709 W Fifth St., Bonham, TX 75418 · Fannin County · (903) 583-8551
65 certified beds, about 44 residents a day · For profit - Corporation · Medicare and Medicaid since 1995
CMS Care Compare ratings, data as of September 1, 2026 · CCN 675471 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on July 2, 2026, inspectors cited 16 health deficiencies (the Texas average is 9.4, the national average 9.2).
Of 61 health citations since January 2024, 5 were rated as actual harm or immediate jeopardy to residents (4 immediate jeopardy).
CMS lists 2 fines totaling $278,005 in the last three years; the largest was $168,236, and the latest is dated February 27, 2025.
Nurses and nurse aides worked 3.46 hours per resident per day, against 3.39 across Texas and 3.86 nationally. Registered nurses accounted for 0.21 of those hours.
45.2% of nursing staff left within the year CMS measured (Texas average 55.3%).
CMS links it to Nexion Health, an affiliated group of 51 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 61 health citations on file.
Inspectors wroteBased on interviews and record review, the facility failed to ensure residents had a right to personal privacy for 3 of 3 confidential residents reviewed for resident rights to receive personal mail. The facility did not ensure residents promptly receive mail on Saturdays. This failure could place residents at risk with a decline in a resident's psychosocial well-being and quality of life.
Inspectors wroteBased on interview and record review, the facility failed to coordinate with the appropriate, State-designated authority, to ensure that individuals with a mental disorder, intellectual disability or a related condition received care and services in the most integrated setting appropriate to their needs for 3 of 6 residents (Resident #6, Resident # 31, and Resident #5) reviewed for resident assessments. 1. The facility failed to coordinate with the appropriate state authority to ensure Resident #6 had PASRR Comprehensive Service Plan (PSCP) meetings annually. 2. The facility failed to provide documentation of Resident #31's PASRR PCSP meetings held quarterly in the year 2025.3. The facility failed to provide documentation of Resident #5's habilitation coordination and independent living skills services as requested in the PCSP Form. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, which includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental needs, for 3 of 4 (Resident #12, Resident #3, and Resident #2) residents reviewed for comprehensive resident centered care plan .1. The facility failed to care plan medication for Resident #12 on 04/23/26 which included Eszopiclone (for insomnia), Lexapro (for depression), and Mirtazapine (for appetite and depression).2. The facility failed to care plan medication for Resident #3's on 06/01/26 which included Zolpidem (medication for insomnia).3. The facility did not ensure Resident #2 was measured for diabetic shoes and diabetic insoles per the physician order. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that a resident who needed respiratory care was provided such care, consistent with professional standards of practice, the comprehensive person-centered care plan, and the resident's goals and preferences for 3 of 4 residents (Residents #12, Resident #27 and Resident #9) reviewed for quality of care. 1. The facility failed to ensure Resident #12's oxygen was set at 2 liters per nasal cannula as ordered on 04/23/26. 2. The facility failed to ensure Resident #27's oxygen concentrator filter was clean. 3. The facility failed to ensure Resident #27's oxygen tubing and water bottle were changed and dated. 4. The facility failed to ensure Resident #9's oxygen tubing was changed when it was dirty. [...]
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 1 of 1 medication storage area (The Facility Medication Room) reviewed for pharmacy services. The facility failed to keep a record of receipt of controlled medications awaiting disposition to allow accurate and periodic reconciliation. This failure could place residents at risk for loss of prescribed medications, resident's safety, and drug diversion.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the meals served met the nutritional needs of residents for 1 of 1 meal (the lunch meal), as reviewed 1. The facility failed to ensure [NAME] E followed the recipe for preparing mechanical diets for Resident #2 on 06/29/26.2. The facility failed to ensure Dietary Manager C followed the recipe by using the correct scoop size when for preparing pinto beans and sausage for the puree lunch on 06/30/26. These failures could place residents at risk for choking, weight loss, not having their nutritional needs met, and a decreased quality of life. 1. Record review of Resident #2's face sheet, dated 07/02/26, reflected Resident #2 was a [AGE] year-old male, admitted to the facility on [DATE]. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide food that was palatable and served at an appetizing temperature for 4 of 18 residents (Resident #28, and 3 anonymous) and 1 of 1 lunch meals reviewed for palatability. The facility failed to provide palatable food served at an appetizing temperature or taste for Resident #28, and 3 anonymous residents, who complained the food served was mushy, cold, and hard. The dietary staff failed to provide food that was palatable for the lunch meal observed on 06/30/26. These failures could place residents at risk of weight loss, altered nutritional status, and diminished quality of life.
