For profit - Corporation · 108 certified beds · CMS number 455959
Westward Trails Nursing and Rehabilitation, Nacogdoches, TX
CMS records 24 health deficiencies at Westward Trails Nursing and Rehabilitation in Nacogdoches, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Jun 25, 2025. The highest severity cited is J (immediate jeopardy to resident health or safety). 2 citations were at the immediate jeopardy level, 2 of them recorded as past non-compliance (fixed before the inspection). CMS lists 3 fines totaling $25,036 in the last three years.
- 24deficiencies, 3 cycles (TX median 25)
- 2in the latest cycle (TX median 8)
- Jhighest severity · Immediate jeopardy
- $25,036fines, last 3 years
- 3CMS overall rating (of 5)
Inspections and deficiencies
CMS findings for Westward Trails Nursing and Rehabilitation as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and Westward Trails Nursing and Rehabilitation may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare
Most recent cycle (2 deficiencies)
Standard inspection Jun 25, 2025. CMS counts 2 health deficiencies and 1 fire safety deficiency in this cycle.
Nov 20, 2025 · Complaint inspection
1 deficiency, highest F
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- F No actual harm, potential for more than minimal harm, widespread
- Status
- Correction date Nov 21, 2025
Jun 25, 2025 · Standard + complaint inspection
1 deficiency, highest J
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection), May 28, 2025
Previous cycle: 16 deficiencies (standard inspection Apr 24, 2024)
Standard inspection Apr 24, 2024. CMS counts 16 health deficiencies and 3 fire safety deficiencies in this cycle.
May 22, 2025 · Complaint inspection
1 deficiency, highest D
F677 · Help with daily care
Requirement cited (CMS): Provide care and assistance to perform activities of daily living for any resident who is unable.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 23, 2025
Mar 31, 2025 · Complaint inspection
5 deficiencies, highest J
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 1, 2025
F690 · Bladder, bowel, and catheter care
Requirement cited (CMS): Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 1, 2025
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection), Feb 25, 2025
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 1, 2025
F600 · Freedom from abuse and neglect
Requirement cited (CMS): Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 1, 2025
Apr 24, 2024 · Standard inspection
10 deficiencies, highest E
F926 · Smoking policies
Requirement cited (CMS): Have policies on smoking.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 30, 2024
F919 · Working call system
Requirement cited (CMS): Make sure that a working call system is available in each resident's bathroom and bathing area.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 30, 2024
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 30, 2024
F695 · Respiratory and oxygen care
Requirement cited (CMS): Provide safe and appropriate respiratory care for a resident when needed.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 30, 2024
F692 · Nutrition and hydration
Requirement cited (CMS): Provide enough food/fluids to maintain a resident's health.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 30, 2024
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 30, 2024
F657 · Care plan timing and team review
Requirement cited (CMS): Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 30, 2024
F644 · Coordinating with PASARR screening
Requirement cited (CMS): Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 30, 2024
F637 · Reassessment after a significant change
Requirement cited (CMS): Assess the resident when there is a significant change in condition
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 30, 2024
F583 · Personal privacy and confidential records
Requirement cited (CMS): Keep residents' personal and medical records private and confidential.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 30, 2024
Earlier cycle: 6 deficiencies (standard inspection Mar 15, 2023)
Standard inspection Mar 15, 2023. CMS counts 6 health deficiencies and 0 fire safety deficiencies in this cycle.
Mar 15, 2023 · Standard inspection
6 deficiencies, highest E
F926 · Smoking policies
Requirement cited (CMS): Have policies on smoking.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 8, 2023
F761 · Drug labeling and secure storage
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 8, 2023
F677 · Help with daily care
Requirement cited (CMS): Provide care and assistance to perform activities of daily living for any resident who is unable.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 8, 2023
F657 · Care plan timing and team review
Requirement cited (CMS): Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 8, 2023
F638 · Quarterly assessment reviews
Requirement cited (CMS): Assure that each resident’s assessment is updated at least once every 3 months.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 8, 2023
F582 · Notice of covered and extra charges
Requirement cited (CMS): Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 8, 2023
Tags cited in more than one inspection
4 tags cited on more than one inspection date at Westward Trails Nursing and Rehabilitation; each date counts once and does not mean the same incident. PNC = past non-compliance.
| Tag | Inspections | Dates |
|---|---|---|
| F689 Accident prevention and supervision | 3 | Jun 25, 2025 (PNC); Mar 31, 2025 (PNC); Apr 24, 2024 |
| F657 Care plan timing and team review | 2 | Apr 24, 2024; Mar 15, 2023 |
| F677 Help with daily care | 2 | May 22, 2025; Mar 15, 2023 |
| F926 Smoking policies | 2 | Apr 24, 2024; Mar 15, 2023 |
Fines and payment denials
| Date | Type | Amount / length |
|---|---|---|
| Jun 25, 2025 | Fine | $14,901 |
| Mar 31, 2025 | Fine | $4,486 |
| Mar 31, 2025 | Fine | $5,649 |
Staffing and CMS ratings
- Total nurse staff hours per resident per day
- 3.27 h (about the same as the Texas median of 3.27 h)
- RN hours per resident per day
- 0.17 h (below the Texas median of 0.38 h)
- Weekend nurse staff hours per resident per day
- 2.59 h
- Nursing staff turnover
- not reported
- Administrators who left
- 1
- CMS overall rating
- 3 of 5
- Health inspection rating
- 4 of 5
- Staffing rating
- 1 of 5
- Quality measure rating
- 3 of 5
CMS figures for Westward Trails Nursing and Rehabilitation, copied as published; Texas medians are ours.
Facility details
- Address
- 3001 Westward Drive, Nacogdoches, TX 75964
- Phone
- (936) 569-2631
- County
- Nacogdoches
- Accepts
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Chain (CMS)
- Creative Solutions in Healthcare
- Certified beds
- 108
- Average residents per day
- 82.1
- In Medicare/Medicaid since
- Nov 15, 1991
- Inside a hospital
- No
- Continuing care retirement community
- No
- Resident and family council
- Resident
- Sprinklers in all required areas
- Yes
Questions to ask on a visit
Based on the tags cited most often here.
- How does the home assess each resident's fall risk and plan to prevent falls? (F689, cited 3 times)
- Who sits on the care planning team, and how are family members invited? (F657, cited 2 times)
- How often do residents who need help get assistance with bathing, grooming, and mouth care? (F677, cited 2 times)
- What is the smoking policy, and how are residents who smoke supervised? (F926, cited 2 times)
Other nursing homes in Nacogdoches and the same chain
- Stallings Court Nursing and Rehabilitation
Nacogdoches · 24 deficiencies - Willowbrook Nursing Center
Nacogdoches · 23 deficiencies - Franklin Heights Nursing & Rehabilitation
El Paso · 76 deficiencies - St. Teresa Nursing & Rehab Center
El Paso · 75 deficiencies - Mountain View Health & Rehabilitation
El Paso · 72 deficiencies - Pleasant Springs Healthcare Center
Mount Pleasant · 66 deficiencies
Source
CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.