Home›Browse›Texas›Texarkana›Avir At Cowhorn Creek

Nursing homeFAID #14380

Avir At Cowhorn Creek

5524 COWHORN CREEK, TEXARKANA, TX, 75503

(903) 223-1188

76 licensed beds

CMS rates Avir At Cowhorn Creek 1 out of 5 overall. Federal inspectors issued 73 citations across 16 inspections in the last three years, with $30,545 in fines. Listing last updated 2026-11-06.

★★★★★1/5CMS Five-Star overall1/5 health inspections1/5 staffing3/5 quality measuresSource: CMS Care Compare

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Address

5524 Cowhorn Creek

Texarkana, TX 75503

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Public record summary

What we can show you for free.

Bed capacity

CMS facility ID

675949

Care type

Nursing home

County

Bowie

Facility name

Avir At Cowhorn Creek

Street address

5524 COWHORN CREEK

City / state / ZIP

Texarkana, TX 75503

Phone

(903) 223-1188

About this facility — Avir At Cowhorn Creek

Avir At Cowhorn Creek is a Medicare/Medicaid-certified skilled nursing facility in Texarkana, Texas. It is licensed for 76 beds — below the median for skilled nursing facilities in Texas (120 beds).

It is one of 24 senior care facilities in Texarkana and 1,179 skilled nursing facilities across Texas. Families comparing options should weigh inspection history, ownership record, and litigation — not just the tour — before deciding.

It is listed as part of Avir Health Group, a group of 118 facilities on this site.

Federal inspectors have cited Avir At Cowhorn Creek 73 times across 16 inspections in the last three years, including 9 food-safety citations, and CMS has imposed $30,545 in fines. Every citation is listed, dated, and graded in the inspection record below.

This listing draws on federal CMS Nursing Home Compare records, and was last updated on November 6, 2026. Background reports are compiled from primary sources — state inspection files, federal CMS data, corporate registrations, and court records — at the time of order.

Facility background

What the public record shows.

Ownership & operator

Parent company

Avir Health Group

Ownership type

Government - Hospital district

Registered owners & officers

Guadalupe County Hospital Board

Direct owner — 100% stake — since 2025

5524 Cowhorn Creek Opco Llc

Operational control — since 2025

5524 Cowhorn Creek Property Owner, Llc

Additional disclosable party — since 2025

Betts, Britney

Additional disclosable party — since 2025

Dagan, Amitai

Owner of a disclosable party — since 2025

Ferguson, Clay

Additional disclosable party — since 2025

Freund, Nochum

Owner of a disclosable party — since 2025

Gann, Kody

Officer — since 2025

Goldberger, Abraham

Owner of a disclosable party — since 2025

Goldberger, Faigy

Owner of a disclosable party — since 2025

Travitsky, Aaron

Operational control — since 2025

Welltower Inc

Additional disclosable party — since 2025

Welltower Nnn Group, Llc

Additional disclosable party — since 2025

Welltower Op Llc

Additional disclosable party — since 2025

Regulatory standing

Licensed / certified since

2002-12-16

CMS overall rating

1 of 5 stars

Health deficiencies

25 at the last standard inspection

Federal fines

$30,545 total

Last standard inspection

2026-02-12

Nurse staffing

3.2 hours per resident per day

Cost & payer profile (FY2023 cost report)

Average billed charges

$193 per day (≈ $5,870/month). Private-pay prices typically track billed charges; Medicare and Medicaid pay set rates.

Payer mix (resident days)

36% Medicaid · 18% Medicare · 47% private/other

Occupancy

80% (fiscal year 2023)

Vs. state median

30% below the TX median of $277/day — full state cost breakdown

Services & coverage

Licensed beds

Medicare

Accepted

Medicaid

Accepted

Compiled from CMS Nursing Home Compare; owners/officers from the CMS Ownership dataset; cost & occupancy from the facility's own CMS cost report · last verified 2026-11-06. Facilities can submit a correction.

Inspection record

Every citation, dated and graded.

Kitchen & food safety

Federal surveyors inspect the kitchen at every standard visit. This facility has 9 food-safety citations on its three-year record — flagged below among the inspections.