Inspectors wroteBased on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed for food and nutrition services. The facility did not ensure:1. Food items were labeled and dated.2. Hair restraints were worn correctly. 3. Hand washing was always performed. 4. The floors, bowls, saucers, pots/pans, and stove were cleaned.5. The microwave was clean and free of food debrisThese failures could place residents at risk for foodborne illness.
Inspectors wroteBased on record review, observations and interviews, the facility failed to enact a policy regarding use and storage of foods brought to residents by family and other visitors to ensure safe and sanitary storage, handling, and consumption for 2 of 2 residents (Resident #19 and Resident #37) reviewed in that: The personal refrigerators of Resident #19 and Resident #37 revealed temperatures were outside of the recommended guidelines and Resident #37 did not have a thermometer in his freezer. This failure could place residents at risk of foodborne illness due to consuming spoiled foods.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents received proper treatment and care to maintain good foot health by providing foot care and treatment, in accordance with professional standards of practice, including to prevent complications from the resident's medical condition for 1 of 18 residents (Resident #2) reviewed for foot care. The facility did not ensure Resident #2 was measured for diabetic shoes and diabetic insoles per the physician order. This failure could result in residents developing fungal infections or other podiatric problems.
Inspectors wroteBased on observation and interview, the facility failed to ensure the environment was as free of accident hazards as is possible and each resident receives adequate supervision to prevent accidents for 2 of 2 halls (east hall and west hall) reviewed for quality of care. The facility failed to ensure the shelves located on the east hall and west hall were free from rough edges. These failures could place residents at risk of accidents that could result in injury or harm.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents who were fed by enteral means received the appropriate treatment and services to prevent complications of enteral feeding for 1 of 1 resident (Resident #4) reviewed for quality of care. The facility failed to ensure Resident #4's physician's order for his enteral feedings (a form of nutrition that is delivered into the digestive system as a liquid form via the feeding tube) indicated the strength of the enteral feed and the specific administration method. This failure could affect residents receiving enteral nutrition and hydration and place them at risk of dehydration, weakness and malnutrition.
Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure all drugs were stored in a locked compartment, only accessible by authorized personnel for 1 of 18 residents (Resident #28) reviewed for storage and labeling of medications and 1 of 2 (East Hall nurse) medication carts reviewed for storage of medications. 1. The facility did not ensure Resident #28's Triamcinolone Acetonide cream (corticosteroid used to reduce inflammation, redness, and itching) was properly secured.2. The facility failed to ensure LVN M locked the east hall nurse's cart when left unattended in the hallway. These failures could place residents at risk for misuse of medication, overdose, drug diversions, adverse reactions of medications, and not receiving the therapeutic benefit of medications.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident received and the facility provided food that accommodated resident allergies, intolerances, and preferences for 2 of 2 residents (Residents #2 and #28) reviewed for food preferences and the accommodation of resident's meal choices. 1. The facility failed to ensure Resident #2's preference for large portions was honored on 06/29/26 and 06/30/26. 2. The facility did not ensure Resident #28's preference for over easy eggs was honored on 06/29/26 and 06/30/26. These failures could result in a decrease in resident choices, diminished interest in meals, and weight loss.
Inspectors wroteBased on record reviews and interviews the facility failed to maintain medical records in accordance with the accepted professional standards and practices that are complete and accurately documented for 2 of 2 (Resident #9 and Resident #24) residents reviewed for documentation. Resident #9 and Resident #24's electronic medical record did not contain complete and accurate documentation that reflected that the resident or the responsible party were informed of and attended or declined to attend the quarterly care conference meeting. This failure could result in the residents' records not accurately documenting participation in the plan of care.
Inspectors wroteBased on interviews 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 the 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 2 of 3 residents (Resident #12, and Resident #27) reviewed for hospice services.1. The facility failed to maintain Resident #12's hospice binder containing information related to hospice services provided for the resident such as the most recent medication profile, last two months of IDG also known as Interdisciplinary Group meetings (a regular, collaborative team review of a patient's care meetings), or updated recertification form.2. [...]
