nursing home in Palestine, TX
Legacy at Town Creek
2212 W Reagan St, Palestine, TX 75801 · (903) 727-8500
★★★★★1
Much below average
CMS overall star rating
CMS overall star rating
- Health inspections★★★★★2
- Staffing★★★★★1
- Quality measures★★★★★2
Source: Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. We refresh our information from this source. About our data
Legacy at Town Creek at a glance
Legacy at Town Creek is a 199-bed government nursing home in Palestine, Texas (Anderson County).
CMS gives it 1 out of 5 stars on its overall star rating, worse than the Texas average of 2.7.
Residents receive about 3.4 hours of nursing care per day (0.3 of them from registered nurses), close to the state average of 3.4 hours.
Its most recent standard health inspection (August 6, 2025) found 6 health citations. The Texas average is 9.4.
Federal regulators fined it 2 times in the past three years, totaling $294,608.
Nursing staff turnover is 53.8% per year (state average 55.3%).
Facility details
- Type
- Nursing home
- Ownership
- Government - Hospital District
- Beds
- 199
- Certified for
- Medicare and Medicaid
- Chain / affiliated entity
- Southwest LTC
- Medicare-certified since
- January 8, 2004
- Resident/family council
- Resident
- County
- Anderson County
- CMS Certification Number
- 675998
Ratings
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Overall star rating ⓘ (higher is better) | 1 / 5 | 2.7 / 5 | 3 / 5 | Worse |
| Health inspection rating ⓘ (higher is better) | 2 / 5 | 2.8 / 5 | 2.8 / 5 | Worse |
| Staffing rating ⓘ (higher is better) | 1 / 5 | 1.9 / 5 | 2.9 / 5 | Worse |
| Quality measures rating ⓘ (higher is better) | 2 / 5 | 3.7 / 5 | 3.6 / 5 | Worse |
| Long-stay quality rating (higher is better) | 2 / 5 | 4 / 5 | 3.8 / 5 | Worse |
| Short-stay (rehab) quality rating (higher is better) | 2 / 5 | 3.2 / 5 | 3.3 / 5 | Worse |
Staffing
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Total nurse staff hours per resident per day ⓘ (higher is better) | 3.37 hrs | 3.39 hrs | 3.86 hrs | Worse |
| Registered nurse hours per resident per day (higher is better) | 0.27 hrs | 0.43 hrs | 0.69 hrs | Worse |
| Nurse aide hours per resident per day (higher is better) | 2.00 hrs | 2.01 hrs | 2.32 hrs | Worse |
| Weekend nurse staff hours per resident per day (higher is better) | 3.06 hrs | 2.98 hrs | 3.42 hrs | Worse |
| Nursing staff turnover (yearly) (lower is better) | 53.8% | 55.3% | 45.8% | Worse |
| Registered nurse turnover (yearly) (lower is better) | 55.6% | 54.6% | 42.9% | Worse |
Inspections
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Health citations in the most recent inspection (lower is better) | 6 | 9 | 9 | Better |
| Citations from complaint investigations (latest cycle) (lower is better) | 2 | 4 | 3 | Better |
| Weighted health inspection score ⓘ (lower is better) | 146.8 | 102 | 80.6 | Worse |
Penalties
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Fines in the past 3 years (lower is better) | 2 | 1 | 1 | Worse |
| Total fines in the past 3 years (lower is better) | $294,608 | $44,141 | $30,972 | Worse |
| All federal penalties in the past 3 years (lower is better) | 2 | 2 | 1 | Worse |
Size
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Certified beds | 199 | 113 | 107 | |
| Average residents per day | 77 | 76 | 86 | |
| Occupancy | 38.8% | 67.6% | 80.9% |
Long-stay residents
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Long-stay residents with a fall causing major injury (lower is better) | 4.3% | 3.3% | 3.2% | Worse |
| Long-stay residents with pressure ulcers (lower is better) | 6% | 3.8% | 4.6% | Worse |
| Long-stay residents given antipsychotic medication (lower is better) | 5% | 9.6% | 15.4% | Better |
| Long-stay residents with a urinary tract infection (lower is better) | 0.3% | 0.8% | 1.6% | Better |
| Long-stay residents with a catheter left in the bladder (lower is better) | 0.8% | 0.3% | 0.8% | Average |
| Long-stay residents needing more help with daily activities (lower is better) | 23.5% | 15.8% | 13.9% | Worse |
