Trucare Living Centers
2265 S Sycamore St, Palestine, TX 75801 · Anderson County · 120 certified beds · avg 81 residents/day · certified since Jul 22, 2010
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★★5/5 · CMS overall rating: 5/5
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.
All citations in the current public record (10)
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 |
|---|---|---|
| Dec 17, 2025 | 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. |
| Dec 17, 2025 | 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. |
| Dec 17, 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. |
| Sep 18, 2024 | E · Potential for harm, repeated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Sep 18, 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. |
| Sep 18, 2024 | E · Potential for harm, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Sep 18, 2024 | E · Potential for harm, repeated | The facility used bed rails without first trying safer alternatives, or without assessing the resident's safety risk, discussing the risks and benefits with the resident or family, getting consent, and installing the rails correctly. |
| Sep 18, 2024 | 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. |
| Sep 18, 2024 | D · Potential for harm, one-off | The facility did not have a policy covering how food brought in by family and visitors is used and stored safely. |
| Aug 16, 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. |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (6 → 3).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 1 | 0 | D |
| 2024 | 6 | 0 | E |
| 2025 | 3 | 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)
No fines or payment denials in the published 3-year window.
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) | 3.88 | 3.46 | 3.95 | top 18% in Texas; top 45% in the U.S. |
| Registered Nurse hours | 0.30 | 0.44 | 0.69 | bottom 28% in Texas; bottom 9% in the U.S. |
| Weekend total nurse staffing | 3.46 | 3.04 | 3.50 | top 18% in Texas; top 44% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.22 | 0.34 | 0.48 | bottom 31% in Texas; bottom 17% in the U.S. |
| Total nursing staff turnover (%) | 25.0 | 55.3 | 45.8 | top 2% in Texas; top 7% in the U.S. |
| RN turnover (%) | 0.0 | 54.6 | 42.9 | — |
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 3.59, RN 0.28, weekend 3.20. Staffing rating: 3/5.
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: 4/5 · short-stay residents: 3/5
Who owns this facility
Government - Hospital district
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Fannin County Hospital Authority | Organization | 5% or Greater Direct Ownership Interest | 100% | 05/01/2026 |
| Burnam, Soon | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2026 |
| Byrum, Joe | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/01/2026 |
| Byrum, Joe | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2026 |
| Byrum, Joe | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2026 |
| Ensign Services INC | Organization | ADP of the SNF | NOT APPLICABLE | 02/13/2026 |
| Keetch, Chad | Individual | Corporate Officer | NOT APPLICABLE | 03/01/2011 |
| Peterson, Marco | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/01/2026 |
| Peterson, Marco | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2026 |
| Peterson, Marco | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2018 |
| Sanderson, Clark | Individual | Corporate Officer | NOT APPLICABLE | 05/01/2026 |
| Sandstone Crest Healthcare LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 05/01/2026 |
| Sandstone Crest Healthcare LLC | Organization | ADP of the SNF | NOT APPLICABLE | 04/15/2026 |
| Standard Bearer Healthcare Op, LP | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2026 |
| Sycamore Street Health Holdings LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2026 |
| The Ensign Group INC | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2026 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "What alternatives do you try before using bed rails, and how do you involve families in that decision?"
- "How do you identify and arrange specialized services for residents with mental health conditions or disabilities?"
- "What are your rules for bringing in my family member's favorite foods, and how are they stored?"
- "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 |
|---|---|---|---|---|---|
| Legacy at Town Creek | 1.7 mi | Palestine, TX | ★☆☆☆☆ | 2/5 | |
| Avir at Town Creek | 2.9 mi | Palestine, TX | ★★★☆☆ | 3/5 | |
| Greenbrier Nursing & Rehabilitation Center of Pale | 4.0 mi | Palestine, TX | ★★★★☆ | 5/5 | |
| Avir at Elkhart | 8.1 mi | Elkhart, TX | ★★★☆☆ | 3/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 676257.