The Homestead of Denison
1101 Reba McEntire Lane, Denison, TX 75020 · Grayson County · 140 certified beds · avg 70 residents/day · certified since Nov 4, 1993
Part of chain: PRIORITY MANAGEMENT (38 facilities, chain avg rating 2.9★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 3/5
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 16, 2025 · 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 (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.
▲ Immediate jeopardy, repeated · Nov 10, 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 (K): A life-threatening or extremely dangerous situation affected several residents. Among the most serious findings an inspection can produce.
Corrected: Jul 26, 2023 (Past Non-Compliance)
All citations in the current public record (27)
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 |
|---|---|---|
| Mar 26, 2026 | 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. |
| Mar 26, 2026 | E · Potential for harm, repeated | 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. |
| Mar 26, 2026 | 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. |
| Mar 26, 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. |
| Mar 26, 2026 | 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. |
| Mar 26, 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. |
| Jul 16, 2025 | ▲ J · Immediate jeopardy, one-off | 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. · from a complaint |
| Jan 3, 2025 | 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. |
| Jan 3, 2025 | E · Potential for harm, repeated | 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. |
| Jan 3, 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. |
| Jan 3, 2025 | D · Potential for harm, one-off | The facility did not provide timely, quality laboratory tests to meet residents' needs. |
| Jan 3, 2025 | 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. · from a complaint |
| Jan 3, 2025 | D · Potential for harm, one-off | The facility did not run an ongoing quality assurance committee that reviews care problems and creates plans to fix them. |
| Jan 3, 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. |
| Nov 6, 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. · from a complaint |
| Jan 4, 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 |
| Jan 4, 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 |
| Jan 4, 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 |
| Nov 10, 2023 | ▲ K · Immediate jeopardy, repeated | 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 |
| Nov 10, 2023 | F · Potential for harm, facility-wide | 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. |
| Nov 10, 2023 | 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. |
| Nov 10, 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. |
| Nov 10, 2023 | E · Potential for harm, repeated | The facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors. |
| Nov 10, 2023 | E · Potential for harm, repeated | The facility did not maintain an effective pest control program to prevent or deal with mice, insects, or other pests. |
| Nov 10, 2023 | D · Potential for harm, one-off | The facility did not prepare and serve food in a form that meets each resident's individual needs — for example, chopped, pureed, or softened food for residents with chewing or swallowing problems. · from a complaint |
| Nov 10, 2023 | D · Potential for harm, one-off | The 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 |
| Oct 14, 2023 | 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 |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (7 → 6).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 9 | 1 | K ▲ |
| 2024 | 4 | 0 | E |
| 2025 | 8 | 1 | J ▲ |
| 2026 | 6 | 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 $29,991.
| Date | Type | Amount / length |
|---|---|---|
| Jul 16, 2025 | Fine | $14,271 |
| Nov 10, 2023 | Fine | $15,720 |
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) | 3.13 | 3.46 | 3.95 | bottom 33% in Texas; bottom 19% in the U.S. |
| Registered Nurse hours | 0.28 | 0.44 | 0.69 | bottom 24% in Texas; bottom 8% in the U.S. |
| Weekend total nurse staffing | 2.80 | 3.04 | 3.50 | bottom 39% in Texas; bottom 21% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.21 | 0.34 | 0.48 | bottom 25% in Texas; bottom 14% in the U.S. |
| Total nursing staff turnover (%) | 58.3 | 55.3 | 45.8 | bottom 36% in Texas; bottom 19% in the U.S. |
| RN turnover (%) | 66.7 | 54.6 | 42.9 | bottom 34% in Texas; bottom 15% 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 3.31, RN 0.30, weekend 2.96. 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: 5/5 · long-stay residents: 5/5 · short-stay residents: 3/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Fannin County Hospital Authority | Organization | 5% or Greater Direct Ownership Interest | 100% | 04/01/2024 |
| Bauder Family Investments, LLC | Organization | 5% or Greater Mortgage Interest | NOT APPLICABLE | 04/01/2024 |
| Bauder Family Investments, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Bauder, Kelly | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Bauder, Madison | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Bauder, Parker | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Bauder, William | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2024 |
| Bauder, William | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Boulware St James LLC | Organization | 5% or Greater Mortgage Interest | NOT APPLICABLE | 04/01/2024 |
| Boulware St James LLC | Organization | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Boulware, Douglas | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/30/2025 |
| Boulware, Sandra | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/30/2025 |
| Boulware, Steven | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2024 |
| Boulware, Steven | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Boulware, Thomas | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Bridgepointe Finanical Services, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Innovative Nurse Consulting, LLC | Organization | Trustee of the SNF | NOT APPLICABLE | 04/01/2024 |
| Innovative Nurse Consulting, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
| Lange, Tyler | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2024 |
| Lange, Tyler | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2024 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "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 |
|---|---|---|---|---|---|
| Avir at Memorial | 0.3 mi | Denison, TX | ★☆☆☆☆ | 2/5 | |
| Woodlands Place Rehabilitation Suites | 1.6 mi | Denison, TX | ★★★☆☆ | 2/5 | |
| Denison Nursing and Rehab | 2.3 mi | Denison, TX | ★★☆☆☆ | 2/5 | |
| Beacon Hill | 3.5 mi | Denison, TX | ★★★★☆ | 4/5 | |
| Southern Pointe Living Center | 6.2 mi | Colbert, OK | ★☆☆☆☆ | 2/5 | |
| Avir at Sherman | 7.2 mi | Sherman, TX | ★★☆☆☆ | 3/5 | |
| Texoma Healthcare Center | 7.7 mi | Sherman, TX | ★★☆☆☆ | 3/5 | |
| Calera Manor | 9.5 mi | Calera, OK | ★★☆☆☆ | 3/5 | |
| Focused Care at Sherman | 10.7 mi | Sherman, TX | ★☆☆☆☆ | 1/5 | abuseSFF |
| Cedar Hollow Rehabilitation Center | 13.3 mi | Sherman, TX | ★★★☆☆ | 3/5 | |
| Mullican Care Center | 15.9 mi | Savoy, TX | ★★☆☆☆ | 3/5 | |
| The King's Daughters & Sons Nursing Home | 17.9 mi | Durant, OK | ★★★★☆ | 3/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 675212.