2026-08-14Health inspectionComplaint-triggered1 citation

F-0842

D · No harm foundFrom a complaint

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Corrected 2026-08-15

2026-07-29Health inspectionComplaint-triggered2 citations

F-0656

D · No harm foundFrom a complaint

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

Corrected 2026-07-30

F-0689

D · No harm foundFrom a complaint

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

Corrected 2026-07-30

11 earlier / fire-safety inspections (70 citations)

2026-07-06Health inspectionComplaint-triggered1 citation

F-0689

D · No harm foundFrom a complaint

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

Corrected 2026-07-07

2026-04-13Health inspectionComplaint-triggered1 citation

F-0755

D · No harm foundFrom a complaint

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

Corrected 2026-04-14

2026-02-12Health inspection20 citations

F-0558

D · No harm found

Reasonably accommodate the needs and preferences of each resident.

Corrected 2026-02-13

F-0565

D · No harm found

Honor the resident's right to organize and participate in resident/family groups in the facility.

Corrected 2026-02-13

F-0582

D · No harm found

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Corrected 2026-02-13

F-0636

E · No harm found

Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

Corrected 2026-02-13

F-0637

D · No harm found

Assess the resident when there is a significant change in condition

Corrected 2026-02-13

F-0640

E · No harm found

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

Corrected 2026-02-13

F-0641

D · No harm found

Ensure each resident receives an accurate assessment.

Corrected 2026-02-13

F-0644

D · No harm found

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Corrected 2026-02-13

F-0656

E · No harm found

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

Corrected 2026-02-13

F-0677

D · No harm found

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

Corrected 2026-02-13

F-0685

D · No harm found

Assist a resident in gaining access to vision and hearing services.

Corrected 2026-02-13

F-0689

D · No harm found

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

Corrected 2026-02-13

F-0727

F · No harm found

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.

Corrected 2026-02-13

F-0755

E · No harm found

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

Corrected 2026-02-13

F-0759

D · No harm found

Ensure medication error rates are not 5 percent or greater.

Corrected 2026-02-13

F-0804

E · No harm foundFood safety

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Corrected 2026-02-13

F-0806

D · No harm foundFood safety

Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.

Corrected 2026-02-13

F-0812

F · No harm foundFood safety

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

Corrected 2026-02-13

F-0813

D · No harm foundFood safety

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

Corrected 2026-02-13

F-0880

E · No harm found

Provide and implement an infection prevention and control program.

Corrected 2026-02-13

2025-08-15Health inspectionComplaint-triggered7 citations

F-0561

D · No harm foundFrom a complaint

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Corrected 2025-08-18

F-0585

E · No harm foundFrom a complaint

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.

Corrected 2025-08-18

F-0600

K · Immediate jeopardyFrom a complaint

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

Corrected 2025-08-16

F-0675

K · Immediate jeopardyFrom a complaint

Honor each resident's preferences, choices, values and beliefs.

Corrected 2025-08-16

F-0677

D · No harm foundFrom a complaint

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

Corrected 2025-08-18

F-0806

D · No harm foundFood safetyFrom a complaint

Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.

Corrected 2025-08-18

F-0838

D · No harm foundFrom a complaint

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.

Corrected 2025-08-18

2025-04-09Health inspectionComplaint-triggered3 citations

F-0550

E · No harm foundFrom a complaint

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

Corrected 2025-04-10

F-0585

D · No harm foundFrom a complaint

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.

Corrected 2025-04-10

F-0600

D · No harm foundFrom a complaint

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

Corrected 2025-04-10

2024-12-04Health inspectionComplaint-triggered12 citations

F-0553

E · No harm found

Allow resident to participate in the development and implementation of his or her person-centered plan of care.

Corrected 2024-12-06

F-0558

D · No harm found

Reasonably accommodate the needs and preferences of each resident.

Corrected 2024-12-06

F-0623

D · No harm found

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Corrected 2024-12-06

F-0640

B · No harm found

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

Corrected 2024-12-06

F-0655

D · No harm found

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

Corrected 2024-12-06

F-0685

D · No harm foundFrom a complaint

Assist a resident in gaining access to vision and hearing services.

Corrected 2024-12-06

F-0688

D · No harm found

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.

Corrected 2024-12-06

F-0692

D · No harm found

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

Corrected 2024-12-06

F-0758

D · No harm found

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.

Corrected 2024-12-06

F-0804

E · No harm foundFood safety

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Corrected 2024-12-06

F-0809

E · No harm foundFood safety

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.

