Nursing homeActive
Paradigm At First Colony
4710 Lexington Blvd, Missouri City, TX 774592814994710150 certified beds · 104 residentsFor profit - Limited Liability companyMedicare and Medicaid
Surveys on file
16
since 2023
Deficiencies
41
● 3● 30● 8
Penalties · 3 yrs
$64,559
2 fines
Last survey
2026-06-11
Complaint
CMS overall
1 / 5
stars as published by CMS
CMS overall 1/5
Health 1
Staffing 1
Quality 4
Star ratings as published by CMS · CMS’s caveats
Survey history
Source: CMS · Texas Health and Human Services Commission · data as of 2026-08-01| Date | Kind | Deficiencies | Official record | Archived PDF |
|---|---|---|---|---|
| 2026-06-11 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2026-03-18 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2026-01-22 | Standard | 000 | CMS-2567 (Care Compare) | — |
| 2025-12-01 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2025-11-14 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2025-09-08 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2025-06-01 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2024-11-27 | Complaint | 002 | CMS-2567 (Care Compare) | — |
| 2024-11-19 | Complaint | 200 | CMS-2567 (Care Compare) | — |
| 2024-10-24 | Standard | 1111 | CMS-2567 (Care Compare) | — |
| 2024-08-21 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2024-07-25 | Complaint | 020 | CMS-2567 (Care Compare) | — |
| 2024-02-08 | Complaint | 020 | CMS-2567 (Care Compare) | — |
| 2023-11-02 | Complaint | 020 | CMS-2567 (Care Compare) | — |
| 2023-09-08 | Standard | 060 | CMS-2567 (Care Compare) | — |
| 2023-08-15 | Complaint | 005 | CMS-2567 (Care Compare) | — |
Counts by class: paperwork · standard · harm.
Deficiencies
CMS · Texas Health and Human Services Commission publishes each citation’s tag, official description and scope/severity letter. The surveyor’s written findings are in the Statement of Deficiencies (CMS-2567) for each survey, linked above.
F695Provide safe and appropriate respiratory care for a resident when needed.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-07-01Record 455812-20260611-F695
F677Provide care and assistance to perform activities of daily living for any resident who is unable.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-03-25Record 455812-20260318-F677
F551Give the resident's representative the ability to exercise the resident's rights.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-12-15Record 455812-20251201-F551
F558Reasonably accommodate the needs and preferences of each resident.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-12-11Record 455812-20251114-F558
F610Respond appropriately to all alleged violations.Scope/severity EStandard
Abuse & neglect
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-09-23Record 455812-20250908-F610
F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-05Record 455812-20250601-F755
F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.Scope/severity KHarm
Care planning
Pattern; immediate jeopardy to resident health or safety.Corrected 2024-12-04Record 455812-20241127-F684
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity KHarm
Care planningFalls
Pattern; immediate jeopardy to resident health or safety.Corrected 2024-12-04Record 455812-20241127-F689
F583Keep residents' personal and medical records private and confidential.Scope/severity CPaperwork
Dignity & rights
Widespread; potential for minimal harm.Corrected 2024-11-20Record 455812-20241119-F583
F732Post nurse staffing information every day.Scope/severity CPaperwork
Staffing
Widespread; potential for minimal harm.Corrected 2024-11-20Record 455812-20241119-F732
F694Provide for the safe, appropriate administration of IV fluids for a resident when needed.Scope/severity KHarm
Care planning
Pattern; immediate jeopardy to resident health or safety.Corrected 2024-10-31Record 455812-20241024-F694
F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F550
F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F607
F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F609
F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedScope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F655
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F656
F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F686
F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F690
F695Provide safe and appropriate respiratory care for a resident when needed.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F695
F759Ensure medication error rates are not 5 percent or greater.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F759
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity FStandard
Food & nutrition
Widespread; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F812
F880Provide and implement an infection prevention and control program.Scope/severity DStandard
Infection control
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-10-31Record 455812-20241024-F880
F814Dispose of garbage and refuse properly.Scope/severity CPaperwork
Food & nutrition
Widespread; potential for minimal harm.Corrected 2024-10-31Record 455812-20241024-F814
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-08-28Record 455812-20240821-F842
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-08-12Record 455812-20240725-F842
F919Make sure that a working call system is available in each resident's bathroom and bathing area.Scope/severity DStandard
Environment
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-08-12Record 455812-20240725-F919
F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-02-12Record 455812-20240208-F690
F880Provide and implement an infection prevention and control program.Scope/severity EStandard
Infection control
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-02-12Record 455812-20240208-F880
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-11-03Record 455812-20231102-F656
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity EStandard
Care planningFalls
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-11-03Record 455812-20231102-F689
F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedScope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-09-15Record 455812-20230908-F655
