury.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public in one (300 hall) of four halls reviewed for environment. The facility failed to ensure the shower room on the 300 hall was closed and locked. This failure could place residents, staff, and visitors at risk for falls and result in serious injury.
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 reviewed and 1 of 1 nutrition room for sanitation. 1. The facility failed to ensure utensils were clean and in working order 2. The facility failed to ensure the meat slicer was kept clean 3. The facility failed to ensure the steam table was kept clean 4. The facility failed to ensure kitchen staff knew how to calibrate thermometers 5. The facility failed to ensure food items in the nutrition room refrigerator were not expired 6. The facility failed to ensure food items in the nutrition room refrigerator were labeled and dated These failures could place residents at risk of foodborne illnesses.
Inspectors wroteBased on observation, interview, and record review, the facility failed to establish and maintain a infection prevention program to provide a safe and sanitary environment for 1 of 1 laundry room, and 1 of 1 resident (Resident #34) reviewed for infection control, in that: A: failed to maintain an infection and prevention control program that included, at a minimum, a system for preventing and controlling Legionella through a program that identifies areas in the water system where Legionella bacteria can grow and spread. B: failed to ensure laundry was disinfected by monitoring/maintaining a water temperature of 140 degrees. C: [...]
Inspectors wroteBased on interviews and record reviews, the facility failed to ensure residents' right to formulate advanced directives for 1 of 8 residents (Resident # 33) reviewed for advanced directives in that: There was no order for Full Code for Resident #33 This failure could place residents at risk of having their end-of-life wishes dishonored
Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure residents maintained acceptable means of hydration for 1 of 8 (Resident #34) reviewed for hydration. Resident #34 did not have fluids for hydration available at the bedside during three surveyor observations from 08/01/2023 through 08/03/2023. This failure could place residents at risk for dehydration, decline in health, serious illness or hospitalization
| Date | Penalty | Amount or length |
|---|---|---|
| September 11, 2025 | Fine | $14,325 |
| November 23, 2024 | Fine | $15,216 |
| October 10, 2024 | Fine | $8,157 |
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 | 0.72 | 0.43 | 0.69 |
| All nursing staff on weekends | 2.89 | 2.98 | 3.42 |
| Nurse aides | 1.39 | ||
| Licensed practical nurses | 1.08 | ||
| Nursing staff turnover (share who left in a year) | 96.9% | 55.3% | 45.8% |
| Registered nurse turnover | 100.0% | 54.6% | 42.9% |
| Administrators who left | 4 |
CMS expects 3.76 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 3.30 on weekdays and 2.89 on weekends, 12% 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 3.36 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 | 0.72 | 3.30 | 2.89 | 0.0% | 0 of 90 | 41 |
| Oct to Dec 2025 | 3.03 | 0.50 | 3.15 | 2.75 | 0.0% | 0 of 92 | 42 |
| Jul to Sep 2025 | 2.92 | 0.67 | 3.08 | 2.51 | 0.0% | 0 of 92 | 42 |
| Apr to Jun 2025 | 3.36 | 0.66 | 3.61 | 2.73 | 0.0% | 0 of 91 | 42 |
| 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. 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 | 21.5 | 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 | 0.7 | 0.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 5.8 | 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 | 16.9 | 14.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 5.4 | 3.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 7.1 | 9.6 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 45.4 | 25.7 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 13.3 | 12.3 | 12.0 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Mission Ridge Rehab & Nursing Center's Medicare short-stay residents. How to read these, and what Medicare pays for.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
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. 20 eligible stays.
10.9% 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. 35 eligible stays.
8.7% 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. 29 eligible stays.
81.0% 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. 21 residents counted.
4.0% 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. 25 residents counted.
3.3% 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. 25 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
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. 9 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: REFUGIO II ENTERPRISES, LLC. CMS links this home to Creative Solutions in Healthcare, a group of 149 nursing homes averaging 2.1 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Huggins, Linda | W-2 managing employee | Individual | 03/01/2021 | |
| Creative Solutions in Healthcare Inc | Operational/managerial control | Organization | 02/01/2022 | |
| Blake, Gary | Operational/managerial control | Individual | 03/01/2021 | |
| Blake, Malisa | Operational/managerial control | Individual | 03/01/2021 |
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.