2900 Stillhouse Road, Paris, TX 75462 · Lamar County · (903) 785-1601
150 certified beds, about 100 residents a day · Government - Hospital district · Medicare and Medicaid since 2008
CMS Care Compare ratings, data as of September 1, 2026 · CCN 676190 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on May 22, 2025, inspectors cited 19 health deficiencies (the Texas average is 9.4, the national average 9.2).
Of 46 health citations since January 2023, 1 was rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 1 fine totaling $8,162 in the last three years; the largest was $8,162, and the latest is dated March 7, 2024.
Nurses and nurse aides worked 3.24 hours per resident per day, against 3.39 across Texas and 3.86 nationally. Registered nurses accounted for 0.29 of those hours.
32.8% of nursing staff left within the year CMS measured (Texas average 55.3%).
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 46 health citations on file.
Inspectors wroteBased on observation, interview 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 to help prevent the development and transmission of communicable diseases and infections for 1 of 4 residents (Resident #1) reviewed for infection control. The facility failed to ensure CNA B followed enhanced barrier precautions when providing incontinent care to Resident #1 on 06/06/2026. This failure could place residents at risk for cross contamination and the spread of infection due to lack of implementation of orders.
Inspectors wroteBased on interview and record review, the facility failed to ensure laboratory services were obtained to meet the needs of 3 of 22 residents (Residents #10, #13 and #27) reviewed for laboratory services. 1. The facility did not obtain a physician's ordered BMP (test used to monitor the blood sugar levels, the balance of electrolytes and fluid as well as the health of kidneys) for Resident #10. 2. The facility did not obtain a physician's ordered Hgb A1C (measures the average blood sugar levels over the past 2-3 months) for Resident #13. 3. The facility did not obtain a physician's ordered CBC (used to measure different parts and features of blood) for Resident #27. These failures could place residents at risk of not receiving lab services as ordered and not managing medications at a therapeutic level.
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 safety in the facility's only kitchen. 1. The facility failed to ensure dented canned goods were removed from the pantry on 05/19/25. 2. The facility failed to ensure the outdated milk was removed from the refrigerator before it expired on 04/25/25. These failures could place residents at risk for food contamination and foodborne illness.
Inspectors wroteBased on interview and record review, the facility failed to maintain a quality assessment and assurance committee consisting at a minimum of the required committee members for 3 of 6 meetings (10/21/24, 11/18/24, and 12/16/24) reviewed for QAA committee. 1. The facility did not ensure the Administrator D, or a representative attended QAPI meetings on 10/21/24, and 12/16/24. 2. The facility did not ensure the DON attended QAPI meetings on 11/18/24, and 12/16/24. These failures could place residents at risk for quality deficiencies being unidentified, no appropriate plans of action developed and implemented, and no appropriate guidance developed.
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 3 of 4 residents (Resident #24, Resident #36 and Resident #10) reviewed for infection control. 1. The facility failed to ensure CNA L performed hand hygiene while providing incontinent care for Resident #24 on 05/21/25. 2. The facility failed to ensure CNA B and CNA C cleaned Resident #36's front perineal area when they provided incontinent care and failed to ensure CNA B followed enhanced barrier precautions when providing care on 05/19/2025. 3. The facility did not ensure CNA F followed enhanced barrier precautions while assisting Resident #10 with catheter care on 05/20/25. [...]
Inspectors wroteBased on observation, interviews and record review, the facility failed to ensure 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 21 (Residents #66) residents reviewed for psychoactive medications. The facility failed to ensure Resident #66 had signed a psychotropic consent from the resident or family for Ativan (antianxiety medication) before administering to Resident #66 on 05/17/25. This failure could place residents at risk for receiving unnecessary antipsychotic medications without informed consent.
