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Part of chain: FANNIN COUNTY HOSPITAL DISTRICT (5 facilities, chain avg rating 3.0★)
4/5
Health inspection rating (on-site)
inspected Apr 16, 2025
1
Serious findings on record
most recent Mar 20, 2024
$8,018
Fines, last 3 years
2.65
Nurse hours/resident/day (adjusted)
Every record stays on this page.
What health inspectors found (on-site government inspections — the most independent evidence available)
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)
▲ Actual harm, isolated · Mar 20, 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 (G): Actual harm was cited, below immediate jeopardy. 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: Apr 10, 2024 (Deficient, Provider has date of correction)
Inspection findings in the public record
Showing the latest 3 of 13 inspection findings. Open the full record below to read every finding.
E · Potential for more than minimal harm, pattern
The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. F-0727
D · Potential for more than minimal harm, isolated
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. F-0656
D · Potential for more than minimal harm, isolated
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. F-0684
View all 13 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.
Date
Severity
What the facility was cited for
Apr 16, 2025
E · Potential for more than minimal harm, pattern
The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. · F-0727
Apr 16, 2025
D · Potential for more than minimal harm, isolated
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. · F-0656
Apr 16, 2025
D · Potential for more than minimal harm, isolated
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684
Apr 16, 2025
D · Potential for more than minimal harm, isolated
The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · F-0755
Apr 16, 2025
D · Potential for more than minimal harm, isolated
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. · F-0758
Apr 16, 2025
D · Potential for more than minimal harm, isolated
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. · F-0812
Apr 16, 2025
D · Potential for more than minimal harm, isolated
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. · F-0880
Mar 20, 2024
▲ G · Actual harm, isolated
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 · F-0689
Mar 7, 2024
F · Potential for more than minimal harm, widespread
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. · F-0812
Mar 7, 2024
E · Potential for more than minimal harm, pattern
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. · F-0677
Mar 7, 2024
D · Potential for more than minimal harm, isolated
The facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle. · F-0679
Nov 22, 2023
D · Potential for more than minimal harm, isolated
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. · from a complaint · F-0686
Jan 5, 2023
E · Potential for more than minimal harm, pattern
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. · F-0880
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (3 → 7).
Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2023
All citations:
2
Serious citations (G–L):
0
2024
All citations:
4
Serious citations (G–L):
1
2025
All citations:
7
Serious citations (G–L):
0
All bars start at zero. Exact values and supporting details remain below.
Year
Citations
Serious (G–L)
Worst severity that year
2023
2
0
E
2024
4
1
G ▲
2025
7
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.
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.
Date
Type
Amount / length
Mar 7, 2024
Fine
$8,018
Nurse staffing (from payroll records, adjusted for how much care residents need)
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:
2.65
Texas average:
3.46
U.S. average:
3.95
Registered Nurse hours
This facility:
0.41
Texas average:
0.44
U.S. average:
0.69
Weekend total nurse staffing
This facility:
2.46
Texas average:
3.04
U.S. average:
3.50
All bars start at zero. Exact values and supporting details remain below.
Measure
This facility
Texas avg
U.S. avg
Where it stands
Total nurse staffing (hours per resident per day)
2.65
3.46
3.95
bottom 6% in Texas; bottom 5% in the U.S.
Registered Nurse hours
0.41
0.44
0.69
top 45% in Texas; bottom 23% in the U.S.
Weekend total nurse staffing
2.46
3.04
3.50
bottom 12% in Texas; bottom 8% in the U.S.
Weekend RN hours (not acuity-adjusted)
0.37
0.34
0.48
top 31% in Texas; bottom 46% in the U.S.
Total nursing staff turnover (%)
42.6
55.3
45.8
top 27% in Texas; top 43% in the U.S.
RN turnover (%)
20.0
54.6
42.9
top 6% in Texas; top 13% 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 2.72, RN 0.42, weekend 2.53.Comparing with Medicare Care Compare? Care Compare shows the raw figure (2.72 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 2/5.
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.
No verified facility-specific private-pay price is available in our data for Rockdale Estates & Rehabilitation. CMS inspection and staffing records do not tell us what this home will charge you.
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Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
Bauder, Madison
Individual
Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
Bauder, Parker
Individual
Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
Bauder, William
Individual
Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
Boulware St James LLC
Organization
ADP of the SNF
NOT APPLICABLE
09/01/2025
Boulware, Douglas
Individual
Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
Boulware, Sandra
Individual
Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
Boulware, Steven
Individual
Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
Boulware, Thomas
Individual
Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
House, Janelle
Individual
ADP of the SNF
NOT APPLICABLE
09/01/2025
Johnson 5.0 LLC
Organization
Operational/Managerial Control
NOT APPLICABLE
09/01/2025
Johnson, Jeffrey
Individual
Operational/Managerial Control
NOT APPLICABLE
09/01/2025
Johnson, Jeffrey
Individual
ADP of the SNF
NOT APPLICABLE
09/01/2025
Johnson, Mary
Individual
Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
PMG Realco-Mabank, LLC
Organization
ADP of the SNF
NOT APPLICABLE
09/01/2025
Sanderson, Clark
Individual
Corporate Director
NOT APPLICABLE
09/01/2025
Steven Boulware Family Investments LLC
Organization
ADP of the SNF
NOT APPLICABLE
09/01/2025
Walker, Katie
Individual
Individual Is an Owner, Partner or Trustee of Any ADP of the SNF
NOT APPLICABLE
09/10/2025
All 20 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 Fannin County Hospital District — 5 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.