Inspectors wroteBased on interview and record review, the facility failed to ensure the discharge information was documented in the resident's medical record and appropriate information was communicated to the receiving health care institution or provider for 1 of 6 (Resident #1) residents reviewed for transfer and discharge process. The facility failed to ensure the necessary information, including a discharge summary was included in Resident #1's discharge with applicable information to include contact information of the practitioner responsible for the care of the resident, Advance Directive information, special instructions or precautions for ongoing care, and comprehensive care plan goals, was completed. This failure could result in poor continuity of care and harm or injury to resident during transition of care.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure residents maintained acceptable parameters of nutritional status, such as usual body weight or desirable body weight range and electrolyte balance, unless the resident's clinical condition demonstrated that it was not possible or the resident preferences indicated otherwise for 4 of 4 residents (Resident #1, Resident #2, Resident #3, Resident #4) reviewed for nutrition status. 1. The facility failed to follow dietary recommendations for Resident #1. Resident # 1 lost 8.2 lbs. from 12/03/2025 to 01/12/2026 which was a significant weight loss of 5.0%. 2. The facility failed to follow dietary recommendations for Resident #2. Resident #2 lost 16.9 lbs. from 12/04/2025 to 01/12/2026 which was a significant weight loss of 5.5% in 1 month. 3. The facility failed to follow dietary recommendations for Resident #3. [...]
Inspectors wroteBased on observation, interview and record review, the facility failed to provide sufficient number of nursing staff on a 24-hour basis to provide nursing care to all residents in accordance with resident care plans and the facility assessment for 1 of 1 facility reviewed and 3 of 20 residents (Resident #2, Resident #4, and Resident #5) for care and services. 1. The facility failed to ensure Resident #2 medications were administered during the scheduled time. 2. The facility failed to ensure sufficient staff was provided to ensure Resident #4 received her showers on Saturdays. 3. The facility failed to ensure sufficient staff was provided to ensure Resident #5 was able to get out of bed when requested. 4. [...]
Inspectors wroteBased on observations, interviews, and record review the facility failed provide pharmaceutical services, which included procedures that assured the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals, to meet the needs of each resident for 1 of 3 residents (Resident #2) reviewed for pharmacy services. The facility failed to ensure Resident #2 medications were administered during the scheduled time. This failure could place residents at risk of medical complications and not receiving the therapeutic effects of their medications.
Inspectors wroteBased on interview and record review, the facility failed to ensure a resident who was unable to carry out activities of daily living receives the necessary services to maintain good nutrition, grooming and personal and oral hygiene for 1 of 9 residents (Resident #4) reviewed for quality of life. The facility failed to provide Resident #4's showers as scheduled on Saturdays. This failure could place residents at risk of not receiving the services and care needed, decreased self-esteem, and a decreased quality of life.
Inspectors wroteBased on interview and record review the facility failed to provide sufficient support personnel to carry out the functions of the food and nutrition service for 1 of 4 dietary staff (Dietary Aide G). The facility failed to ensure that dietary staff (Dietary Aide G) serving in the kitchen maintained a current Food Handler Certificate. This failure could place residents at risk of the facility not having staff to provide dietary services requirements.
Inspectors wroteBased on observation, interviews, and record reviews, the facility failed to provide rehabilitative services as the physician ordered, for 1 (Resident #5) of 12 residents reviewed for rehabilitative services. The facility failed to ensure that Resident #5 received physical therapy (PT) or occupational therapy (OT) treatments as ordered by the physician from 06/16/25 through 06/20/25 and again from 06/23/25 through 06/24/25. This deficient practice could place residents who require rehabilitative services at risk of a decline or decrease in their physical capabilities.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for 4 of 7 residents reviewed for environment. (Resident #1, Resident #2, Resident #3, and Resident #4). The facility failed to ensure Residents #1, #2, #3 and #4's heating and cooling vents, within the rooms they resided in, were not covered in black mold like substance on 5/24/25. This failure could cause decreased quality of life, and health complications of respiratory issues.
Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure all drugs were stored in a locked compartment, only accessible by authorized personnel for 1 of 7 resident (Resident #1) reviewed for medications at their bedside. The facility did not ensure Resident #1's was administered his Protonix pill (a proton pump inhibitor used to treat GERD [gastroesophageal reflux disease a common digestive disease in which stomach acid or bile irritates the food pipe lining]) during his morning medication pass on 5/24/25 and left the unlabeled, unsecured medication on Resident #1's bedside table for several hours. This failure could place residents at risk for misuse of medication, overdose, drug diversions, adverse reactions of medications, and not receiving the therapeutic benefit of medications.
Inspectors wrote2. Record review of Resident #22's face sheet, dated 04/23/25, reflected Resident #22 was a [AGE] year-old male, readmitted to the facility on [DATE] with a diagnosis which included multiple sclerosis (chronic, progressive disease involving damage to the sheaths of nerves cells in the brain and spinal cord causing numbness, impairment of speech, and of muscular coordination, blurred vison and sever fatigue). Record review of Resident #22's significant change in status MDS, dated [DATE], reflected Resident #22 made himself understood, and understood others. Resident #22's BIMS score was 15, which indicated his cognition was intact. Resident #22 required substantial/maximum assistance with eating, oral hygiene, upper body dressing, personal hygiene and dependent with toileting, shower/bath, and lower body dressing. [...]
Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure all drugs were stored in a locked compartment, only accessible by authorized personnel for 1 of 18 resident (Resident #103) reviewed for medications at their bedside. The facility did not ensure Resident #103's fluticasone propionate (nasal spray), biotene dry mouth Moisturizing Spray, and barbasol shaving cream were secured in locked compartments and not left on his bedside table and windowsill. This failure could place residents at risk for misuse of medication, overdose, drug diversions, adverse reactions of medications, and not receiving the therapeutic benefit of medications.
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, for 4 of 4 eyewash stations reviewed (kitchen eyewash, laundry eyewash station, east wing medication room eyewash station, and east wing shower room eyewash station) reviewed for physical environment. The facility failed to ensure the Saline eyewash solutions located in the kitchen, the medication room on east wing, the laundry, and the shower room were within the date of expiration.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that residents who need respiratory care were provided such care consistent with professional standards of practice for 4 of 8 residents (Residents #103, #35, #203, and #36) reviewed for oxygen therapy. 1. The facility failed to ensure Resident #103 had physician's order in his chart for oxygen. 2. The facility failed to ensure Resident #35 's oxygen was placed on 2 liters per nasal cannula as ordered by the physician. 3. The facility failed to ensure Resident #203 had an oxygen order and an oxygen sign on her door. 4. The facility failed to ensure Resident #36 had orders for oxygen. These failures could place residents who receive respiratory care at risk for developing respiratory complications and a decreased quality of care. Findings Included: 1. [...]
Inspectors wroteBased on observation, interview, and record review the facility failed to provide residents with food and drink that was palatable, attractive, and at a safe and appetizing temperature for 4 of 18 residents (Resident #31, Resident #47, Resident #8, and Resident #42) and 1 of 3 meals observed. The facility failed to provide palatable food served at an appetizing temperature or taste to Resident #47, Resident #31, Resident #8, and Resident #42. The facility failed to provide food that was palatable for 1 of 3 meals observed on 04/22/25 (lunch) meal. This failure could place residents at risk of decreased food intake, weight loss, altered nutritional status, and a diminished quality of life.
Inspectors wroteBased on interviews and record review, the facility failed to ensure consent to the prescription of psychoactive medications given by a resident or by a person authorized by law to give consent on behalf of the resident is valid only if consent is given in writing on a form prescribed by HHSC for 1 of 18 (Residents #1) residents reviewed for psychoactive medications. The facility did not ensure written consent was obtained from the legal authorized representative on HHSC Form 3713 to administer Seroquel 25mg to Resident #1. This failure could place residents at risk for receiving antipsychotic medications without informed consent.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident had the right to reside and receive services in the facility with reasonable accommodation of resident needs and preferences for 1 of 18 residents (Resident #45) reviewed for reasonable accommodations. The facility did not ensure portable oxygen was available to allow Resident #45 to leave his room. This failure could place residents at risk for decreased quality of life, self-worth, and dignity.
Inspectors wroteBased on interview and record review, the facility failed to ensure the right to formulate an advanced directive was provided for 1 of 18 residents (Resident #37) reviewed for advanced directives. 1. The facility did not ensure Resident #37's OOH-DNR included the MPOA printed name and date the document was signed. 2. The facility did not ensure Resident #37's OOH-DNR included the notary's signature. 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 each resident was informed before, or at the time of admission, and periodically during the residents stay, of services available in the facility and of changes for those services, which included changes for services not covered under Medicare/Medicaid or by the facility's per diem rate for 1 of 3 residents (Resident #104) reviewed for Medicare/Medicaid coverage. The facility failed to ensure Resident #104 was given a SNF ABN when discharged from skilled services at the facility prior to covered days being exhausted. This failure could place residents at risk for not being aware of changes to provided services.
Inspectors wroteBased on interview and record review, the facility failed to ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source were reported immediately, but no later than 2 hours after the allegation was made, for 1 of 18 (Resident #11) residents reviewed for abuse and neglect. The Abuse Coordinator failed to identify and report an allegation of abuse to HHSC within 2 hours when LVN E informed him on 04/22/25 that CNA D witnessed Resident #16 hit Resident #11 right arm. This failure to report could place the residents at risk for abuse.
