Paradigm at Kountze
604 Fm 1293, Kountze, TX 77625 · Hardin County · 60 certified beds · avg 48 residents/day · certified since Oct 23, 1985
Part of chain: PARADIGM HEALTHCARE (17 facilities, chain avg rating 1.9★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★☆☆3/5 · 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.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · Jul 25, 2024 · F-0689
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: Aug 1, 2024 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, repeated · Jun 14, 2023 · F-0684
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): A life-threatening or extremely dangerous situation affected several residents. Among the most serious findings an inspection can produce.
Corrected: Jun 15, 2023 (Deficient, Provider has date of correction)
All citations in the current public record (25)
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 |
|---|---|---|
| Aug 13, 2025 | E · Potential for harm, repeated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| 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 | D · Potential for harm, one-off | The facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. |
| Jul 25, 2024 | ▲ 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. |
| Jul 25, 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. |
| Jul 25, 2024 | F · Potential for harm, facility-wide | The facility did not properly inform residents or their representatives about arbitration agreements — contracts that give up the right to sue in court — including their right to refuse to sign. |
| Jul 25, 2024 | E · Potential for harm, repeated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Jul 25, 2024 | E · Potential for harm, repeated | 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. |
| Jul 25, 2024 | E · Potential for harm, repeated | The 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. |
| Jul 25, 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. |
| Jul 25, 2024 | 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. |
| Jul 25, 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 |
| Jul 25, 2024 | 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 |
| Jul 25, 2024 | 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. |
| Jul 25, 2024 | D · Potential for harm, one-off | 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. |
| Jul 25, 2024 | D · Potential for harm, one-off | The facility did not make sure residents actually saw their doctor face-to-face at all required visits. Doctors must examine nursing home residents in person on a regular schedule. |
| Jul 25, 2024 | D · Potential for harm, one-off | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Jul 25, 2024 | D · Potential for harm, one-off | The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. |
| Jul 25, 2024 | D · Potential for harm, one-off | The facility did not provide timely, quality laboratory tests to meet residents' needs. |
| Jul 25, 2024 | D · Potential for harm, one-off | The facility did not have enough support staff to safely and effectively run its food and nutrition service. |
| Jul 25, 2024 | 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. |
| Jul 25, 2024 | D · Potential for harm, one-off | The facility did not arrange hospice services for a resident who needed them, or help the resident move to a facility that could arrange hospice. Hospice provides comfort-focused care for people nearing the end of life. |
| Jun 14, 2023 | ▲ K · Immediate jeopardy, repeated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Jun 14, 2023 | D · Potential for harm, one-off | The facility did not provide safe, appropriate care for residents who need dialysis — the treatment that filters the blood when kidneys fail. |
| Jun 14, 2023 | D · Potential for harm, one-off | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (19 → 3).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 3 | 1 | K ▲ |
| 2024 | 19 | 1 | J ▲ |
| 2025 | 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)
1 fine totaling $16,801.
| Date | Type | Amount / length |
|---|---|---|
| Jul 25, 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) | 3.19 | 3.46 | 3.95 | bottom 38% in Texas; bottom 21% in the U.S. |
| Registered Nurse hours | 0.57 | 0.44 | 0.69 | top 18% in Texas; bottom 48% in the U.S. |
| Weekend total nurse staffing | 2.91 | 3.04 | 3.50 | bottom 50% in Texas; bottom 26% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.47 | 0.34 | 0.48 | top 15% in Texas; top 36% in the U.S. |
| Total nursing staff turnover (%) | 25.6 | 55.3 | 45.8 | top 2% in Texas; top 8% in the U.S. |
| RN turnover (%) | 14.3 | 54.6 | 42.9 | top 3% in Texas; top 7% 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 3.23, RN 0.58, weekend 2.95. 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: 5/5 · long-stay residents: 5/5 · short-stay residents: 4/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Oakbend Medical Center | Organization | 5% or Greater Direct Ownership Interest | 100% | 03/31/2017 |
| Council, Jeff | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2013 |
| Crayton, Tom | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2013 |
| Douds, Robert | Individual | Corporate Officer | NOT APPLICABLE | 01/19/2016 |
| Freudenberger, Joseph | Individual | W-2 Managing Employee | NOT APPLICABLE | 06/19/2007 |
| Freudenberger, Joseph | Individual | Corporate Officer | NOT APPLICABLE | 06/19/2007 |
| Haley, Jeff | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2012 |
| Kountze Nursing & Rehabilitation LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 10/01/2022 |
| Martin, Melissa | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2015 |
| Mefford, Ruthanne | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2015 |
| Petrosewicz, Norma | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2013 |
| Popatia, Amirali | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2011 |
| Uthman, Edward | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2008 |
| Zerwas, John | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2013 |
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?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "How do you identify and arrange specialized services for residents with mental health conditions or disabilities?"
- "Is signing an arbitration agreement required for admission, and can we refuse it without affecting my family member's care?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "Who reviews your menus, and can I see this week's menu and join my family member for a meal?"
- "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 |
|---|---|---|---|---|---|
| Mill Creek | 7.7 mi | Silsbee, TX | ★★★☆☆ | 3/5 | |
| Silsbee Oaks Health Care LLP | 9.0 mi | Silsbee, TX | ★★★☆☆ | 4/5 | |
| Paradigm at the Pines | 10.1 mi | Silsbee, TX | ★★☆☆☆ | 2/5 | abuse |
| Village Creek Rehabilitation and Nursing Center | 10.3 mi | Lumberton, TX | ★☆☆☆☆ | 1/5 | |
| Jefferson Nursing and Rehabilitation Center | 19.1 mi | Beaumont, TX | ★☆☆☆☆ | 2/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 455594.