Average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at The Cottages At Texarkana during CMS and state inspections, most recent first.
A resident with diabetes and other medical conditions experienced a low blood sugar level and multiple refusals of blood glucose checks, which were not reported to the physician. Additionally, the resident suffered a fall resulting in fractures, but the incident was not reported for six days, delaying appropriate medical care. Interviews revealed communication failures and a lack of a fall policy in the facility.
The facility failed to serve meals according to the planned menu, resulting in incorrect portion sizes and substitutions. CNAs in multiple cottages did not review the menu, leading to residents receiving inadequate portions of meals such as Fritos pie and steak fingers. Additionally, French toast was not served as planned due to frozen bread, despite its availability in storage.
The facility exhibited multiple deficiencies in food storage and handling, including unsealed food items, expired products, and improper temperature management. Staff failed to maintain hand hygiene, and storage practices were inadequate, leading to potential contamination and spoilage. These issues compromised the safety and quality of food served to residents.
A facility failed to accurately complete an MDS assessment for a resident identified as PASARR Level II, who required specialized mental health services. Despite a state agency's determination, the MDS inaccurately indicated no serious mental illness, affecting care planning. The MDS Coordinator and DON confirmed the error, emphasizing the importance of correct coding for CMS reporting and care planning.
A facility failed to ensure staff followed enhanced barrier precautions and proper hand hygiene during medication administration for a resident with a feeding tube. The resident, with conditions such as end-stage renal disease and diabetes, required enhanced precautions due to a gastrostomy tube. An LPN was observed not changing gloves or washing hands after touching contaminated surfaces and not wearing a gown as required. Interviews confirmed the staff's non-compliance with infection control policies.
A resident with paraplegia and other conditions was injured during a transfer to a wheelchair when their foot got caught in the wheel, resulting in a patella fracture. The CNA involved was unfamiliar with the resident and did not position the wheelchair correctly. The incident was reported, but the resident proceeded to a dental appointment with knee pain. Staff competencies were unavailable as they had been shredded by the previous DON.
A facility failed to ensure proper staff training and competency evaluations, leading to an incident where a resident was injured during a transfer by an unfamiliar CNA. The resident suffered a fractured patella and knee effusion. Investigation revealed missing competency documentation and untrained CNAs.
The facility failed to secure medications in several cottages, with surveyors observing unlocked storage areas containing various medications, including those for high blood pressure and Alzheimer's. An unlocked medication cart was also found unattended in Cottage 5. Staff confirmed that medications should be locked to prevent unauthorized access, as per facility policy.
Failure to Notify Physician and Address Resident's Medical Needs
Penalty
Summary
The facility failed to provide timely evaluation and treatment for a resident, resulting in actual harm. The resident, who had a history of diabetes and other medical conditions, experienced a low blood sugar level of 40, which was documented by an LPN but not reported to the physician as required. Additionally, the resident refused evening blood glucose checks multiple times in October, but the physician was not notified of these refusals. This lack of communication and failure to follow professional standards of practice contributed to the resident's deteriorating condition. The resident also suffered a fall on November 2, which resulted in a right femur fracture and right hip fracture. Despite the severity of the injuries, the incident was not reported to the physician or other facility staff until six days later, on November 8, when the resident was sent to the hospital due to altered mental status and other health issues. The delay in reporting and addressing the fall led to the resident not receiving appropriate medical care for the fractures until hospitalization. Interviews with facility staff revealed a lack of awareness and communication regarding the resident's condition and incidents. The Medical Director and Nurse Practitioner were not informed of the resident's low blood sugar or the fall in a timely manner. The Director of Nursing acknowledged the failure to report the low blood sugar and the fall, and the LPN involved admitted to not reporting the fall due to being new to the facility. The facility also lacked a fall policy, which contributed to the inadequate response to the resident's fall and subsequent injuries.