Inspectors wroteBased on interview and record review, the facility failed to ensure all alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source, and misappropriation of resident property were thoroughly investigated for 1 of 18 residents (Resident #11) reviewed for abuse. The Abuse Coordinator failed to investigate/protect/correct when an allegation of abuse allegedly occurred when LVN E informed him on 04/22/25 that CNA D witnessed Resident #16 hit Resident #11 right arm. This failure could place residents at risk for abuse, neglect, exploitation, mistreatment, and further injuries of unknown source.
Inspectors wroteBased on interview and record review, the facility failed to ensure assessments accurately reflected the resident status for 2 of 18 residents (Residents #16 and #30) reviewed for MDS assessment accuracy. 1. Resident #16's quarterly MDS, dated [DATE], identified the resident had a feeding tube. However, Resident #16 did not have a feeding tube. 2. Resident #30's quarterly MDS, dated [DATE], identified the use of restraint for Resident #30. However, Resident #30 had a transfer assist bar (bar used on the side of the bed to help with movement). These failures could place residents at risk of not receiving adequate care and services to meet their needs.
Inspectors wroteBased on interview and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs, for 2 of 5 (Resident #203 and Resident #36) residents reviewed. The facility failed to care plan Resident #203 and Resident #36's oxygen. These failures could affect residents by placing them at risk of not receiving appropriate interventions to meet their current needs.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident's drug regimen was free of unnecessary medication for 1 of 9 residents reviewed for unnecessary medication (Resident #40) The facility did not monitor Resident #40 for side effects of the anticoagulation medication, Eliquis (a blood-thinning medication). This failure could place the residents at risk for adverse consequences of the anticoagulant medication.
Inspectors wroteBased on interview and record review, the facility failed to ensure laboratory services were obtained to meet the needs of 1 of 18 residents (Resident #25) reviewed for laboratory services. The facility failed to ensure Resident #25's Comprehensive Metabolic Panel, also known as CMP (a blood test that checks for a wide range of substances in your blood, including proteins, enzymes, electrolytes, and minerals) was drawn every 6 months as ordered. Also, his Phenobarbital (used to control seizures) and Dilantin (an anti-seizure medication) levels were not drawn every 3 months as ordered. This failure could place residents at risk of not receiving lab services as ordered and not managing medications at a therapeutic level.
Inspectors wroteBased on interview and record review the facility failed to promptly notify and follow-up with the ordering physician regarding laboratory results outside of clinical reference range for 1of 18 residents (Resident #1) reviewed for laboratory services. 1. The facility did not ensure the physician was notified when Resident #1's Dilantin (used to control seizures) and Phenobarbital (used to control seizures) level was low. This failure could place residents at risk of not receiving lab services as ordered and not managing medications at a therapeutic level.
Inspectors wroteBased on observation, interviews, and record review, the facility failed to follow menus for 1 of 12 residents (Resident #4) meal reviewed for menus. The facility did not ensure Resident #4 received ground chicken fried chicken as ordered instead of ground beef patty. This failure could result in a decrease in resident choices, diminished interest in meals, and weight loss.
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, in that: 1) The facility failed to ensure the ice scoop holder did not have sediment in the bottom. 2) Dietary staff failed to dispose of expired boiled eggs in the refrigerator dated 04/03/25. These failures could place residents at risk for food contamination and foodborne illness.
Inspectors wroteBased on observation, interview, and record review, the facility failed to establish policies regarding smoking areas, and smoking safety for 1 of 1 smoking area. The facility failed to ensure cigarettes were not discarded in the trash can designed for the disposing of trash. This failure could place residents who smoke at risk of physical harm and lead to an unsafe smoking environment. Findings Included: During an observation of the and interview on 04/22/25 at 11:05 a.m., there was a trash can with a cigarette that had been smoked noted inside the trash can located in the designated smoking area. Laundry Aide EE stated whoever takes the residents out to smoke should check the trash can for cigarettes. Laundry Aide EE stated the trash can should not have cigarettes inside, only trash. Laundry Aide EE stated this failure could put residents at risk for a fire. [...]
