Government - Hospital district · 76 certified beds · CMS number 675949

Avir at Cowhorn Creek, Texarkana, TX

CMS records 68 health deficiencies at Avir at Cowhorn Creek in Texarkana, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Feb 12, 2026. The highest severity cited is K (immediate jeopardy to resident health or safety). 2 citations were at the immediate jeopardy level. CMS lists 1 fine totaling $30,545 and 1 payment denial in the last three years.

Inspections and deficiencies

CMS findings for Avir at Cowhorn Creek as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and Avir at Cowhorn Creek may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare

Most recent cycle (24 deficiencies)

Standard inspection Feb 12, 2026. CMS counts 24 health deficiencies and 1 fire safety deficiency in this cycle.

Jul 29, 2026 · Complaint inspection

2 deficiencies, highest D

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 Jul 30, 2026

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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Jul 30, 2026

Jul 6, 2026 · Complaint inspection

1 deficiency, highest D

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 Jul 7, 2026

Apr 13, 2026 · Complaint inspection

1 deficiency, highest D

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 14, 2026

Feb 12, 2026 · Standard inspection

20 deficiencies, highest F

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 Feb 13, 2026

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 Feb 13, 2026

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 Feb 13, 2026

F806 · Allergies, preferences, and meal substitutes

Requirement cited (CMS): Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Feb 13, 2026

F804 · Palatable, attractive food at safe temperatures

Requirement cited (CMS): Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Feb 13, 2026

F759 · Medication error rate under 5 percent

Requirement cited (CMS): Ensure medication error rates are not 5 percent or greater.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Feb 13, 2026

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
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Feb 13, 2026

F727 · RN coverage and director of nursing

Requirement cited (CMS): Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

Severity
F No actual harm, potential for more than minimal harm, widespread
Status
Correction date Feb 13, 2026

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 Feb 13, 2026

F685 · Vision and hearing services

Requirement cited (CMS): Assist a resident in gaining access to vision and hearing services.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Feb 13, 2026

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 Feb 13, 2026

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 Feb 13, 2026

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 Feb 13, 2026

F641 · Accurate resident assessments

Requirement cited (CMS): Ensure each resident receives an accurate assessment.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Feb 13, 2026

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
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Feb 13, 2026

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 Feb 13, 2026

F636 · Full assessment at admission and yearly

Requirement cited (CMS): Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Feb 13, 2026

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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Feb 13, 2026

F565 · Resident and family councils

Requirement cited (CMS): Honor the resident's right to organize and participate in resident/family groups in the facility.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Feb 13, 2026

F558 · Accommodating individual needs and preferences

Requirement cited (CMS): Reasonably accommodate the needs and preferences of each resident.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Feb 13, 2026
Previous cycle: 28 deficiencies (standard inspection Dec 4, 2024)

Standard inspection Dec 4, 2024. CMS counts 28 health deficiencies and 0 fire safety deficiencies in this cycle.

Aug 15, 2025 · Complaint inspection

7 deficiencies, highest K

F838 · Facility-wide assessment of needs

Requirement cited (CMS): Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Aug 18, 2025

F806 · Allergies, preferences, and meal substitutes

Requirement cited (CMS): Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Aug 18, 2025

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 Aug 18, 2025

F675 · Quality of life

Requirement cited (CMS): Honor each resident's preferences, choices, values and beliefs.

Severity
K Immediate jeopardy to resident health or safety, pattern
Status
Correction date Aug 16, 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
K Immediate jeopardy to resident health or safety, pattern
Status
Correction date Aug 16, 2025

F585 · Grievances and how they are handled

Requirement cited (CMS): Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Aug 18, 2025

F561 · Making everyday choices

Requirement cited (CMS): Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Aug 18, 2025

Apr 9, 2025 · Complaint inspection

3 deficiencies, highest E

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 10, 2025

F585 · Grievances and how they are handled

Requirement cited (CMS): Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Apr 10, 2025

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
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Apr 10, 2025

Dec 4, 2024 · Standard + complaint inspection

12 deficiencies, 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 Dec 6, 2024

F809 · Meal times and snacks

Requirement cited (CMS): Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Dec 6, 2024

F804 · Palatable, attractive food at safe temperatures

Requirement cited (CMS): Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Dec 6, 2024

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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Dec 6, 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 Dec 6, 2024

F688 · Range of motion and mobility

Requirement cited (CMS): Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Dec 6, 2024

F685 · Vision and hearing services

Requirement cited (CMS): Assist a resident in gaining access to vision and hearing services.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Dec 6, 2024

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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Dec 6, 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 Dec 6, 2024

F623 · Written notice before a move

Requirement cited (CMS): Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Dec 6, 2024

F558 · Accommodating individual needs and preferences

Requirement cited (CMS): Reasonably accommodate the needs and preferences of each resident.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Dec 6, 2024

F553 · Taking part in care planning

Requirement cited (CMS): Allow resident to participate in the development and implementation of his or her person-centered plan of care.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Dec 6, 2024

Oct 29, 2024 · Complaint inspection

6 deficiencies, highest D

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 Oct 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 Nov 1, 2024

F610 · Investigating and responding to allegations

Requirement cited (CMS): Respond appropriately to all alleged violations.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Oct 30, 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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Oct 30, 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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Oct 30, 2024

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 Oct 31, 2024
Earlier cycle: 16 deficiencies (standard inspection Nov 16, 2023)

Standard inspection Nov 16, 2023. CMS counts 16 health deficiencies and 3 fire safety deficiencies in this cycle.