Inspectors wroteBased on interview and record review, the facility failed to ensure all residents had the right to formulate an advance directive for 1 of 21 residents (Resident #24) reviewed for advanced directives. The facility failed to complete Resident #24's DNR (Do Not Resuscitate) or Out-of-Hospital do-not-resuscitate (OOH-DNR) form correctly on 07/26/24. This failure could place residents at risk for not having their end-of-life wishes honored and for incomplete records.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the residents' right to privacy during personal care for 1 of 22 residents (Resident #24) reviewed for privacy. The facility failed to ensure RN A provided privacy to Resident #24 when she administered Resident #24's medication via her PEG tube (tube placed in the stomach to administer feedings and medications) on 05/20/2025 when RN A did not close the privacy curtain and she did not close the door. This failure could place residents at risk of having their bodies exposed to the public, low self-esteem, and a diminished quality of life.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, clean, comfortable, and homelike environment, which allowed residents to use his or her personal belongings to the extent possible for 1 of 22 residents (#27) reviewed for environment. The facility did not ensure Resident #27's bathroom drains were free from a foul sewage odor. These failures could place the residents at risk for embarrassment due to the room having a foul odor.
Inspectors wroteBased on interview and record review, the facility failed to implement written policies and procedures that prohibit mistreatment, neglect, and abuse of residents, for 3 of 22 residents (Resident #23, Resident #32 and Resident #47) reviewed for abuse. 1. The facility failed to follow their policy to report to HHSC when Resident #32 alleged a hospital staff member hit her while in the hospital on 5/10/2025. 2. The facility did not implement their policy on reporting abuse to state agency for a resident-to-resident altercation that occurred on 05/02/25 between Resident #23 and Resident #47. These failures could place residents at risk of abuse, physical harm, mental anguish, and emotional distress.
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 involved abuse or resulted in serious bodily injury, or not later than 24 hours if the events that caused the allegation did not involve abuse and did 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 3 of 22 residents (Resident #23, Resident #32, and Resident #47) reviewed for abuse. 1. [...]
Inspectors wroteBased on interview and record review the facility failed to ensure assessments accurately reflected the resident status for 2 of 22 residents (Residents #23 and #27) reviewed for MDS assessment accuracy. 1. The facility failed to interview Resident #23 regarding his mood on his 04/18/25 quarterly MDS assessment. 2. The facility failed to accurately reflect Resident #27's active diagnoses to not include a diagnosis of depression (a mood disorder characterized by persistent feelings of sadness and loss of interest or please in activities) on his 04/19/25 quarterly MDS assessment. These failures 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 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 1 of 8 (Resident #29) residents reviewed for the care plans. The facility failed to ensure Resident #29's fall mat was beside her bed on 05/20/25. This failure 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 residents who were unable to carry out activities of daily living received the necessary services to maintain good nutrition, grooming, and personal and oral hygiene for 1 of 22 residents (Resident #68) reviewed for ADL (activities of daily living) care. The facility failed to provide nail care by removing black material from under fingernails for dependent female Resident #68 on 05/19/2025 and 05/20/2025. This failure could place residents at risk of not receiving care and services to meet their needs.
Inspectors wroteBased on interviews, 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 1 of 22 residents (Residents #13) reviewed for pharmacy services. The facility did not ensure Resident #13 was given Tylenol (pain medication) 650 mg after a fall with complaints of lower back pain. This failure could place the resident at risk of not receiving medications as ordered.
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 22 resident (Resident #22) reviewed for storage and labeling of medications. The facility did not ensure Resident #22's eye drops was properly secured. 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 observations, interviews, and record review the facility failed ensure each resident receives and the facility provides food that accommodates residents' food preferences for 1 of 22 residents (Resident #10) reviewed for food preferences and the accommodation of resident's meal choices. The facility did not honor Resident #10's preference for chocolate health shake. 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 ensure food was prepared in a form designed to meet individual needs and as prescribed by the physician for 1 of 22 residents (Resident #10) reviewed for therapeutic diets. The facility did not ensure Resident #10 was given double protein portion as ordered by the physician. This failure could place residents at risk for poor intake, weight loss, unmet nutritional needs, and a loss of dignity. Findings Included: Record review of Resident #10's face sheet, dated 05/27/25, reflected Resident #10 was a [AGE] year-old female, readmitted to the facility on [DATE] with a diagnosis which included diabetes mellitus without hyperglycemia (chronic condition that affects the way the body processes blood sugar) and protein-calorie malnutrition. [...]
