The Hills Nursing & Rehabilitation

201 E Thompson St · Decatur, TX · 76234 · 9406272165

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

Why this verdict

  • Inspection record is far worse than the national median (deficiency count and severity).
  • Staffing levels are well below research benchmarks for safe care.
  • Inspection results have improved across recent cycles.

Red flags

4 immediate-jeopardy citations in prior inspection cycles

Serious past findings — check whether the underlying problems were fixed and stayed fixed.

Cited under the freedom-from-abuse rule

Cited 1 time under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.

Total nurse staffing below 3.0 hours per resident-day

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

96% of nursing staff left within a year

High turnover disrupts continuity of care; the national median is 45%.

Score breakdown

Inspection record 30% of score 37
Serious harm & abuse 20% 80
Staffing 20% 35
Federal penalties 15% 57
Trend 10% 92
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: 4 of 5

Total nurse hours / resident-day2.673.48 min · 4.1 strong
RN hours / resident-day0.330.55–0.75
Weekend hours / resident-day2.28≈ weekday level
Nursing turnover / year96%median 45%
Fines (3-yr window)2 · $29,325

Inspection citations (18 in the current record)

  • Potential for harm · D February 26, 2026

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

    Corrected March 17, 2026 · Resident Assessment and Care Planning

  • Potential for harm · E February 26, 2026

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    Corrected March 17, 2026 · Quality of Life and Care

  • Potential for harm · D February 26, 2026

    Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Corrected March 17, 2026 · Quality of Life and Care

  • Potential for harm · E February 26, 2026

    Provide and implement an infection prevention and control program.

    Corrected March 17, 2026 · Infection Control

  • Potential for harm · E July 17, 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 July 24, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Immediate jeopardy · K April 30, 2025 · found via complaint

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

    Corrected April 7, 2025 · Quality of Life and Care

  • Immediate jeopardy · K March 14, 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 March 15, 2025 · Resident Assessment and Care Planning

  • Immediate jeopardy · K March 14, 2025 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected March 15, 2025 · Quality of Life and Care

  • Immediate jeopardy · K March 14, 2025 · found via complaint

    Ensure that residents are free from significant medication errors.

    Corrected March 15, 2025 · Pharmacy Service

  • Potential for harm · D February 19, 2025 · found via complaint

    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

    Corrected February 20, 2025 · Resident Rights

  • Potential for harm · D November 20, 2024

    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Corrected November 22, 2024 · Resident Rights

  • Potential for harm · D November 20, 2024

    Provide safe, appropriate dialysis care/services for a resident who requires such services.

    Corrected November 22, 2024 · Quality of Life and Care

  • Potential for harm · E November 20, 2024

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

    Corrected November 22, 2024 · Nutrition and Dietary

  • Potential for harm · D November 20, 2024 · found via complaint

    Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

    Corrected November 22, 2024 · Pharmacy Service

  • Potential for harm · E September 28, 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 September 29, 2023 · Resident Assessment and Care Planning

  • Potential for harm · D September 28, 2023

    Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

    Corrected September 29, 2023 · Quality of Life and Care

  • Potential for harm · D September 28, 2023

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

    Corrected September 29, 2023 · Quality of Life and Care

  • Potential for harm · E September 28, 2023 · found via complaint

    Provide and implement an infection prevention and control program.

    Corrected September 29, 2023 · Infection Control

Federal penalties

DateTypeAmount / length
April 30, 2025Fine$15,151
March 14, 2025Fine$14,174

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.

Sign in to share your family's experience — reviews are moderated and never affect the Safety Score.

Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 676004 · certified since February 18, 2004. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.