Failure to Adhere to Planned Menu and Portion Sizes
Penalty
Summary
The facility failed to ensure that meals were prepared and served according to the planned written menu, which was intended to meet the nutritional needs of the residents. During observations, it was noted that Certified Nursing Assistants (CNAs) in multiple cottages did not adhere to the specified portion sizes as outlined in the menu. For instance, in Cottage #6, a CNA used a scoop that served only 2 ounces of chili and 4 ounces of corn chips instead of the required 8 ounces of Fritos pie. Similar discrepancies were observed in other cottages, where CNAs served incorrect portion sizes and did not review the menu prior to meal service. Further issues were identified during breakfast and dinner meal services. In one instance, French toast was not prepared and served as per the menu due to the bread being frozen, and instead, toast was served. This was despite the availability of French toast in the storage freezer. Additionally, during dinner service, residents were served chicken tenders instead of steak fingers, and the portion sizes were incorrect. In some cases, gravy was not served to residents on pureed and mechanical soft diets, as required by the menu. Interviews with the CNAs and dietary staff revealed a lack of awareness and adherence to the menu specifications. Many staff members admitted to not reviewing the menu before serving meals, leading to incorrect portion sizes and substitutions that did not meet the nutritional requirements. The dietary manager confirmed the availability of the required food items, indicating a breakdown in communication and execution of the planned menu across the facility.
Food Storage and Handling Deficiencies
Penalty
Summary
The facility failed to maintain proper food storage and handling practices, leading to multiple deficiencies. Observations revealed that various food items, including coffee, potato chips, bread, tea, tortillas, and cobbler dough crust, were not sealed or covered, exposing them to potential contamination and spoilage. Additionally, expired food items such as sour cream, lime juice, chocolate milk, and cocktail marinade were found in storage areas, indicating a lack of adherence to expiration dates and proper stock rotation. Dented cans were also present on shelves, which the Dietary Manager acknowledged should have been removed due to the risk of bacterial contamination. The facility's food temperature management was inadequate, as several food items on the steam table were not maintained at the required temperatures. For instance, corn wagon, cream corn, pureed chili, and pureed corn were served at temperatures below the recommended 135 degrees Fahrenheit. The Dietary Manager and staff acknowledged that these items should have been reheated before serving to residents. Furthermore, hand hygiene practices were not consistently followed, as staff members were observed handling food and equipment without washing their hands between tasks, increasing the risk of cross-contamination. In addition to these issues, the facility's storage practices were found to be lacking. Opened containers of spices, such as onion powder, chili powder, and garlic powder, were not covered, leaving them vulnerable to pests. Measuring cups were left inside containers of flour, sugar, cornmeal, and rice, which the Dietary Manager admitted could lead to cross-contamination. The facility's failure to adhere to professional standards for food storage, preparation, and handling resulted in numerous deficiencies that compromised the safety and quality of food served to residents.
Inaccurate MDS Assessment for PASARR Level II Resident
Penalty
Summary
The facility failed to ensure that a Minimum Data Set (MDS) assessment was completed accurately for a resident who was considered a PASARR Level II by the State Authority for PASARR assessments. The resident, who had diagnoses of anxiety, major depression, and bipolar depression, was assessed with a Brief Interview for Mental Status (BIMS) score indicating cognitive intactness. However, the MDS inaccurately indicated that the resident did not have a serious mental illness or intellectual disability, despite a Determination Letter from the state agency confirming the need for specialized services related to mental illness. Interviews with the MDS Coordinator and the Director of Nursing (DON) confirmed the coding error in the MDS, which should have reflected the resident's PASARR Level II status. The MDS Coordinator acknowledged that the incorrect coding was significant because the information is sent to CMS and influences care planning. The DON also confirmed that the MDS should have been coded correctly to ensure accurate care planning for the resident.
Failure to Follow Enhanced Barrier Precautions During Medication Administration
Penalty
Summary
The facility failed to ensure that staff followed enhanced barrier precautions and performed appropriate hand hygiene during medication administration for a resident with a feeding tube. The resident, who had diagnoses including end-stage renal disease, diabetes mellitus, and dysphagia, was on enhanced barrier precautions due to the presence of a gastrostomy tube. The care plan and physician's orders required the use of gowns and gloves during high-contact care activities, such as administering medication through the feeding tube. During an observation, an LPN was seen preparing and administering medication to the resident without changing gloves or washing hands after touching potentially contaminated surfaces, such as keys and a computer screen. The LPN also failed to wear a gown as required by the enhanced barrier precautions. Interviews with the LPN, the Infection Preventionist, and the Director of Nursing confirmed that the staff member did not adhere to the facility's infection control policies, which could lead to cross-contamination and infection control issues.
