Government - Hospital district · 199 certified beds · CMS number 675998
Legacy at Town Creek, Palestine, TX
CMS records 37 health deficiencies at Legacy at Town Creek in Palestine, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Aug 6, 2025. The highest severity cited is K (immediate jeopardy to resident health or safety). 3 citations were at the immediate jeopardy level. CMS lists 2 fines totaling $294,608 in the last three years.
- 37deficiencies, 3 cycles (TX median 25)
- 6in the latest cycle (TX median 8)
- Khighest severity · Immediate jeopardy
- $294,608fines, last 3 years
- 1CMS overall rating (of 5)
Inspections and deficiencies
CMS findings for Legacy at Town Creek as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and Legacy at Town Creek may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare
Most recent cycle (6 deficiencies)
Standard inspection Aug 6, 2025. CMS counts 6 health deficiencies and 2 fire safety deficiencies in this cycle.
Jan 7, 2026 · Complaint inspection
1 deficiency, highest D
F580 · Telling residents and families about changes
Requirement cited (CMS): Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jan 8, 2026
Oct 8, 2025 · Complaint inspection
1 deficiency, highest G
F695 · Respiratory and oxygen care
Requirement cited (CMS): Provide safe and appropriate respiratory care for a resident when needed.
- Severity
- G Actual harm (not immediate jeopardy), isolated
- Status
- Correction date Oct 9, 2025
Aug 6, 2025 · Standard inspection
4 deficiencies, highest E
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Sep 10, 2025
F813 · Food brought in by visitors
Requirement cited (CMS): Have a policy regarding use and storage of foods brought to residents by family and other visitors.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Sep 10, 2025
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
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Sep 10, 2025
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 Sep 10, 2025
Previous cycle: 7 deficiencies (standard inspection Jul 31, 2024)
Standard inspection Jul 31, 2024. CMS counts 7 health deficiencies and 1 fire safety deficiency in this cycle.
Jul 31, 2024 · Standard + complaint inspection
7 deficiencies, highest F
F925 · Pest control
Requirement cited (CMS): Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Aug 12, 2024
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Aug 12, 2024
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 Aug 12, 2024
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 Aug 12, 2024
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 Aug 12, 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 Aug 12, 2024
F640 · Submitting assessment data on time
Requirement cited (CMS): Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
- Severity
- B No actual harm, potential for minimal harm, pattern
- Status
- Correction date Aug 12, 2024
Earlier cycle: 24 deficiencies (standard inspection Apr 26, 2023)
Standard inspection Apr 26, 2023. CMS counts 24 health deficiencies and 1 fire safety deficiency in this cycle.
Jun 6, 2024 · Complaint inspection
6 deficiencies, highest K
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 7, 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
- G Actual harm (not immediate jeopardy), isolated
- Status
- Correction date Jun 7, 2024
F610 · Investigating and responding to allegations
Requirement cited (CMS): Respond appropriately to all alleged violations.
- Severity
- K Immediate jeopardy to resident health or safety, pattern
- Status
- Correction date Jun 7, 2024
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
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jun 7, 2024
F607 · Abuse prevention policies
Requirement cited (CMS): Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- Severity
- K Immediate jeopardy to resident health or safety, pattern
- Status
- Correction date Jun 7, 2024
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
- K Immediate jeopardy to resident health or safety, pattern
- Status
- Correction date Jun 7, 2024
Jan 22, 2024 · Complaint inspection
2 deficiencies, highest E
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
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 14, 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 Feb 14, 2024
Apr 26, 2023 · Standard inspection
16 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 May 15, 2023
F921 · Safe, functional, sanitary building
Requirement cited (CMS): Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 1, 2023
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 27, 2023
F758 · Psychotropic drug safeguards
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 19, 2023
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 May 12, 2023
F698 · Dialysis care
Requirement cited (CMS): Provide safe, appropriate dialysis care/services for a resident who requires such services.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 12, 2023
F695 · Respiratory and oxygen care
Requirement cited (CMS): Provide safe and appropriate respiratory care for a resident when needed.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 12, 2023
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 May 19, 2023
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
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 15, 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 27, 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
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 19, 2023
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 16, 2023
F655 · Baseline care plan within 48 hours
Requirement cited (CMS): Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 20, 2023
F584 · Safe, clean, homelike surroundings
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 19, 2023
F552 · Being informed about health and treatment
Requirement cited (CMS): Ensure that residents are fully informed and understand their health status, care and treatments.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 19, 2023
F550 · Dignity and the right to exercise rights
Requirement cited (CMS): Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 12, 2023
Tags cited in more than one inspection
6 tags cited on more than one inspection date at Legacy at Town Creek; each date counts once and does not mean the same incident. PNC = past non-compliance.
| Tag | Inspections | Dates |
|---|---|---|
| F880 Infection prevention and control program | 4 | Aug 6, 2025; Jul 31, 2024; Jun 6, 2024; Apr 26, 2023 |
| F695 Respiratory and oxygen care | 3 | Oct 8, 2025; Jan 22, 2024; Apr 26, 2023 |
| F755 Pharmacy services and a consultant pharmacist | 3 | Aug 6, 2025; Jul 31, 2024; Apr 26, 2023 |
| F689 Accident prevention and supervision | 2 | Jul 31, 2024; Jun 6, 2024 |
| F761 Drug labeling and secure storage | 2 | Jul 31, 2024; Jan 22, 2024 |
| F812 Food safety and sanitation | 2 | Aug 6, 2025; Jul 31, 2024 |
Fines and payment denials
| Date | Type | Amount / length |
|---|---|---|
| Oct 8, 2025 | Fine | $10,358 |
| Jun 6, 2024 | Fine | $284,250 |
Staffing and CMS ratings
- Total nurse staff hours per resident per day
- 3.37 h (about the same as the Texas median of 3.27 h)
- RN hours per resident per day
- 0.27 h (below the Texas median of 0.38 h)
- Weekend nurse staff hours per resident per day
- 3.06 h
- Nursing staff turnover
- 53.8% (Texas median 52.1%)
- Administrators who left
- not reported
- CMS overall rating
- 1 of 5
- Health inspection rating
- 2 of 5
- Staffing rating
- 1 of 5
- Quality measure rating
- 2 of 5
CMS figures for Legacy at Town Creek, copied as published; Texas medians are ours.
Facility details
- Address
- 2212 W Reagan St, Palestine, TX 75801
- Phone
- (903) 727-8500
- County
- Anderson
- Accepts
- Medicare and Medicaid
- Ownership
- Government - Hospital district
- Chain (CMS)
- Southwest LTC
- Certified beds
- 199
- Average residents per day
- 77.2
- In Medicare/Medicaid since
- Jan 8, 2004
- 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 do staff track and report infections among residents? (F880, cited 4 times)
- How are oxygen equipment and breathing treatments managed and checked? (F695, cited 3 times)
- How are new medication orders filled, and how quickly can urgent medications arrive? (F755, cited 3 times)
- How does the home assess each resident's fall risk and plan to prevent falls? (F689, cited 2 times)
Other nursing homes in Palestine and the same chain
- Avir at Town Creek
Palestine · 21 deficiencies - Greenbrier Nursing & Rehabilitation Center of Pale
Palestine · 12 deficiencies - Trucare Living Centers
Palestine · 10 deficiencies - Cedar Hill Healthcare Center
Cedar Hill · 26 deficiencies - Legacy at Jacksonville
Jacksonville · 12 deficiencies - Reunion Plaza Healthcare & Rehabilitation
Tyler · 5 deficiencies
Source
CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.