facebook tracking Legacy at Town Creek, Palestine TX: CMS Ratings
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Legacy at Town Creek

All states › Texas › Palestine › Legacy at Town Creek

2212 W Reagan St Palestine, TX 75801 · Anderson County

(903) 727-8500

All 4 nursing homes in Palestine, TX (4 take Medicaid)

Accepts Medicare Accepts Medicaid 199 certified beds Government

CMS certification number 675998 · See this home on Medicare Care Compare

Ratings come from CMS and are updated monthly; these are from October 2026. Check the latest inspection report and visit in person before you decide.

Is Legacy at Town Creek a good nursing home? Reviews, ratings and inspection record

There are no official resident reviews of nursing homes: Medicare's Care Compare publishes inspections, staffing and quality data instead. Here is what that record shows for Legacy at Town Creek as of October 2026.

CMS rates it 1 out of 5 stars overall, below the Texas average of 2.8. Inspectors issued 37 citations in the last three years. CMS imposed 2 penalties, including $294,608 in fines, in that time. For short-term rehab patients CMS rates quality 1 out of 5; for long-term residents, 2 out of 5.

Online reviews from families and residents are on Google Maps and other sites; they reflect individual experiences and aren't checked by CMS. The full inspection reports, including what inspectors observed, are on Medicare Care Compare.

Staffing

Nursing staff spend about 3.20 hours per resident per day at Legacy at Town Creek, about the same as the Texas median of 3.30 (US median: 3.72). About 0.19 of those hours are from registered nurses. On weekends it falls to 2.94 hours, 8% below its all-week average. 50.7% of nursing staff left within a year (Texas median 50.2%).

Nursing care per resident per day 3.20 hours
Below the Texas median of 3.30 Registered nurses, licensed practical nurses and aides combined, from payroll records.
Registered nurse hours 0.19 per resident a day RNs handle assessments, medications and changes in condition.
Weekend nursing care 2.94 hours Per resident a day. A big drop from weekdays can mean thin weekend staffing.
Nursing staff turnover 50.7% a year Share of nursing staff who left over a year. Lower usually means steadier care.
Registered nurse turnover 33.3% a year Share of registered nurses who left over a year.
Administrators who left — Frequent leadership changes are worth asking about on a visit.

About this nursing home

Certified beds199
Residents per day 81 About 40% of beds filled, on average
OwnershipGovernment - Hospital district
Payment acceptedMedicare and Medicaid
Certified sinceJanuary 2004
Part of a chainSouthwest Ltc
Legal business nameLIBERTY COUNTY HOSPITAL DISTRICT NO 1

Paying for care at Legacy at Town Creek: Medicare and Medicaid

Legacy at Town Creek is certified for both Medicare and Medicaid. Medicare Part A can cover a short skilled-nursing or rehab stay here after a qualifying hospital stay of at least three inpatient days (observation days don't count), for up to 100 days per benefit period. Medicaid can pay for long-term care for residents who meet Texas's income and asset rules. Being certified doesn't guarantee a Medicaid bed is open, so ask whether the home accepts residents whose Medicaid application is still pending.

In 2026 Medicare covers days 1–20 in full after the Part A deductible ($1,736 per benefit period); for days 21–100 you pay $217 a day; after day 100 you pay all costs. Medicare doesn't pay for long-term custodial care. Medicare's coverage rules.

Health inspections

The most recent standard inspection was on August 6, 2025 and found 4 deficiencies, plus 2 from complaint inspections in the same period. In total, inspectors issued 37 citations in the last three years.

Each citation has a scope and severity letter from A to L. A–C: potential for minimal harm. D–F: potential for more than minimal harm. G–I: actual harm. J–L: immediate jeopardy to resident health or safety.

