Texas ›Missouri City

Paradigm at First Colony

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4710 Lexington Blvd, Missouri City, TX 77459 (opens Google Maps) · Fort Bend County · (281) 499-4710· 150 certified beds · avg 104 residents/day · certified since Apr 21, 1989 · Medicare and Medicaid certified

Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →

Part of chain: PARADIGM HEALTHCARE (17 facilities, chain avg rating 1.9★)

1/5
Health inspection rating (on-site)
inspected Jan 22, 2026
8
Serious findings on record
most recent Nov 27, 2024
$64,559
Fines, last 3 years
3.12
Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

New to these records? How to read an inspection report →

Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5 · how star ratings work →

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 quality measures from resident assessments and claims.

Most serious findings (actual harm or immediate jeopardy)

▲ Immediate jeopardy, pattern · Nov 27, 2024 · 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 (K): Immediate jeopardy to resident health or safety was cited. The scope was a pattern: more than a limited occurrence, without being widespread. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Dec 4, 2024 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, pattern · Nov 27, 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): Immediate jeopardy to resident health or safety was cited. The scope was a pattern: more than a limited occurrence, without being widespread. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Dec 4, 2024 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, pattern · Oct 24, 2024 · F-0694 · triggered by a complaint

The facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them.

Why it matters: Improper IV care can cause infections, dehydration, or dangerous fluid imbalances.

Severity (K): Immediate jeopardy to resident health or safety was cited. The scope was a pattern: more than a limited occurrence, without being widespread. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Oct 31, 2024 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, pattern · Aug 15, 2023 · 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 (K): Immediate jeopardy to resident health or safety was cited. The scope was a pattern: more than a limited occurrence, without being widespread. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Aug 22, 2023 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, pattern · Aug 15, 2023 · F-0656 · triggered by a complaint

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.

Why it matters: Without a complete, working care plan, important needs can slip through the cracks and no one is accountable for results.

Severity (K): Immediate jeopardy to resident health or safety was cited. The scope was a pattern: more than a limited occurrence, without being widespread. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Sep 15, 2023 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, isolated · Aug 15, 2023 · F-0678 · triggered by a complaint

The facility did not provide basic life support, such as CPR, before emergency medical help arrived — care that's required when it matches the doctor's orders and the resident's own written wishes.

Why it matters: In a cardiac or breathing emergency, failure to start CPR promptly can be the difference between life and death.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Aug 22, 2023 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, isolated · Aug 15, 2023 · F-0686 · triggered by a complaint

The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.

Why it matters: Bedsores are painful, can become deeply infected, and in serious cases can be life-threatening.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Aug 22, 2023 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, isolated · Aug 15, 2023 · 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): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Aug 22, 2023 (Deficient, Provider has date of correction)

Inspection findings in the public record

Showing the latest 3 of 41 inspection findings. Open the full record below to read every finding.

  1. D · Potential for more than minimal harm, isolated

    The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. · from a complaint F-0695

  2. D · Potential for more than minimal harm, isolated

    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 F-0677

  3. D · Potential for more than minimal harm, isolated

    The facility did not allow a resident's chosen representative — often a family member or someone with power of attorney — to exercise the resident's rights on their behalf. When a resident can't speak for themselves, their representative steps into that role. · from a complaint F-0551

View all 41 inspection findingsShow only the latest 3 findings

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.

