Texas › Nacogdoches County › Nacogdoches
Westward Trails Nursing and Rehabilitation
3001 Westward Drive, Nacogdoches, TX 75964
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.
Westward Trails Nursing and Rehabilitation, in Nacogdoches, Texas, is certified for 108 beds under for-profit, corporation ownership and belongs to the Creative Solutions In Healthcare chain.
CMS gives it 3 of 5 stars overall, equal to the Texas median; the health inspection rating is 4, staffing 1 and quality measures 3.
Inspectors recorded 24 health deficiencies across the three most recent survey cycles (2, 16, 6 by cycle, most recent first), 2 of them at the actual-harm or immediate-jeopardy level. That is 22.2 per 100 beds, about the same as the state median of 22.5.
CMS lists 3 penalties in the period covered: fines totalling $25K.
Reported nurse staffing is 3.3 hours per resident per day (0.2 RN), close to the Texas median of 3.3.
Compared with county, state and nation
| Measure | This facility | Nacogdoches Co. median | Texas median | US average |
|---|---|---|---|---|
| Overall star rating | 3 | 3 | 3 | 3.0 |
| Health citations, 3 cycles | 24 | 24 | 25 | 28.7 |
| Citations per 100 beds | 22.2 | 20.8 | 22.5 | 26.8 |
| Total nurse hours per resident day | 3.3 | 3.3 | 3.3 | 3.9 |
| RN hours per resident day | 0.2 | 0.3 | 0.4 | 0.7 |
| Nursing staff turnover | — | 45.7% | 52.1% | 45.8% |
| Fines listed | $25,036 | $52,951 | $16,801 | — |
County and state figures are medians across facilities (4 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: 25 Jun 2025, 24 Apr 2024.
Severity mix: J ×2 D ×14 E ×7 F ×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 |
|---|---|---|---|---|---|
| 20 Nov 2025 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Complaint investigation | 21 Nov 2025 |
| 25 Jun 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Complaint investigation | 28 May 2025 |
| 22 May 2025 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Complaint investigation | 23 May 2025 |
| 31 Mar 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Complaint investigation | 25 Feb 2025 |
| 31 Mar 2025 | 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. | E | Complaint investigation | 1 Apr 2025 |
| 31 Mar 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 | 1 Apr 2025 |
| 31 Mar 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | 1 Apr 2025 |
| 31 Mar 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 | 1 Apr 2025 |
| 24 Apr 2024 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 30 Apr 2024 |
| 24 Apr 2024 | F0583 | Keep residents' personal and medical records private and confidential. | D | Standard survey | 30 Apr 2024 |
| 24 Apr 2024 | F0637 | Assess the resident when there is a significant change in condition | D | Standard survey | 30 Apr 2024 |
| 24 Apr 2024 | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | Standard survey | 30 Apr 2024 |
| 24 Apr 2024 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard survey | 30 Apr 2024 |
| 24 Apr 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Standard survey | 30 Apr 2024 |
| 24 Apr 2024 | F0692 | Provide enough food/fluids to maintain a resident's health. | D | Standard survey | 30 Apr 2024 |
| 24 Apr 2024 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Standard survey | 30 Apr 2024 |
| 24 Apr 2024 | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | D | Standard survey | 30 Apr 2024 |
| 24 Apr 2024 | F0926 | Have policies on smoking. | D | Standard survey | 30 Apr 2024 |
| 15 Mar 2023 | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | E | Standard survey | 8 Apr 2023 |
| 15 Mar 2023 | F0638 | Assure that each resident’s assessment is updated at least once every 3 months. | E | Standard survey | 8 Apr 2023 |
| 15 Mar 2023 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | E | Standard survey | 8 Apr 2023 |
| 15 Mar 2023 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | Standard survey | 8 Apr 2023 |
| 15 Mar 2023 | F0926 | Have policies on smoking. | E | Standard survey | 8 Apr 2023 |
| 15 Mar 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 | 8 Apr 2023 |
Penalties
| Date | Type | Amount | Detail |
|---|---|---|---|
| 25 Jun 2025 | Fine | $14,901 | |
| 31 Mar 2025 | Fine | $5,649 | |
| 31 Mar 2025 | Fine | $4,486 |
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the Texas average. Turnover: nursing staff —, RNs —; 1 administrator 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 | 17.3% | 14.9% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.2% | 0.0% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 2.3% | 0.3% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 4.9% | 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 | 9.2% | 12.4% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 6.8% | 3.4% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 6.3% | 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, corporation. Legal business name: Westward I Enterprises Llc. Chain: Creative Solutions In Healthcare (149 facilities).
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Creative Solutions In Healthcare Inc | Operational/managerial control | NOT APPLICABLE | 05/01/2021 |
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 Nacogdoches County
| Facility | City | Beds | Overall | Health | Staffing | Citations | Per 100 beds | Fines | Last survey |
|---|---|---|---|---|---|---|---|---|---|
| Stallings Court Nursing and Rehabilitation | Nacogdoches | 120 | 5 | 4 | 3 | 25 | 20.8 | — | 28 May 2026 |
| Garrison Nursing Home & Rehabilitation Center | Garrison | 93 | 3 | 3 | 2 | 13 | 14.0 | $53K | 30 Jul 2025 |
| Willowbrook Nursing Center | Nacogdoches | 166 | 3 | 3 | 1 | 23 | 13.9 | $153K | 9 Jul 2025 |
All 4 facilities in Nacogdoches County
Questions and answers
How many deficiencies has Westward Trails Nursing and Rehabilitation been cited for?
24 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 Westward Trails Nursing and Rehabilitation been fined?
Yes. CMS lists fines totalling $25K in the period covered.
How does staffing at Westward Trails Nursing and Rehabilitation 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 Westward Trails Nursing and Rehabilitation?
It is part of the Creative Solutions In Healthcare chain. Ownership type is for-profit, corporation. Organisations in the CMS ownership record include Creative Solutions In Healthcare Inc. Individual owners and managers are not listed on this site.
When was Westward Trails Nursing and Rehabilitation last inspected?
The most recent survey or investigation in the CMS record is dated 20 Nov 2025; the most recent standard health survey was 25 Jun 2025.
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.