NursingHomeGrade

WESTWARD TRAILS NURSING AND REHABILITATION

3001 WESTWARD DR, NACOGDOCHES, TX 75964

Operator

CREATIVE SOLUTIONS IN HEALTHCARE · 45 facilities

Provider number (CCN)
455959
Certification
Medicare and Medicaid
Ownership
For profit - Corporation
Certified beds
108
Phone
(936) 569-2631
CMS data as of
July 1, 2026
F

What the records show

CMS rates WESTWARD TRAILS NURSING AND REHABILITATION 3 out of 5 stars overall, with 4 of 5 for health inspections, 1 of 5 for staffing, 3 of 5 for quality measures. Federal inspectors cited 24 health deficiencies across the last three survey cycles, most recently surveyed in 2025, 2 at actual-harm level or higher. CMS enforcement records list 3 fines totalling $25,036.

Facility Assessment Inspectors recorded 2 citations at the actual-harm level or worse in the last three survey cycles. This facility is operated by CREATIVE SOLUTIONS IN HEALTHCARE, which scores 23 points below the national average. This facility staffs below 0.55 RN hours per resident day — the level the 2024 federal rule, repealed in February 2026, would have required.

Reviews, Ratings and Official Records

This page reviews WESTWARD TRAILS NURSING AND REHABILITATION using federal government records — CMS star ratings, health-inspection findings, staffing data and enforcement actions. NursingHomeGrade does not collect, host or publish resident or family testimonials, and no star rating below is a consumer review score.

Below the repealed 0.55 hr RN benchmark — review inspection history before visiting.

Ratings and Grade Breakdown

RN Staffing
Registered nurse time each resident receives daily. 2024 federal benchmark: 0.55 hrs. Repealed February 2026.
 0.17 — Below the repealed 0.55 hr benchmark

The 0.55 hour RN standard was repealed effective February 2, 2026 and is not currently enforced. We still grade against it. Why
Health Deficiencies (last 3 survey cycles)
Violations found during federal inspections, with how many remain open and how many involved actual harm.
Total 24
Outstanding 0
Actual harm or worse (G–L) 2
CMS Ratings
Federal five-star ratings published by CMS. These are regulatory ratings, not consumer review scores.
Overall: ★★★☆☆ (3/5)
Health inspection: ★★★★☆ (4/5)
Quality: ★★★☆☆ (3/5)
Staffing: ★☆☆☆☆ (1/5)
NursingHomeGrade Score
 31/100

Loaded into NursingHomeGrade on August 7, 2026. This is the load date, not the date CMS published the underlying survey data — see release dates.

CMS scores each facility from one to five stars — one is in the bottom fifth of facilities in its state on health inspections, five is in the top tenth. Our own A–F grade is a separate 0–100 score built from staffing hours, inspection citations, and the severity and correction status of those citations, weighted as described in our grading methodology.

Staffing Compared With State and National Levels

This facility0.17 hrs
TX median0.38 hrs
National average0.69 hrs

Staffing figures are the values CMS published in its file processed July 1, 2026, drawn from payroll-based journal reporting.

Inspection Records Covered

Source records: CMS Care Compare profile for provider 455959 ↗ · the federal files we load and when.

Inspection Deficiencies

Health inspections identify violations of federal standards. Severity ranges from no actual harm (A–F) to immediate jeopardy (J–L).

2 immediate jeopardy issues found among 24 total deficiencies. 24 corrected.

Most recent inspection (November 20, 2025)

F Potential harm — widespread F0812 Status: Corrected

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

Nutrition and Dietary Deficiencies — Deficient, Provider has date of correction, corrected November 21, 2025

J Immediate jeopardy — isolated F0689 Status: Corrected

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

Quality of Life and Care Deficiencies — Past Non-Compliance, corrected May 28, 2025

Inspection cycle 2 (April 24, 2024)

D Potential harm — isolated F0919 Status: Corrected

Make sure that a working call system is available in each resident's bathroom and bathing area.

Environmental Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

D Potential harm — isolated F0926 Status: Corrected

Have policies on smoking.

Environmental Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

D Potential harm — isolated F0600 Status: Corrected

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected April 1, 2025

D Potential harm — isolated F0609 Status: Corrected

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

Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected April 1, 2025

E Potential harm — pattern F0880 Status: Corrected

Provide and implement an infection prevention and control program.

Infection Control Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

D Potential harm — isolated F0755 Status: Corrected

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

Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected April 1, 2025

D Potential harm — isolated F0677 Status: Corrected

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

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected May 23, 2025

J Immediate jeopardy — isolated F0689 Status: Corrected

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

Quality of Life and Care Deficiencies — Past Non-Compliance, corrected February 25, 2025

E Potential harm — pattern F0690 Status: Corrected

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 1, 2025

D Potential harm — isolated F0689 Status: Corrected

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

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

D Potential harm — isolated F0692 Status: Corrected

Provide enough food/fluids to maintain a resident's health.

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

D Potential harm — isolated F0695 Status: Corrected

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

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

D Potential harm — isolated F0637 Status: Corrected

Assess the resident when there is a significant change in condition

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

D Potential harm — isolated F0644 Status: Corrected

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

D Potential harm — isolated F0657 Status: Corrected

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

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

D Potential harm — isolated F0583 Status: Corrected

Keep residents' personal and medical records private and confidential.

Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected April 30, 2024

Inspection cycle 3 (March 15, 2023)

E Potential harm — pattern F0926 Status: Corrected

Have policies on smoking.

Environmental Deficiencies — Deficient, Provider has date of correction, corrected April 8, 2023

D Potential harm — isolated F0761 Status: Corrected

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.

Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected April 8, 2023

E Potential harm — pattern F0677 Status: Corrected

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

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 8, 2023

E Potential harm — pattern F0638 Status: Corrected

Assure that each resident’s assessment is updated at least once every 3 months.

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected April 8, 2023

E Potential harm — pattern F0657 Status: Corrected

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

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected April 8, 2023

E Potential harm — pattern F0582 Status: Corrected

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected April 8, 2023

Fines and Enforcement Actions

Penalties CMS has imposed on this facility. A fine is a civil money penalty; a payment denial suspends Medicare or Medicaid payment for new admissions.

Date Action Amount or length
June 25, 2025 Fine $14,901
March 31, 2025 Fine $5,649
March 31, 2025 Fine $4,486

3 fines totalling $25,036.

Source: CMS Penalties file (dataset g6vv-u9sr).

Ownership and Contact Information

Facility name
WESTWARD TRAILS NURSING AND REHABILITATION
Legal business name
WESTWARD I ENTERPRISES LLC
Address
3001 WESTWARD DR, NACOGDOCHES, TX 75964
Phone
(936) 569-2631
Provider number (CCN)
455959
Ownership type
For profit - Corporation
Operator
CREATIVE SOLUTIONS IN HEALTHCARE · 45 facilities
Medicare/Medicaid certified since
November 15, 1991
Official record
CMS Care Compare profile ↗
Details verified against CMS data dated
July 1, 2026

The federal nursing-home files publish no email address for certified facilities, so none is listed here. We do not guess or construct contact addresses. Contact details above are reproduced from CMS Provider Information; call the facility to confirm before relying on them.

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Sources and Methodology

The NursingHomeGrade score is our own calculation from these federal files — it is not a CMS rating and not a consumer review score. See exactly how the score is calculated · full methodology · source files and load dates.

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