North Star Ranch Rehabilitation and Healthcare CenCMS ratings, inspections and fines
- Address
- 709 W Fifth St, Bonham, TX 75418
- CCN
- 675471
- Ownership type
- For-profit, corporation
- Certified beds
- 65
- Chain
- Nexion Health
- Residents per day
- 44
- CMS flags
- None in the CMS record
Open the watch listCare Compare record (Medicare.gov)
The watch list stays in this browser. After each CMS update, it shows the values that changed at the homes on the list.
CMS gives North Star Ranch Rehabilitation and Healthcare Cen an overall rating of 2 of 5 stars. The last standard survey was on 2 Jul 2026. The latest survey cycle has 23 health citations. The median for nursing homes in Texas is 8. CMS lists 2 fines with a total of $278,005 for this home in its penalties file.
Facilities may see a change in their overall rating for a number of reasons. Since the overall rating is based on three individual domains, a change in any one of the domains can affect the overall rating. Any new data for a nursing home could potentially change a star rating domain.
Centers for Medicare & Medicaid Services, Five-Star Quality Rating System: Technical Users' Guide, July 2026. CMS processed this record on .
Since the last CMS update
The site has no recorded change for this home. In each CMS update, the site compares the ratings, the penalties and the citations of each home.
Ratings
CMS gives each home 1 to 5 stars for health inspections, for staffing and for quality measures, and one overall rating.
| Rating (1 to 5 stars) | This home | Fannin County median | Texas median | US average (CMS) |
|---|---|---|---|---|
| Overall rating | 2 | 2.0 | 3.0 | 3.0 |
| Health inspection rating | 1 | 3.0 | 3.0 | 2.8 |
| Staffing rating | 2 | 1.0 | 2.0 | 2.9 |
| Quality measure rating | 5 | 4.0 | 4.0 | 3.6 |
A median is the middle value of the homes in the group: 5 homes in the county, 1,177 homes in the state. What the CMS star ratings measure
Citations by survey cycle
CMS keeps the last three cycles, and cycle 1 is the latest. A cycle has one standard survey. Citations from complaint and infection control inspections go into cycles of 12 months.
| Survey cycle | Standard survey | Citations | Texas median |
|---|---|---|---|
| Cycle 1 (latest) | 2 Jul 2026 | 23 | 8 |
| Cycle 2 | 24 Apr 2025 | 24 | 8 |
| Cycle 3 | No date | 14 | 8 |
Health citations
The record of one deficiency in an inspection. One inspection can give many citations.
Scope and severity. A letter from A to L on each citation. Scope is the number of residents that the deficiency affected. Severity is the level of harm.
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy to resident health or safety | L0 | ||
| Actual harm that is not immediate jeopardy | H0 | I0 | |
| No actual harm, potential for more than minimal harm | |||
| No actual harm, potential for minimal harm | A0 | B0 |
Survey cycle 1 (latest): 23 citations
Standard survey of this cycle: .
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 2 Jul 2026 | F0583 | Keep residents' personal and medical records private and confidential. | E | Standard survey | 27 Jul 2026 |
| 2 Jul 2026 | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | E | Standard survey | 28 Jul 2026 |
| 2 Jul 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 | 27 Jul 2026 |
| 2 Jul 2026 | F0687 | Provide appropriate foot care. | D | Standard survey | 27 Jul 2026 |
| 2 Jul 2026 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Standard survey | 27 Jul 2026 |
| 2 Jul 2026 | F0693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | Standard survey | 27 Jul 2026 |
| 2 Jul 2026 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | Standard survey | 27 Jul 2026 |
| 2 Jul 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 | 27 Jul 2026 |
| 2 Jul 2026 | 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 | 27 Jul 2026 |
| 2 Jul 2026 | F0803 | Ensure 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. | E | Standard survey | 27 Jul 2026 |
| 2 Jul 2026 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Standard survey | 27 Jul 2026 |
| 2 Jul 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 | 27 Jul 2026 |
| 2 Jul 2026 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 27 Jul 2026 |
| 2 Jul 2026 | F0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors. | E | Standard survey | 27 Jul 2026 |
| 2 Jul 2026 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Standard survey | 27 Jul 2026 |
| 2 Jul 2026 | 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 | 27 Jul 2026 |
| 6 Mar 2026 | F0628 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | Complaint investigation | 9 Mar 2026 |
| 20 Feb 2026 | F0692 | Provide enough food/fluids to maintain a resident's health. | E | Complaint investigation | 23 Feb 2026 |
| 1 Dec 2025 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Complaint investigation | 2 Dec 2025 |
| 1 Dec 2025 | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | F | Complaint investigation | 2 Dec 2025 |
| 1 Dec 2025 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | Complaint investigation | 2 Dec 2025 |
| 1 Dec 2025 | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | D | Complaint investigation | 2 Dec 2025 |
| 1 Dec 2025 | F0825 | Provide or get specialized rehabilitative services as required for a resident. | D | Complaint investigation | 2 Dec 2025 |
Survey cycle 2: 24 citations
Standard survey of this cycle: .
