Texas › Fort Bend County › Missouri City
Paradigm At First Colony
4710 Lexington Blvd, Missouri City, TX 77459
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.
Paradigm At First Colony is a For-profit, limited liability company nursing home in Missouri City, Texas, certified for 150 beds and caring for about 104 residents a day.
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 4.
Inspectors recorded 41 health deficiencies across the three most recent survey cycles (5, 19, 17 by cycle, most recent first), 8 of them at the actual-harm or immediate-jeopardy level. That is 27.3 per 100 beds, about the same as the state median of 22.5.
CMS lists 2 penalties in the period covered: fines totalling $65K.
Reported nurse staffing is 3.4 hours per resident per day (0.5 RN), close to the Texas median of 3.3; nursing staff turnover is 67.0%.
Compared with county, state and nation
| Measure | This facility | Fort Bend Co. median | Texas median | US average |
|---|---|---|---|---|
| Overall star rating | 1 | 3 | 3 | 3.0 |
| Health citations, 3 cycles | 41 | 17 | 25 | 28.7 |
| Citations per 100 beds | 27.3 | 19.4 | 22.5 | 26.8 |
| Total nurse hours per resident day | 3.4 | 3.6 | 3.3 | 3.9 |
| RN hours per resident day | 0.5 | 0.6 | 0.4 | 0.7 |
| Nursing staff turnover | 67.0% | 57.5% | 52.1% | 45.8% |
| Fines listed | $64,559 | $64,559 | $16,801 | — |
County and state figures are medians across facilities (15 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: 22 Jan 2026, 24 Oct 2024.
Severity mix: J ×3 K ×5 D ×22 E ×7 F ×1 C ×3
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 |
|---|---|---|---|---|---|
| 11 Jun 2026 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Complaint investigation | 1 Jul 2026 |
| 18 Mar 2026 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Complaint investigation | 25 Mar 2026 |
| 1 Dec 2025 | F0551 | Give the resident's representative the ability to exercise the resident's rights. | D | Complaint investigation | 15 Dec 2025 |
| 14 Nov 2025 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Complaint investigation | 11 Dec 2025 |
| 8 Sep 2025 | F0610 | Respond appropriately to all alleged violations. | E | Complaint investigation | 23 Sep 2025 |
| 1 Jun 2025 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Complaint investigation | 5 Jun 2025 |
| 27 Nov 2024 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | K | Complaint investigation | 4 Dec 2024 |
| 27 Nov 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | K | Complaint investigation | 4 Dec 2024 |
| 19 Nov 2024 | F0583 | Keep residents' personal and medical records private and confidential. | C | Complaint investigation | 20 Nov 2024 |
| 19 Nov 2024 | F0732 | Post nurse staffing information every day. | C | Complaint investigation | 20 Nov 2024 |
| 24 Oct 2024 | F0694 | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | K | Complaint investigation | 31 Oct 2024 |
| 24 Oct 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 | 31 Oct 2024 |
| 24 Oct 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 | Complaint investigation | 31 Oct 2024 |
| 24 Oct 2024 | F0759 | Ensure medication error rates are not 5 percent or greater. | E | Standard survey | 31 Oct 2024 |
| 24 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 |
| 24 Oct 2024 | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | Complaint investigation | 31 Oct 2024 |
| 24 Oct 2024 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | 31 Oct 2024 |
| 24 Oct 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 | 31 Oct 2024 |
| 24 Oct 2024 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Standard survey | 31 Oct 2024 |
| 24 Oct 2024 | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Standard survey | 31 Oct 2024 |
| 24 Oct 2024 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Complaint investigation | 31 Oct 2024 |
| 24 Oct 2024 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 31 Oct 2024 |
| 24 Oct 2024 | F0814 | Dispose of garbage and refuse properly. | C | Standard survey | 31 Oct 2024 |
| 21 Aug 2024 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Complaint investigation | 28 Aug 2024 |
| 25 Jul 2024 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Complaint investigation | 12 Aug 2024 |
| 25 Jul 2024 | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | Complaint investigation | 12 Aug 2024 |
| 8 Feb 2024 | F0880 | Provide and implement an infection prevention and control program. | E | Complaint investigation | 12 Feb 2024 |
| 8 Feb 2024 | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Complaint investigation | 12 Feb 2024 |