Mar 13, 2024 · Complaint inspection

2 deficiencies, highest D

F805 · Food prepared for individual needs

Requirement cited (CMS): Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Mar 15, 2024

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 Mar 15, 2024

Nov 16, 2023 · Standard + complaint inspection

14 deficiencies, highest E

F940 · Staff training program

Requirement cited (CMS): Develop, implement, and/or maintain an effective training program for all new and existing staff members.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Nov 17, 2023

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 Nov 17, 2023

F849 · Hospice services

Requirement cited (CMS): 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.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Nov 17, 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 Nov 17, 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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Nov 21, 2023

F712 · Required physician visits

Requirement cited (CMS): Ensure that the resident and his/her doctor meet face-to-face at all required visits.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Nov 17, 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 Nov 17, 2023

F688 · Range of motion and mobility

Requirement cited (CMS): Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Nov 17, 2023

F686 · Pressure ulcer prevention and care

Requirement cited (CMS): Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Nov 17, 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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Nov 17, 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 Nov 22, 2023

F645 · Pre-admission screening for mental disorder or intellectual disability

Requirement cited (CMS): PASARR screening for Mental disorders or Intellectual Disabilities

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Nov 22, 2023

F641 · Accurate resident assessments

Requirement cited (CMS): Ensure each resident receives an accurate assessment.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Nov 17, 2023

F575 · Posting agency and advocate contacts

Requirement cited (CMS): Post a list of names, addresses, and telephone numbers of all pertinent State agencies and advocacy groups and a statement that the resident may file a complaint with the State Survey Agency.

Severity
C No actual harm, potential for minimal harm, widespread
Status
Correction date Nov 17, 2023

Tags cited in more than one inspection

18 tags cited on more than one inspection date at Avir at Cowhorn Creek; each date counts once and does not mean the same incident. PNC = past non-compliance.

TagInspectionsDates
F689 Accident prevention and supervision4Jul 29, 2026; Jul 6, 2026; Feb 12, 2026; Oct 29, 2024
F550 Dignity and the right to exercise rights3Apr 9, 2025; Oct 29, 2024; Mar 13, 2024
F600 Freedom from abuse and neglect3Aug 15, 2025; Apr 9, 2025; Oct 29, 2024
F656 Comprehensive person-centered care plan3Jul 29, 2026; Feb 12, 2026; Nov 16, 2023
F677 Help with daily care3Feb 12, 2026; Aug 15, 2025; Nov 16, 2023
F880 Infection prevention and control program3Feb 12, 2026; Oct 29, 2024; Nov 16, 2023
F558 Accommodating individual needs and preferences2Feb 12, 2026; Dec 4, 2024
F585 Grievances and how they are handled2Aug 15, 2025; Apr 9, 2025
F640 Submitting assessment data on time2Feb 12, 2026; Dec 4, 2024
F641 Accurate resident assessments2Feb 12, 2026; Nov 16, 2023
F685 Vision and hearing services2Feb 12, 2026; Dec 4, 2024
F688 Range of motion and mobility2Dec 4, 2024; Nov 16, 2023
F692 Nutrition and hydration2Dec 4, 2024; Nov 16, 2023
F755 Pharmacy services and a consultant pharmacist2Apr 13, 2026; Feb 12, 2026
F758 Psychotropic drug safeguards2Dec 4, 2024; Nov 16, 2023
F804 Palatable, attractive food at safe temperatures2Feb 12, 2026; Dec 4, 2024
F806 Allergies, preferences, and meal substitutes2Feb 12, 2026; Aug 15, 2025
F812 Food safety and sanitation2Feb 12, 2026; Dec 4, 2024

Fines and payment denials

DateTypeAmount / length
Aug 15, 2025Fine$30,545
Aug 15, 2025Payment Denial5 days from Sep 13, 2025

Staffing and CMS ratings

Total nurse staff hours per resident per day
3.26 h (about the same as the Texas median of 3.27 h)
RN hours per resident per day
0.38 h (about the same as the Texas median of 0.38 h)
Weekend nurse staff hours per resident per day
2.93 h
Nursing staff turnover
68.2% (Texas median 52.1%)
Administrators who left
0
CMS overall rating
1 of 5
Health inspection rating
1 of 5
Staffing rating
1 of 5
Quality measure rating
3 of 5

CMS figures for Avir at Cowhorn Creek, copied as published; Texas medians are ours.

Facility details

Address
5524 Cowhorn Creek, Texarkana, TX 75503
Phone
(903) 223-1188
County
Bowie
Accepts
Medicare and Medicaid
Ownership
Government - Hospital district
Chain (CMS)
Avir Health Group
Certified beds
76
Average residents per day
67.8
In Medicare/Medicaid since
Dec 16, 2002
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 4 times)
  • How do staff learn about and respect each resident's personal routines and choices? (F550, cited 3 times)
  • How does the home screen, train, and supervise staff to protect residents? (F600, cited 3 times)
  • How are a resident's goals and preferences written into the care plan? (F656, cited 3 times)

Other nursing homes in Texarkana and the same chain

Source

CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.

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