C
TRUCARE LIVING CENTERS
60/100 score
0.28 hrs RN staffing
3 deficiencies
LEGACY AT TOWN CREEK
2212 W REAGAN ST, PALESTINE, TX 75801
Operator
LIBERTY COUNTY HOSPITAL DISTRICT NO1 · 35 facilities
- Provider number (CCN)
- 675998
- Certification
- Medicare and Medicaid
- Ownership
- Government - Hospital district
- Certified beds
- 199
- Phone
- (903) 727-8500
- CMS data as of
- July 1, 2026
F
What the records show
CMS rates LEGACY AT TOWN CREEK 1 out of 5 stars overall, with 2 of 5 for health inspections, 1 of 5 for staffing, 2 of 5 for quality measures. Federal inspectors cited 38 health deficiencies across the last three survey cycles, most recently surveyed in 2025, 5 at actual-harm level or higher. CMS enforcement records list 2 fines totalling $294,608.
Facility Assessment
Inspectors recorded 5 citations at the actual-harm level or worse in the last three survey cycles. This facility is operated by LIBERTY COUNTY HOSPITAL DISTRICT NO1, which scores 17 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 This facility staffs below 0.55 RN hours per resident day — the level the 2024 federal rule, repealed in February 2026, would have required.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 LEGACY AT TOWN CREEK 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Below the repealed 0.55 hr RN benchmark — review inspection history before visiting.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 Repealed February 2026.
|
0.27 — Below the repealed 0.55 hr benchmark |
The 0.55 hour RN standard was repealed effective February 2, 2026 and is not currently enforced.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
38
Outstanding
0
Actual harm or worse (G–L)
5
|
|
CMS Ratings
Federal five-star ratings published by CMS. These are regulatory ratings, not consumer review scores.
|
Overall: ★☆☆☆☆ (1/5)
Health inspection: ★★☆☆☆ (2/5)
Quality: ★★☆☆☆ (2/5)
Staffing: ★☆☆☆☆ (1/5)
|
|
NursingHomeGrade Score
|
24/100 |
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 | 0.27 hrs |
|---|---|
| TX median | 0.38 hrs |
| National average | 0.69 hrs |
Registered nurse turnover: 55.6% · Total nursing staff turnover: 53.8%
Staffing figures are the values CMS published in its file processed July 1, 2026, drawn from payroll-based journal reporting.
Audit and Inspection Reports
LEGACY AT TOWN CREEK is a Government - Hospital district facility. The records on this page are the federal health-inspection and enforcement records CMS publishes. We do not hold, and have not reviewed, any separate financial or performance audit issued by a county, state or independent auditor — if one exists for this facility, it is not part of the data described below.
- Most recent standard health survey: August 6, 2025.
- Citations shown below span 3 recorded inspection cycles.
- Survey dates on file range from April 26, 2023 to January 7, 2026.
Source records: CMS Care Compare profile for provider 675998 ↗ · 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).
3 immediate jeopardy, 2 actual harm issues found among 38 total deficiencies. 38 corrected.
Most recent inspection (August 6, 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 September 10, 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 September 10, 2025
D
Potential harm — isolated
F0813
Status: Corrected
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Nutrition and Dietary Deficiencies — Deficient, Provider has date of correction, corrected September 10, 2025
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 September 10, 2025
G
Actual 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 October 9, 2025
D
Potential harm — isolated
F0580
Status: Corrected
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected January 8, 2026
Inspection cycle 2 (July 31, 2024)
D
Potential harm — isolated
F0925
Status: Corrected
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Environmental Deficiencies — Deficient, Provider has date of correction, corrected August 12, 2024
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 August 12, 2024
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 August 12, 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 August 12, 2024
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 August 12, 2024
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 August 12, 2024
B
No harm — pattern
F0640
Status: Corrected
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected August 12, 2024
Inspection cycle 3 (April 26, 2023)
E
Potential 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 May 1, 2023
D
Potential harm — isolated
F0926
Status: Corrected
Have policies on smoking.
Environmental Deficiencies — Deficient, Provider has date of correction, corrected May 15, 2023
K
Immediate jeopardy — pattern
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 June 7, 2024
K
Immediate jeopardy — pattern
F0607
Status: Corrected
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected June 7, 2024
K
Immediate jeopardy — pattern
F0610
Status: Corrected
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected June 7, 2024
E
Potential harm — pattern
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 June 7, 2024
D
Potential harm — isolated
F0607
Status: Corrected
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected August 9, 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 June 7, 2024
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 May 27, 2023
E
Potential harm — pattern
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 February 14, 2024
E
Potential harm — pattern
F0758
Status: Corrected
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.
Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected May 19, 2023
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 May 12, 2023
G
Actual 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 June 7, 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 February 14, 2024
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 27, 2023
E
Potential harm — pattern
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 May 12, 2023
D
Potential harm — isolated
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 May 15, 2023
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 May 19, 2023
D
Potential harm — isolated
F0698
Status: Corrected
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected May 12, 2023
E
Potential harm — pattern
F0655
Status: Corrected
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected May 20, 2023
E
Potential harm — pattern
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 May 16, 2023
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 May 19, 2023
E
Potential harm — pattern
F0552
Status: Corrected
Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected May 19, 2023
E
Potential harm — pattern
F0584
Status: Corrected
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected May 19, 2023
D
Potential harm — isolated
F0550
Status: Corrected
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected May 12, 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 |
|---|---|---|
| October 8, 2025 | Fine | $10,358 |
| June 6, 2024 | Fine | $284,250 |
2 fines totalling $294,608.
Source: CMS Penalties file (dataset g6vv-u9sr).
Ownership and Contact Information
- Facility name
- LEGACY AT TOWN CREEK
- Legal business name
- LIBERTY COUNTY HOSPITAL DISTRICT NO.1
- Address
- 2212 W REAGAN ST, PALESTINE, TX 75801
- Phone
- (903) 727-8500
- Provider number (CCN)
- 675998
- Ownership type
- Government - Hospital district
- Operator
- LIBERTY COUNTY HOSPITAL DISTRICT NO1 · 35 facilities
- Medicare/Medicaid certified since
- January 8, 2004
- 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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Learn about our data methodology →Nearby facilities in PALESTINE
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Avir at Town Creek
50/100 score
0.37 hrs RN staffing
7 deficiencies
D
GREENBRIER NURSING & REHABILITATION CENTER OF PALE
47/100 score
0.38 hrs RN staffing
6 deficiencies
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 Penalties — fines and payment denials with the dates CMS recorded them. Dataset g6vv-u9sr ↗
- 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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