Nursing homes › Texas › Windsor Rehabilitation and Healthcare
250 W British Flying School Blvd, Terrell, TX 75160 · 9725510122 · 108 certified beds
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).
Total nurse staffing: 3.55 (Texas median: 3.27). RN hours: 0.32. Weekend total: 3.08. Nursing staff turnover: 43%.
All-time on record: 39 deficiency citations. Below: citations from 2023 onward (severity letters explained in methodology).
| Survey date | Deficiency | Sev. | Type | Status |
|---|---|---|---|---|
| 2026-02-27 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Health | corrected 2026-04-01 |
| 2026-02-27 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | Health | corrected 2026-04-01 |
| 2026-02-27 | Provide enough food/fluids to maintain a resident's health. | E | Health | corrected 2026-04-01 |
| 2026-02-27 | Ensure 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. | E | Health | corrected 2026-04-01 |
| 2026-02-27 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Health | corrected 2026-04-01 |
| 2026-02-27 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | E | Health | corrected 2026-04-01 |
| 2026-02-27 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Health | corrected 2026-04-01 |
| 2026-02-27 | Provide and implement an infection prevention and control program. | E | Health | corrected 2026-04-01 |
| 2026-02-27 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Health | corrected 2026-04-01 |
| 2026-02-27 | Ensure that residents are fully informed and understand their health status, care and treatments. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | Ensure each resident receives an accurate assessment. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | 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. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | Provide safe and appropriate respiratory care for a resident when needed. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | complaint | corrected 2026-04-01 |
| 2026-02-27 | 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. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | D | Health | corrected 2026-04-01 |
| 2026-02-27 | Implement a program that monitors antibiotic use. | D | Health | corrected 2026-04-01 |
| 2024-11-21 | Ensure each resident’s drug regimen must be free from unnecessary drugs. | E | Health | corrected 2024-12-30 |
| 2024-11-21 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Health | corrected 2024-12-30 |
| 2024-11-21 | Keep residents' personal and medical records private and confidential. | D | Health | corrected 2024-12-30 |
| 2024-11-21 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Health | corrected 2024-12-30 |
| 2024-11-21 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | complaint | corrected 2024-12-30 |
| 2024-11-21 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | complaint | corrected 2024-12-30 |
| 2024-11-21 | Ensure medication error rates are not 5 percent or greater. | D | Health | corrected 2024-12-30 |
| 2024-11-21 | Ensure that residents are free from significant medication errors. | D | complaint | corrected 2024-12-30 |
| 2024-11-21 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | complaint | corrected 2024-12-30 |
| 2024-11-21 | Provide and implement an infection prevention and control program. | D | complaint | corrected 2024-12-30 |
| 2023-09-27 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | complaint | corrected 2023-10-31 |
| 2023-09-27 | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | E | Health | corrected 2023-10-31 |
| 2023-09-27 | Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | D | Health | corrected 2023-10-30 |
| 2023-09-27 | Ensure each resident receives an accurate assessment. | D | Health | corrected 2023-10-31 |
| 2023-09-27 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Health | corrected 2023-10-31 |
| 2023-09-27 | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | D | Health | corrected 2023-10-31 |
| 2023-09-27 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | D | Health | corrected 2023-10-31 |
| 2023-09-27 | Provide and implement an infection prevention and control program. | D | complaint | corrected 2023-10-31 |
No federal fines or payment denials on record.
| Name | Role | Type | % | Since |
|---|---|---|---|---|
| EASTLAND MEMORIAL HOSPITAL DISTRICT | 5% Or Greater Direct Ownership Interest | Organization | 100% | since 03/01/2024 |
| ARZE, STEVEN | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 01/05/2021 |
| GROVER, KENNETH | Managing Control - Governing Body | Individual | NOT APPLICABLE | since 03/01/2024 |
| BURNAM, SOON | Corporate Officer | Individual | NOT APPLICABLE | since 03/01/2024 |
| KEETCH, CHAD | Corporate Officer | Individual | NOT APPLICABLE | since 03/01/2024 |
| WRIGHT, LABAN | Corporate Officer | Individual | NOT APPLICABLE | since 03/01/2024 |
| BUFFALO CREEK HEALTHCARE LLC | Operational/Managerial Control | Organization | NOT APPLICABLE | since 03/01/2024 |
| GROVER, KENNETH | Operational/Managerial Control | Individual | NOT APPLICABLE | since 03/01/2024 |
Source: CMS Provider Data Catalog (July 2026 release) — provider file, deficiency file, ownership file, penalty file. CCN 675808. Corrections: data@carerecords.org.