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Nursing homesTexas › Misty Willow Healthcare and Rehabilitation Center

Misty Willow Healthcare and Rehabilitation Center

12921 Misty Willow Dr, Houston, TX 77070 · 2814697881 · 124 certified beds

Overall★☆☆☆☆ 1/5
Health inspections★☆☆☆☆ 1/5
Staffing★★☆☆☆ 2/5
Quality measures★★★★☆ 4/5
Special Focus: CMS lists this facility as SFF Candidate — among the facilities with the most serious ongoing compliance problems in the country.
Abuse icon: CMS flags this facility for an abuse citation in recent inspections.

Ownership group

Per CMS filings, this facility is affiliated with The Ensign Group, a group operating 346 facilities in 17 states. Group record: average rating 3.2/5, 33 abuse citation icons, 9 facilities on the Special Focus list, $7,179,329 in federal fines. This facility rates below its group average (3.2/5).

See all 346 facilities in this group →

Staffing (hours per resident per day)

Total nurse staffing: 3.30 (Texas median: 3.27). RN hours: 0.35. Weekend total: 2.87.

Inspection deficiencies

All-time on record: 30 deficiency citations, including 8 at immediate-jeopardy level. Below: citations from 2023 onward (severity letters explained in methodology).

Survey dateDeficiencySev.TypeStatus
2026-03-09Provide appropriate treatment and care according to orders, resident’s preferences and goals. Jcomplaintcorrected 2026-03-11
2026-03-09Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Dcomplaintcorrected 2026-03-11
2025-12-04Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. FHealthcorrected 2025-12-06
2025-12-04Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. EHealthcorrected 2025-12-06
2025-12-04Have a policy regarding use and storage of foods brought to residents by family and other visitors. EHealthcorrected 2025-12-06
2025-12-04Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. DHealthcorrected 2025-12-06
2025-12-04Provide for the safe, appropriate administration of IV fluids for a resident when needed. DHealthcorrected 2025-12-06
2025-12-04Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. DHealthcorrected 2025-12-06
2025-12-04Ensure 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. DHealthcorrected 2025-12-06
2025-09-24Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Kcomplaintcorrected 2025-10-16
2025-09-24Develop and implement policies and procedures to prevent abuse, neglect, and theft. Kcomplaintcorrected 2025-10-16
2025-09-24Respond appropriately to all alleged violations. Kcomplaintcorrected 2025-10-16
2025-09-24Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Kcomplaintcorrected 2025-10-16
2025-09-24Inform each resident of his or her visitation rights and ensure that all visitors enjoy equal visitation privileges. Dcomplaintcorrected 2025-10-16
2025-03-29Provide appropriate treatment and care according to orders, resident’s preferences and goals. Kcomplaintcorrected 2025-03-31
2025-03-29Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Kcomplaintcorrected 2025-03-31
2025-03-29Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Jcomplaintcorrected 2025-03-31
2024-08-30Provide and implement an infection prevention and control program. Ecomplaintcorrected 2024-09-03
2024-08-30Keep residents' personal and medical records private and confidential. DHealthcorrected 2024-09-03
2024-08-30Provide appropriate pressure ulcer care and prevent new ulcers from developing. DHealthcorrected 2024-09-03
2024-08-30Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. DHealthcorrected 2024-09-03
2024-08-30Provide safe and appropriate respiratory care for a resident when needed. DHealthcorrected 2024-09-03
2024-08-30Ensure 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. DHealthcorrected 2024-09-03
2023-06-16Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. EHealthcorrected 2023-07-14
2023-06-16Keep residents' personal and medical records private and confidential. DHealthcorrected 2023-07-14
2023-06-16Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted DHealthcorrected 2023-07-14
2023-06-16Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. DHealthcorrected 2023-07-14
2023-06-16Provide safe and appropriate respiratory care for a resident when needed. DHealthcorrected 2023-07-14
2023-06-16Ensure medication error rates are not 5 percent or greater. DHealthcorrected 2023-07-14
2023-06-16Ensure 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. DHealthcorrected 2023-07-14

Federal penalties

DateTypeAmount
2026-03-09Fine$43,770
2025-09-24Fine$20,495
2025-03-29Fine$15,147

Ownership & control records (CMS filings)

NameRoleType%Since
LIBERTY COUNTY HOSPITAL DISTRICT NO.15% Or Greater Direct Ownership InterestOrganization100%since 04/01/2017
ALI, NIDAManaging Control - Governing BodyIndividualNOT APPLICABLEsince 09/18/2024
FITZGERALD, TAMIManaging Control - Governing BodyIndividualNOT APPLICABLEsince 04/01/2017
BURNAM, SOONCorporate OfficerIndividualNOT APPLICABLEsince 04/01/2017
KEETCH, CHADCorporate OfficerIndividualNOT APPLICABLEsince 03/01/2011
STRATTON, CHARLESCorporate OfficerIndividualNOT APPLICABLEsince 02/07/2005
MISTY WILLOW HEALTHCARE, INC.Operational/Managerial ControlOrganizationNOT APPLICABLEsince 04/01/2017
ALI, NIDAOperational/Managerial ControlIndividualNOT APPLICABLEsince 09/18/2024
FITZGERALD, TAMIOperational/Managerial ControlIndividualNOT APPLICABLEsince 04/01/2017

Compare nearby (Harris County)

Source: CMS Provider Data Catalog (July 2026 release) — provider file, deficiency file, ownership file, penalty file. CCN 676251. Corrections: data@carerecords.org.