Inspectors wroteBased on interview and record review, the facility failed to maintain medical records for 1 of 22 residents (Residents #43). The facility failed to ensure the care plan was updated to reflect the discontinuation of Resident #43's fall mat. This failure could place residents at risk of not receiving appropriate interventions meet their current needs.
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. 1. The facility did not ensure cigarettes were not discarded in the trash can designed for the disposing of trash. 2. The facility did not ensure trash was not discarded in the red trash can designed for the disposing of cigarettes. These failures could place residents who smoke at risk of physical harm and lead to an unsafe smoking environment. Findings Included: During an observation and interview on 05/20/25 at 10:30 a.m., there was a red can with trash observed inside the can located in the designated smoking area. CNA B stated the trash observed inside the can was the foil wrapper part of the cigarette box when you first open the box. CNA B stated the wrapper should be disposed in the trash can. [...]
Inspectors wroteBased on interview and record review, the facility failed to electronically submit to CMS complete and accurate direct care staffing information, including information for agency and contract staff, based on payroll and other verifiable and auditable data in a uniform format according to specifications established by CMS fiscal year 2024 for the first quarter (October 1, 2023, to December 31, 2023) reviewed for administration. The facility failed to transmit RN hours for: 11/18/2023, 11/19/2023, 12/02/2023, 12/03/2023, 12/16/2023, 12/17/2023, and 12/30/2023. This failure could place residents at risk for personal needs not being identified and met.
Inspectors wroteBased on observations, interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with the resident rights, that includes measurable objectives and timeframes to meet a resident's medical, nursing, mental and psychosocial needs that are identified in the comprehensive assessment for 3 of 23 residents (Resident #63, Resident #25, and Resident #42) reviewed for comprehensive person-centered care plans. 1. The facility failed to ensure Resident #63's grab bar was included on the care plan. 2. The facility failed to ensure Resident #25's comprehensive care plan addressed that he received an anticoagulant medication and that he required the use of assist/grab bars. 3. [...]
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 17.95 % based on 7 errors out of 39 opportunities, which involved 3 of 6 residents (Resident #'s 172, 16, and 17) reviewed for medication administration. The facility failed to ensure LVN A administered Resident #172's Levetiracetam (medication used to treat seizures) timely. The facility failed to ensure LVN A administered Resident #66's midodrine (medication to treat blood pressure), Eliquis (medication to coagulation of blood), and levothyroxine (medication for thyroid disease) timely. The facility failed to ensure MA B administered Resident #17's tramadol (medication for pain), levothyroxine (medication for thyroid disease), and Protonix (medication for gastric upset) timely. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that residents were free of significant medication errors for 3 of 10 residents (Resident's #172, #66, and #17) reviewed for pharmacy services. 1. The facility failed to ensure LVN A administered Resident #172's Keppra (medication used to treat seizures) timely. 2. The facility failed to ensure LVN A administered Resident #66's midodrine (medication to treat blood pressure), and Eliquis (medication to coagulation of blood timely. 3. The facility failed to ensure MA B administered Resident #17's tramadol (medication for pain), timely. This failure could place the resident at risk of medical complications and not receiving the therapeutic effects of their medications. Findings Included: [...]
Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure a resident who is unable to carry out activities of daily living receives the necessary services to maintain good nutrition for 1 of 6 residents (Resident #16) reviewed for quality of life. The facility did not ensure Resident #16 was provided assistance with eating during the lunch meal on 03/25/2024. This failure could place residents at risk for decreased food intake, weight loss, and a decreased quality of life.
Inspectors wroteBased on observation, interview and record review, the facility failed to follow their own established smoking policy for 1 of 6 residents reviewed for quality of care (Resident #3). The facility did not provide a smoking apron per their smoking assessment for Resident #3. The failure could place residents at risk of an unsafe smoking environment and burns.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident received appropriate treatment and services to prevent urinary tract infections for 1 of 2 residents (Resident #2) reviewed for quality of care. The facility failed to ensure Resident #2's urinary (foley) catheter was properly secured to his leg. This failure could place residents with urinary catheters at risk for damage to the bladder, penis, or urethra (a hollow tube that lets urine leave your body), dislodging of the catheter, and urinary tract infections.
