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Last checked October 26, 2026 · 2,911 nursing homes and 3,257 assisted living licenses in 5 states · CMS data processed September 1, 2026

Home › Texas › Bowie County › Avir at Cowhorn Creek

Avir at Cowhorn Creek

5524 Cowhorn Creek, Texarkana, TX 75503 · CMS Certification Number (CCN) 675949

At a glance

CMS overall rating
★☆☆☆☆ 1 of 5
Health inspection citations
68 in the last 3 inspection cycles (2 immediate jeopardy, 0 actual harm, 25 from complaints)
Fire safety citations
4
Fines (last 3 years)
1 fine, total $30,545
Payment denials
1
Most recent standard inspection
February 12, 2026
Official record
Medicare Care Compare page for this facility

Source: CMS Nursing Home Provider Information: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

CMS star ratings

CMS rates every Medicare- and Medicaid-certified nursing home from 1 to 5 stars. Health inspection stars are relative to other homes in the same state: the top 10% get 5 stars and the bottom 20% get 1 star. CMS says to use the ratings together with other information, including a visit. Technical Users’ Guide

RatingThis facilityTexas averageU.S. average
Overall★☆☆☆☆ 1 of 52.73
Health inspections★☆☆☆☆ 1 of 52.82.8
Staffing★☆☆☆☆ 1 of 51.92.9
Quality measures★★★☆☆ 3 of 53.73.6
Long-stay quality★★★★☆ 4 of 5Not publishedNot published
Short-stay quality★★★☆☆ 3 of 5Not publishedNot published

Averages: CMS State and US Averages: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Health inspections

Inspection cycleStandard survey dateHealth citationsFrom standard surveyFrom complaints
Cycle 1 (most recent)February 12, 202624204
Cycle 2December 4, 2024321221

CMS weighted health inspection score: 207.5 (lower is better; it counts citation severity, complaints and repeat revisits). Citations from infection control inspections: Not published. How to read these citations

68 health citations across 10 inspection dates, newest first. The letter is CMS’s scope/severity code: A–C means potential for minimal harm, D–F potential for more than minimal harm, G–I actual harm, and J–L immediate jeopardy.

July 29, 2026: 2 citations (Complaint)
SeverityTagWhat was citedTypeStatus
D F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 07/30/2026
D F-0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 07/30/2026
July 6, 2026: 1 citation (Complaint)
SeverityTagWhat was citedTypeStatus
D F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 07/07/2026
April 13, 2026: 1 citation (Complaint)
SeverityTagWhat was citedTypeStatus
D F-0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 04/14/2026
February 12, 2026: 20 citations (Standard)
SeverityTagWhat was citedTypeStatus
E F-0880 Provide and implement an infection prevention and control program.
Infection Control Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0813 Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Nutrition and Dietary Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
F F-0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0806 Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Nutrition and Dietary Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
E F-0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0759 Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
E F-0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
F F-0727 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.
Nursing and Physician Services Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0685 Assist a resident in gaining access to vision and hearing services.
Quality of Life and Care Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0677 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
E F-0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0644 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0641 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
E F-0640 Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0637 Assess the resident when there is a significant change in condition
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
E F-0636 Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0582 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0565 Honor the resident's right to organize and participate in resident/family groups in the facility.
Resident Rights Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
D F-0558 Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies
Standard Deficient, Provider has date of correction
Corrected 02/13/2026
August 15, 2025: 7 citations (Complaint)
SeverityTagWhat was citedTypeStatus
D F-0838 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.
Administration Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 08/18/2025
D F-0806 Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Nutrition and Dietary Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 08/18/2025
D F-0677 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 08/18/2025
K F-0675 Honor each resident's preferences, choices, values and beliefs.
Quality of Life and Care Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 08/16/2025
K F-0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 08/16/2025
E F-0585 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.
Resident Rights Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 08/18/2025
D F-0561 Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Resident Rights Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 08/18/2025
April 9, 2025: 3 citations (Complaint)
SeverityTagWhat was citedTypeStatus
D F-0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 04/10/2025
D F-0585 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.
Resident Rights Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 04/10/2025
E F-0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 04/10/2025
December 4, 2024: 12 citations (Standard + Complaint)
SeverityTagWhat was citedTypeStatus
F F-0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
E F-0809 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.
Nutrition and Dietary Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
E F-0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
D F-0758 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.
Pharmacy Service Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
D F-0692 Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
D F-0688 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.
Quality of Life and Care Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
D F-0685 Assist a resident in gaining access to vision and hearing services.
Quality of Life and Care Deficiencies
Standard + Complaint Deficient, Provider has date of correction
Corrected 12/06/2024
D F-0655 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
B F-0640 Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
D F-0623 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
D F-0558 Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
E F-0553 Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Resident Rights Deficiencies
Standard Deficient, Provider has date of correction
Corrected 12/06/2024
October 29, 2024: 6 citations (Complaint)
SeverityTagWhat was citedTypeStatus
D F-0880 Provide and implement an infection prevention and control program.
Infection Control Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 10/30/2024
D F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 11/01/2024
D F-0610 Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 10/30/2024
D F-0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 10/30/2024
D F-0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 10/30/2024
D F-0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 10/31/2024
March 13, 2024: 2 citations (Complaint)
SeverityTagWhat was citedTypeStatus
D F-0805 Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Nutrition and Dietary Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 03/15/2024
D F-0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies
Complaint Deficient, Provider has date of correction
Corrected 03/15/2024
November 16, 2023: 14 citations (Standard + Complaint)
SeverityTagWhat was citedTypeStatus
D F-0940 Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Administration Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/17/2023
E F-0880 Provide and implement an infection prevention and control program.
Infection Control Deficiencies
Standard + Complaint Deficient, Provider has date of correction
Corrected 11/17/2023
D F-0849 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.
Administration Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/17/2023
D F-0761 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.
Pharmacy Service Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/17/2023
D F-0758 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.
Pharmacy Service Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/21/2023
E F-0712 Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Nursing and Physician Services Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/17/2023
D F-0692 Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/17/2023
D F-0688 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.
Quality of Life and Care Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/17/2023
D F-0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/17/2023
D F-0677 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/17/2023
E F-0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/22/2023
D F-0645 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/22/2023
D F-0641 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies
Standard Deficient, Provider has date of correction
Corrected 11/17/2023
C F-0575 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.
Resident Rights Deficiencies
Standard + Complaint Deficient, Provider has date of correction
Corrected 11/17/2023

