Texas › Bowie County › Texarkana
Avir At Cowhorn Creek
5524 Cowhorn Creek, Texarkana, TX 75503
Ratings are based on the most recent data available; a facility's ratings may have changed since the last update. The health inspection rating is based on the three most recent standard surveys and complaint investigations. CMS processed this record on 1 Aug 2026. View the Care Compare record.
Avir At Cowhorn Creek, in Texarkana, Texas, is certified for 76 beds under government, hospital district ownership and belongs to the Avir Health Group chain.
CMS gives it 1 of 5 stars overall, below the Texas median of 3; the health inspection rating is 1, staffing 1 and quality measures 3.
Inspectors recorded 65 health deficiencies across the three most recent survey cycles (28, 21, 16 by cycle, most recent first), 2 of them at the actual-harm or immediate-jeopardy level. That is 85.5 per 100 beds, more than the state median of 22.5.
CMS lists 2 penalties in the period covered: fines totalling $30K and 1 payment denial.
Reported nurse staffing is 3.3 hours per resident per day (0.4 RN), close to the Texas median of 3.3; nursing staff turnover is 68.2%.
CMS flags that the facility carries the CMS abuse icon and is a Special Focus Facility candidate.
Compared with county, state and nation
| Measure | This facility | Bowie Co. median | Texas median | US average |
|---|---|---|---|---|
| Overall star rating | 1 | 1 | 3 | 3.0 |
| Health citations, 3 cycles | 65 | 40 | 25 | 28.7 |
| Citations per 100 beds | 85.5 | 45.6 | 22.5 | 26.8 |
| Total nurse hours per resident day | 3.3 | 3.4 | 3.3 | 3.9 |
| RN hours per resident day | 0.4 | 0.5 | 0.4 | 0.7 |
| Nursing staff turnover | 68.2% | 61.7% | 52.1% | 45.8% |
| Fines listed | $30,105 | $89,633 | $16,801 | — |
County and state figures are medians across facilities (7 in the county, 1177 in the state); the US column is the CMS national average where CMS publishes one.
Citations by survey cycle
Dark bar: this facility. Grey bar: Texas average per facility for the same cycle, as published by CMS. Standard health survey dates: 12 Feb 2026, 4 Dec 2024.
Severity mix: K ×2 D ×44 E ×14 F ×3 B ×1 C ×1
Health deficiencies
Every health citation in the current CMS record (three survey cycles), most recent first. Tag text is the CMS requirement summary, not the inspection narrative.
Scope and severity letters (A–L)
| Survey date | Tag | What the tag requires | Severity | Type | Corrected |
|---|---|---|---|---|---|
| 13 Apr 2026 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Complaint investigation | 14 Apr 2026 |
| 12 Feb 2026 | F0727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | F | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0636 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | E | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | E | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0565 | Honor the resident's right to organize and participate in resident/family groups in the facility. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0637 | Assess the resident when there is a significant change in condition | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0685 | Assist a resident in gaining access to vision and hearing services. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0759 | Ensure medication error rates are not 5 percent or greater. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | Standard survey | 13 Feb 2026 |
| 12 Feb 2026 | F0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors. | D | Standard survey | 13 Feb 2026 |
| 15 Aug 2025 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | Complaint investigation | 16 Aug 2025 |
| 15 Aug 2025 | F0675 | Honor each resident's preferences, choices, values and beliefs. | K | Complaint investigation | 16 Aug 2025 |
| 15 Aug 2025 | F0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | E | Complaint investigation | 18 Aug 2025 |
| 15 Aug 2025 | F0561 | Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | D | Complaint investigation | 18 Aug 2025 |
| 15 Aug 2025 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Complaint investigation | 18 Aug 2025 |
| 15 Aug 2025 | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | Complaint investigation | 18 Aug 2025 |
| 15 Aug 2025 | F0838 | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. | D | Complaint investigation | 18 Aug 2025 |
| 9 Apr 2025 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | Complaint investigation | 10 Apr 2025 |
| 9 Apr 2025 | F0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | D | Complaint investigation | 10 Apr 2025 |
| 9 Apr 2025 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint investigation | 10 Apr 2025 |
| 4 Dec 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0553 | Allow resident to participate in the development and implementation of his or her person-centered plan of care. | E | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0685 | Assist a resident in gaining access to vision and hearing services. | D | Complaint investigation | 6 Dec 2024 |
| 4 Dec 2024 | F0688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0692 | Provide enough food/fluids to maintain a resident's health. | D | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0758 | Implement 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. | D | Standard survey | 6 Dec 2024 |
| 4 Dec 2024 | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | B | Standard survey | 6 Dec 2024 |
| 29 Oct 2024 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Complaint investigation | 31 Oct 2024 |
| 29 Oct 2024 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint investigation | 30 Oct 2024 |
| 29 Oct 2024 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | 30 Oct 2024 |
| 29 Oct 2024 | F0610 | Respond appropriately to all alleged violations. | D | Complaint investigation | 30 Oct 2024 |
| 29 Oct 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 1 Nov 2024 |
| 29 Oct 2024 | F0880 | Provide and implement an infection prevention and control program. | D | Complaint investigation | 30 Oct 2024 |
| 13 Mar 2024 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Complaint investigation | 15 Mar 2024 |
| 13 Mar 2024 | F0805 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | D | Complaint investigation | 15 Mar 2024 |
| 16 Nov 2023 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Standard survey | 22 Nov 2023 |
| 16 Nov 2023 | F0712 | Ensure that the resident and his/her doctor meet face-to-face at all required visits. | E | Standard survey | 17 Nov 2023 |
| 16 Nov 2023 | F0880 | Provide and implement an infection prevention and control program. | E | Complaint investigation | 17 Nov 2023 |
| 16 Nov 2023 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 17 Nov 2023 |
| 16 Nov 2023 | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | Standard survey | 22 Nov 2023 |
| 16 Nov 2023 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard survey | 17 Nov 2023 |
| 16 Nov 2023 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Standard survey | 17 Nov 2023 |
| 16 Nov 2023 | F0688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | Standard survey | 17 Nov 2023 |
| 16 Nov 2023 | F0692 | Provide enough food/fluids to maintain a resident's health. | D | Standard survey | 17 Nov 2023 |
| 16 Nov 2023 | F0758 | Implement 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. | D | Standard survey | 21 Nov 2023 |
| 16 Nov 2023 | F0761 | Ensure 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. | D | Standard survey | 17 Nov 2023 |
| 16 Nov 2023 | F0849 | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | D | Standard survey | 17 Nov 2023 |
| 16 Nov 2023 | F0940 | Develop, implement, and/or maintain an effective training program for all new and existing staff members. | D | Standard survey | 17 Nov 2023 |
| 16 Nov 2023 | F0575 | Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency. | C | Complaint investigation | 17 Nov 2023 |
Penalties
| Date | Type | Amount | Detail |
|---|---|---|---|
| 15 Aug 2025 | Payment denial | — | 5 days |
| 15 Aug 2025 | Fine | $30,105 |
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the Texas average. Turnover: nursing staff 68.2%, RNs —; 0 administrators left in the reporting year.
