Graham Oaks Care Center
1325 First St, Graham, TX 76450 · Young County · 110 certified beds · avg 76 residents/day · certified since Oct 28, 1991
Abuse citation flag (CMS)
Part of chain: CREATIVE SOLUTIONS IN HEALTHCARE (149 facilities, chain avg rating 2.1★)
The abuse flag means inspectors cited this facility for abuse that caused harm to a resident within the past year, or potential for harm in each of the last two years. Source: CMS.
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 1/5
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 · Oct 10, 2025 · F-0600 · triggered by a complaint
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.
Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.
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: Sep 3, 2025 (Past Non-Compliance)
▲ Immediate jeopardy, one-off · Oct 10, 2025 · 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 (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: Sep 3, 2025 (Past Non-Compliance)
▲ Actual harm, one-off · Dec 7, 2023 · F-0697
The facility did not provide safe and appropriate pain management for a resident who needed it.
Why it matters: Untreated pain causes needless suffering and can lead to depression, poor sleep, and declining health.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Dec 8, 2023 (Deficient, Provider has date of correction)
All citations in the current public record (16)
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 |
|---|---|---|
| Jun 14, 2026 | E · Potential for harm, repeated | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · from a complaint |
| Apr 9, 2026 | 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. |
| Mar 25, 2026 | 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 |
| Nov 8, 2025 | C · Minimal risk, facility-wide | The facility did not follow the rules about disclosing who owns it, or did not tell the state agency about changes in ownership or key administrative staff. · from a complaint |
| Oct 10, 2025 | ▲ J · Immediate jeopardy, one-off | 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 10, 2025 | ▲ J · Immediate jeopardy, 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 |
| May 23, 2025 | D · Potential for harm, one-off | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint |
| Jan 22, 2025 | E · Potential for harm, repeated | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · from a complaint |
| Jan 22, 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. · from a complaint |
| Oct 18, 2024 | D · Potential for harm, 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 |
| Dec 7, 2023 | ▲ G · Actual harm, one-off | The facility did not provide safe and appropriate pain management for a resident who needed it. |
| Dec 7, 2023 | E · Potential for harm, repeated | The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable. |
| Dec 7, 2023 | D · Potential for harm, 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 |
| Dec 7, 2023 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Dec 7, 2023 | 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. |
| Aug 9, 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 |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (2 → 1).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 6 | 1 | G ▲ |
| 2024 | 1 | 0 | D |
| 2025 | 6 | 2 | J ▲ |
| 2026 | 3 | 0 | E |
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 $34,690.
| Date | Type | Amount / length |
|---|---|---|
| Oct 10, 2025 | Fine | $17,345 |
| Oct 10, 2025 | Fine | $17,345 |
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) | 2.66 | 3.46 | 3.95 | bottom 6% in Texas; bottom 6% in the U.S. |
| Registered Nurse hours | 0.33 | 0.44 | 0.69 | bottom 35% in Texas; bottom 12% in the U.S. |
| Weekend total nurse staffing | 2.28 | 3.04 | 3.50 | bottom 6% in Texas; bottom 5% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.18 | 0.34 | 0.48 | bottom 16% in Texas; bottom 9% in the U.S. |
| Total nursing staff turnover (%) | 94.4 | 55.3 | 45.8 | bottom 6% in Texas; bottom 1% in the U.S. |
| RN turnover (%) | 100.0 | 54.6 | 42.9 | bottom 8% in Texas; bottom 1% 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 2.99, RN 0.37, weekend 2.57. Staffing rating: 1/5.
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: 3/5 · long-stay residents: 2/5 · short-stay residents: 4/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| County of Throckmorton | Organization | 5% or Greater Direct Ownership Interest | 100% | 07/01/2022 |
| Blake, Gary | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/01/2019 |
| Blake, Gary | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2019 |
| Blake, Malisa | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/01/2019 |
| Brockman, Gregory | Individual | Managing Control - Governing Body | NOT APPLICABLE | 01/01/2021 |
| Cook, Roxy | Individual | ADP of the SNF | NOT APPLICABLE | 04/12/2025 |
| Gober, Kirby | Individual | Managing Control - Governing Body | NOT APPLICABLE | 06/20/2014 |
| Gober, Kirby | Individual | Corporate Officer | NOT APPLICABLE | 06/20/2014 |
| Graham I Enterprises, LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 01/01/2019 |
| Graham I Enterprises, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 04/12/2025 |
| Hibbitts, Kasey | Individual | Managing Control - Governing Body | NOT APPLICABLE | 06/18/2020 |
| Hodges, Caleb | Individual | Managing Control - Governing Body | NOT APPLICABLE | 01/01/2023 |
| Huggins, Linda | Individual | Corporate Director | NOT APPLICABLE | 07/01/2022 |
| Mitchell, Klayton | Individual | Managing Control - Governing Body | NOT APPLICABLE | 01/31/2020 |
| Purdy, Aaron | Individual | ADP of the SNF | NOT APPLICABLE | 04/12/2025 |
| Wells, Casey | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/10/2004 |
| Willig, Zachary | Individual | Corporate Director | NOT APPLICABLE | 01/01/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "How do you assess and manage residents' pain, especially for those who have trouble communicating?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "Who owns this facility, and has ownership or top management changed recently?"
- "How do you keep residents' medical records accurate, complete, and secure?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "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 |
|---|---|---|---|---|---|
| Avir at Graham | 1.0 mi | Graham, TX | ★★★★★ | 5/5 |
Compare this facility with the 1 closest →
Facility data as of CMS processing date 2026-08-01. CCN 455968.