| Long-stay residents whose walking worsened (lower is better) | 36.7% | 14% | 14.1% | Worse |
| Long-stay residents who lose too much weight (lower is better) | 7.4% | 3% | 5.2% | Worse |
| Long-stay residents with depressive symptoms (lower is better) | 0.7% | 2.4% | 12.8% | Better |
| Long-stay residents who were physically restrained (lower is better) | 0% | 0% | 0.1% | Better |
| Long-stay residents given anti-anxiety or sleep medication (lower is better) | 32.7% | 18% | 19.5% | Worse |
| Long-stay residents with new or worse incontinence (lower is better) | 20.9% | 13.4% | 19% | Worse |
| Long-stay residents given a flu vaccine (higher is better) | 99.1% | 98% | 95.5% | Average |
| Long-stay residents given a pneumonia vaccine (higher is better) | 99.4% | 96.6% | 93.6% | Better |
Short-stay residents
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Short-stay residents newly given antipsychotic medication (lower is better) | 1% | 1.5% | 1.6% | Better |
| Short-stay residents given a flu vaccine (higher is better) | 91.5% | 88% | 79.8% | Better |
| Short-stay residents given a pneumonia vaccine (higher is better) | 90% | 88.9% | 82% | Better |
Inspection citations
State inspectors cited this home for 37 health deficiencies and 4 fire safety deficiencies in the inspection records CMS currently publishes. 5 citations involved actual harm, including 3 rated "immediate jeopardy".
| Date | Citation | Severity | Status |
|---|---|---|---|
| January 7, 2026 Complaint | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Tag F0580 | D Potential harm, isolated | Corrected January 8, 2026 |
| October 8, 2025 Complaint | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Tag F0695 | G Actual harm, isolated | Corrected October 9, 2025 |
| August 6, 2025 Fire safety | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Tag K0321 | E Potential harm, pattern | Corrected September 10, 2025 |
| August 6, 2025 Fire safety | Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Tag K0372 | E Potential harm, pattern | Corrected September 10, 2025 |
| August 6, 2025 Standard | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Tag F0812 | E Potential harm, pattern | Corrected September 10, 2025 |
| August 6, 2025 Standard | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Tag F0755 | D Potential harm, isolated | Corrected September 10, 2025 |
| August 6, 2025 Standard | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected September 10, 2025 |
| August 6, 2025 Standard | Have a policy regarding use and storage of foods brought to residents by family and other visitors. Nutrition and Dietary Deficiencies · Tag F0813 | D Potential harm, isolated | Corrected September 10, 2025 |
| July 31, 2024 Fire safety | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Tag K0353 | E Potential harm, pattern | Corrected August 22, 2024 |
| July 31, 2024 Standard | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Tag F0812 | F Potential harm, widespread | Corrected August 12, 2024 |
| July 31, 2024 Standard | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Tag F0689 | D Potential harm, isolated | Corrected August 12, 2024 |
| July 31, 2024 Complaint | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Environmental Deficiencies · Tag F0925 | D Potential harm, isolated | Corrected August 12, 2024 |
| July 31, 2024 Standard | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected August 12, 2024 |
| July 31, 2024 Standard | 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. Pharmacy Service Deficiencies · Tag F0761 | D Potential harm, isolated | Corrected August 12, 2024 |
| July 31, 2024 Standard | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Tag F0755 | D Potential harm, isolated | Corrected August 12, 2024 |
| July 31, 2024 Standard | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. Resident Assessment and Care Planning Deficiencies · Tag F0640 | B No harm, pattern | Corrected August 12, 2024 |
| June 6, 2024 Complaint | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0600 | K Immediate jeopardy, pattern | Corrected June 7, 2024 |
