Avir at Cowhorn Creek

Nursing Home · Texarkana, TX

CMS overall rating 1/5 SFF candidate Abuse citation Government - Hospital district

CMS certification number675949
CMS lists this nursing home as a Special Focus Facility candidate – one of the lowest-performing nursing homes in its state based on inspection history.
This facility was cited for abuse, neglect or exploitation in a recent inspection (CMS abuse icon).

Contact & location

5524 Cowhorn Creek
Texarkana, TX 75503
Bowie County
Phone
(903) 223-1188
ZIP code
75503 – all care providers

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Facility details

Certified beds
76
Residents per day
67.8 (89% occupied)
Ownership
Government - Hospital district
Legal name
Guadalupe County Hospital Board
Chain
Avir Health Group (116 facilities, avg 2.3★)
Medicare certified since
December 16, 2002
Participates in
Medicare and Medicaid
Council
Resident council

CMS star ratings

Overall★★★★★ 1/5
State avg 2.6
Health inspections★★★★★ 1/5
State avg 2.8
Staffing★★★★★ 1/5
State avg 1.9
Quality measures★★★★★ 3/5
State avg 3.7
Long-stay quality★★★★★ 4/5
Short-stay quality★★★★★ 3/5

Staffing

Hours of nursing care per resident per day, from payroll data. More hours generally mean more time for each resident.

Total nurse staffing
3.26 (state 3.39 · U.S. 3.86)
Registered nurses (RN)
0.38 (state 0.43 · U.S. 0.69)
Licensed practical nurses
0.94 (state 0.95 · U.S. 0.86)
Nurse aides
1.94 (state 2.00 · U.S. 2.32)
Weekend total
2.93 (state 2.98 · U.S. 3.42)
Nursing staff turnover
68.2 (state 55.3 · U.S. 45.8)%
RN turnover
—
Administrators who left
0 in the last year

Inspections

Last standard inspection
February 12, 2026
Health deficiencies (last cycle)
28.0 (state 9.3 · U.S. 9.3)
From complaints
8
Citations on record (3 years)
65 health · 4 fire safety · includes immediate jeopardy
DateCitationSeverityStatus
2026-04-13 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
F0755 · Pharmacy Service Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-04-14
2026-02-12 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.
F0727 · Nursing and Physician Services Deficiencies		 F
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F0812 · Nutrition and Dietary Deficiencies		 F
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
F0636 · Resident Assessment and Care Planning Deficiencies		 E
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
F0640 · Resident Assessment and Care Planning Deficiencies		 E
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
F0656 · Resident Assessment and Care Planning Deficiencies		 E
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
F0755 · Pharmacy Service Deficiencies		 E
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
F0804 · Nutrition and Dietary Deficiencies		 E
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Provide and implement an infection prevention and control program.
F0880 · Infection Control Deficiencies		 E
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Reasonably accommodate the needs and preferences of each resident.
F0558 · Resident Rights Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Honor the resident's right to organize and participate in resident/family groups in the facility.
F0565 · Resident Rights Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
F0582 · Resident Rights Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Assess the resident when there is a significant change in condition
F0637 · Resident Assessment and Care Planning Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Ensure each resident receives an accurate assessment.
F0641 · Resident Assessment and Care Planning Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
F0644 · Resident Assessment and Care Planning Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Provide care and assistance to perform activities of daily living for any resident who is unable.
F0677 · Quality of Life and Care Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Assist a resident in gaining access to vision and hearing services.
F0685 · Quality of Life and Care Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F0689 · Quality of Life and Care Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Ensure medication error rates are not 5 percent or greater.
F0759 · Pharmacy Service Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
F0806 · Nutrition and Dietary Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2026-02-12 Have a policy regarding use and storage of foods brought to residents by family and other visitors.
F0813 · Nutrition and Dietary Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2026-02-13
2025-08-15 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
F0600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection		 K
Immediate jeopardy to resident health or safety		 Corrected 2025-08-16
2025-08-15 Honor each resident's preferences, choices, values and beliefs.
F0675 · Quality of Life and Care Deficiencies · complaint inspection		 K
Immediate jeopardy to resident health or safety		 Corrected 2025-08-16
2025-08-15 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.
F0585 · Resident Rights Deficiencies · complaint inspection		 E
No actual harm, potential for more than minimal harm		 Corrected 2025-08-18
2025-08-15 Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
F0561 · Resident Rights Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2025-08-18
2025-08-15 Provide care and assistance to perform activities of daily living for any resident who is unable.
F0677 · Quality of Life and Care Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2025-08-18
2025-08-15 Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
F0806 · Nutrition and Dietary Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2025-08-18
2025-08-15 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.
F0838 · Administration Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2025-08-18
2025-04-09 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
F0550 · Resident Rights Deficiencies · complaint inspection		 E
No actual harm, potential for more than minimal harm		 Corrected 2025-04-10
2025-04-09 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.
F0585 · Resident Rights Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2025-04-10
2025-04-09 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
F0600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2025-04-10
2024-12-04 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F0812 · Nutrition and Dietary Deficiencies		 F
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 Allow resident to participate in the development and implementation of his or her person-centered plan of care.
F0553 · Resident Rights Deficiencies		 E
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
F0804 · Nutrition and Dietary Deficiencies		 E
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 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.
F0809 · Nutrition and Dietary Deficiencies		 E
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 Reasonably accommodate the needs and preferences of each resident.
F0558 · Resident Rights Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
F0623 · Resident Rights Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
F0655 · Resident Assessment and Care Planning Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 Assist a resident in gaining access to vision and hearing services.
F0685 · Quality of Life and Care Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 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.
F0688 · Quality of Life and Care Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 Provide enough food/fluids to maintain a resident's health.
F0692 · Quality of Life and Care Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 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.
F0758 · Pharmacy Service Deficiencies		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-12-06
2024-12-04 Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
F0640 · Resident Assessment and Care Planning Deficiencies		 B
No actual harm, potential for minimal harm		 Corrected 2024-12-06
2024-10-29 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
F0550 · Resident Rights Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-10-31
2024-10-29 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
F0600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-10-30
2024-10-29 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
F0609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-10-30
2024-10-29 Respond appropriately to all alleged violations.
F0610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-10-30
2024-10-29 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F0689 · Quality of Life and Care Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-11-01
2024-10-29 Provide and implement an infection prevention and control program.
F0880 · Infection Control Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-10-30
2024-03-13 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
F0550 · Resident Rights Deficiencies · complaint inspection		 D
No actual harm, potential for more than minimal harm		 Corrected 2024-03-15