Inspectors wroteBased on observation, interview, and record review the facility failed to post the nurse staffing data on a daily at the beginning of each shift for 2 days of 23 days of reviewed for April 2025 nursing staffing. The facility failed to post the total number of hours worked for licensed nurses and certified nurse aides or the daily census on April 22, 2025, and April 23, 2025. This failure could place residents at risk of being unaware of the facility daily staffing requirements.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that the resident environment remained free of accident hazards and each resident was provided adequate supervision to prevent injuries for 1 of 6 residents (Resident #1) reviewed for accident hazards. The facility failed to ensure Resident #1's bed was locked while providing care resulting in a fall with fractures to the orbital floor (a break to the thin, bony plate that forms the bottom of the eye socket) and cervical spine on 1/30/25. This failure resulted in an identification of an Immediate Jeopardy (IJ) on 2/26/25 at 12:00 p.m. While the IJ was removed on 2/27/25, the facility remained out of compliance at no actual harm with a scope identified as isolated due to the facility's need to complete in-service training and evaluate the effectiveness of the corrective systems. [...]
Inspectors wroteBased on interview 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, are reported immediately, but , but not later than 2 hours after forming the suspicion, if the events that cause the suspicion result in serious bodily injury, or not later than 24 hours if the events that cause the suspicion do not result in serious bodily injury for 1 of 6 (Resident #1) residents reviewed for abuse and neglect. The facility staff did not report to the state agency Resident #1's fractured orbital floor (a break to the thin, bony plate that forms the bottom of the eye socket) and cervical spine fractures, following a fall out of bed during care, that were discovered during a hospital admission starting 1/30/25. [...]
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 in (1 of 1) kitchen reviewed for dietary services. 1) The facility failed to label and date all food items in the refrigerator and freezer #1. 2) Dietary staff failed to dispose of expired food items. 3) Dietary Staff failed to store (1) dented cans in a separate area. 4) Dietary Staff failed to effectively reseal, label and date frozen food items. 5) The dietary staff failed to maintain safe temperatures at or above 135 degrees F for hot foods. 6) The facility failed to store raw foods (ground turkey) in a manner to reduce the risk of contamination of cooked or ready-to-eat foods. 7) The dietary staff failed to clean the microwave after use. [...]
Inspectors wroteBased on observations, interviews, and record reviews the facility failed to provide a safe, clean, comfortable, and homelike environment in 2 of 2 halls (hall 100 and hall 200) reviewed for a clean and homelike environment. 1. The facility failed to ensure hall 200 was free of a urine odor. 2. The facility failed to deep clean several room floors on Hall 100. 3. The facility failed to ensure the wallpaper for Resident #45 was not peeling/torn. 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 observations, interviews, and record review the facility failed to ensure that residents requiring respiratory care were provided such care, consistent with professional standards of practice for 1 of 4 (Resident #16) who were reviewed for respiratory care. The facility failed to ensure Resident #16 had orders for her Bipap machine (a type of ventilator-a device that helps with breathing). This failure could place residents who receive respiratory care at risk of developing respiratory complications and a decreased quality of care.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure that licensed nurses have the specific competencies and skill sets necessary to care for residents' needs, as identified through resident assessments and described in the plan of care for 1 of 1 resident reviewed (Resident #16) for respiratory care. The facility failed to ensure nurses were trained on the use of a Bipap machine (a machine that helps you breathe) for Resident #16. This failure could potentially affect residents by placing them at an increased and unnecessary risk of exposure to staff who lack the appropriate skills and competencies to provide safe care and minimize respiratory issues.
Inspectors wroteBased on interviews and record review, the facility failed to ensure each Minimum Data Set (MDS) was electronically completed and transmitted to the CMS System within 14 days after completion for 1 of 16 residents (Resident #36) reviewed for MDS transmittal. The facility did not ensure Resident # 36's quarterly MDS assessment dated [DATE] was completed and successfully electronically transmitted and accepted as required as of 03/06/2024. This deficient practice could place residents at risk of not having their assessments transmitted and accepted in a timely manner and causing a delay in payments for the facility.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure the resident environment remains as free of accident hazards as possible to prevent accidents for 1 of 2 hallways (Hall 100) and 1 of 1 oxygen storage areas reviewed for accidents. 1. The facility did not ensure the flooring on Hall 100 was even and free of cracked/broken floor tiles. 2. The facility failed to ensure 1 oxygen cylinder was secured in the oxygen storage area. These failures could place residents at risk for injury.
