Avir At River Valley
Nursing Home · 1907 Refinery Rd, Gainesville, TX 76240 · 9406650386
B
graded on 75% of our rubric
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 | 4.0 / 5 | high |
| Staffing | 1.5 / 5 | high |
| Clinical outcomes | 3.8 / 5 | high |
| Enforcement | 5.0 / 5 | high |
| Financial stability | 4.1 / 5 | med |
Key facts
| Care type | Nursing Home |
| Beds | 116 |
| Ownership | Government - Hospital District |
| Operator | Dallas County Hospital District |
| Chain size | 117 facilities |
| Certified since | 1992-01-01 |
| CMS overall star | 3 / 5 |
| Accepts Medicaid | Yes |
| Price tier | $$$$$ of 5 · ~$469/day reported charge (within TX) |
Inspection & enforcement record
- Health-inspection citations: 0 immediate jeopardy · 0 actual harm · 25 potential for harm · 0 minor
- Federal fines: $0 · payment denials: 0 · penalty actions: 0
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 |
|---|---|---|---|
| 2025-11-26 | Provide and implement an infection prevention and control program. (Infection Control Deficiencies, tag 0880) | D | corrected 2025-12-01 |
| 2025-02-27 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. (Freedom from Abuse, Neglect, and Exploitation Deficiencies, tag 0607) | E | corrected 2025-02-28 |
| 2025-02-27 | 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 0690) | D | corrected 2025-03-12 |
| 2025-02-27 | 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. (Nursing and Physician Services Deficiencies, tag 0727) | E | corrected 2025-02-28 |
| 2025-02-27 | 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 0812) | D | corrected 2025-02-28 |
| 2025-02-27 | Provide and implement an infection prevention and control program. (Infection Control Deficiencies, tag 0880) | E | corrected 2025-03-12 |
| 2025-02-27 | Ensure that residents are free from significant medication errors. (Pharmacy Service Deficiencies, tag 0760) | E | corrected 2025-02-28 |
| 2025-01-16 | Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. (Resident Rights Deficiencies, tag 0622) | E | corrected 2025-02-05 |
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: 3.05 hrs/resident/day (expected 3.81 for this facility's resident acuity — below expected) (US median 3.69 · TX 3.27)
- Registered-nurse staffing: 0.25 hrs/resident/day (expected 0.67 for this facility's resident acuity — below expected) (US median 0.58)
- Breakdown: nurse aide 1.24 · LPN 1.57 hrs/resident/day
- Weekend total staffing: 2.72 hrs/resident/day (expected 3.38 for this facility's resident acuity — below expected)
- Annual nursing-staff turnover: 52.0% (US median 45.3% · lower is better)
- Resident acuity (nursing case-mix index): 1.37 (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 experiencing one or more falls with major injury (long stay) | 4.1% | 2.3 → 2.6 → 4.5 → 7 | worse than 70% of US homes · TX median 3% |
| Percentage of long-stay residents with pressure ulcers (long stay) | 5.2% | 4.5 → 5.7 → 6.5 → 4.1 | worse than 61% of US homes · TX median 3.4% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder (long stay) | 0.4% | 0 → 0 → 1.6 → 0 | worse than 54% of US homes · TX median 0% |
| Percentage of long-stay residents who received an antipsychotic medication (long stay) | 13.7% | 16 → 16.7 → 11.1 → · | worse than 51% of US homes · TX median 8.1% |
| Percentage of long-stay residents whose ability to walk independently worsened (long stay) | 5.1% | not reported | better than 87% of US homes · TX median 13% |
| Percentage of long-stay residents whose need for help with daily activities has increased (long stay) | 4.4% | 5.9 → 0 → 5.7 → 5.9 | better than 90% of US homes · TX median 14.8% |
| Percentage of long-stay residents with a urinary tract infection (long stay) | 0% | 0 → 0 → 0 → 0 | better than 100% of US homes · TX median 0.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication (short stay) | 0% | not reported | better than 100% of US homes · TX median 0.7% |
What this costs
- This facility's reported avg daily charge: $469/day · $$$$$ (price tier 5 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): 69% Medicaid · 6% Medicare · 25% other/private · 40% 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 Cooke 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 |
|---|---|---|---|---|
| North Texas Medical Center | Gainesville | Yes | 4★ | Acute care |
| Muenster Memorial Hospital | Muenster | Yes | — | Critical access |
Compare nearby
- B- Renaissance Care Center · Gainesville
- C- Pecan Tree Rehab And Healthcare Center · Gainesville
- D+ Gainesville Convalescent Center · Gainesville
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 Cooke County nursing homes coverage. Spot an error? Tell us.