Greenbrier Nursing & Rehabilitation Center of Pale
2404 State Highway 155, Palestine, TX 75803 · Anderson County · 120 certified beds · avg 47 residents/day · certified since Dec 21, 1999
Part of chain: CREATIVE SOLUTIONS IN HEALTHCARE (149 facilities, chain avg rating 2.1★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★★5/5 · CMS overall rating: 4/5
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.
All citations in the current public record (12)
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 |
|---|---|---|
| Apr 30, 2026 | D · Potential for harm, one-off | 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 |
| Mar 4, 2026 | 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. · from a complaint |
| Mar 4, 2026 | D · Potential for harm, one-off | 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. · from a complaint |
| Jan 29, 2026 | 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. |
| Sep 10, 2025 | 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. · from a complaint |
| Sep 10, 2025 | 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 |
| Jun 10, 2025 | 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. · from a complaint |
| Mar 12, 2025 | 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 |
| Sep 20, 2023 | F · Potential for harm, facility-wide | The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices. |
| Sep 20, 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 |
| Sep 20, 2023 | D · Potential for harm, one-off | 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. |
| Sep 20, 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 |
Inspection trend by year
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 4 | 0 | F |
| 2025 | 4 | 0 | D |
| 2026 | 4 | 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)
No fines or payment denials in the published 3-year window.
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) | 2.74 | 3.46 | 3.95 | bottom 9% in Texas; bottom 7% 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 | 2.30 | 3.04 | 3.50 | bottom 7% in Texas; bottom 5% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.24 | 0.34 | 0.48 | bottom 35% in Texas; bottom 20% in the U.S. |
| Total nursing staff turnover (%) | 97.9 | 55.3 | 45.8 | bottom 2% in Texas; bottom 1% in the U.S. |
| RN turnover (%) | 80.0 | 54.6 | 42.9 | bottom 21% in Texas; bottom 6% 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 3.18, RN 0.38, weekend 2.67. 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: 3/5 · short-stay residents: —/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Fannin County Hospital Authority | Organization | 5% or Greater Direct Ownership Interest | 100% | 10/01/2024 |
| Honor X Enterprises, LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2024 |
| Blake, Gary | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2024 |
| Blake, Gary | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Blake, Malisa | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2024 |
| Blake, Malisa | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Hekimian, Khoren | Individual | ADP of the SNF | NOT APPLICABLE | 07/01/2025 |
| Holt, Erin | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/01/2024 |
| Holt, Erin | Individual | Corporate Director | NOT APPLICABLE | 10/01/2024 |
| Honor X Enterprises, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 07/01/2025 |
| Huggins, Linda | Individual | Corporate Director | NOT APPLICABLE | 10/01/2024 |
| Huggins, Linda | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/04/2024 |
| Huggins, Linda | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Johnson, Juanita | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2024 |
| Johnson, Juanita | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Keeton, Wendy | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/01/2024 |
| Keeton, Wendy | Individual | Corporate Director | NOT APPLICABLE | 10/01/2024 |
| Kissling, Monica | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/01/2024 |
| Kissling, Monica | Individual | Corporate Director | NOT APPLICABLE | 10/01/2024 |
| McBean, Patricia | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/01/2024 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
- "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?"
- "How do you inspect and maintain essential equipment, and how quickly are repairs made?"
- "When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "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 | 3.6 mi | Palestine, TX | ★☆☆☆☆ | 2/5 | |
| Trucare Living Centers | 4.0 mi | Palestine, TX | ★★★★★ | 5/5 | |
| Avir at Town Creek | 5.1 mi | Palestine, TX | ★★★☆☆ | 3/5 | |
| Avir at Elkhart | 11.9 mi | Elkhart, TX | ★★★☆☆ | 3/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 675816.