Corrected 2024-12-06

F-0812

F · No harm foundFood safety

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

Corrected 2024-12-06

2024-10-29Health inspectionComplaint-triggered6 citations

F-0550

D · No harm foundFrom a complaint

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

Corrected 2024-10-31

F-0600

D · No harm foundFrom a complaint

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

Corrected 2024-10-30

F-0609

D · No harm foundFrom a complaint

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

Corrected 2024-10-30

F-0610

D · No harm foundFrom a complaint

Respond appropriately to all alleged violations.

Corrected 2024-10-30

F-0689

D · No harm foundFrom a complaint

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

Corrected 2024-11-01

F-0880

D · No harm foundFrom a complaint

Provide and implement an infection prevention and control program.

Corrected 2024-10-30

2024-03-13Health inspectionComplaint-triggered2 citations

F-0550

D · No harm foundFrom a complaint

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

Corrected 2024-03-15

F-0805

D · No harm foundFood safetyFrom a complaint

Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

Corrected 2024-03-15

2023-11-16Health inspectionComplaint-triggered14 citations

F-0575

C · No harm foundFrom a complaint

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.

Corrected 2023-11-17

F-0641

D · No harm found

Ensure each resident receives an accurate assessment.

Corrected 2023-11-17

F-0645

D · No harm found

PASARR screening for Mental disorders or Intellectual Disabilities

Corrected 2023-11-22

F-0656

E · No harm found

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

Corrected 2023-11-22

F-0677

D · No harm found

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

Corrected 2023-11-17

F-0686

D · No harm found

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2023-11-17

F-0688

D · No harm found

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.

Corrected 2023-11-17

F-0692

D · No harm found

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

Corrected 2023-11-17

F-0712

E · No harm found

Ensure that the resident and his/her doctor meet face-to-face at all required visits.

Corrected 2023-11-17

F-0758

D · No harm found

Corrected 2023-11-21

F-0761

D · No harm found

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.

Corrected 2023-11-17

F-0849

D · No harm found

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.

Corrected 2023-11-17

F-0880

E · No harm foundFrom a complaint

Provide and implement an infection prevention and control program.

Corrected 2023-11-17

F-0940

D · No harm found

Develop, implement, and/or maintain an effective training program for all new and existing staff members.

Corrected 2023-11-17

2026-02-12Fire-safety inspection1 citation

K-0321

E · No harm found

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Corrected 2026-02-11

2023-11-16Fire-safety inspection3 citations

K-0353

D · No harm found

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2024-02-19

K-0372

E · No harm found

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Corrected 2024-02-08

K-0923

D · No harm found

Have proper medical gas storage and administration areas.

Corrected 2024-02-08

Federal penalties

2025-08-15Fine$30,545

2025-08-15Medicare payment denial — 5 days

Citations and penalties from the CMS Provider Data Catalog (three-year survey window, refreshed monthly). Severity codes follow the federal scope/severity grid; “Immediate jeopardy” is the most serious grade CMS issues. CCN 675949.

Quality of care & staffing

How it compares in Texas.

Inspection citations, 3 years

More than 95% of nursing homes in the state

State median: 33

Federal fines, 3 years

$30,545

More than 65% of nursing homes in the state

State median: $15,642

Nurse staffing, hours per resident per day

3.2

Higher than 33% of nursing homes in the state

State median: 3.3

Nursing staff turnover, annual

64%

Higher than 82% of nursing homes in the state

State median: 50%

Resident outcomes

On 21 federal quality measures, this facility does better than the Texas average on 11 and worse on 5. Differences within 10% of the average are shown as near average.