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-09-15Record 455812-20230908-F656
F695Provide safe and appropriate respiratory care for a resident when needed.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-09-15Record 455812-20230908-F695
F803Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-09-15Record 455812-20230908-F803
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-09-15Record 455812-20230908-F812
F814Dispose of garbage and refuse properly.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-09-15Record 455812-20230908-F814
F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Scope/severity KHarm
Abuse & neglect
Pattern; immediate jeopardy to resident health or safety.Corrected 2023-08-22Record 455812-20230815-F600
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity KHarm
Care planningRecords
Pattern; immediate jeopardy to resident health or safety.Corrected 2023-09-15Record 455812-20230815-F656
F678Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.Scope/severity JHarm
Care planning
Isolated; immediate jeopardy to resident health or safety.Corrected 2023-08-22Record 455812-20230815-F678
F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Scope/severity JHarm
Care planning
Isolated; immediate jeopardy to resident health or safety.Corrected 2023-08-22Record 455812-20230815-F686
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity JHarm
Care planningFalls
Isolated; immediate jeopardy to resident health or safety.Corrected 2023-08-22Record 455812-20230815-F689
Penalties & enforcement
| Date | Action | Amount | Source |
|---|---|---|---|
| 2024-11-27 | Civil money penalty | $19,838 | CMS · Penalties |
| 2024-10-24 | Civil money penalty | $44,721 | CMS · Penalties |
Staffing
CMS Payroll-Based Journal · PBJ, as published Aug 2026 · explainerRN hours per resident day0.47
Facility
Texas
National
Texas 0.43 · National 0.69
Total nurse hours per resident day3.36
Facility
Texas
National
Texas 3.39 · National 3.86
Weekend total nurse hours2.90
Facility
Texas
National
Texas 2.98 · National 3.42
Total nursing staff turnover67%
Facility
Texas
National
Texas 55% · National 46%
Registered nurse turnover91%
Facility
Texas
National
Texas 55% · National 43%
Quality measures
CMS MDS quality measures · 2025Q2-2026Q1 · definitions| Measure | Facility | Texas | National |
|---|---|---|---|
| Percentage of long-stay residents with pressure ulcers lower is better | 7.5% | 3.8% | 4.6% |
| Percentage of long-stay residents experiencing one or more falls with major injury lower is better | 0.5% | 3.3% | 3.2% |
| Percentage of long-stay residents who received an antipsychotic medication lower is better | 20.4% | 9.6% | 15.4% |
| Percentage of long-stay residents with a urinary tract infection lower is better | 0.0% | 0.8% | 1.6% |
| Percentage of long-stay residents who were physically restrained lower is better | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose need for help with daily activities has increased lower is better | 8.2% | 15.8% | 13.9% |
| Percentage of long-stay residents who lose too much weight lower is better | 2.9% | 3.0% | 5.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication lower is better | 13.4% | 18.0% | 19.5% |
Figures verbatim from CMS, with the state and national figures from the same release. The direction that counts as better is CMS’s own and is stated on every row.
Ownership
As reported to CMS (Provider Enrollment)| Entity | Role | Interest | Since | Registry |
|---|---|---|---|---|
| Oakbend Medical Center Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | — | — |
| Ssc Missouri City Operating Company LLC Organization | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Beard, Barry Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
| Council, Jeff Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
| Crayton, Tom Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
| Freudenberger, Joseph Individual | W-2 MANAGING EMPLOYEE | NOT APPLICABLE | — | — |
| Freudenberger, Joseph Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Martin, Melissa Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
| Mcclamroch, James Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
| Mefford, Ruthanne Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
| Murray, Mark Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
| Petrosewicz, Norma Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
| Tape, May Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
| Uthman, Edward Individual | CORPORATE DIRECTOR | NOT APPLICABLE | — | — |
Part of a chain
Paradigm Healthcare — 17 facilities
Ownership as reported to CMS/state. CMS ownership data has known gaps; merges between entities are published only after human review.
Cost context
County figures from public surveys. Not this facility’s price. Nursing-home rates are not published by CMS or Texas.
No county cost figures on file for Fort Bend.
Nearby nursing homes
| Facility | Distance | Last survey | Deficiencies · 3 yrs |
|---|---|---|---|
| Park Manor of Quail Valley Missouri City | 1.4 mi | 2025-06-24 | 0211 |
| Chelsea Gardens Missouri City | 2.4 mi | 2026-06-10 | 053 |
| Windsor Quail Valley Post-Acute Healthcare Missouri City | 2.5 mi | 2026-06-05 | 1105 |
| Sugar Land Health Care Center Sugar Land | 3.6 mi | 2025-12-17 | 081 |
| The Crescent Sugar Land | 3.9 mi | 2026-07-02 | 1337 |
Watch this facility
One email when a new survey, harm-class deficiency, penalty, Special Focus change or ownership change is recorded. Nothing else, ever.
Sources & provenance
| Section | Agency · dataset | Retrieved |
|---|---|---|
| Facility, ratings | CMS Provider Data · Nursing Home Provider Information | 2026-08-01 |
| Surveys | CMS · Survey Summary | 2026-08-01 |
| Deficiencies | CMS · Health Deficiencies (CMS-2567 findings via Care Compare) | 2026-08-01 |
| Penalties | CMS · Penalties | 2026-08-01 |
| Staffing | CMS · Payroll-Based Journal (PBJ, as published Aug 2026) | 2026-08-01 |
| Quality measures | CMS · MDS Quality Measures | 2026-08-01 |
| Ownership | CMS · Ownership | 2026-08-01 |