Quality measures
| Measure | Residents | This facility | Texas median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 25.1% | 14.9% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.0% | 0.0% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 0.9% | 0.3% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 0.4% | 3.0% | 2.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 0.0% | 0.7% | 1.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 21.5% | 12.4% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 4.5% | 3.4% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 1.8% | 8.3% | 13.4% |
Four-quarter averages for the measures CMS uses in the quality-measure star rating (2025Q2-2026Q1). Lower is better for every measure listed. Medians are computed across facilities on this site.
Ownership
Ownership type: government, hospital district. Legal business name: Guadalupe County Hospital Board. Chain: Avir Health Group (116 facilities).
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Guadalupe County Hospital Board | 5% or greater direct ownership interest | 100% | 09/01/2025 |
| 5524 Cowhorn Creek Opco LLC | Operational/managerial control | NOT APPLICABLE | 09/01/2025 |
| 5524 Cowhorn Creek Property Owner, LLC | Adp of the snf | NOT APPLICABLE | 09/01/2025 |
| Welltower Inc | Adp of the snf | NOT APPLICABLE | 09/01/2025 |
| Welltower Nnn Group, LLC | Adp of the snf | NOT APPLICABLE | 09/01/2025 |
| Welltower Op, LLC | Adp of the snf | NOT APPLICABLE | 09/01/2025 |
Only organisations are shown. CMS also records individual owners, officers and managing employees; this site does not publish people's names.
Other nursing homes in Bowie County
| Facility | City | Beds | Overall | Health | Staffing | Citations | Per 100 beds | Fines | Last survey |
|---|---|---|---|---|---|---|---|---|---|
| Cornerstone Retirement Community | Texarkana | 40 | 4 | 3 | 5 | 19 | 47.5 | $40K | 13 May 2026 |
| Heritage Plaza Nursing Center | Texarkana | 95 | 3 | 3 | 2 | 40 | 42.1 | $90K | 2 Jun 2026 |
| The Villa At Texarkana | Texarkana | 106 | 3 | 4 | 1 | 30 | 28.3 | — | 30 Jun 2026 |
| Avir At Citizens Trail | Texarkana | 114 | 1 | 1 | 2 | 52 | 45.6 | $121K | 20 Nov 2025 |
| Avir At Texarkanaabuse icon | Texarkana | 110 | 1 | 1 | 4 | 33 | 30.0 | $142K | 30 Apr 2026 |
| Reunion Plaza Senior Care and Rehabilitation Cente | Texarkana | 129 | 1 | 1 | 1 | 90 | 69.8 | $269K | 25 Jun 2026 |
All 7 facilities in Bowie County
Questions and answers
How many deficiencies has Avir At Cowhorn Creek been cited for?
65 health deficiencies across the three most recent survey cycles, 2 at the actual-harm or immediate-jeopardy level. The Texas median is 25 per facility.
Has Avir At Cowhorn Creek been fined?
Yes. CMS lists fines totalling $30K in the period covered, plus 1 payment denial.
How does staffing at Avir At Cowhorn Creek compare?
Reported total nurse staffing is 3.3 hours per resident per day against a Texas median of 3.3 and a national average of 3.9.
Who operates Avir At Cowhorn Creek?
It is part of the Avir Health Group chain. Ownership type is government, hospital district. Organisations in the CMS ownership record include Guadalupe County Hospital Board and 5524 Cowhorn Creek Opco LLC. Individual owners and managers are not listed on this site.
When was Avir At Cowhorn Creek last inspected?
The most recent survey or investigation in the CMS record is dated 13 Apr 2026; the most recent standard health survey was 12 Feb 2026.
Where does this data come from?
All figures are from the Centers for Medicare & Medicaid Services Care Compare datasets (provider information, health deficiencies, penalties, ownership and quality measures), processed 1 Aug 2026. Ratings and citations may change; the Care Compare record is authoritative.
Provenance
Source: Centers for Medicare & Medicaid Services, Care Compare nursing home datasets (provider information, health deficiencies, penalties, ownership, MDS quality measures, state and national averages), public domain, processed by CMS on 1 Aug 2026. Facility record: Care Compare. Errors in processing are corrected at the next daily build; see corrections.