Inspectors wroteBased on observations, interviews, 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 1 of 1 storage area reviewed for expired and discontinued medications. The facility failed to keep a record of receipt of controlled medications awaiting disposition to allow accurate and periodic reconciliation. This failure could place residents at risk for loss of prescribed medications, resident's safety, and drug diversion.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure the meals served met the nutritional needs of residents for 1 of 1 meal (the lunch meal) reviewed for nutritional adequacy, as evidenced by: 1.) The facility failed to serve hot spiced apples as part of the noon-time (lunch) meal on 3/5/24 for all residents. The residents were served sherbert ice cream instead. 2) The facility failed to follow puree recipe for chicken fettuccine alfredo served on 3/5/24 (lunch meal) for residents on a puree diet. This failure could affect all residents in the facility who required pureed food consistency by placing them at risk of not receiving adequate nutritive food value needed to promote/maintain health.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide food that was palatable, attractive, and at a safe and appetizing temperature for 1 of 3 meals reviewed for palatability, attractiveness, and appetizing . The dietary staff failed to provide food that was palatable and appetizing temperature for 1 of 3 meals observed on 3/5/24 (lunch) meal for all residents. These failures could place residents at risk of decreased food intake, hunger, and unwanted weight loss.
Inspectors wroteBased on observations, interviews, 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 3 residents (Resident #43) and 1 of 3 shower rooms (hall 100 shower room) reviewed for infection control practices. 1) Facility failed to ensure [NAME] button extension for Resident #43 was bagged and dated. 2) LVN D failed to wash or sanitize hands and change gloves between dirty and clean while providing bolus feeding for Resident #43. 3) The facility failed to store clean linen away from dirty. These failures could place residents and staff at risk for cross contamination and the spread of infection.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide treatment and care in accordance with the comprehensive person-centered care plan and in accordance with professional standards of practice for 1 of 6 residents reviewed for quality of care. (Resident #1) The facility failed to provide an in-house wound evaluation for treatment of Resident #1's left foot declining condition. The facility failed to provide an evaluation to ensure Resident #1's mental health did not complicate her physical health. The facility failed to provide a recent to provide psychiatric services when Resident #1's behaviors continued. The facility failed to accurately assess Resident #1's left foot wound. The facility failed to inform the physician of continued refusals of medical care and psychiatric care . An IJ was identified on 1/11/2024 at 12:56 p.m. [...]
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure each resident received necessary behavioral health care services to maintain the highest practicable mental and psychosocial wellbeing for 1 of 6 residents (Resident #1) reviewed for behavioral services. The facility failed to have Resident #1 evaluated for decision making capacity. The facility failed to provide a psychological evaluation to determine if Resident #1 was a harm to herself. The facility failed to re-offer psychiatric services since 8/2023 for Resident #1. The facility failed to develop interventions to address the resident's acute schizophrenic behaviors. The facility failed to implement licensed social services to provide crises support, and coordination with the healthcare team. The facility failed to recognize and obtain Resident #1's schizophrenia diagnosis from behavioral health care. [...]
Inspectors wroteBased on interview and record review, the facility failed to ensure adequate supervision and assistance devices to prevent accidents for 1 of 3 (Resident #2) residents reviewed for accidents. The facility failed to ensure CNA F used two-person assistance to provide incontinent care for Resident #2 which resulted in a fall with injury. This failure could place residents at risk of injuries, falls and hospitalizations.
15 fire safety citations on file: 5 on July 2, 2026, 6 on April 24, 2025, 4 on March 6, 2024.
| Date | Penalty | Amount or length |
|---|---|---|
| February 27, 2025 | Fine | $168,236 |
| January 12, 2024 | Fine | $109,769 |
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) | 3.46 | 3.39 | 3.86 |
| Registered nurses | 0.21 | 0.43 | 0.69 |
| All nursing staff on weekends | 3.23 | 2.98 | 3.42 |
| Nurse aides | 1.95 | ||
| Licensed practical nurses | 1.30 | ||
| Nursing staff turnover (share who left in a year) | 45.2% | 55.3% | 45.8% |
| Registered nurse turnover | not reported | 54.6% | 42.9% |
| Administrators who left | 1 |
CMS expects 3.58 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.55 on weekdays and 3.23 on weekends, 9% 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 2.91 in April to June 2025 to 3.46 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 | 3.46 | 0.21 | 3.55 | 3.23 | 0.0% | 0 of 90 | 44 |
| Oct to Dec 2025 | 3.66 | 0.27 | 3.84 | 3.21 | 0.0% | 0 of 92 | 45 |
| Jul to Sep 2025 | 3.11 | 0.30 | 3.28 | 2.68 | 0.0% | 0 of 92 | 49 |
| Apr to Jun 2025 | 2.91 | 0.21 | 3.08 | 2.49 | 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
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Texas, all employers | |||
| CNAs (nursing assistants) | $18.03 | $16.97 to $20.71 | 88,680 |
| LPNs and LVNs | $29.92 | $27.46 to $32.89 | 57,560 |
| Registered nurses | $46.14 | $38.06 to $50.53 | 271,380 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Texas | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 23.4 | 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 | 0.0 | 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 | 20.2 | 14.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 3.4 | 3.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 12.0 | 9.6 | 15.4 |
For a stay to recover after a hospital visit, these are the results CMS publishes for North Star Ranch Rehabilitation and Healthcare Cen'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. 22 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. 30 eligible stays.