DateSeverityWhat the facility was cited for
Jun 11, 2026D · Potential for more than minimal harm, isolatedThe facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. · from a complaint · F-0695
Mar 18, 2026D · Potential for more than minimal harm, isolatedThe 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 · F-0677
Dec 1, 2025D · Potential for more than minimal harm, isolatedThe facility did not allow a resident's chosen representative — often a family member or someone with power of attorney — to exercise the resident's rights on their behalf. When a resident can't speak for themselves, their representative steps into that role. · from a complaint · F-0551
Nov 14, 2025D · Potential for more than minimal harm, isolatedThe facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. · from a complaint · F-0558
Sep 8, 2025E · Potential for more than minimal harm, patternThe facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint · F-0610
Jun 1, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint · F-0755
Nov 27, 2024▲ K · Immediate jeopardy, patternThe 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 · F-0684
Nov 27, 2024▲ K · Immediate jeopardy, patternThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Nov 19, 2024C · Potential for minimal harm, widespreadThe facility did not keep residents' personal and medical information private and confidential. · from a complaint · F-0583
Nov 19, 2024C · Potential for minimal harm, widespreadThe 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. · from a complaint · F-0732
Oct 24, 2024▲ K · Immediate jeopardy, patternThe facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them. · from a complaint · F-0694
Oct 24, 2024F · Potential for more than minimal harm, widespreadThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Oct 24, 2024E · Potential for more than minimal harm, patternThe 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 · F-0656
Oct 24, 2024E · Potential for more than minimal harm, patternThe facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. · F-0759
Oct 24, 2024D · Potential for more than minimal harm, isolatedThe 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 · F-0550
Oct 24, 2024D · Potential for more than minimal harm, isolatedThe 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 · F-0607
Oct 24, 2024D · Potential for more than minimal harm, isolatedThe 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 · F-0609
Oct 24, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0655
Oct 24, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · F-0686
Oct 24, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0690
Oct 24, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. · from a complaint · F-0695
Oct 24, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0880
Oct 24, 2024C · Potential for minimal harm, widespreadThe facility did not dispose of garbage and refuse properly. · F-0814
Aug 21, 2024D · Potential for more than minimal harm, isolatedThe facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint · F-0842
Jul 25, 2024D · Potential for more than minimal harm, isolatedThe facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint · F-0842
Jul 25, 2024D · Potential for more than minimal harm, isolatedThe facility did not have a working call system — the button or cord residents use to summon help — in each resident's bathroom and bathing area. · from a complaint · F-0919
Feb 8, 2024E · Potential for more than minimal harm, patternThe 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 · F-0880
Feb 8, 2024D · Potential for more than minimal harm, isolatedThe 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 · F-0690
Nov 2, 2023E · Potential for more than minimal harm, patternThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Nov 2, 2023D · Potential for more than minimal harm, isolatedThe 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 · F-0656
Sep 8, 2023E · Potential for more than minimal harm, patternThe facility's menus did not meet residents' nutritional needs, or were not prepared in advance, followed as written, kept up to date, or reviewed by a dietician. · from a complaint · F-0803
Sep 8, 2023E · Potential for more than minimal harm, patternThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · from a complaint · F-0812
Sep 8, 2023D · Potential for more than minimal harm, isolatedThe 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. · from a complaint · F-0655
Sep 8, 2023D · Potential for more than minimal harm, isolatedThe 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 · F-0656
Sep 8, 2023D · Potential for more than minimal harm, isolatedThe facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. · from a complaint · F-0695
Sep 8, 2023D · Potential for more than minimal harm, isolatedThe facility did not dispose of garbage and refuse properly. · from a complaint · F-0814
Aug 15, 2023▲ K · Immediate jeopardy, patternThe 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 · F-0600
Aug 15, 2023▲ K · Immediate jeopardy, patternThe 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 · F-0656
Aug 15, 2023▲ J · Immediate jeopardy, isolatedThe facility did not provide basic life support, such as CPR, before emergency medical help arrived — care that's required when it matches the doctor's orders and the resident's own written wishes. · from a complaint · F-0678
Aug 15, 2023▲ J · Immediate jeopardy, isolatedThe facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaint · F-0686
Aug 15, 2023▲ J · Immediate jeopardy, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689

Inspection trend by year

Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2023
All citations: 13
Serious citations (G–L): 5
2024
All citations: 22
Serious citations (G–L): 3
2025
All citations: 4
Serious citations (G–L): 0
2026
All citations: 2
Serious citations (G–L): 0

All bars start at zero. Exact values and supporting details remain below.

YearCitationsSerious (G–L)Worst severity that year
2023135K ▲
2024223K ▲
202540E
202620D

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)

How to file a complaint about care →

2 fines totaling $64,559.

Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.

DateTypeAmount / length
Nov 27, 2024Fine$19,838
Oct 24, 2024Fine$44,721

Nurse staffing (from payroll records, adjusted for how much care residents need)

What these staffing numbers mean →

Nurse time, in contextAdjusted hours per resident per day · Source: CMS, 2026-08-01
This facilityTexas averageU.S. average
Total nurse staffing (hours per resident per day)
This facility: 3.12
Texas average: 3.46
U.S. average: 3.95
Registered Nurse hours
This facility: 0.44
Texas average: 0.44
U.S. average: 0.69
Weekend total nurse staffing
This facility: 2.70
Texas average: 3.04
U.S. average: 3.50

All bars start at zero. Exact values and supporting details remain below.

MeasureThis facilityTexas avgU.S. avgWhere it stands
Total nurse staffing (hours per resident per day)3.123.463.95bottom 32% in Texas; bottom 18% in the U.S.
Registered Nurse hours0.440.440.69top 37% in Texas; bottom 28% in the U.S.
Weekend total nurse staffing2.703.043.50bottom 30% in Texas; bottom 16% in the U.S.
Weekend RN hours (not acuity-adjusted)0.360.340.48top 33% in Texas; bottom 44% in the U.S.
Total nursing staff turnover (%)67.055.345.8bottom 22% in Texas; bottom 8% in the U.S.
RN turnover (%)90.554.642.9bottom 10% in Texas; bottom 2% in the U.S.

Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — 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 3.36, RN 0.47, weekend 2.90.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.36 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 1/5.

Quality measures: assessments & claims

Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.

