Nursing homeActive
Legacy At Town Creek
2212 W Reagan St, Palestine, TX 758019037278500199 certified beds · 77 residentsGovernment - Hospital districtMedicare and Medicaid
Surveys on file
8
since 2023
Deficiencies
38
● 1● 32● 5
Penalties · 3 yrs
$294,608
2 fines
Last survey
2026-01-07
Complaint
CMS overall
1 / 5
stars as published by CMS
CMS overall 1/5
Health 2
Staffing 1
Quality 2
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 |
|---|---|---|---|---|
| 2026-01-07 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2025-10-08 | Complaint | 001 | CMS-2567 (Care Compare) | — |
| 2025-08-06 | Standard | 040 | CMS-2567 (Care Compare) | — |
| 2024-07-31 | Standard | 160 | CMS-2567 (Care Compare) | — |
| 2024-06-06 | Complaint | 024 | CMS-2567 (Care Compare) | — |
| 2024-01-22 | Complaint | 020 | CMS-2567 (Care Compare) | — |
| 2023-08-08 | Complaint | 010 | CMS-2567 (Care Compare) | — |
| 2023-04-26 | Standard | 0160 | 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.
F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-01-08Record 675998-20260107-F580
F695Provide safe and appropriate respiratory care for a resident when needed.Scope/severity GHarm
Care planning
Isolated; actual harm that is not immediate jeopardy.Corrected 2025-10-09Record 675998-20251008-F695
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 2025-09-10Record 675998-20250806-F755
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 2025-09-10Record 675998-20250806-F812
F813Have a policy regarding use and storage of foods brought to residents by family and other visitors.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-09-10Record 675998-20250806-F813
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 2025-09-10Record 675998-20250806-F880
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity DStandard
Care planningFalls
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-08-12Record 675998-20240731-F689
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 2024-08-12Record 675998-20240731-F755
F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-08-12Record 675998-20240731-F761
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 2024-08-12Record 675998-20240731-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 2024-08-12Record 675998-20240731-F880
F925Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.Scope/severity DStandard
Environment
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-08-12Record 675998-20240731-F925
F640Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.Scope/severity BPaperwork
Care planningRecords
Pattern; potential for minimal harm.Corrected 2024-08-12Record 675998-20240731-F640
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 2024-06-07Record 675998-20240606-F600
F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Scope/severity KHarm
Abuse & neglect
Pattern; immediate jeopardy to resident health or safety.Corrected 2024-06-07Record 675998-20240606-F607
F610Respond appropriately to all alleged violations.Scope/severity KHarm
Abuse & neglect
Pattern; immediate jeopardy to resident health or safety.Corrected 2024-06-07Record 675998-20240606-F610
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity GHarm
Care planningFalls
Isolated; actual harm that is not immediate jeopardy.Corrected 2024-06-07Record 675998-20240606-F689
F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Scope/severity EStandard
Abuse & neglect
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-07Record 675998-20240606-F609
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 2024-06-07Record 675998-20240606-F880
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 2024-02-14Record 675998-20240122-F695
F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-02-14Record 675998-20240122-F761
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 2023-08-09Record 675998-20230808-F607
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 2023-05-12Record 675998-20230426-F550
F552Ensure that residents are fully informed and understand their health status, care and treatments.Scope/severity EStandard
Dignity & rights
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-05-19Record 675998-20230426-F552
F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Scope/severity EStandard
Dignity & rights
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-05-19Record 675998-20230426-F584
F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedScope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-05-20Record 675998-20230426-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 2023-05-16Record 675998-20230426-F656
F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-05-19Record 675998-20230426-F657
F677Provide care and assistance to perform activities of daily living for any resident who is unable.Scope/severity EStandard
Care planning
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-04-27Record 675998-20230426-F677
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 2023-05-15Record 675998-20230426-F690
F692Provide enough food/fluids to maintain a resident's health.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-05-19Record 675998-20230426-F692
F695Provide safe and appropriate respiratory care for a resident when needed.Scope/severity EStandard
Care planning
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-05-12Record 675998-20230426-F695
F698Provide safe, appropriate dialysis care/services for a resident who requires such services.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-05-12Record 675998-20230426-F698
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 2023-05-12Record 675998-20230426-F755
F758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-05-19Record 675998-20230426-F758
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 2023-05-27Record 675998-20230426-F880
F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.Scope/severity EStandard
Environment
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-05-01Record 675998-20230426-F921
F926Have policies on smoking.Scope/severity DStandard
Environment
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-05-15Record 675998-20230426-F926
Penalties & enforcement
| Date | Action | Amount | Source |
|---|---|---|---|
| 2025-10-08 | Civil money penalty | $10,358 | CMS · Penalties |
| 2024-06-06 | Civil money penalty | $284,250 | CMS · Penalties |
Staffing
CMS Payroll-Based Journal · PBJ, as published Aug 2026 · explainerRN hours per resident day0.27
Facility
Texas
National
Texas 0.43 · National 0.69
Total nurse hours per resident day3.37
Facility
Texas
National
Texas 3.39 · National 3.86
Weekend total nurse hours3.06
Facility
Texas
National
Texas 2.98 · National 3.42
Total nursing staff turnover54%
Facility
Texas
National
Texas 55% · National 46%
Registered nurse turnover56%
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 | 6.0% | 3.8% | 4.6% |
| Percentage of long-stay residents experiencing one or more falls with major injury lower is better | 4.3% | 3.3% | 3.2% |
| Percentage of long-stay residents who received an antipsychotic medication lower is better | 5.0% | 9.6% | 15.4% |
| Percentage of long-stay residents with a urinary tract infection lower is better | 0.3% | 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 | 23.5% | 15.8% | 13.9% |
| Percentage of long-stay residents who lose too much weight lower is better | 7.4% | 3.0% | 5.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication lower is better | 32.7% | 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 |
|---|---|---|---|---|
| Liberty County Hospital District No 1 Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | — | — |
| Adewale, Adebayo Individual | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Franklin, Bradley Individual | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Pmg Opco- Palestine LLC Organization | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Adewale, Adebayo Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Bauder Family Investments, LLC Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Bauder, Kelly Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Bauder, Madison Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Bauder, Parker Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Bauder, William Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Boulware St James LLC Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Boulware, Douglas Individual | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | NOT APPLICABLE | — | — |
| Boulware, Sandra Individual | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | NOT APPLICABLE | — | — |
| Boulware, Steven Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Boulware, Thomas Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Franklin, Bradley Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Pmg Realco- Palestine LLC Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Steven Boulware Family Investments LLC Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Stratton, Charles Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Walker, Katie Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
Part of a chain
Southwest Ltc — 10 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 Anderson.
Nearby nursing homes
| Facility | Distance | Last survey | Deficiencies · 3 yrs |
|---|---|---|---|
| Trucare Living Centers Palestine | 1.7 mi | 2025-12-17 | 090 |
| Avir at Town Creek Palestine | 1.7 mi | 2026-02-18 | 0192 |
| Greenbrier Nursing & Rehabilitation Center of Pale Palestine | 3.6 mi | 2026-04-30 | 0120 |
| Avir at Elkhart Elkhart | 9.6 mi | 2026-01-21 | 0210 |
| Avir at Jacksonville Jacksonville | 26.2 mi | 2026-02-25 | 060 |
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 |