Avir At Cowhorn Creek
Nursing Home · 5524 Cowhorn Creek, Texarkana, TX 75503 · 9032231188
D+
graded on 75% of our rubric
Public records for this provider include abuse or neglect findings. Review the underlying records before deciding.
Why you can trust this grade. HearthGrades is independent and free to use. Every grade is computed from public CMS and state records on a fixed, published rubric — safety inspections, staffing, clinical outcomes, enforcement and financial stability. This provider was graded on 75% of that rubric. No facility can pay to change its grade or where it appears, and we take no money from the providers we grade. See the full methodology.
Scores by dimension
| Dimension | Score | Data confidence |
|---|---|---|
| Safety & compliance | 0.0 / 5 | high |
| Staffing | 2.2 / 5 | high |
| Clinical outcomes | 3.7 / 5 | high |
| Enforcement | 1.1 / 5 | high |
| Financial stability | 4.6 / 5 | med |
Key facts
| Care type | Nursing Home |
| Beds | 76 |
| Ownership | Government - Hospital District |
| Operator | Legal Business Name Not Available |
| Chain size | 117 facilities |
| Certified since | 2002-12-16 |
| CMS overall star | 1 / 5 |
| Accepts Medicaid | Yes |
| Price tier | $ of 5 · ~$214/day reported charge (within TX) |
Inspection & enforcement record
- Health-inspection citations: 2 immediate jeopardy · 0 actual harm · 60 potential for harm · 2 minor
- Federal fines: $46,315 · payment denials: 1 · penalty actions: 2
Recent inspection findings
The 8 most recent health-inspection deficiencies on file with CMS, newest first. Severity is the CMS scope/severity scale (A–L); G and above mean actual harm or immediate jeopardy. "Corrected" shows the date the facility certified the fix.
| Date | Finding | Severity | Status |
|---|---|---|---|
| 2026-02-12 | Reasonably accommodate the needs and preferences of each resident. (Resident Rights Deficiencies, tag 0558) | D | corrected 2026-02-13 |
| 2026-02-12 | Honor the resident's right to organize and participate in resident/family groups in the facility. (Resident Rights Deficiencies, tag 0565) | D | corrected 2026-02-13 |
| 2026-02-12 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. (Resident Rights Deficiencies, tag 0582) | D | 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. (Resident Assessment and Care Planning Deficiencies, tag 0636) | E | corrected 2026-02-13 |
| 2026-02-12 | Assess the resident when there is a significant change in condition (Resident Assessment and Care Planning Deficiencies, tag 0637) | D | 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. (Resident Assessment and Care Planning Deficiencies, tag 0640) | E | corrected 2026-02-13 |
| 2026-02-12 | Ensure each resident receives an accurate assessment. (Resident Assessment and Care Planning Deficiencies, tag 0641) | D | corrected 2026-02-13 |
| 2026-02-12 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. (Resident Assessment and Care Planning Deficiencies, tag 0644) | D | corrected 2026-02-13 |
Staffing
Nurse hours per resident per day (CMS Payroll-Based Journal) — the strongest objective predictor of care. "Expected" is what CMS's case-mix model says this facility's resident acuity calls for.
- Total nurse staffing: 3.56 hrs/resident/day (expected 3.61 for this facility's resident acuity — below expected) (US median 3.69 · TX 3.27)
- Registered-nurse staffing: 0.34 hrs/resident/day (expected 0.63 for this facility's resident acuity — below expected) (US median 0.58)
- Breakdown: nurse aide 2.28 · LPN 0.95 hrs/resident/day
- Weekend total staffing: 3.24 hrs/resident/day (expected 3.20 for this facility's resident acuity — at or above expected)
- Annual nursing-staff turnover: 65.1% · RN turnover 66.7% (US median 45.3% · lower is better)
- Resident acuity (nursing case-mix index): 1.30 (1.0 ≈ national average; higher = more care-intensive residents)
Clinical outcomes — the measures behind the score
The 8 CMS MDS quality measures (2025Q1-2025Q4) driving this facility's clinical score — the same measures behind the CMS QM star. All are adverse-event rates: lower is better. Worst first. The quarterly column shows the four most recent quarters (Q1→Q4); benchmarks are the national percentile and the TX state median.
| Measure | 4-qtr avg | Quarterly (Q1→Q4) | Benchmark |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased (long stay) | 26% | 25.6 → 16.3 → 12.2 → 47.8 | worse than 90% of US homes · TX median 14.8% |
| Percentage of long-stay residents whose ability to walk independently worsened (long stay) | 22.2% | not reported | worse than 79% of US homes · TX median 13% |
| Percentage of long-stay residents with pressure ulcers (long stay) | 4.7% | 5.5 → 5.6 → 6.6 → 1.2 | worse than 54% of US homes · TX median 3.4% |
| Percentage of long-stay residents with a urinary tract infection (long stay) | 0.5% | 0 → 0 → 0 → 1.7 | better than 66% of US homes · TX median 0.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury (long stay) | 0.4% | 1.7 → 0 → 0 → 0 | better than 91% of US homes · TX median 3% |
| Percentage of long-stay residents who received an antipsychotic medication (long stay) | 1.8% | 0 → 0 → 3.8 → 3.2 | better than 96% of US homes · TX median 8.1% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder (long stay) | 0% | 0 → 0 → 0 → 0 | better than 100% of US homes · TX median 0% |
| Percentage of short-stay residents who newly received an antipsychotic medication (short stay) | 0% | 0 → 0 → 0 → 0 | better than 100% of US homes · TX median 0.7% |
What this costs
- This facility's reported avg daily charge: $214/day · $ (price tier 1 of 5 among Texas nursing homes) — from its own federal cost report, FY ending 2024-12. Gross charges across all payers and services: higher than a quoted private rate, but computed identically for every facility, which makes the tier a fair within-state comparison.
- Payer mix (resident days): 42% Medicaid · 10% Medicare · 48% other/private · 92% occupancy
- Texas median (quoted rates): $185/day semi-private · $250/day private (national: $315 · $355)
- Accepts Medicaid: yes
- This facility's quoted rate: not public. This facility's quoted private rate isn't published by any federal or state source. Medicare covers short rehab stays (up to 100 days, copays after day 20); long-term stays are private pay until savings spend down to Medicaid. How to get the real number →
Market medians: CareScout Cost of Care Survey 2025 (collected July–November 2025), state-level — individual providers vary widely around a median. Facility-level prices aren't published by any government source; how to get a real quote.
Hospitals serving Bowie County
Hospitals in the same county — those with an emergency department first, then by CMS hospital star rating. Useful for transfers and emergencies.
| Hospital | City | ER | CMS star | Type |
|---|---|---|---|---|
| Christus St Michael Health System | Texarkana | Yes | 3★ | Acute care |
| Wadley Regional Medical Center | Texarkana | Yes | — | Acute care |
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- C- Avir At Citizens Trail · Texarkana
Full interactive report card → Facility's own website ↗ CMS Care Compare ↗
Source: CMS Provider Information + Health Deficiencies + Penalties (as of 2026-05). Part of our Bowie County nursing homes coverage. Spot an error? Tell us.