Inspectors wroteBased on observations, interview, and record reviews, the facility failed to attempt to use alternatives prior to installing a side or bed rail, obtain informed consent prior to installation, ensure correct installation, use and maintenance of bedrails for 2 of 2 residents (Residents #63 and #25) reviewed for quality of care. 1. The facility failed to ensure informed consent for the use of Resident #63's bed rails were obtained prior to installation. 2. The facility failed to follow Resident #63's bed rail assessment, which did not recommend the use of bed rails. 3. The facility failed to document the attempt of alternatives used prior to installation of Resident #25's bed rails. 4. The facility failed to ensure an informed consent for the use of Resident #25's bed rails were obtained prior to installation. [...]
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 storage area reviewed for pharmacy services The facility failed to keep a record or 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 interview and record review, the facility failed to ensure residents' drug regimen was adequately monitored and free from unnecessary drugs for 2 of 5 residents (Resident #25 and Resident #42) reviewed for pharmacy services. 1. The facility failed to monitor Resident #25 for side effects/adverse reactions for the use of Xarelto (an anticoagulant medication- blood thinner). 2. The facility failed to ensure Resident #42's edema was monitored while taking furosemide. (Medication given to remove fluid and reduce swelling.) These failures could place residents at risk of swelling, bruising, and bleeding .
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure food was prepared in a form designed to meet individual needs for 1 of 6 residents (Resident #16) reviewed for nutrition. The facility failed to ensure Resident #16 received her health shake with her lunch meal as ordered by the physician. This failure could place residents at risk for poor intake, weight loss, and unmet nutritional needs.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure residents the right to be free from abuse for 1 of 19 residents reviewed for abuse (Resident # 10) in that: On 8/11/23 CNA A slapped Resident #10 on the left forearm with a washcloth multiple times telling her to stop complaining while giving her a shower on 8/11/23. The non-compliance was identified as past non-compliance. The immediate jeopardy (IJ) began on 8/11/23 and ended on 8/16/23. The facility had corrected the noncompliance before the investigation began. This failure could place all residents in the facility at risk for physical harm, and pain which could prevent them from achieving their highest practicable physical, mental, and psychosocial well-being.
Inspectors wroteBased on observation, interviews, and record review, the facility failed to implement a comprehensive person-centered care plan to meet resident's medical, nursing, mental and psychosocial needs identified in the comprehensive assessment for 3 of 22 residents reviewed for care plans. (Resident #18, Resident #49, and Resident #51). 1. The facility failed to ensure Resident #18 had a person-centered care plan to accurately reflect Resident #18's actual pressure wound. 2. The facility failed to ensure Resident #49 had a person-centered care plan to accurately reflect Resident #49's required one on one activities. 3. The facility failed to ensure Resident #51 had a person-centered care plan to accurately reflect refusal of care for ADLs. These failures could place the residents at increased risk of injury or infection and not having their individual needs met.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure respiratory care was provided with professional standards of practice for 3 of 6 residents (Residents #36, #40, and #3) reviewed for respiratory care and services. 1. The facility failed to ensure Residents #36 and #40's oxygen concentrator filters were free of grey, fuzzy material. 2. The facility failed to administer oxygen at 2 via nasal cannula as prescribed by the physician for Resident #3. These failures could place residents who receive respiratory care at risk for developing respiratory complications.
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 meals (the lunch meal), as evidenced by: The facility failed to ensure [NAME] C followed the recipe for pureeing the country fried steak and California blend vegetables. The facility failed to ensure [NAME] C used a #6 scoop to serve the country fried steak. The facility failed to ensure [NAME] C used a #12 scoop to serve the California blend vegetables. These failures could place residents at risk for weight loss, not having their nutritional needs met, and a decreased quality of life.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide food that was palatable and served at an appetizing temperature for 5 of 22 residents (Resident #36, Resident #41, Resident #46, Resident #50, and Resident #59) reviewed for dietary services. The facility failed to provide palatable food served at an appetizing temperature or taste to residents' who complained the food was not hot 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 observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food safety in the facility's only kitchen. The facility failed to ensure: o food items were dated, labeled, and sealed appropriately. o expired food items were discarded. o the vent hood was clean. o the juice dispenser nozzle was clean. o the juice drain on the floor was clean. o the toaster was free of food debris. o the ice machine was clean. o a food cart was clean. o a fan on the floor in the kitchen was clean. o the floor was clean. These failures could place residents at risk for foodborne illness.
Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure safe and sanitary storage of resident's food items for 3 of 22 residents reviewed for personal food safety. (Resident #16, Resident #63, and Resident #59) The facility did not implement the personal food policy related to personal refrigerators for Resident #16, Resident #63, and Resident #59. This failure could place the residents at risk for food borne illnesses.
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 (Residents #18, Resident #4, Resident #25 and Resident #69) reviewed for infection control. 1. The facility did not ensure Resident #4 utilized appropriate PPE use throughout the facility. 2. The facility failed to ensure CMA H disinfected the wrist blood pressure monitor between Resident #25 and Resident # 69. 3. The facility failed to ensure NA K changed her gloves and performed hand hygiene during incontinent care provided to Resident #18. These failures could place residents and staff at risk for cross-contamination, spread of infection and could potentially affect all others in the building.
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 2 of 22 residents (Resident #15 and Resident #49) reviewed for resident rights. 1. The facility failed to ensure NA K provided privacy for Resident #15 while providing incontinent care. 2. The facility failed to ensure NA K and CMA L treated Resident #49 with dignity and respect by referring to her as a feeder. These failures could place residents at an increased risk of embarrassment, isolation, and diminished quality of life.
Inspectors wroteBased on interview and record review the facility failed to ensure an accurate MDS was completed for 1 of 22 residents (Resident #43) reviewed for MDS assessment accuracy. The facility failed to accurately document Resident #43's tobacco use. This failure could place residents at risk for not receiving care and services to meet their needs.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure each resident received adequate supervision to prevent accidents for 2 out of 22 residents (Resident #52 and Resident #70) reviewed for accident hazards. 1. The facility failed to ensure Resident #52's oxygen cylinder was securely stored. 2. The facility failed to ensure Resident #70 was free from an antiseptic agent containing alcohol. These failures could place residents at risk of injury.
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 1 (Resident #45) of 22 residents reviewed for pharmacy services. The facility did not ensure Resident #45 received her Lantus Solostar Solution (diabetic medication) and blood sugar checks as ordered by the physician. This failure could place the residents at risk of not receiving the intended therapeutic benefit of their medications and accidental exposure or drug diversion.
Inspectors wroteBased on observation, record review and interview, the facility failed to ensure that it was free of medication error rate of 5 percent or greater. 27 opportunities were observed with a total of 3 errors, resulting in a 11.11 percent medication error rate. Two (Residents #37 and Resident # 25) of five residents reviewed for pharmacy services. The facility failed to ensure Resident #37 received oxycodone-acetaminophen tablet 10/325mg to be administered at 6:00 a.m. CMA H administered the medication at 8:33 a.m. to Resident #37. The facility failed to ensure Resident #25 received Tramadol 50 mg at 6:00 a.m. and Protonix 40 mg at 6:30 a.m. The medications were administered at 8:51 a.m. These failures could place residents at risk for not receiving the intended therapeutic benefit of their medications or receiving them as prescribed, per physician orders.
Inspectors wroteBased on interview and record review, the facility failed to maintain a quality assessment and assurance committee consisting at a minimum the required committee members for 3 of 4 meetings (November 2022, December 2022, and January 2023) reviewed for QAPI. 1. The facility did not ensure the Administrator attended their QAPI meetings in November 2022, December 2022, and January 2023. 2. The facility did not ensure the Infection Preventionist attended their QAPI meeting in December 2022 and January 2023. This failure could place residents at risk for quality deficiencies being unidentified, infections, no appropriate plans of action developed and implemented, and no appropriate guidance developed.