Long-stay residents	This facility	State	US	Compared with state
Need for help with daily activities has increased	24.7%	15.8%	13.5%	Worse than state
Lose too much weight	0.6%	2.9%	5.1%	Better than state
With a catheter inserted and left in their bladder	0.0%	0.3%	0.7%	Better than state
With a urinary tract infection	1.8%	0.8%	1.5%	Worse than state
Have depressive symptoms	0.5%	2.3%	13.5%	Better than state
Were physically restrained	0.0%	0.0%	0.1%	Better than state
Experiencing one or more falls with major injury	0.9%	3.2%	3.2%	Better than state
Assessed and appropriately given the pneumococcal vaccine	96.5%	96.4%	93.7%	Near state average
Ability to walk independently worsened	20.6%	12.9%	12.7%	Worse than state
Received an antianxiety or hypnotic medication	19.8%	17.8%	19.5%	Worse than state
Assessed and appropriately given the seasonal influenza vaccine	100.0%	97.0%	95.3%	Near state average
With pressure ulcers	3.4%	3.7%	4.5%	Near state average
With new or worsened bowel or bladder incontinence	11.4%	12.5%	18.3%	Near state average
Received an antipsychotic medication	1.8%	9.8%	15.4%	Better than state
Hospitalizations per 1000 long-stay resident days	2.54	2.05	1.81	Worse than state
Outpatient emergency department visits per 1000 long-stay resident days	1.78	1.97	1.69	Near state average

Short-stay residents	This facility	State	US	Compared with state
Assessed and appropriately given the pneumococcal vaccine	98.4%	88.7%	82.3%	Better than state
Newly received an antipsychotic medication	0.0%	1.4%	1.5%	Better than state
Were assessed and appropriately given the seasonal influenza vaccine	96.9%	85.4%	80.1%	Better than state
Were rehospitalized after a nursing home admission	19.8%	25.5%	23.4%	Better than state
Had an outpatient emergency department visit	9.2%	12.2%	11.8%	Better than state

Source: CMS MDS and Medicare claims quality measures, measure period 2025Q3-2026Q2. Averages are computed from all nursing homes reporting each measure.

Cited more than once

The same rule cited at separate inspections can point to a problem that wasn't fully fixed.

F-0689 4 inspections. Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F-0656 3 inspections. Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
F-0677 3 inspections. Provide care and assistance to perform activities of daily living for any resident who is unable.
F-0880 3 inspections. Provide and implement an infection prevention and control program.
F-0600 3 inspections. Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
F-0550 3 inspections. Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

What its owners also hold

Guadalupe County Hospital Board has an ownership stake on file at 27 nursing homes, averaging 2.2 of 5 on CMS's overall rating.

Source: CMS ownership filings. Shows organizations with an ownership stake; people are left out.

Verify & compare

Where to check, and what's nearby.

Who to contact in Texas

Licensing: Texas Health and Human Services
File a complaint: 800-458-9858 · Online
Long-Term Care Ombudsman: 800-252-2412. A free advocate for residents and families.
Adult Protective Services: 800-252-5400. Some states send facility cases to licensing instead. In an emergency, call 911.
Eldercare Locator: 800-677-1116, a federal service for local aging help.

Nearest emergency hospitals

Christus St Michael Health System, about 0.7 miles. CMS rating 3 of 5.
Wadley Regional Medical Center, about 3.5 miles.
Little River Memorial Hospital, about 14 miles.

Source: CMS Hospital General Information. Straight-line distance.

Nearby facilities with inspection records

Cornerstone Retirement Community, Texarkana, about 0.9 miles. CMS rating 4 of 5.
Reunion Plaza Senior Care and Rehabilitation Center, Texarkana, about 1.0 miles. CMS rating 1 of 5.
Avir At Texarkana, Texarkana, about 1.6 miles. CMS rating 1 of 5.
The Villa At Texarkana, Texarkana, about 1.7 miles. CMS rating 3 of 5.
Heritage Plaza Nursing Center, Texarkana, about 1.8 miles. CMS rating 3 of 5.

Inside your report

What unlocks when you order.

Ownership & corporate history

Primary tier

Prior operators & transfers

Corporate network & affiliates

Owners' other facilities

· · 2 more

Inspection citations — last 5 years

Locked

The 73 citations above are shown free. The report takes each one and explains it in plain English — what the tag requires, how serious the scope/severity grade really is, whether it recurred across surveys — plus the five-year pattern a single inspection can't show.

Civil & criminal lawsuits

Advanced tier only

Active civil suits

Federal dockets

CDC infection data

Unlock the full file

Citations, owner history, lawsuits — decoded into one PDF.

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Original records

Sources we pull for this facility.

Source

CMS Nursing Home Compare

data.cms.gov Provider Data Catalog

Last verified 2026-11-06

Source

Secretary of State filings

Entity & officer search

Pulled when a report is ordered

Source

PACER federal dockets

pacer.uscourts.gov

Pulled when a report is ordered