Timberwood Nursing and Rehabilitation Center
4001 Hwy 59 North, Livingston, TX 77351 · Polk County · 120 certified beds · avg 90 residents/day · certified since Apr 7, 1999
Part of chain: THE ENSIGN GROUP (342 facilities, chain avg rating 3.2★)
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 · Sep 12, 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 (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: Jan 22, 2024 (Past Non-Compliance)
All citations in the current public record (16)
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 |
|---|---|---|
| Jan 14, 2026 | 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 14, 2026 | F · Potential for harm, facility-wide | The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices. |
| Jan 14, 2026 | 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 14, 2026 | E · Potential for harm, repeated | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. |
| Jan 14, 2026 | E · Potential for harm, repeated | 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. |
| Jan 14, 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. |
| Nov 19, 2025 | D · Potential for harm, one-off | The facility did not make sure a transfer or discharge met the resident's needs and preferences, or did not properly prepare the resident to leave safely. · from a complaint |
| Oct 16, 2024 | E · Potential for harm, repeated | The facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them. |
| Oct 16, 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 16, 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. |
| Oct 16, 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. |
| Oct 16, 2024 | D · Potential for harm, one-off | The 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. |
| Oct 16, 2024 | D · Potential for harm, one-off | The facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident. |
| Sep 12, 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. · from a complaint |
| Aug 23, 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. |
| Aug 23, 2023 | 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 |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (6 → 6).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 2 | 0 | E |
| 2024 | 7 | 1 | J ▲ |
| 2025 | 1 | 0 | D |
| 2026 | 6 | 0 | F |
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 $8,021.
| Date | Type | Amount / length |
|---|---|---|
| Sep 12, 2024 | Fine | $8,021 |
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) | 3.40 | 3.46 | 3.95 | top 42% in Texas; bottom 32% in the U.S. |
| Registered Nurse hours | 0.31 | 0.44 | 0.69 | bottom 32% in Texas; bottom 11% in the U.S. |
| Weekend total nurse staffing | 2.77 | 3.04 | 3.50 | bottom 36% in Texas; bottom 19% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.13 | 0.34 | 0.48 | bottom 7% in Texas; bottom 4% in the U.S. |
| Total nursing staff turnover (%) | 40.5 | 55.3 | 45.8 | top 21% in Texas; top 38% in the U.S. |
| RN turnover (%) | 37.5 | 54.6 | 42.9 | top 26% in Texas; top 42% 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 3.28, RN 0.30, weekend 2.67. Staffing rating: 2/5.
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 - Individual
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Liberty County Hospital District No 1 | Organization | 5% or Greater Direct Ownership Interest | 100% | 05/01/2015 |
| Barley, Christopher | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/01/2015 |
| Barley, Christopher | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2015 |
| Barley, Christopher | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2015 |
| Burnam, Soon | Individual | Corporate Officer | NOT APPLICABLE | 05/01/2015 |
| Caretrust GP LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2015 |
| Caretrust Reit INC | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2015 |
| Ctr Partnership LP | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2015 |
| Ensign Services INC | Organization | ADP of the SNF | NOT APPLICABLE | 04/05/2006 |
| Keetch, Chad | Individual | Corporate Officer | NOT APPLICABLE | 03/01/2011 |
| Livingston Care Associates, INC. | Organization | Operational/Managerial Control | NOT APPLICABLE | 05/01/2015 |
| Livingston Care Associates, INC. | Organization | ADP of the SNF | NOT APPLICABLE | 11/03/2025 |
| Luna, Jeffrey | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/01/2025 |
| Luna, Jeffrey | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2025 |
| Luna, Jeffrey | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| Polk Health Holdings LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2015 |
| Stratton, Charles | Individual | Corporate Officer | NOT APPLICABLE | 02/07/2005 |
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?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "How do you inspect and maintain essential equipment, and how quickly are repairs made?"
- "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
- "How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
- "What systems do you use to prevent medication errors, and what happens when one occurs?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "Before a resident is discharged or transferred, how do you make sure the new place can actually meet their needs?"
- "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 |
|---|---|---|---|---|---|
| The Bradford at Brookside | 5.4 mi | Livingston, TX | ★★★☆☆ | 4/5 | |
| Woodland Park Nursing & Rehab | 12.4 mi | Shepherd, TX | ★☆☆☆☆ | 1/5 | |
| Pine Ridge Health Care LLP | 16.4 mi | Livingston, TX | ★★★★☆ | 4/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 455745.