What the inspections found

Over the last three years, inspectors issued 37 citations at Legacy at Town Creek across 7 inspection dates, 11 of them from complaint investigations. 3 were at the immediate-jeopardy level (J–L), CMS's most serious category, most recently on June 6, 2024 (complaint inspection). The most common areas cited were quality of life and care (9) and pharmacy service (6). The most serious was cited under the CMS rule to "protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody" (tag F0600, level K, June 6, 2024). 4 citations were under CMS's abuse, neglect and exploitation rules.

January 7, 2026 · 1 citation · includes complaint inspection

DImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0580 · Complaint inspection · Deficient, Provider has date of correction (Jan 8, 2026)

October 8, 2025 · 1 citation, includes actual harm · includes complaint inspection

GProvide safe and appropriate respiratory care for a resident when needed.

Actual harm · Quality of Life and Care Deficiencies · Tag F0695 · Complaint inspection · Deficient, Provider has date of correction (Oct 9, 2025)

August 6, 2025 · 4 citations

EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (Sep 10, 2025)

DProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0755 · Deficient, Provider has date of correction (Sep 10, 2025)

DHave a policy regarding use and storage of foods brought to residents by family and other visitors.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0813 · Deficient, Provider has date of correction (Sep 10, 2025)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (Sep 10, 2025)

July 31, 2024 · 7 citations · includes complaint inspection

FProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (Aug 12, 2024)

DEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0689 · Deficient, Provider has date of correction (Aug 12, 2024)

DProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0755 · Deficient, Provider has date of correction (Aug 12, 2024)

DEnsure 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.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0761 · Deficient, Provider has date of correction (Aug 12, 2024)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (Aug 12, 2024)

DMake sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0925 · Complaint inspection · Deficient, Provider has date of correction (Aug 12, 2024)

BEncode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Potential for minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0640 · Deficient, Provider has date of correction (Aug 12, 2024)

June 6, 2024 · 6 citations, includes immediate jeopardy · includes complaint inspection

KProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Immediate jeopardy · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0600 · Complaint inspection · Deficient, Provider has date of correction (Jun 7, 2024)

KDevelop and implement policies and procedures to prevent abuse, neglect, and theft.

Immediate jeopardy · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0607 · Complaint inspection · Deficient, Provider has date of correction (Jun 7, 2024)

KRespond appropriately to all alleged violations.

Immediate jeopardy · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610 · Complaint inspection · Deficient, Provider has date of correction (Jun 7, 2024)

GEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Actual harm · Quality of Life and Care Deficiencies · Tag F0689 · Complaint inspection · Deficient, Provider has date of correction (Jun 7, 2024)

ETimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 · Complaint inspection · Deficient, Provider has date of correction (Jun 7, 2024)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Complaint inspection · Deficient, Provider has date of correction (Jun 7, 2024)

January 22, 2024 · 2 citations · includes complaint inspection

EEnsure 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.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0761 · Complaint inspection · Deficient, Provider has date of correction (Feb 14, 2024)

DProvide safe and appropriate respiratory care for a resident when needed.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0695 · Complaint inspection · Deficient, Provider has date of correction (Feb 14, 2024)

April 26, 2023 · 16 citations

EEnsure that residents are fully informed and understand their health status, care and treatments.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0552 · Deficient, Provider has date of correction (May 19, 2023)

EHonor 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.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0584 · Deficient, Provider has date of correction (May 19, 2023)

ECreate and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0655 · Deficient, Provider has date of correction (May 20, 2023)

EDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Deficient, Provider has date of correction (May 16, 2023)

EProvide care and assistance to perform activities of daily living for any resident who is unable.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0677 · Deficient, Provider has date of correction (Apr 27, 2023)

EProvide safe and appropriate respiratory care for a resident when needed.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0695 · Deficient, Provider has date of correction (May 12, 2023)

EImplement 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.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0758 · Deficient, Provider has date of correction (May 19, 2023)

EMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0921 · Deficient, Provider has date of correction (May 1, 2023)

DHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0550 · Deficient, Provider has date of correction (May 12, 2023)

DDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0657 · Deficient, Provider has date of correction (May 19, 2023)

DProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0690 · Deficient, Provider has date of correction (May 15, 2023)

DProvide enough food/fluids to maintain a resident's health.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0692 · Deficient, Provider has date of correction (May 19, 2023)

DProvide safe, appropriate dialysis care/services for a resident who requires such services.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0698 · Deficient, Provider has date of correction (May 12, 2023)

DProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0755 · Deficient, Provider has date of correction (May 12, 2023)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (May 27, 2023)

DHave policies on smoking.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0926 · Deficient, Provider has date of correction (May 15, 2023)

Questions to ask on a tour of Legacy at Town Creek

  1. Inspectors cited the home at the immediate-jeopardy level on June 6, 2024 under the rule on freedom from abuse, neglect, and exploitation. What changed afterwards, and can I see the plan of correction?
  2. CMS cited the home under its abuse and neglect rules on June 6, 2024. How are staff trained, and how are concerns reported?
  3. CMS rates staffing 1 out of 5. How many residents does each nurse aide care for on day, evening and night shifts?
  4. CMS rates short-stay quality 1 out of 5. How often do rehab patients go back to the hospital, and how many therapy sessions a week are typical?
  5. The home averages about 40% of its beds filled. Are any units closed?
  6. Do you have a Medicaid bed open now, and will you admit someone whose Medicaid application is still pending?
  7. When is the first care-plan meeting, and can family attend?

Questions come from this home's CMS data: its inspections, staffing and ownership record.

Fines and payment denials

2 penalties in the last three years, including $294,608 in fines.

DateTypeAmount or length
Oct 8, 2025 Fine $10,358
Jun 6, 2024 Fine $284,250

Rating history

CMS monthOverallInspectionStaffingQuality
October 2026 1/5 2/5 1/5 2/5
August 2026 1/5 2/5 1/5 2/5
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Location

Hospitals near Legacy at Town Creek

The Medicare-certified hospitals closest to this nursing home, with their CMS data. Ask the home which hospital it usually sends residents to.

  • 1.5 mi
    Palestine Regional Medical Center Palestine
    Emergency room ★☆☆☆☆ Medicare overall 1 of 5
    Median ER visit 2h 16m for patients treated and sent home

Hospital ratings, ER visit times and more at Hospitals In Each State
Source: CMS Care Compare. Distances are approximate.

Nearby nursing homes

Trucare Living Centers Palestine · 1.7 mi away ★★★★★ Inspection 5/5 · Staffing 3/5 120 beds · Medicaid
Avir at Town Creek Palestine · 1.7 mi away ★★★☆☆ Inspection 3/5 · Staffing 3/5 102 beds · Medicaid
Greenbrier Nursing & Rehabilitation Center of Pale Palestine · 3.6 mi away ★★★★☆ Inspection 5/5 · Staffing 1/5 120 beds · Medicaid
Avir at Elkhart Elkhart · 9.6 mi away ★★★☆☆ Inspection 3/5 · Staffing 3/5 98 beds · Medicaid
Avir at Jacksonville Jacksonville · 26.2 mi away ★★★★★ Inspection 5/5 · Staffing 3/5 53 beds · Medicaid

More nursing homes near Legacy at Town Creek ›   All nursing homes in Palestine ›

Compare Legacy at Town Creek with the 3 closest homes side by side ›

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Other Southwest Ltc nursing homes in Texas

Affiliation comes from CMS's affiliated-entity data, October 2026. All 10 Southwest Ltc nursing homes ›

Source: CMS Provider Data Catalog (provider information, health deficiencies, penalties), October 2026. Inspection citations and penalties cover the last three years. Nursing Homes In Each State is independent and not affiliated with CMS or Medicare. About the data · Report a problem with this listing. Is this your nursing home? Feature it here.

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https://www.nursinghomesineachstate.com/texas/palestine/legacy-at-town-creek/ · Data: CMS, October 2026 · Nursing Homes In Each State, not affiliated with CMS or Medicare.