Nursing homeActive
The Waterton Healthcare & Rehabilitation
2875 Shiloh Road, Tyler, TX 75703903561130092 certified beds · 67 residentsGovernment - Hospital districtMedicare and Medicaid
Surveys on file
5
since 2024
Deficiencies
10
● 0● 8● 2
Penalties · 3 yrs
$23,389
2 fines
Last survey
2026-05-06
Standard
CMS overall
4 / 5
stars as published by CMS
CMS overall 4/5
Health 4
Staffing 2
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 |
|---|---|---|---|---|
| 2026-05-06 | Standard | 040 | CMS-2567 (Care Compare) | — |
| 2026-04-23 | Complaint | 001 | CMS-2567 (Care Compare) | — |
| 2025-03-26 | Standard | 020 | CMS-2567 (Care Compare) | — |
| 2024-01-31 | Standard | 020 | CMS-2567 (Care Compare) | — |
| 2024-01-08 | Complaint | 001 | 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.
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 DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-05-07Record 676193-20260506-F584
F694Provide for the safe, appropriate administration of IV fluids for a resident when needed.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-05-07Record 676193-20260506-F694
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 2026-05-07Record 676193-20260506-F842
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 2026-05-07Record 676193-20260506-F880
F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.Scope/severity GHarm
Care planning
Isolated; actual harm that is not immediate jeopardy.Corrected 2026-04-27Record 676193-20260423-F684
F641Ensure each resident receives an accurate assessment.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-04-10Record 676193-20250326-F641
F692Provide enough food/fluids to maintain a resident's health.Scope/severity EStandard
Care planning
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-04-10Record 676193-20250326-F692
F576Ensure residents have reasonable access to and privacy in their use of communication methods.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-03-01Record 676193-20240131-F576
F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.Scope/severity DStandard
Environment
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-03-01Record 676193-20240131-F921
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 2024-01-09Record 676193-20240108-F689
Penalties & enforcement
| Date | Action | Amount | Source |
|---|---|---|---|
| 2026-04-23 | Civil money penalty | $14,380 | CMS · Penalties |
| 2024-01-08 | Civil money penalty | $9,009 | CMS · Penalties |
Staffing
CMS Payroll-Based Journal · PBJ, as published Aug 2026 · explainerRN hours per resident day0.51
Facility
Texas
National
Texas 0.43 · National 0.69
Total nurse hours per resident day3.38
Facility
Texas
National
Texas 3.39 · National 3.86
Weekend total nurse hours3.00
Facility
Texas
National
Texas 2.98 · National 3.42
Total nursing staff turnover51%
Facility
Texas
National
Texas 55% · National 46%
Registered nurse turnover44%
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 | 2.7% | 3.8% | 4.6% |
| Percentage of long-stay residents experiencing one or more falls with major injury lower is better | 6.8% | 3.3% | 3.2% |
| Percentage of long-stay residents who received an antipsychotic medication lower is better | 6.8% | 9.6% | 15.4% |
| Percentage of long-stay residents with a urinary tract infection lower is better | 0.5% | 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 | 17.4% | 15.8% | 13.9% |
| Percentage of long-stay residents who lose too much weight lower is better | 0.5% | 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 |
|---|---|---|---|---|
| Fannin County Hospital Authority Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | — | — |
| Chickadee Healthcare LLC Organization | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Costa, Charlie Individual | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE | — | — |
| Burnam, Soon Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Chickadee Healthcare LLC Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Costa, Charlie Individual | MANAGING CONTROL - GOVERNING BODY | NOT APPLICABLE | — | — |
| Costa, Charlie Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Ensign Services Inc Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Rose Health Holdings LLC Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Sanderson, Clark Individual | CORPORATE OFFICER | NOT APPLICABLE | — | — |
| Standard Bearer Healthcare Op, LP Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| The Ensign Group Inc Organization | ADP OF THE SNF | NOT APPLICABLE | — | — |
| Wilson, Jennifer Individual | MANAGING CONTROL - GOVERNING BODY | NOT APPLICABLE | — | — |
| Wilson, Jennifer Individual | ADP OF THE SNF | NOT APPLICABLE | — | — |
Part of a chain
The Ensign Group — 342 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 Smith.
Nearby nursing homes
| Facility | Distance | Last survey | Deficiencies · 3 yrs |
|---|---|---|---|
| The Center At Grande Tyler | 1.3 mi | 2026-05-20 | 180 |
| Providence Park Rehabilitation and Skilled Nursing Tyler | 1.6 mi | 2026-06-15 | 1142 |
| Park Place Nursing & Rehabilitation Center Tyler | 2.6 mi | 2026-04-22 | 0283 |
| Meadow Lake Health Center Tyler | 2.6 mi | 2025-09-24 | 020 |
| Avir at Rose Trail Tyler | 3.2 mi | 2026-06-26 | 0447 |
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 |