The Carlyle at Stonebridge Park
170 Stonebridge Lane, Southlake, TX 76092 · Tarrant County · 112 certified beds · avg 95 residents/day · certified since Mar 31, 2010
Part of chain: CANTEX CONTINUING CARE (37 facilities, chain avg rating 3.1★)
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 · Aug 22, 2025 · 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 (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 23, 2025 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, one-off · Oct 19, 2023 · 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 (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: Oct 20, 2023 (Deficient, Provider has date of correction)
All citations in the current public record (35)
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 |
|---|---|---|
| May 12, 2026 | 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. · from a complaint |
| Jan 8, 2026 | E · Potential for harm, repeated | The facility did not allow residents to take their own medications when a clinical review showed they could do so safely. Residents have this right if their care team determines it's appropriate. |
| Jan 8, 2026 | E · Potential for harm, repeated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Jan 8, 2026 | E · Potential for harm, repeated | The facility did not provide proper foot care for residents. Foot care includes routine care like nail trimming and attention to foot problems, which matter greatly for older adults. |
| Jan 8, 2026 | E · Potential for harm, repeated | 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. |
| Jan 8, 2026 | 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. |
| Jan 8, 2026 | D · Potential for harm, one-off | 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. |
| Jan 8, 2026 | 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. |
| Jan 8, 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. |
| Dec 1, 2025 | E · Potential for harm, repeated | The 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 |
| Aug 22, 2025 | ▲ J · Immediate jeopardy, 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 |
| Jun 24, 2025 | E · Potential for harm, repeated | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint |
| Jun 24, 2025 | D · Potential for harm, one-off | The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. · from a complaint |
| Jan 21, 2025 | D · Potential for harm, one-off | The facility allowed residents to lose the ability to do daily activities — like bathing, dressing, and eating — when there was no medical reason for the decline. Good care helps residents keep the abilities they have. · from a complaint |
| Oct 3, 2024 | 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. |
| Oct 3, 2024 | 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. |
| Oct 3, 2024 | D · Potential for harm, one-off | The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal. |
| Oct 3, 2024 | D · Potential for harm, one-off | The facility did not maintain an effective pest control program to prevent or deal with mice, insects, or other pests. · from a complaint |
| Sep 5, 2024 | 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. · from a complaint |
| May 22, 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. · from a complaint |
| May 22, 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. · from a complaint |
| Mar 14, 2024 | D · Potential for harm, one-off | The facility did not have doctor's orders in place for a resident's immediate care at the time the resident was admitted. · from a complaint |
| Mar 14, 2024 | 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 |
| Dec 14, 2023 | 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 |
| Nov 22, 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. · from a complaint |
| Oct 19, 2023 | ▲ J · Immediate jeopardy, one-off | The facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them. · from a complaint |
| Oct 19, 2023 | D · Potential for harm, one-off | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint |
| Sep 20, 2023 | E · Potential for harm, repeated | 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. |
| Sep 20, 2023 | 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. |
| Sep 20, 2023 | 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. · from a complaint |
| Sep 20, 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 |
| Sep 20, 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. |
| Sep 20, 2023 | D · Potential for harm, one-off | The facility did not provide each resident with a nourishing, tasty, well-balanced diet that meets their daily nutritional and special dietary needs. |
| Sep 20, 2023 | C · Minimal risk, facility-wide | The 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. |
| Sep 20, 2023 | C · Minimal risk, facility-wide | The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records. |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (4 → 8).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 12 | 1 | J ▲ |
| 2024 | 9 | 0 | E |
| 2025 | 5 | 1 | J ▲ |
| 2026 | 9 | 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 $125,895.
| Date | Type | Amount / length |
|---|---|---|
| Aug 22, 2025 | Fine | $113,246 |
| Sep 20, 2023 | Fine | $12,649 |
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) | 3.28 | 3.46 | 3.95 | bottom 47% in Texas; bottom 25% in the U.S. |
| Registered Nurse hours | 0.37 | 0.44 | 0.69 | bottom 44% in Texas; bottom 17% in the U.S. |
| Weekend total nurse staffing | 2.87 | 3.04 | 3.50 | bottom 46% in Texas; bottom 24% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.30 | 0.34 | 0.48 | top 48% in Texas; bottom 32% in the U.S. |
| Total nursing staff turnover (%) | 60.9 | 55.3 | 45.8 | bottom 32% in Texas; bottom 15% in the U.S. |
| RN turnover (%) | 72.7 | 54.6 | 42.9 | bottom 26% in Texas; bottom 9% 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 3.30, RN 0.37, weekend 2.89. 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: 4/5 · long-stay residents: 5/5 · short-stay residents: 3/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Dallas County Hospital District | Organization | 5% or Greater Direct Ownership Interest | 100% | 09/01/2019 |
| Carlyle Health Care Center LTD Co | Organization | Operational/Managerial Control | NOT APPLICABLE | 09/01/2019 |
| Carlyle Health Care Center LTD Co | Organization | ADP of the SNF | NOT APPLICABLE | 09/01/2019 |
| Castaneda, Edmundo | Individual | Corporate Officer | NOT APPLICABLE | 01/10/2022 |
| Cerise, Frederick | Individual | Corporate Officer | NOT APPLICABLE | 03/24/2014 |
| Megwa, Bernadine | Individual | ADP of the SNF | NOT APPLICABLE | 11/01/2024 |
| Washington, Michael | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/06/2024 |
| Washington, Michael | Individual | ADP of the SNF | NOT APPLICABLE | 06/06/2024 |
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?"
- "Who on your staff manages IV therapy, and what training and monitoring is in place?"
- "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
- "If my family member is able to manage their own medications, would you allow it, and how is that decided?"
- "How is routine foot care handled here, and does a podiatrist visit regularly?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "How do you identify and arrange specialized services for residents with mental health conditions or disabilities?"
- "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
- "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 |
|---|---|---|---|---|---|
| Discovery Village at Southlake | 0.5 mi | Southlake, TX | ★★★★★ | 5/5 | |
| Keller Oaks Healthcare Center | 1.8 mi | Keller, TX | ★★★★☆ | 4/5 | |
| Bear Creek Nursing and Rehabilitation | 3.9 mi | Grapevine, TX | ★☆☆☆☆ | 1/5 | |
| Heritage House at Keller Rehab & Nursing | 4.2 mi | Keller, TX | ★★★★★ | 4/5 | |
| Oakmont Guest Care Center | 5.0 mi | Hurst, TX | ★☆☆☆☆ | 1/5 | |
| Green Valley Healthcare and Rehabilitation Center | 5.4 mi | Fort Worth, TX | ★☆☆☆☆ | 1/5 | |
| Avir at Grapevine | 5.6 mi | Grapevine, TX | ★★☆☆☆ | 2/5 | |
| Legend Oaks Healthcare and Rehabilitation - Fort W | 5.9 mi | Keller, TX | ★☆☆☆☆ | 1/5 | |
| The Harrison at Heritage | 6.0 mi | Fort Worth, TX | ★★★☆☆ | 2/5 | |
| Grapevine Medical Lodge | 6.0 mi | Grapevine, TX | ★★★★★ | 4/5 | |
| North Pointe Nursing and Rehabilitation | 6.3 mi | Watauga, TX | ★☆☆☆☆ | 1/5 | |
| Avir at Emerald Hills | 6.3 mi | North Richland Hills, TX | ★★☆☆☆ | 2/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 676249.