Avir at Town Creek
1816 Tile Factory Rd, Palestine, TX 75801 · Anderson County · 102 certified beds · avg 40 residents/day · certified since Jul 19, 1985
Part of chain: AVIR HEALTH GROUP (116 facilities, chain avg rating 2.3★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 3/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · Aug 9, 2023 · F-0607 · triggered by a complaint
The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection.
Why it matters: Without working prevention policies, mistreatment is more likely to happen and less likely to be caught.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Aug 10, 2023 (Deficient, Provider has date of correction)
▲ Actual harm, repeated · Feb 3, 2025 · F-0684 · triggered by a complaint
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.
Severity (H): Multiple residents were actually harmed by the same failure — a pattern of real harm, not an isolated incident.
Corrected: Jan 27, 2025 (Past Non-Compliance)
▲ Actual harm, repeated · Feb 3, 2025 · F-0917 · triggered by a complaint
The facility did not provide bedrooms with required basics: a window to the outside, a room at or above ground level, adequate bedding, furniture that fits the resident's needs, or enough closet space.
Why it matters: A room without daylight, decent bedding, or storage takes a daily toll on a resident's comfort and dignity.
Severity (H): Multiple residents were actually harmed by the same failure — a pattern of real harm, not an isolated incident.
Corrected: Jan 27, 2025 (Past Non-Compliance)
All citations in the current public record (23)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Feb 18, 2026 | D · Potential for harm, one-off | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint |
| Aug 13, 2025 | E · Potential for harm, repeated | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Aug 13, 2025 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Aug 13, 2025 | D · Potential for harm, one-off | The facility did not keep residents' personal and medical information private and confidential. |
| Aug 13, 2025 | D · Potential for harm, one-off | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. |
| Aug 13, 2025 | D · Potential for harm, one-off | The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. |
| Aug 13, 2025 | D · Potential for harm, one-off | The facility did not have policies on smoking. |
| Mar 25, 2025 | E · Potential for harm, repeated | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Mar 25, 2025 | D · Potential for harm, one-off | The facility did not have a policy covering how food brought in by family and visitors is used and stored safely. · from a complaint |
| Feb 3, 2025 | ▲ H · Actual harm, repeated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Feb 3, 2025 | ▲ H · Actual harm, repeated | The facility did not provide bedrooms with required basics: a window to the outside, a room at or above ground level, adequate bedding, furniture that fits the resident's needs, or enough closet space. · from a complaint |
| Oct 1, 2024 | F · Potential for harm, facility-wide | The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. |
| Oct 1, 2024 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Oct 1, 2024 | F · Potential for harm, facility-wide | The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records. |
| Oct 1, 2024 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. |
| Oct 1, 2024 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Nov 29, 2023 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · from a complaint |
| Oct 26, 2023 | E · Potential for harm, repeated | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Oct 26, 2023 | E · Potential for harm, repeated | The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint |
| Oct 26, 2023 | D · Potential for harm, one-off | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint |
| Oct 26, 2023 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Aug 9, 2023 | ▲ J · Immediate jeopardy, one-off | The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint |
| Aug 9, 2023 | E · Potential for harm, repeated | The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · from a complaint |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (2 → 6).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 7 | 1 | J ▲ |
| 2024 | 5 | 0 | F |
| 2025 | 10 | 2 | H ▲ |
| 2026 | 1 | 0 | D |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
2 fines totaling $49,065.
| Date | Type | Amount / length |
|---|---|---|
| Feb 3, 2025 | Fine | $17,345 |
| Apr 5, 2024 | Fine | $31,720 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Texas avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.69 | 3.46 | 3.95 | top 6% in Texas; top 19% in the U.S. |
| Registered Nurse hours | 0.46 | 0.44 | 0.69 | top 32% in Texas; bottom 32% in the U.S. |
| Weekend total nurse staffing | 4.20 | 3.04 | 3.50 | top 6% in Texas; top 18% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.31 | 0.34 | 0.48 | top 45% in Texas; bottom 34% in the U.S. |
| Total nursing staff turnover (%) | 47.1 | 55.3 | 45.8 | top 39% in Texas; bottom 44% in the U.S. |
| RN turnover (%) | 40.0 | 54.6 | 42.9 | top 30% in Texas; top 46% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.76, RN 0.37, weekend 3.37. Staffing rating: 3/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 4/5 · long-stay residents: 4/5 · short-stay residents: —/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| 1816 Tile Factory Rd Opco LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 10/01/2025 |
| 1816 Tile Factory Rd Opco LLC | Organization | ADP of the SNF | NOT APPLICABLE | 03/05/2026 |
| 1816 Tile Factory Rd Property Owner LLC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| Dagan, Amitai | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 03/09/2026 |
| Freund, Nochum | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2025 |
| Goldberger, Abraham | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 03/09/2026 |
| Goldberger, Faigy | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 03/09/2026 |
| Hekimian, Khoren | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2024 |
| Jones, Jeremy | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2024 |
| Murrell, Edward | Individual | Corporate Director | NOT APPLICABLE | 01/01/2024 |
| Travitsky, Aaron | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2025 |
| Welltower INC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| Welltower NNN Group, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| Welltower Op, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What specific steps do you take to prevent abuse and neglect, and how are staff trained on them?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "Can I see the actual room my family member would live in, not just a model room?"
- "When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "How do you protect residents' privacy, both in their medical records and in day-to-day care?"
- "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Legacy at Town Creek | 1.7 mi | Palestine, TX | ★☆☆☆☆ | 2/5 | |
| Trucare Living Centers | 2.9 mi | Palestine, TX | ★★★★★ | 5/5 | |
| Greenbrier Nursing & Rehabilitation Center of Pale | 5.1 mi | Palestine, TX | ★★★★☆ | 5/5 | |
| Avir at Elkhart | 9.7 mi | Elkhart, TX | ★★★☆☆ | 3/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 455565.