Graham Oaks Care Center

1325 First St · Graham, TX · 76450 · 9405498787

110 certified beds For profit - Limited Liability company Chain: Creative Solutions in Healthcare

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).
  • Staffing levels are well below research benchmarks for safe care.

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.

Total nurse staffing below 3.0 hours per resident-day

2.14 reported hours vs the 3.48 minimum CMS's own staffing study recommends.

Weekends run noticeably short-staffed

Weekend staffing is 75% of the overall level. Visit on a Saturday or Sunday before deciding.

Score breakdown

Inspection record 30% of score 54
Serious harm & abuse 20% 4
Staffing 20% 31
Federal penalties 15% 56
Trend 10% 57
Context 5% 75

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 1 of 5 Inspections: 2 of 5 Staffing: 1 of 5 Quality measures: 3 of 5

Total nurse hours / resident-day2.143.48 min · 4.1 strong
RN hours / resident-day0.360.55–0.75
Weekend hours / resident-day1.60≈ weekday level
Nursing turnover / yearmedian 45%
Fines (3-yr window)2 · $34,690

Inspection citations (21 in the current record)

  • Potential for harm · D March 25, 2026 · found via complaint

    Provide and implement an infection prevention and control program.

    Corrected March 26, 2026 · Infection Control

  • No harm found · C November 8, 2025 · found via complaint

    Follow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.

    Corrected November 9, 2025 · Administration

  • Immediate jeopardy · J October 10, 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 September 3, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Immediate jeopardy · J October 10, 2025 · found via complaint

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Corrected September 3, 2025 · Quality of Life and Care

  • Potential for harm · D May 23, 2025 · found via complaint

    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Corrected June 9, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D January 22, 2025 · found via complaint

    Ensure each resident receives an accurate assessment.

    Corrected January 23, 2025 · Resident Assessment and Care Planning

  • Potential for harm · E January 22, 2025 · found via complaint

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Corrected January 23, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D October 18, 2024 · found via complaint

    Develop and implement policies and procedures to prevent abuse, neglect, and theft.

    Corrected October 25, 2024 · Freedom from Abuse, Neglect, and Exploitation

  • Actual harm · G December 7, 2023

    Provide safe, appropriate pain management for a resident who requires such services.

    Corrected December 8, 2023 · Quality of Life and Care

  • Potential for harm · E December 7, 2023

    Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

    Corrected January 5, 2024 · Resident Assessment and Care Planning

  • Potential for harm · D December 7, 2023

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected January 5, 2024 · Resident Assessment and Care Planning

  • Potential for harm · D December 7, 2023

    Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

    Corrected January 5, 2024 · Pharmacy Service

  • Potential for harm · D December 7, 2023 · found via complaint

    Develop and implement policies and procedures to prevent abuse, neglect, and theft.

    Corrected January 5, 2024 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D August 9, 2023 · found via complaint

    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

    Corrected August 29, 2023 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D October 25, 2022

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Corrected November 15, 2022 · Resident Assessment and Care Planning

  • Potential for harm · E October 25, 2022

    Provide safe and appropriate respiratory care for a resident when needed.

    Corrected November 15, 2022 · Quality of Life and Care

  • Potential for harm · D October 25, 2022

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Corrected November 15, 2022 · Pharmacy Service

  • Potential for harm · E October 25, 2022

    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

    Corrected November 15, 2022 · Pharmacy Service

  • Potential for harm · E October 25, 2022

    Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

    Corrected November 15, 2022 · Pharmacy Service

  • Potential for harm · E October 25, 2022

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Corrected November 15, 2022 · Nutrition and Dietary

  • Potential for harm · D October 25, 2022

    Provide and implement an infection prevention and control program.

    Corrected November 15, 2022 · Infection Control

Federal penalties

DateTypeAmount / length
October 10, 2025Fine$17,345
October 10, 2025Fine$17,345

Family & resident reviews — a separate signal, never mixed into the score

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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 455968 · certified since October 28, 1991. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.