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 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. 18 eligible stays.
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: 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. 6 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: 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. 6 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: 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. 6 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. 1 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 Nexion Health, a group of 51 nursing homes averaging 2.2 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Fannin County Hospital Authority | 5% or greater direct ownership interest | Organization | 100% | 05/01/2025 |
| Holt, Erin | Managing control - governing body | Individual | 02/25/2020 | |
| Keeton, Wendy | Managing control - governing body | Individual | 10/29/2012 | |
| Kissling, Monica | Managing control - governing body | Individual | 06/21/2017 | |
| Liberatore, Dante | Managing control - governing body | Individual | 12/19/2022 | |
| McBean, Patricia | Managing control - governing body | Individual | 08/30/2021 | |
| Owens, Angela | Managing control - governing body | Individual | 06/22/2016 | |
| Riner, Meera | Managing control - governing body | Individual | 02/01/2012 | |
| Sanderson, Clark | Managing control - governing body | Individual | 10/29/2012 | |
| Trompler, Kelly | Managing control - governing body | Individual | 02/22/2022 | |
| Sanderson, Clark | Corporate officer | Individual | 05/01/2025 | |
| Fannin County Hospital Authority | Operational/managerial control | Organization | 05/01/2025 | |
| Nexion Health at Bonham, Inc. | Operational/managerial control | Organization | 05/01/2025 | |
| Nexion Health Leasing, Inc. | Operational/managerial control | Organization | 05/01/2025 | |
| Nexion Health of Ohi Inc | Operational/managerial control | Organization | 05/01/2025 | |
| Nexion Health, Inc. | Operational/managerial control | Organization | 05/01/2025 | |
| Correra, Kristy | Operational/managerial control | Individual | 11/17/2025 | |
| Fallon, John | Operational/managerial control | Individual | 05/01/2025 | |
| Kirley, Christopher | Operational/managerial control | Individual | 05/01/2025 | |
| Kirley, Francis | Operational/managerial control | Individual | 05/01/2025 | |
| Liberatore, Dante | Operational/managerial control | Individual | 05/01/2025 | |
| Mitchell, Ryan | Operational/managerial control | Individual | 05/01/2025 | |
| Pierce, Daniel | Operational/managerial control | Individual | 05/01/2025 | |
| Riner, Meera | Operational/managerial control | Individual | 05/01/2025 | |
| Sanderson, Clark | Operational/managerial control | Individual | 05/01/2025 | |
| Shah, Jagdish | Operational/managerial control | Individual | 05/01/2025 | |
| Thomison, Isaac | Operational/managerial control | Individual | 05/01/2025 | |
| Fannin County Hospital Authority | Adp of the SNF | Organization | 05/01/2025 | |
| Nexion Health at Bonham, Inc. | Adp of the SNF | Organization | 05/01/2025 | |
| Nexion Health Leasing, Inc. | Adp of the SNF | Organization | 05/01/2025 | |
| Nexion Health of Ohi Inc | Adp of the SNF | Organization | 05/01/2025 | |
| Nexion Health, Inc. | Adp of the SNF | Organization | 05/01/2025 | |
| Correra, Kristy | Adp of the SNF | Individual | 11/17/2025 | |
| Fallon, John | Adp of the SNF | Individual | 05/01/2025 | |
| Kirley, Christopher | Adp of the SNF | Individual | 05/01/2025 | |
| Kirley, Francis | Adp of the SNF | Individual | 05/01/2025 | |
| Liberatore, Dante | Adp of the SNF | Individual | 05/01/2025 | |
| Mitchell, Ryan | Adp of the SNF | Individual | 05/01/2025 | |
| Pierce, Daniel | Adp of the SNF | Individual | 05/01/2025 | |
| Riner, Meera | Adp of the SNF | Individual | 05/01/2025 | |
| Sanderson, Clark | Adp of the SNF | Individual | 05/01/2025 | |
| Shah, Jagdish | Adp of the SNF | Individual | 05/01/2025 | |
| Thomison, Isaac | Adp of the SNF | Individual | 05/01/2025 |
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.
Chosen from this home's own inspection record.
These are the official offices in Texas. NursingHomeClear cannot take or act on complaints.