Garrison Nursing Home & Rehabilitation Center
333 North Fm 95, Garrison, TX 75946 · Nacogdoches County · 93 certified beds · avg 80 residents/day · certified since Jan 1, 2008
Part of chain: CARING HEALTHCARE GROUP (14 facilities, chain avg rating 3.0★)
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, repeated · Feb 8, 2024 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (K): A life-threatening or extremely dangerous situation affected several residents. Among the most serious findings an inspection can produce.
Corrected: Feb 9, 2024 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, one-off · Feb 8, 2024 · 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: Oct 12, 2023 (Past Non-Compliance)
All citations in the current public record (13)
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 |
|---|---|---|
| Jul 30, 2025 | 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. |
| Jul 30, 2025 | E · Potential for harm, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Jul 30, 2025 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Jun 26, 2024 | 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. |
| Jun 26, 2024 | D · Potential for harm, one-off | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. |
| Jun 26, 2024 | C · Minimal risk, facility-wide | The facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. |
| Feb 8, 2024 | ▲ K · Immediate jeopardy, repeated | 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 |
| Feb 8, 2024 | ▲ 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 |
| Feb 8, 2024 | E · Potential for harm, repeated | 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 |
| Feb 8, 2024 | D · Potential for harm, one-off | The facility did not bring in qualified outside professionals to provide a required service when it didn't have a qualified professional on staff. · from a complaint |
| May 10, 2023 | E · Potential for harm, repeated | The facility did not maintain an effective pest control program to prevent or deal with mice, insects, or other pests. |
| May 10, 2023 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| May 10, 2023 | D · Potential for harm, one-off | 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. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (3 → 3).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 3 | 0 | E |
| 2024 | 7 | 2 | K ▲ |
| 2025 | 3 | 0 | F |
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)
3 fines totaling $52,951.
| Date | Type | Amount / length |
|---|---|---|
| Aug 22, 2024 | Fine | $28,129 |
| Feb 8, 2024 | Fine | $8,021 |
| Feb 8, 2024 | Fine | $16,801 |
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) | 3.87 | 3.46 | 3.95 | top 18% in Texas; top 45% in the U.S. |
| Registered Nurse hours | 0.24 | 0.44 | 0.69 | bottom 15% in Texas; bottom 4% in the U.S. |
| Weekend total nurse staffing | 3.10 | 3.04 | 3.50 | top 34% in Texas; bottom 37% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.31 | 0.34 | 0.48 | top 44% in Texas; bottom 35% in the U.S. |
| Total nursing staff turnover (%) | 45.7 | 55.3 | 45.8 | top 35% in Texas; bottom 48% in the U.S. |
| RN turnover (%) | 44.4 | 54.6 | 42.9 | top 37% in Texas; bottom 45% 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 4.43, RN 0.27, weekend 3.55. Staffing rating: 2/5.
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: 5/5 · short-stay residents: 3/5
Who owns this facility
For profit - Individual
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Havins, Joshua | Individual | W-2 Managing Employee | NOT APPLICABLE | 03/16/2020 |
| Murrell, Edward | Individual | Corporate Officer | NOT APPLICABLE | 11/30/2012 |
| Shapiro, Menachem | Individual | Operational/Managerial Control | NOT APPLICABLE | 08/31/2014 |
| Winnie-Stowell Hospital District | Organization | Operational/Managerial Control | NOT APPLICABLE | 05/01/2004 |
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 is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "What specific steps do you take to prevent abuse and neglect, and how are staff trained on them?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
- "Where do you post your daily staffing numbers, and can I see today's?"
- "When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
- "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 |
|---|---|---|---|---|---|
| Stallings Court Nursing and Rehabilitation | 15.0 mi | Nacogdoches, TX | ★★★★★ | 4/5 | |
| Willowbrook Nursing Center | 15.1 mi | Nacogdoches, TX | ★★★☆☆ | 3/5 | |
| Westward Trails Nursing and Rehabilitation | 16.5 mi | Nacogdoches, TX | ★★★☆☆ | 4/5 | |
| Focused Care of Center | 18.5 mi | Center, TX | ★★★☆☆ | 2/5 | abuse |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 676177.