Severity letters A–L combine how widespread a problem was (isolated, pattern, widespread) with how serious (from potential for minimal harm to immediate jeopardy). How to read inspection results

Fines & penalties

2 penalties in the last three years, including $30,105 in fines.

DateTypeAmount
2025-08-15Payment Denial5 days payment denial
2025-08-15Fine$30,105

Ownership & management

NameRoleSince
Guadalupe County Hospital Board (organization)5%+ Direct Ownership Interest · 100%
5524 Cowhorn Creek Property Owner, LLC (organization)Administrator · NOT APPLICABLE
Betts, Britney (individual)Administrator · NOT APPLICABLE
Ferguson, Clay (individual)Administrator · NOT APPLICABLE
Welltower INC (organization)Administrator · NOT APPLICABLE
Welltower NNN Group, LLC (organization)Administrator · NOT APPLICABLE
Welltower Op, LLC (organization)Administrator · NOT APPLICABLE
Gann, Kody (individual)Corporate Officer · NOT APPLICABLE
Dagan, Amitai (individual)Individual Is An Owner, Partner Or Trustee Of Any Administrator · NOT APPLICABLE
Freund, Nochum (individual)Individual Is An Owner, Partner Or Trustee Of Any Administrator · NOT APPLICABLE
Goldberger, Abraham (individual)Individual Is An Owner, Partner Or Trustee Of Any Administrator · NOT APPLICABLE
Goldberger, Faigy (individual)Individual Is An Owner, Partner Or Trustee Of Any Administrator · NOT APPLICABLE
5524 Cowhorn Creek Opco LLC (organization)Operational/managerial Control · NOT APPLICABLE
Travitsky, Aaron (individual)Operational/managerial Control · NOT APPLICABLE

Frequently asked questions

What is the rating of Avir at Cowhorn Creek?

Avir at Cowhorn Creek has a 1-star overall rating from the Centers for Medicare & Medicaid Services on a scale of 1 to 5, compared with a 2.6-star average in Texas.

How many beds does Avir at Cowhorn Creek have?

It has 76 certified beds and cares for about 68 residents per day.

Has Avir at Cowhorn Creek been fined?

Yes. CMS lists 2 penalties totaling $30,105 in the last three years.

Who owns Avir at Cowhorn Creek?

It is part of Avir Health Group and is classified as government - hospital district. See the ownership table above for all owners and managers reported to CMS.

What is the phone number of Avir at Cowhorn Creek?

(903) 223-1188. The facility is located at 5524 Cowhorn Creek, Texarkana, TX 75503.

Other nursing homes in Texarkana

Compare all nursing homes in Texarkana, TX →

Source: CMS Care Compare, August 2026. Information is provided as published by CMS; verify details directly with the facility.