Avir at Cowhorn Creek
5524 Cowhorn Creek · Texarkana, TX · 75503 · 9032231188
76 certified beds Government - Hospital district Chain: Avir Health Group
Why this verdict
- Carries CMS’s abuse warning icon.
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (2 citations).
- Inspection record is far worse than the national median (deficiency count and severity).
- Federal penalties on record: $46,315 in fines in the last 24 months.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
CMS abuse warning
CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.
2 immediate-jeopardy citations in the most recent inspection cycle
Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.
1 abuse-related citation at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
Medicare/Medicaid payments were denied
CMS refused payment for new admissions for a period — one of its strongest enforcement tools.
65% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 1 of 5 Staffing: 2 of 5 Quality measures: 3 of 5
| Total nurse hours / resident-day | 3.56 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.34 | 0.55–0.75 |
| Weekend hours / resident-day | 3.24 | ≈ weekday level |
| Nursing turnover / year | 65% | median 45% |
| Fines (3-yr window) | 1 · $46,315 |
Inspection citations (65 in the current record)
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Potential for harm · D April 13, 2026 · found via complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected April 14, 2026 · Pharmacy Service
-
Potential for harm · D February 12, 2026
Reasonably accommodate the needs and preferences of each resident.
Corrected February 13, 2026 · Resident Rights
-
Potential for harm · D February 12, 2026
Honor the resident's right to organize and participate in resident/family groups in the facility.
Corrected February 13, 2026 · Resident Rights
-
Potential for harm · D February 12, 2026
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected February 13, 2026 · Resident Rights
-
Potential for harm · E February 12, 2026
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Corrected February 13, 2026 · Resident Assessment and Care Planning
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Potential for harm · D February 12, 2026
Assess the resident when there is a significant change in condition
Corrected February 13, 2026 · Resident Assessment and Care Planning
-
Potential for harm · E February 12, 2026
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Corrected February 13, 2026 · Resident Assessment and Care Planning
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Potential for harm · D February 12, 2026
Ensure each resident receives an accurate assessment.
Corrected February 13, 2026 · Resident Assessment and Care Planning
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Potential for harm · D February 12, 2026
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected February 13, 2026 · Resident Assessment and Care Planning
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Potential for harm · E February 12, 2026
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected February 13, 2026 · Resident Assessment and Care Planning
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Potential for harm · D February 12, 2026
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected February 13, 2026 · Quality of Life and Care
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Potential for harm · D February 12, 2026
Assist a resident in gaining access to vision and hearing services.
Corrected February 13, 2026 · Quality of Life and Care
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Potential for harm · D February 12, 2026
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected February 13, 2026 · Quality of Life and Care
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Potential for harm · F February 12, 2026
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Corrected February 13, 2026 · Nursing and Physician Services
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Potential for harm · E February 12, 2026
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected February 13, 2026 · Pharmacy Service
-
Potential for harm · D February 12, 2026
Ensure medication error rates are not 5 percent or greater.
Corrected February 13, 2026 · Pharmacy Service
-
Potential for harm · E February 12, 2026
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected February 13, 2026 · Nutrition and Dietary
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Potential for harm · D February 12, 2026
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Corrected February 13, 2026 · Nutrition and Dietary
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Potential for harm · F February 12, 2026
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected February 13, 2026 · Nutrition and Dietary
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Potential for harm · D February 12, 2026
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Corrected February 13, 2026 · Nutrition and Dietary
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Potential for harm · E February 12, 2026
Provide and implement an infection prevention and control program.
Corrected February 13, 2026 · Infection Control
-
Immediate jeopardy · K August 15, 2025 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected August 16, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Immediate jeopardy · K August 15, 2025 · found via complaint
Honor each resident's preferences, choices, values and beliefs.
Corrected August 16, 2025 · Quality of Life and Care
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Potential for harm · D August 15, 2025 · found via complaint
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Corrected August 18, 2025 · Resident Rights
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Potential for harm · E August 15, 2025 · found via complaint
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Corrected August 18, 2025 · Resident Rights
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| August 15, 2025 | Fine | $46,315 |
| August 15, 2025 | Payment Denial | 5 days |
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 675949 · certified since December 16, 2002. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.