Inspectors wroteBased on interview, and record review, the facility failed to ensure the resident's medical record included documentation that indicates the resident received education on the influenza and the pneumococcal immunizations of 2 of 5 residents reviewed for immunizations. (Resident #3 and Resident #10). 1 The facility failed to ensure Resident #3's medical record contained evidence of education on the pneumococcal immunization when the vaccine was administered to the resident. 2. The facility failed to ensure Resident #3's medical record contained evidence of education on the influenza vaccine when the vaccine was administered to the resident. The facility failed to ensure Resident #10's medical record contained evidence of education on the pneumococcal immunization when the vaccine was administered to the resident. [...]
3 fire safety citations on file: 1 on March 27, 2024, 2 on January 25, 2023.
| Date | Penalty | Amount or length |
|---|---|---|
| March 7, 2024 | Fine | $8,162 |
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) | 3.24 | 3.39 | 3.86 |
| Registered nurses | 0.29 | 0.43 | 0.69 |
| All nursing staff on weekends | 2.71 | 2.98 | 3.42 |
| Nurse aides | 2.06 | ||
| Licensed practical nurses | 0.89 | ||
| Nursing staff turnover (share who left in a year) | 32.8% | 55.3% | 45.8% |
| Registered nurse turnover | 16.7% | 54.6% | 42.9% |
| Administrators who left | 1 |
CMS expects 4.05 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 3.46 on weekdays and 2.71 on weekends, 22% 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 3.47 in April to June 2025 to 3.24 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 | 3.24 | 0.29 | 3.46 | 2.71 | 0.0% | 1 of 90 | 100 |
| Oct to Dec 2025 | 3.54 | 0.38 | 3.81 | 2.85 | 0.0% | 0 of 92 | 94 |
| Jul to Sep 2025 | 3.16 | 0.32 | 3.38 | 2.62 | 0.0% | 1 of 92 | 88 |
| Apr to Jun 2025 | 3.47 | 0.45 | 3.69 | 2.91 | 0.0% | 0 of 91 | 76 |
| 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 | 3.5 | 15.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 0.3 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.0 | 0.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 0.4 | 3.3 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.9 | 1.5 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 12.0 | 14.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.9 | 3.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 9.4 | 9.6 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 26.9 | 25.7 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 12.7 | 12.3 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.7 | 2.2 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.8 | 2.1 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Stillhouse Rehabilitation and Healthcare Center's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (47.8% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
47.8% 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. 235 eligible stays.
13.5% this home
Worse than 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. 245 eligible stays.
10.1% this home
Worse than 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. 146 eligible stays.
69.7% 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. 66 residents counted.
0.8% 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. 126 residents counted.
1.4% 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. 126 residents counted.
98.2% 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. 56 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 | |
| Reese, Michael | Managing control - governing body | Individual | 02/01/2019 | |
| Burnam, Soon | Corporate officer | Individual | 04/01/2017 | |
| Keetch, Chad | Corporate officer | Individual | 03/01/2011 | |
| Sanderson, Clark | Corporate officer | Individual | 04/01/2017 | |
| Grassland Healthcare and Rehabilitation Inc | Operational/managerial control | Organization | 04/01/2017 | |
| Burns, Stephen | Operational/managerial control | Individual | 08/01/2022 | |
| Reese, Michael | Operational/managerial control | Individual | 02/01/2019 | |
| Caretrust Gp LLC | Adp of the SNF | Organization | 04/01/2017 | |
| Caretrust Reit Inc | Adp of the SNF | Organization | 04/01/2017 | |
| Ctr Partnership LP | Adp of the SNF | Organization | 04/01/2017 | |
| Ensign Services Inc | Adp of the SNF | Organization | 06/02/2012 | |
| Grassland Healthcare and Rehabilitation Inc | Adp of the SNF | Organization | 09/24/2025 | |
| Stillhouse Health Holdings LLC | Adp of the SNF | Organization | 04/01/2017 | |
| Burns, Stephen | Adp of the SNF | Individual | 08/01/2022 | |
| Reese, Michael | Adp of the SNF | Individual | 02/01/2019 |
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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