Staffing
CMS publishes a 1-star staffing rating for this facility.
RN staffing was 0.38 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceAsk Trust Hub Network
CMS overview
No proprietary TrustHub score. These ratings are published separately by CMS.
Facility information
CMS remains the primary federal record. Public website and additional contact details appear only when independently verified.
Decision guide
Factual evidence to examine before you decide. These summaries are not a score or recommendation.
CMS publishes a 1-star staffing rating for this facility.
RN staffing was 0.38 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceThe latest standard inspection on Feb 6, 2025 cited 11 deficiencies.
View inspection evidenceCMS-published records list 29 ownership or control parties.
CMS records show an ownership change effective March 2023.
View ownership evidenceCMS records show a $13,397 fine in the loaded enforcement dataset.
View enforcement evidence →Ownership & operation
Operator, licensee, owner, manager, and chain stay separate. A connected organization is not automatically the party that runs daily operations.
SeniorTrustHub found evidence connecting this facility to:
7 currently connected nursing homes share this CMS organization identity with MIDLAND COUNTY HOSPITAL DISTRICT.
These figures summarize currently connected CMS-certified nursing homes. Some facilities have incomplete measures; missing values are omitted, not treated as zero. Ownership structures can change. State operator or licensee evidence may differ from CMS ownership disclosures.
Ownership
These are CMS-published ownership disclosures. Medicare enrollment ownership and managerial-control information is reported by enrolled providers through CMS forms; it is not an independent determination of beneficial ownership.
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 23, 2025
Other facilities connected through this exact CMS organization identity: 0 across TX.
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Individual · CORPORATE OFFICER
Association date reported to CMS: Mar 1, 2023
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: May 6, 2026
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: May 6, 2026
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: May 6, 2026
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: May 6, 2026
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: May 6, 2026
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · Medicare-enrolled legal organization
Other facilities connected through this exact CMS organization identity: 6 across TX.
Roles are shown as CMS publishes them. Different CMS sources can describe different enrollment, ownership, and control concepts, so TrustHub keeps each source-specific disclosure distinct.
Inspections & deficiencies
Scope and severity terms below are CMS classifications. They are not a TrustHub score.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 11, 2026)
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 11, 2026)
Provide safe and appropriate respiratory care for a resident when needed.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 11, 2026)
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.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 11, 2026)
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 3, 2025)
Protect each resident from the wrongful use of the resident's belongings or money.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 3, 2025)
Respond appropriately to all alleged violations.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 3, 2025)
No health-deficiency rows were deterministically linked to this inspection.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Reasonably accommodate the needs and preferences of each resident.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Provide care and assistance to perform activities of daily living for any resident who is unable.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Provide safe and appropriate respiratory care for a resident when needed.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Provide and implement an infection prevention and control program.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 1, 2025)
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 31, 2024)
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
CMS scope/severity J: Isolated; Immediate jeopardy to resident health or safety.
Correction status: Deficient, Provider has date of correction (Jan 6, 2024)
No health-deficiency rows were deterministically linked to this inspection.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 6, 2024)
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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 6, 2024)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 6, 2024)
Provide and implement an infection prevention and control program.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 6, 2024)
No health-deficiency rows were deterministically linked to this inspection.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Nov 20, 2022)
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Nov 20, 2022)
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Nov 20, 2022)
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Nov 20, 2022)
Provide and implement an infection prevention and control program.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Nov 20, 2022)
Penalties & enforcement
Published fine amount: $13,397.00
Questions to ask
Facility history
10 historical events available. Dates and values come from published CMS and official state regulator evidence, not a score.
4 deficiencies were recorded.
CMS · Recorded event date · View related evidence
Total nurse staffing decreased from 3.65 to 3.41 hours per resident day between 2025Q2 and 2025Q3. Staffing declined across those reported periods.
3.65 → 3.41
CMS · Reported in a source release · View related evidence
3 deficiencies were recorded.
CMS · Recorded event date · View related evidence
11 deficiencies were recorded.
CMS · Recorded event date · View related evidence
1 deficiency was recorded.
CMS · Recorded event date · View related evidence
1 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
CMS recorded a $13,397 civil monetary penalty.
CMS · Recorded event date · View related evidence
4 deficiencies were recorded.
CMS · Recorded event date · View related evidence
An ownership change was recorded. New organization: MIDLAND COUNTY HOSPITAL DISTRICT.
FOURSQUARE TEXAS 16 LLC → MIDLAND COUNTY HOSPITAL DISTRICT
CMS · Recorded event date · View related evidence
5 deficiencies were recorded.
CMS · Recorded event date · View related evidence
Staffing
CMS staffing rating: 1 of 5 stars. CMS calculates that rating separately using its published methodology. The values below are calculations from daily PBJ records for 2026Q1 (current source quarter).
| Measure | Monday–Friday | Saturday–Sunday |
|---|---|---|
| Total nursing | 3.549 | 2.998 |
| RN categories | 0.399 | 0.349 |
Contract staff accounted for 0% of reported nursing hours included in this quarter calculation.
Reported RN-category hours per resident day were 0.071 higher than the prior loaded quarter.
Solid bar: Total nursing · Outlined bar: RN categories
| Quarter | Total nursing | RN categories | LPN/LVN | CNA | Contract share | Days |
|---|---|---|---|---|---|---|
| 2025Q2 | 3.645 | 0.431 | 0.905 | 2.032 | 0% | 91 |
| 2025Q3 | 3.414 | 0.384 | 0.923 | 1.84 | 0% | 92 |
| 2025Q4 | 3.289 | 0.314 | 0.916 | 1.816 | 0% | 92 |
| 2026Q1 | 3.391 | 0.385 | 0.887 | 1.885 | 0% | 90 |
Hours-per-resident-day values are calculated by this platform from CMS-published daily PBJ hours and MDS census. For each displayed period, included hours are summed and divided by the summed census for days with a positive census. They are not CMS case-mix-adjusted staffing measures or a staffing rating.
View official CMS PBJ sourceWhat we can verify today
These measures come from the current successfully ingested CMS Nursing Home Provider Information release.
Planned evidence layers
These areas require separate authoritative CMS datasets. No findings are shown until those sources are ingested and reviewed.
Trust participation
Claims, corrections, and factual context are free. Submissions never replace CMS evidence or affect ranking.
Source register
No paid placements. Facilities cannot pay to rank higher. We cite. You decide.