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 24 May 2025 | F0584 | Honor 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. | E | Complaint investigation | 25 May 2025 |
| 24 May 2025 | 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 | Complaint investigation | 25 May 2025 |
| 24 Apr 2025 | F0552 | Ensure that residents are fully informed and understand their health status, care and treatments. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0610 | Respond appropriately to all alleged violations. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | K | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0732 | Post nurse staffing information every day. | C | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0757 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | 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. | F | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0770 | Provide timely, quality laboratory services/tests to meet the needs of residents. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0773 | Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0803 | Ensure 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. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | F | Standard survey | 25 Apr 2025 |
| 24 Apr 2025 | F0926 | Have policies on smoking. | D | Standard survey | 25 Apr 2025 |
| 27 Feb 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | 28 Feb 2025 |
| 27 Feb 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Complaint investigation | 28 Feb 2025 |
Survey cycle 3: 14 citations
The CMS provider file has no standard survey date for this cycle.
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 6 Mar 2024 | F0584 | Honor 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. | E | Standard survey | 28 Mar 2024 |
| 6 Mar 2024 | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | Standard survey | 28 Mar 2024 |
| 6 Mar 2024 | 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 | 28 Mar 2024 |
| 6 Mar 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Standard survey | 28 Mar 2024 |
| 6 Mar 2024 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | E | Standard survey | 28 Mar 2024 |
| 6 Mar 2024 | F0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | E | Standard survey | 28 Mar 2024 |
| 6 Mar 2024 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Standard survey | 28 Mar 2024 |
| 6 Mar 2024 | F0803 | Ensure 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. | D | Standard survey | 28 Mar 2024 |
| 6 Mar 2024 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D | Complaint investigation | 28 Mar 2024 |
| 6 Mar 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Complaint investigation | 28 Mar 2024 |
| 6 Mar 2024 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 28 Mar 2024 |
| 12 Jan 2024 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | Complaint investigation | 13 Jan 2024 |
| 12 Jan 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Complaint investigation | 13 Jan 2024 |
| 12 Jan 2024 | F0740 | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | J | Complaint investigation | 13 Jan 2024 |
The requirement text is the CMS summary of the F-tag. It is not the report of the surveyor. How to read an inspection report
Penalties
A fine, or a payment denial: a period in which Medicare or Medicaid does not pay for new admissions. The CMS penalties file holds three years.
| Date | Type | Fine | Days without payment |
|---|---|---|---|
| 27 Feb 2025 | Fine | $168,236 | |
| 12 Jan 2024 | Fine | $109,769 |
Staffing
Hours per resident per day. The nurse hours for one resident on an average day. CMS calculates the figure from the hours that the home reports for a quarter.
| Staff | This home | Texas median | Texas average (CMS) |
|---|---|---|---|
| All nurse staff | 3.46 | 3.30 | 3.39 |
| Registered nurses (RN) | 0.21 | 0.40 | 0.43 |
| Licensed practical nurses (LPN) | 1.30 | 0.95 | |
| Nurse aides | 1.95 | 2.00 | |
| All nurse staff, weekends | 3.23 | 2.90 | 2.98 |
- Nurse staff turnover in a year
- 45.2%
- Nurse staff turnover, Texas median
- 52.1%
- RN turnover in a year
- No data
- Administrators who left in a year
- 1
Homes report the hours to CMS in the Payroll-Based Journal.