| June 6, 2024 Complaint | Respond appropriately to all alleged violations. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610 | K Immediate jeopardy, pattern | Corrected June 7, 2024 |
| June 6, 2024 Complaint | Develop and implement policies and procedures to prevent abuse, neglect, and theft. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0607 | K Immediate jeopardy, pattern | Corrected June 7, 2024 |
| June 6, 2024 Complaint | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Tag F0689 | G Actual harm, isolated | Corrected June 7, 2024 |
| June 6, 2024 Complaint | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 | E Potential harm, pattern | Corrected June 7, 2024 |
| June 6, 2024 Complaint | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected June 7, 2024 |
| January 22, 2024 Complaint | 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. Pharmacy Service Deficiencies · Tag F0761 | E Potential harm, pattern | Corrected February 14, 2024 |
| January 22, 2024 Complaint | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Tag F0695 | D Potential harm, isolated | Corrected February 14, 2024 |
| April 26, 2023 Fire safety | Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Tag K0345 | E Potential harm, pattern | Corrected July 14, 2023 |
| April 26, 2023 Standard | Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Tag F0677 | E Potential harm, pattern | Corrected April 27, 2023 |
| April 26, 2023 Standard | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Tag F0695 | E Potential harm, pattern | Corrected May 12, 2023 |
| April 26, 2023 Standard | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Tag F0656 | E Potential harm, pattern | Corrected May 16, 2023 |
| April 26, 2023 Standard | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · Tag F0655 | E Potential harm, pattern | Corrected May 20, 2023 |
| April 26, 2023 Standard | 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. Resident Rights Deficiencies · Tag F0584 | E Potential harm, pattern | Corrected May 19, 2023 |
| April 26, 2023 Standard | Ensure that residents are fully informed and understand their health status, care and treatments. Resident Rights Deficiencies · Tag F0552 | E Potential harm, pattern | Corrected May 19, 2023 |
| April 26, 2023 Standard | 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. Pharmacy Service Deficiencies · Tag F0758 | E Potential harm, pattern | Corrected May 19, 2023 |
| April 26, 2023 Standard | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Environmental Deficiencies · Tag F0921 | E Potential harm, pattern | Corrected May 1, 2023 |
| April 26, 2023 Standard | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Tag F0550 | D Potential harm, isolated | Corrected May 12, 2023 |
| April 26, 2023 Standard | Have policies on smoking. Environmental Deficiencies · Tag F0926 | D Potential harm, isolated | Corrected May 15, 2023 |
| April 26, 2023 Standard | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected May 27, 2023 |
| April 26, 2023 Standard | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Tag F0755 | D Potential harm, isolated | Corrected May 12, 2023 |
| April 26, 2023 Standard | Provide safe, appropriate dialysis care/services for a resident who requires such services. Quality of Life and Care Deficiencies · Tag F0698 | D Potential harm, isolated | Corrected May 12, 2023 |
| April 26, 2023 Standard | Provide enough food/fluids to maintain a resident's health. Quality of Life and Care Deficiencies · Tag F0692 | D Potential harm, isolated | Corrected May 19, 2023 |
| April 26, 2023 Standard | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies · Tag F0690 | D Potential harm, isolated | Corrected May 15, 2023 |
| April 26, 2023 Standard | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Tag F0657 | D Potential harm, isolated | Corrected May 19, 2023 |
Severity letters follow the CMS scope-and-severity grid: A–C no actual harm with potential for minimal harm; D–F potential for more than minimal harm; G–I actual harm; J–L immediate jeopardy to resident health or safety. How to read inspection citations.