Source: CMS Health Deficiencies: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Fire safety inspections

4 fire safety citations across 2 inspection dates
DateSeverityTagWhat was citedStatus
02/12/2026EK-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Smoke Deficiencies
Deficient, Provider has date of correction
Corrected 02/11/2026
11/16/2023DK-0923Have proper medical gas storage and administration areas.
Gas, Vacuum, and Electrical Systems Deficiencies
Deficient, Provider has date of correction
Corrected 02/08/2024
11/16/2023EK-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Smoke Deficiencies
Deficient, Provider has date of correction
Corrected 02/08/2024
11/16/2023DK-0353Inspect, test, and maintain automatic sprinkler systems.
Smoke Deficiencies
Deficient, Provider has date of correction
Corrected 02/19/2024

Automatic sprinklers in all required areas: Yes. CMS does not count fire safety citations in the health inspection star rating.

Source: CMS Fire Safety Deficiencies: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Penalties

DateTypeFine amountPayment denial
August 15, 2025Fine$30,545—
August 15, 2025Payment Denial—Starting September 13, 2025, 5 days

Source: CMS Penalties: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Staffing

MeasureThis facilityTexas averageU.S. average
Total nurse staff hours per resident per day3.263.393.86
Registered nurse (RN) hours per resident per day0.380.430.69
LPN/LVN hours per resident per day0.94Not publishedNot published
Nurse aide hours per resident per day1.94Not publishedNot published
Total nurse staff hours per resident per day, weekends2.93Not publishedNot published
RN hours per resident per day, weekends0.32Not publishedNot published
Total nursing staff turnover (%)68.255.345.8
Registered nurse turnover (%)Staffing data did not meet the criteria required to calculate a turnover measure.Not publishedNot published
Administrators who have left0Not publishedNot published

Reported hours come from the Payroll-Based Journal (PBJ) staffing data that facilities submit to CMS each quarter.

Source: CMS Provider Information; State and US Averages: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Facility details

Legal business name
Guadalupe County Hospital Board
Ownership type
Government - Hospital district
Chain
Avir Health Group (118 facilities)
Ownership changed in last 12 months
No
Certified beds
76
Average residents per day
67.8
Participates in
Medicare and Medicaid
Located inside a hospital
No
Continuing care retirement community
No
Resident and family council
Resident
First approved for Medicare/Medicaid
December 16, 2002
County/parish
Bowie

Source: CMS Provider Information: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Owners and managers reported to CMS

14 ownership and management records
NameRoleTypeOwnership %Since
GUADALUPE COUNTY HOSPITAL BOARD5% OR GREATER DIRECT OWNERSHIP INTERESTOrganization100%undefined undefined, NaN
GANN, KODYCORPORATE OFFICERIndividualNOT APPLICABLEundefined undefined, NaN
5524 COWHORN CREEK OPCO LLCOPERATIONAL/MANAGERIAL CONTROLOrganizationNOT APPLICABLEundefined undefined, NaN
TRAVITSKY, AARONOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEundefined undefined, NaN
DAGAN, AMITAIINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFIndividualNOT APPLICABLEundefined undefined, NaN
FREUND, NOCHUMINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFIndividualNOT APPLICABLEundefined undefined, NaN
GOLDBERGER, ABRAHAMINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFIndividualNOT APPLICABLEundefined undefined, NaN
GOLDBERGER, FAIGYINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFIndividualNOT APPLICABLEundefined undefined, NaN
5524 COWHORN CREEK PROPERTY OWNER, LLCADP OF THE SNFOrganizationNOT APPLICABLEundefined undefined, NaN
WELLTOWER INCADP OF THE SNFOrganizationNOT APPLICABLEundefined undefined, NaN
WELLTOWER NNN GROUP, LLCADP OF THE SNFOrganizationNOT APPLICABLEundefined undefined, NaN
WELLTOWER OP, LLCADP OF THE SNFOrganizationNOT APPLICABLEundefined undefined, NaN
BETTS, BRITNEYADP OF THE SNFIndividualNOT APPLICABLEundefined undefined, NaN
FERGUSON, CLAYADP OF THE SNFIndividualNOT APPLICABLEundefined undefined, NaN

Source: CMS Ownership: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Check it yourself

Page built from CMS data files processed September 1, 2026 (CMS refreshes monthly). Last checked October 26, 2026. Not a ranking or endorsement.