Unsafe Transfer Leads to Resident Injury
Penalty
Summary
The facility failed to ensure a safe transfer for a resident, leading to an injury. The resident, who had paraplegia, osteoarthritis, anxiety, a fracture of the right patella, and effusion, required maximal assistance with bed mobility and was dependent on transfers. The resident's care plan indicated a need for a one-person assist with transfers and fall precautions. However, during a transfer to a wheelchair for a dental appointment, the resident's right foot became caught in the wheelchair wheel, resulting in a fracture of the right patella. The incident occurred because the CNA did not position the wheelchair correctly and proceeded with the transfer despite the resident's foot being caught. The resident reported immediate pain in the right knee, but the knee was not assessed before the resident left for the dental appointment. The CNA involved was unfamiliar with the resident and had considered using a patient lift, but the resident indicated a preference for direct transfer. The incident was reported to the nurse, but the resident proceeded to the appointment with knee pain. The facility's administrator noted that staff competencies related to transfers were not available, as they had been shredded by the previous DON due to being incorrect.
Deficiency in Staff Training and Competency Evaluation
Penalty
Summary
The facility failed to ensure ongoing staff training, competencies, and evaluations for all nursing staff, which led to an incident involving a resident. On 12/18/2024, a Certified Nursing Assistant (CNA) who was unfamiliar with a resident attempted to assist the resident into a wheelchair. During the transfer, the resident's right foot got caught in the wheelchair wheel, causing the resident's leg to twist and resulting in knee pain. The CNA reported the incident to a Licensed Practical Nurse (LPN), but there was no documentation of an assessment in the resident's progress notes until after the resident returned from a dental appointment with pain and swelling in the right knee. The resident was later diagnosed with a fractured right patella and knee effusion. Further investigation revealed that the facility did not have proper documentation of staff competencies. The Director of Nursing (DON) and Administrator were unable to locate the competency files for several CNAs, as the previous DON had shredded them, claiming they were incorrect. Additionally, several CNAs reported that they had not been trained or checked off on competencies before working with residents. This lack of proper training and documentation contributed to the incident and highlighted deficiencies in the facility's staff training and competency evaluation processes.
Medication Security Lapses in Facility
Penalty
Summary
The facility failed to ensure medications were kept secure to prevent unauthorized access in several cottages. On January 21, 2025, surveyors observed that medication storage areas in Secure Cottages 2 and 2A were unlocked, allowing unauthorized access to various medications, including those for high blood pressure, thyroid issues, and Alzheimer's disease, among others. Similar observations were made in Cottage 3, where unlocked cabinets contained bronchodilators and eye drops, and in Cottage 4, where medications such as opiate antagonists and anti-convulsants were unsecured. Additionally, an unlabeled bottle containing pills was found in an unlocked cabinet in Cottage 4. On January 22, 2025, an unlocked medication cart was observed in the living room area of Cottage 5 without authorized personnel present, with residents nearby. Interviews with staff, including an LPN and the DON, confirmed that medications should be kept locked to prevent unauthorized access and potential overdoses. The facility's policy, revised in January 2018, mandates that medication storage areas be locked and only accessible to authorized personnel, which was not adhered to during the survey observations.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 116 citations issued within 25 miles in the last 12 months — including the 7 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Texarkana
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Bailey Creek Health And Rehab | 0.3 mi | ★★★★★ | 4 | 0 |
| Heritage Plaza Nursing Center | 1 mi | ★★★★★ | 2 | 0 |
| Avir At Texarkana | 1.2 mi | ★★★★★ | 7 | 3 |
| The Villa At Texarkana | 1.2 mi | ★★★★★ | 9 | 0 |
| Reunion Plaza Senior Care And Rehabilitation Cente | 1.9 mi | ★★★★★ | 25 | 2 |
Every risk area ranked, a do-first checklist, and your local survey patterns
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.