Fines and payment denials
CMS reports 2 federal penalties in the past three years, including $294,608 in fines.
| Date | Penalty | Amount / length |
|---|---|---|
| October 8, 2025 | Fine | $10,358 |
| June 6, 2024 | Fine | $284,250 |
Owners and managers
Individuals and organizations reported to CMS as owning or operating this nursing home.
| Name | Role | Share | Since |
|---|---|---|---|
| LIBERTY COUNTY HOSPITAL DISTRICT NO 1 Organization | 5% or greater direct ownership interest | 100% | 04/01/2018 |
| ADEWALE, ADEBAYO Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| BAUDER FAMILY INVESTMENTS, LLC Organization | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| BAUDER, KELLY Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| BAUDER, MADISON Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| BAUDER, PARKER Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| BAUDER, WILLIAM Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| BOULWARE, STEVEN Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| BOULWARE ST JAMES LLC Organization | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| BOULWARE, THOMAS Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| FRANKLIN, BRADLEY Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| PMG REALCO- PALESTINE LLC Organization | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| STEVEN BOULWARE FAMILY INVESTMENTS LLC Organization | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| WALKER, KATIE Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| STRATTON, CHARLES Individual | corporate officer | NOT APPLICABLE | 04/01/2018 |
| BOULWARE, DOUGLAS Individual | individual is an owner, partner or trustee of any adp of the snf | NOT APPLICABLE | 03/24/2026 |
| BOULWARE, SANDRA Individual | individual is an owner, partner or trustee of any adp of the snf | NOT APPLICABLE | 03/24/2026 |
| ADEWALE, ADEBAYO Individual | operational/managerial control | NOT APPLICABLE | 10/01/2025 |
| FRANKLIN, BRADLEY Individual | operational/managerial control | NOT APPLICABLE | 10/01/2025 |
| PMG OPCO- PALESTINE LLC Organization | operational/managerial control | NOT APPLICABLE | 10/01/2025 |
Other nursing homes near Legacy at Town Creek
Trucare Living Centers
2265 S Sycamore St, Palestine, TX 75801 · 1.7 mi
Government · 120 beds
- CMS high performer
★★★★★5Much above averageAvir at Town Creek
1816 Tile Factory Rd, Palestine, TX 75801 · 1.7 mi
For-profit · 102 beds · Part of Avir Health Group
★★★★★3AverageGreenbrier Nursing & Rehabilitation Center of Pale
2404 State Highway 155, Palestine, TX 75803 · 3.6 mi
For-profit · 120 beds · Part of Creative Solutions in Healthcare
★★★★★4Above averageAvir at Elkhart
214 Jones Rd, Elkhart, TX 75839 · 9.6 mi
Government · 98 beds · Part of Avir Health Group
- New owner (last 12 months)
★★★★★3AverageAvir at Jacksonville
305 Bonita St, Jacksonville, TX 75766 · 26.2 mi
For-profit · 53 beds · Part of Avir Health Group
- New owner (last 12 months)
★★★★★5Much above averageTwin Oaks Health & Rehabilitation Center
1123 North Bolton Street, Jacksonville, TX 75766 · 27.3 mi
For-profit · 116 beds · Part of Creative Solutions in Healthcare
★★★★★2Below average
Frequently asked questions
What is Legacy at Town Creek's rating?
Legacy at Town Creek has 1 out of 5 stars on the CMS overall star rating. The average for Texas nursing homes is 2.7 stars.
How many inspection citations did Legacy at Town Creek receive?
Its most recent standard health inspection found 6 citations, compared with a Texas average of 9.4. Every citation is listed on this page with its severity.
Does Legacy at Town Creek accept Medicare and Medicaid?
CMS lists it as certified for: Medicare and Medicaid. Call the facility to confirm bed availability and whether it accepts your specific plan.
Who owns Legacy at Town Creek?
It is government - hospital district and part of Southwest LTC. The ownership section on this page lists the owners and managers reported to CMS.
Where is Legacy at Town Creek and how do I contact it?
Legacy at Town Creek is at 2212 W Reagan St, Palestine, TX 75801. Phone: (903) 727-8500.
About this data
Ratings and measures come from the Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. They're based on state inspections, patient surveys and facility reports, and they describe the past. Facilities change, so visit in person and confirm details directly. About our data · Spotted an error? Let us know.