Quality measures rating: 4/5 · long-stay residents: 4/5 · short-stay residents: —/5

Costs & payment

Price evidence · separate from quality

No verified facility-specific private-pay price is available in our data for Paradigm at First Colony. CMS inspection and staffing records do not tell us what this home will charge you.

Calculate a stay from a quote you receive

Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.

Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.

Before you compare prices

  • Request the room type, effective date and itemized daily rate in writing.
  • Ask about therapy, medicines, supplies, care-level charges, deposits, refunds and annual increases.
  • Confirm insurance or Medicaid eligibility and bed availability directly; certification alone does not guarantee either.

Understand who pays for care · How we handle price evidence · Report an incorrect price

Who owns this facility

How to read ownership records →

Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →

For profit - Limited Liability company

Owner / managerTypeRoleStakeSince
Oakbend Medical CenterOrganization5% or Greater Direct Ownership Interest100%02/28/2015
Beard, BarryIndividualCorporate DirectorNOT APPLICABLE01/01/2012
Council, JeffIndividualCorporate DirectorNOT APPLICABLE01/01/2013
Crayton, TomIndividualCorporate DirectorNOT APPLICABLE01/01/2013
Freudenberger, JosephIndividualW-2 Managing EmployeeNOT APPLICABLE06/19/2007
Freudenberger, JosephIndividualCorporate OfficerNOT APPLICABLE06/19/2007
Martin, MelissaIndividualCorporate DirectorNOT APPLICABLE01/01/2015
McClamroch, JamesIndividualCorporate DirectorNOT APPLICABLE01/01/2013
Mefford, RuthanneIndividualCorporate DirectorNOT APPLICABLE01/01/2015
Murray, MarkIndividualCorporate DirectorNOT APPLICABLE01/01/2011
Petrosewicz, NormaIndividualCorporate DirectorNOT APPLICABLE01/01/2013
SSC Missouri City Operating Company LLCOrganizationOperational/Managerial ControlNOT APPLICABLE02/28/2015
Tape, MayIndividualCorporate DirectorNOT APPLICABLE01/15/2008
Uthman, EdwardIndividualCorporate DirectorNOT APPLICABLE01/01/2008

All 14 owning or managing parties CMS has on file are shown — none excluded.

Other facilities in the same chain

CMS lists this facility under the chain Paradigm Healthcare — 17 facilities in the current records. Chain membership says who operates these homes. It says nothing about how any individual one of them was inspected; each has its own record.

Listed by state, then facility name — not a ranking. Showing 8 of the 16 others, continuing from this facility's own place in that list.

Questions to ask on your visit

Full visit checklist →

Print visit checklist

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?"
  • "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
  • "Who on your staff manages IV therapy, and what training and monitoring is in place?"
  • "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
  • "Can you show me an example care plan, and how are families included when it's created and updated?"
  • "Are staff on every shift trained and certified in CPR, and how do they know each resident's resuscitation wishes?"
  • "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
  • "How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"

Also worth asking anywhere

  • "Your weekend nurse staffing is reported below the Texas midpoint — how does the weekend schedule differ from a weekday?"
  • "Can I see the plan of correction for the findings in your most recent state inspection?"
  • "CMS reports 67% total nursing staff turnover here — who on the care team has been with you longest?"
  • "The ownership record on file lists 14 owning or managing parties — who makes the decisions about staffing levels?"
  • "Can I visit again unannounced, at a mealtime or on a weekend?"

Nearby facilities (12 closest of 61 within 20 miles)

FacilityDistanceCityOverallInspectionFlags
Park Manor of Quail Valley1.4 miMissouri City, TX★★☆☆☆2/5
Chelsea Gardens2.4 miMissouri City, TX★☆☆☆☆2/5
Windsor Quail Valley Post-Acute Healthcare2.5 miMissouri City, TX★★★☆☆3/5
Sugar Land Health Care Center3.6 miSugar Land, TX★★★☆☆3/5
The Crescent3.9 miSugar Land, TX★☆☆☆☆1/5
Ignite Medical Resort Sugar Land, LLC3.9 miSugar Land, TX★☆☆☆☆2/5
Focused Care at Westwood5.7 miHouston, TX★★★☆☆3/5
West Houston Rehabilitation and Healthcare Center6.0 miHouston, TX★☆☆☆☆1/5
Focused Care at Beechnut6.3 miHouston, TX★★☆☆☆1/5
Houston Transitional Care6.6 miHouston, TX★★★☆☆4/5
Seven Acres Jewish Senior Care Services7.2 miHouston, TX★★★★☆3/5
Paradigm at Westbury7.6 miHouston, TX★☆☆☆☆1/5

Compare this facility with the 3 closest →

Other facilities in the same county

CMS records place this facility in Fort Bend, TX — 15 certified facilities there. These are outside the 20-mile list above, or far enough down it not to appear.

Listed by facility name — not a ranking. Homes already in the table above are not repeated here.

All facilities in Missouri City →

Facility data as of CMS processing date 2026-08-01. CCN 455812.

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