Quality measures
A figure that CMS calculates from the assessments of residents. One example is the percentage of long-stay residents with a fall and a major injury.
| Measure (CMS text) | Residents | This home | Texas median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 23.4% | 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 | 0.0% | 0.3% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 0.0% | 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 | 20.2% | 12.4% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 3.4% | 3.4% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 12.0% | 8.3% | 13.4% |
For each measure in this table, CMS gives more points in the quality measure rating for a lower percentage. The site calculates the medians from the CMS file. What the CMS star ratings measure
Ownership
An organisation in the CMS ownership file. CMS records its role, for example an ownership interest, operational or managerial control, or a mortgage interest.
- Ownership type
- For-profit, corporation
- Legal business name
- Fannin County Hospital Authority
- Chain
- Nexion Health (51 homes in the CMS chain file)
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Fannin County Hospital Authority | 5% or greater direct ownership interest | 100% | 1 May 2025 |
| Fannin County Hospital Authority | Operational/managerial control | 1 May 2025 | |
| Nexion Health at Bonham, Inc. | Operational/managerial control | 1 May 2025 | |
| Nexion Health Leasing, Inc. | Operational/managerial control | 1 May 2025 | |
| Nexion Health of Ohi Inc | Operational/managerial control | 1 May 2025 | |
| Nexion Health, Inc. | Operational/managerial control | 1 May 2025 | |
| Fannin County Hospital Authority | Adp of the snf | 1 May 2025 | |
| Nexion Health at Bonham, Inc. | Adp of the snf | 1 May 2025 | |
| Nexion Health Leasing, Inc. | Adp of the snf | 1 May 2025 | |
| Nexion Health of Ohi Inc | Adp of the snf | 1 May 2025 | |
| Nexion Health, Inc. | Adp of the snf | 1 May 2025 |
The site shows organisations only. It does not show the names of persons.
Other homes in Fannin County
| Nursing home | City | Overall rating | Citations, latest cycle | Fines | Last standard survey | |
|---|---|---|---|---|---|---|
| Seven Oaks Nursing & Rehabilitation | Bonham | 4 of 5 | 10 | $0 | 23 Jul 2025 | |
| Clyde W Cosper Texas State Veterans Home | Bonham | 1 of 5 | 17 | $216,749 | 29 Apr 2026 | |
| Mullican Care Center | Savoy | 2 of 5 | 10 | $5,159 | 29 May 2025 | |
| Honey Grove Nursing Center | Honey Grove | 2 of 5 | 8 | $80,698 | 18 Dec 2025 |
Official channels
- Care Compare record of this nursing homeMedicare.gov. The official CMS record of this home.
- Texas Health and Human Services: complaint and incident intakeThe complaint page of the State Survey Agency for Texas, from the CMS list of agencies.
- Contact information for State Survey AgenciesCMS. The web address and the telephone number of the State Survey Agency of each state. These agencies investigate complaints about nursing homes.
- Filing a complaintMedicare.gov. The page names the State Survey Agency as the place for a complaint about nursing home care or facility conditions.
- Eldercare LocatorAdministration for Community Living. A public service that connects older adults and their families to local services. Telephone: 1-800-677-1116.
Cite this page
Centers for Medicare & Medicaid Services, Care Compare. Record of North Star Ranch Rehabilitation and Healthcare Cen (CCN 675471). Data processed 1 Aug 2026. Elder Care Record, https://eldercarerecord.com/facility/north-star-ranch-rehabilitation-and-healthcare-cen-bonham-tx-675471/
Provenance
- Licence
- US government work, public domain
- CMS processed the data on
A program makes this page from the CMS files, and the same files always give the same text. How the site makes the figures. Report an error.
Questions
- When was North Star Ranch Rehabilitation and Healthcare Cen last inspected?
- The latest inspection with a citation in the CMS record was on 2 Jul 2026. It was a standard survey. It gave 16 citations. The standard survey before the last one was on 24 Apr 2025.
- Who operates North Star Ranch Rehabilitation and Healthcare Cen?
- The CMS record gives the ownership type as for-profit, corporation. CMS lists the home in the chain Nexion Health. The CMS ownership file names 5 organisations for operational or managerial control. This site does not show the names of persons.
- Is North Star Ranch Rehabilitation and Healthcare Cen a Special Focus Facility?
- No. The CMS provider file lists no Special Focus status for this home. CMS lists 6 homes in Texas as Special Focus Facilities and 30 as candidates.
- Where does the data on this page come from?
- The data comes from the CMS Care Compare files for nursing homes. CMS processed the files on 1 Aug 2026. The Care Compare record on Medicare.gov is the official record of the home.