Towers Nursing Home
372 Hill Road, Smithville, TX 78957 · Bastrop County · 120 certified beds · avg 111 residents/day · certified since Dec 17, 2002
Part of chain: WELLSENTIAL HEALTH (67 facilities, chain avg rating 2.7★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★☆4/5 · 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, repeated · Aug 20, 2024 · F-0760 · triggered by a complaint
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.
Why it matters: A serious medication error can cause real harm, hospitalization, or worse.
Severity (K): A life-threatening or extremely dangerous situation affected several residents. Among the most serious findings an inspection can produce.
Corrected: Aug 9, 2024 (Past Non-Compliance)
▲ Actual harm, one-off · Jun 6, 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 (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Jun 7, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (17)
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 |
|---|---|---|
| Jun 11, 2026 | D · Potential for harm, one-off | The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. · from a complaint |
| Jun 11, 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. · from a complaint |
| Apr 1, 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. · from a complaint |
| Apr 1, 2026 | 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. · from a complaint |
| Jan 29, 2026 | D · Potential for harm, one-off | 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. · from a complaint |
| Jul 31, 2025 | D · Potential for harm, one-off | The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. |
| Jul 31, 2025 | 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. |
| Jul 31, 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. |
| Aug 20, 2024 | ▲ K · Immediate jeopardy, 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. · from a complaint |
| Jun 6, 2024 | ▲ G · Actual 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. |
| Jun 6, 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. |
| Jun 6, 2024 | E · Potential for harm, repeated | The facility did not have a working program to monitor how antibiotics are used. Tracking antibiotic use helps make sure these drugs are given only when needed and remain effective. |
| Jun 6, 2024 | D · Potential for harm, one-off | The facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services. |
| Jun 6, 2024 | 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. |
| Jun 6, 2024 | D · Potential for harm, one-off | The facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them. |
| Jun 6, 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. |
| Aug 3, 2023 | 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. · from a complaint |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (7 → 3).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 1 | 0 | D |
| 2024 | 8 | 2 | K ▲ |
| 2025 | 3 | 0 | D |
| 2026 | 5 | 0 | D |
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 $15,239.
| Date | Type | Amount / length |
|---|---|---|
| Aug 20, 2024 | Fine | $15,239 |
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) | 2.54 | 3.46 | 3.95 | bottom 4% in Texas; bottom 4% in the U.S. |
| Registered Nurse hours | 0.20 | 0.44 | 0.69 | bottom 8% in Texas; bottom 3% in the U.S. |
| Weekend total nurse staffing | 2.28 | 3.04 | 3.50 | bottom 6% in Texas; bottom 5% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.15 | 0.34 | 0.48 | bottom 9% in Texas; bottom 5% in the U.S. |
| Total nursing staff turnover (%) | 58.8 | 55.3 | 45.8 | bottom 35% in Texas; bottom 18% in the U.S. |
| RN turnover (%) | 33.3 | 54.6 | 42.9 | top 20% in Texas; top 33% 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 2.59, RN 0.21, weekend 2.32. 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
Non profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| CSV Rhea Management Holdco, LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 06/27/2016 |
| DWD TX Holdings LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 06/27/2016 |
| Jack and Nancy Dwyer Workforce Development Center INC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 06/27/2016 |
| Reg Bridge Opco LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 06/27/2016 |
| Reg HG Opco LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 06/27/2016 |
| Reg Operator Holdco LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 06/27/2016 |
| Regency Ihs of Smithville Towers LLC | Organization | Direct Ownership Interest | NOT APPLICABLE | 06/27/2016 |
| Regency Integrated Health Services LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 06/27/2016 |
| Regency Texas Holdings LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 06/27/2016 |
| Smithville Hospital Authority | Organization | 5% or Greater Direct Ownership Interest | 100% | 06/27/2016 |
| Baird, Daniel | Individual | Managing Control - Governing Body | NOT APPLICABLE | 04/13/2021 |
| Bunte, Mark | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/27/2020 |
| Chudleigh, James | Individual | ADP of the SNF | NOT APPLICABLE | 01/01/2025 |
| Clapp, Barbara | Individual | Managing Control - Governing Body | NOT APPLICABLE | 06/01/2021 |
| Cortese, Daren | Individual | Managing Control - Governing Body | NOT APPLICABLE | 08/10/2021 |
| Dekowski, Donovan | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/27/2016 |
| Dekowski, Donovan | Individual | ADP of the SNF | NOT APPLICABLE | 06/27/2016 |
| Fulcher, Ann | Individual | Managing Control - Governing Body | NOT APPLICABLE | 01/22/2015 |
| Gibson, Patricia | Individual | Managing Control - Governing Body | NOT APPLICABLE | 08/01/2021 |
| Gray, Cole | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/17/2025 |
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 systems do you use to prevent medication errors, and what happens when one occurs?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "How do you monitor residents' weight and eating, and what happens when someone starts losing weight?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
- "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "Can you give me examples of how you adjust daily routines and room setups to fit each resident's preferences?"
- "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 |
|---|---|---|---|---|---|
| Windsor Nursing and Rehabilitation Center of Bastr | 13.7 mi | Bastrop, TX | ★★☆☆☆ | 3/5 | |
| Bastrop Lost Pines Nursing and Rehabilitation Cent | 13.9 mi | Bastrop, TX | ★☆☆☆☆ | 2/5 | abuse |
| Silver Pines Nursing and Rehabilitation Center | 14.0 mi | Bastrop, TX | ★★★★☆ | 4/5 | |
| Avir at la Grange | 16.6 mi | La Grange, TX | ★★★☆☆ | 3/5 | |
| Monument Rehabilitation and Nursing Center | 17.5 mi | La Grange, TX | ★★★★☆ | 4/5 | |
| Harmony Care at Giddings | 17.7 mi | Giddings, TX | ★☆☆☆☆ | 1/5 | abuseSFF |
| Avir at Giddings | 17.9 mi | Giddings, TX | ★☆☆☆☆ | 1/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 675942.