| 2 Nov 2023 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | Complaint investigation | 3 Nov 2023 |
| 2 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. | D | Complaint investigation | 3 Nov 2023 |
| 8 Sep 2023 | 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 | Complaint investigation | 15 Sep 2023 |
| 8 Sep 2023 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Complaint investigation | 15 Sep 2023 |
| 8 Sep 2023 | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Complaint investigation | 15 Sep 2023 |
| 8 Sep 2023 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Complaint investigation | 15 Sep 2023 |
| 8 Sep 2023 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Complaint investigation | 15 Sep 2023 |
| 8 Sep 2023 | F0814 | Dispose of garbage and refuse properly. | D | Complaint investigation | 15 Sep 2023 |
| 15 Aug 2023 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | K | Complaint investigation | 22 Aug 2023 |
| 15 Aug 2023 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | K | Complaint investigation | 15 Sep 2023 |
| 15 Aug 2023 | F0678 | Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. | J | Complaint investigation | 22 Aug 2023 |
| 15 Aug 2023 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | J | Complaint investigation | 22 Aug 2023 |
| 15 Aug 2023 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Complaint investigation | 22 Aug 2023 |
Penalties
| Date | Type | Amount | Detail |
|---|---|---|---|
| 27 Nov 2024 | Fine | $19,838 | |
| 24 Oct 2024 | Fine | $44,721 |
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the Texas average. Turnover: nursing staff 67.0%, RNs 90.5%; 2 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 | 8.2% | 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 | 0.5% | 3.0% | 2.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 2.2% | 0.7% | 1.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 1.2% | 12.4% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 7.5% | 3.4% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 20.4% | 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: for-profit, limited liability company. Legal business name: Oakbend Medical Center. Chain: Paradigm Healthcare (17 facilities).
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Oakbend Medical Center | 5% or greater direct ownership interest | 100% | 02/28/2015 |
| Ssc Missouri City Operating Company LLC | Operational/managerial control | NOT APPLICABLE | 02/28/2015 |
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 Fort Bend County
| Facility | City | Beds | Overall | Health | Staffing | Citations | Per 100 beds | Fines | Last survey |
|---|---|---|---|---|---|---|---|---|---|
| Paradigm At the Brazos | Richmond | 56 | 5 | 5 | 3 | 6 | 10.7 | — | 1 Aug 2025 |
| S.P.J.S.T. Rest Home No 2 | Needville | 58 | 5 | 5 | 4 | 7 | 12.1 | — | 18 Dec 2025 |
| Oak Bend Medical Center | Richmond | 36 | 4 | 4 | 1 | 7 | 19.4 | $12K | 17 Jun 2026 |
| Richmond Health Care Center | Richmond | 92 | 4 | 4 | 2 | 23 | 25.0 | $78K | 10 Jul 2025 |
| Cambridge Health and Rehabilitation Center | Richmond | 158 | 3 | 2 | 2 | 26 | 16.5 | $68K | 25 Mar 2026 |
| Fort Bend Healthcare Center | Rosenberg | 56 | 3 | 3 | 1 | 15 | 26.8 | $23K | 9 Aug 2025 |
| Sugar Land Health Care Center | Sugar Land | 150 | 3 | 3 | 2 | 17 | 11.3 | $30K | 17 Dec 2025 |
| Windsor Quail Valley Post-Acute Healthcare | Missouri City | 120 | 3 | 3 | 2 | 16 | 13.3 | $52K | 5 Jun 2026 |
All 15 facilities in Fort Bend County
Questions and answers
How many deficiencies has Paradigm At First Colony been cited for?
41 health deficiencies across the three most recent survey cycles, 8 at the actual-harm or immediate-jeopardy level. The Texas median is 25 per facility.
Has Paradigm At First Colony been fined?
Yes. CMS lists fines totalling $65K in the period covered.
How does staffing at Paradigm At First Colony compare?
Reported total nurse staffing is 3.4 hours per resident per day against a Texas median of 3.3 and a national average of 3.9.
Who operates Paradigm At First Colony?
It is part of the Paradigm Healthcare chain. Ownership type is for-profit, limited liability company. Organisations in the CMS ownership record include Oakbend Medical Center and Ssc Missouri City Operating Company LLC. Individual owners and managers are not listed on this site.
When was Paradigm At First Colony last inspected?
The most recent survey or investigation in the CMS record is dated 11 Jun 2026; the most recent standard health survey was 22 Jan 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.