D
Avir at River Ridge
37/100 score
0.46 hrs RN staffing
12 deficiencies
PALMA REAL
1220 LOOP 459, MATHIS, TX 78368
- Provider number (CCN)
- 675312
- Certification
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified beds
- 90
- Phone
- (361) 547-3318
- CMS data as of
- July 1, 2026
C
What the records show
CMS rates PALMA REAL 5 out of 5 stars overall, with 4 of 5 for health inspections, 2 of 5 for staffing, 5 of 5 for quality measures. Federal inspectors cited 15 health deficiencies across the last three survey cycles, most recently surveyed in 2025. CMS lists no fines or payment denials for this facility in the covered period.
Facility Assessment
This facility staffs below 0.55 RN hours per resident day — the level the 2024 federal rule, repealed in February 2026, would have required.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 PALMA REAL 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Below the repealed 0.55 hr RN benchmark — average inspection record.
Ratings and Grade Breakdown
|
RN Staffing
Registered nurse time each resident receives daily. 2024 federal benchmark: 0.55 hrs. Repealed February 2026.
|
0.37 — Below the repealed 0.55 hr benchmark |
The 0.55 hour RN standard was repealed effective February 2, 2026 and is not currently enforced.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
15
Outstanding
0
Actual harm or worse (G–L)
0
|
|
CMS Ratings
Federal five-star ratings published by CMS. These are regulatory ratings, not consumer review scores.
|
Overall: ★★★★★ (5/5)
Health inspection: ★★★★☆ (4/5)
Quality: ★★★★★ (5/5)
Staffing: ★★☆☆☆ (2/5)
|
|
NursingHomeGrade Score
|
57/100 |
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 facility | 0.37 hrs |
|---|---|
| TX median | 0.38 hrs |
| National average | 0.69 hrs |
Registered nurse turnover: 50.0% · Total nursing staff turnover: 31.9%
Staffing figures are the values CMS published in its file processed July 1, 2026, drawn from payroll-based journal reporting.
Inspection Records Covered
- Most recent standard health survey: April 17, 2025.
- Citations shown below span 3 recorded inspection cycles.
- Survey dates on file range from January 6, 2023 to November 21, 2025.
Source records: CMS Care Compare profile for provider 675312 ↗ · 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).
15 deficiencies found. 15 corrected. None involved actual harm.
Most recent inspection (August 20, 2025)
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 September 26, 2025
D
Potential harm — isolated
F0880
Status: Corrected
Provide and implement an infection prevention and control program.
Infection Control Deficiencies — Deficient, Provider has date of correction, corrected November 22, 2025
E
Potential harm — pattern
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 May 17, 2025
D
Potential harm — isolated
F0686
Status: Corrected
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected May 17, 2025
D
Potential harm — isolated
F0656
Status: Corrected
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected September 26, 2025
D
Potential harm — isolated
F0645
Status: Corrected
PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected May 17, 2025
D
Potential harm — isolated
F0842
Status: Corrected
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected May 17, 2025
D
Potential harm — isolated
F0561
Status: Corrected
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected May 17, 2025
Inspection cycle 2 (February 23, 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 March 31, 2024
B
No harm — pattern
F0921
Status: Corrected
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Environmental Deficiencies — Deficient, Provider has date of correction, corrected March 31, 2024
E
Potential harm — pattern
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 March 31, 2024
D
Potential harm — isolated
F0656
Status: Corrected
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected March 31, 2024
Inspection cycle 3 (November 13, 2023)
D
Potential harm — isolated
F0880
Status: Corrected
Provide and implement an infection prevention and control program.
Infection Control Deficiencies — Deficient, Provider has date of correction, corrected December 4, 2023
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 February 17, 2023
E
Potential harm — pattern
F0759
Status: Corrected
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected February 17, 2023
Fines and Enforcement Actions
CMS lists no fines and no payment denials for PALMA REAL in the enforcement records covering the last three years, as published in the file processed July 1, 2026.
Ownership and Contact Information
- Facility name
- PALMA REAL
- Legal business name
- HAMILTON COUNTY HOSPITAL DISTRICT
- Address
- 1220 LOOP 459, MATHIS, TX 78368
- Phone
- (361) 547-3318
- Provider number (CCN)
- 675312
- Ownership type
- For profit - Corporation
- Medicare/Medicaid certified since
- May 11, 1994
- 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.
How We Stay Independent
NursingHomeGrade is strictly independent. We do not accept payments from facilities. Our grades are calculated solely from federal CMS datasets.
Learn about our data methodology →Nearby facilities in MATHIS
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Sources and Methodology
- CMS Provider Information (file processed July 1, 2026) — ratings, staffing, ownership, certification and contact details. Dataset 4pq5-n9py ↗
- CMS Health Deficiencies — inspection citations, scope and severity, correction status. Dataset r5ix-sfxw ↗
- CMS Ownership — owning and managing organisations. Dataset y2hd-n93e ↗
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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