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Nursing homeFAID #14415

Legacy At Town Creek

2212 W REAGAN ST, PALESTINE, TX, 75801
(903) 727-8500
www.legacytowncreek.com
199 licensed beds

CMS rates Legacy At Town Creek 1 out of 5 overall. Federal inspectors issued 41 citations across 11 inspections in the last three years, with $294,608 in fines. Listing last updated 2026-11-06.

★★★★★1/5CMS Five-Star overall2/5 health inspections1/5 staffing2/5 quality measuresSource: CMS Care Compare

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Photo via Google · Legacy at Town Creek

Public record summary

What we can show you for free.
Bed capacity
199
CMS facility ID
675998
Care type
Nursing home
County
Anderson
Facility name
Legacy At Town Creek
Street address
2212 W REAGAN ST
City / state / ZIP
Palestine, TX 75801
Phone
(903) 727-8500
Website
www.legacytowncreek.com

About this facility — Legacy At Town Creek

Legacy At Town Creek is a Medicare/Medicaid-certified skilled nursing facility in Palestine, Texas. It is licensed for 199 beds — well above the median for skilled nursing facilities in Texas (120 beds).

It is one of 7 senior care facilities in Palestine 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 Southwest Ltc, a group of 10 facilities on this site.

Federal inspectors have cited Legacy At Town Creek 41 times across 11 inspections in the last three years, including 3 food-safety citations, and CMS has imposed $294,608 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
Southwest Ltc
Ownership type
Government - Hospital district

Registered owners & officers

Liberty County Hospital District No 1
Direct owner — 100% stake — since 2018
Adewale, Adebayo
Operational control · Additional disclosable party — since 2025
Bauder Family Investments, Llc
Additional disclosable party — since 2025
Bauder, Kelly
Additional disclosable party — since 2025
Bauder, Madison
Additional disclosable party — since 2025
Bauder, Parker
Additional disclosable party — since 2025
Bauder, William
Additional disclosable party — since 2025
Boulware St James Llc
Additional disclosable party — since 2025
Boulware, Douglas
Owner of a disclosable party — since 2026
Boulware, Sandra
Owner of a disclosable party — since 2026
Boulware, Steven
Additional disclosable party — since 2025
Boulware, Thomas
Additional disclosable party — since 2025
Franklin, Bradley
Operational control · Additional disclosable party — since 2025
Pmg Opco- Palestine Llc
Operational control — since 2025
Pmg Realco- Palestine Llc
Additional disclosable party — since 2025
Steven Boulware Family Investments Llc
Additional disclosable party — since 2025
Stratton, Charles
Officer — since 2018
Walker, Katie
Additional disclosable party — since 2025

Regulatory standing

Federal court records
10 naming its parent company — view the cases (a listed case is not a finding of wrongdoing)
Licensed / certified since
2004-01-08
CMS overall rating
1 of 5 stars
Health deficiencies
6 at the last standard inspection
Federal fines
$294,608 total
Last standard inspection
2025-08-06
Nurse staffing
3.2 hours per resident per day

Cost & payer profile (FY2023 cost report)

Average billed charges
$364 per day (≈ $11,070/month). Private-pay prices typically track billed charges; Medicare and Medicaid pay set rates.
Payer mix (resident days)
61% Medicaid · 8% Medicare · 31% private/other
Occupancy
43% (fiscal year 2023)
Vs. state median
31% above the TX median of $277/day — full state cost breakdown

Services & coverage

Licensed beds
199
Medicare
Accepted
Medicaid
Accepted
Wheelchair accessible
entrance and parking
Visiting hours
Daily Open 24 hours
Compiled from CMS Nursing Home Compare; owners/officers from the CMS Ownership dataset; cost & occupancy from the facility's own CMS cost report; hours/accessibility via Google · 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 3 food-safety citations on its three-year record — flagged below among the inspections.
2026-01-07Health inspectionComplaint-triggered1 citation
F-0580
D · No harm foundFrom a complaint
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2026-01-08
2025-10-08Health inspectionComplaint-triggered1 citation
F-0695
G · Actual harmFrom a complaint
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2025-10-09
8 earlier / fire-safety inspections (39 citations)
2025-08-06Health inspection4 citations
F-0755
D · No harm found
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2025-09-10
F-0812
E · 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 2025-09-10
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 2025-09-10
F-0880
D · No harm found
Provide and implement an infection prevention and control program.
Corrected 2025-09-10
2024-07-31Health inspectionComplaint-triggered7 citations
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 2024-08-12
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 2024-08-12
F-0755
D · No harm found
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2024-08-12
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 2024-08-12
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 2024-08-12
F-0880
D · No harm found
Provide and implement an infection prevention and control program.
Corrected 2024-08-12
F-0925
D · No harm foundFrom a complaint
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Corrected 2024-08-12
2024-06-06Health inspectionComplaint-triggered6 citations
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 2024-06-07
F-0607
K · Immediate jeopardyFrom a complaint
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2024-06-07
F-0609
E · No harm foundFrom a complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2024-06-07
F-0610
K · Immediate jeopardyFrom a complaint
Respond appropriately to all alleged violations.
Corrected 2024-06-07
F-0689
G · Actual harmFrom a complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-06-07
F-0880
D · No harm foundFrom a complaint
Provide and implement an infection prevention and control program.
Corrected 2024-06-07
2024-01-22Health inspectionComplaint-triggered2 citations
F-0695
D · No harm foundFrom a complaint
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2024-02-14
F-0761
E · No harm foundFrom a complaint
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 2024-02-14
2023-04-26Health inspection16 citations
F-0550
D · No harm found
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2023-05-12
F-0552
E · No harm found
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected 2023-05-19
F-0584
E · No harm found
Honor 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.
Corrected 2023-05-19
F-0655
E · 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 2023-05-20
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 2023-05-16
F-0657
D · No harm found
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-05-19
F-0677
E · No harm found
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2023-04-27
F-0690
D · No harm found
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected 2023-05-15
F-0692
D · No harm found
Provide enough food/fluids to maintain a resident's health.
Corrected 2023-05-19
F-0695
E · No harm found
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2023-05-12
F-0698
D · No harm found
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Corrected 2023-05-12
F-0755
D · No harm found
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2023-05-12
F-0758
E · 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 2023-05-19
F-0880
D · No harm found
Provide and implement an infection prevention and control program.
Corrected 2023-05-27
F-0921
E · No harm found
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected 2023-05-01
F-0926
D · No harm found
Have policies on smoking.
Corrected 2023-05-15
2025-08-06Fire-safety inspection2 citations
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 2025-09-10
K-0372
E · No harm found
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2025-09-10
2024-07-31Fire-safety inspection1 citation
K-0353
E · No harm found
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-08-22
2023-04-26Fire-safety inspection1 citation
K-0345
E · No harm found
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2023-07-14

Federal penalties

2025-10-08Fine$10,358
2024-06-06Fine$284,250
Total fines$294,608
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 675998.

Quality of care & staffing

How it compares in Texas.
Inspection citations, 3 years
41
More than 66% of nursing homes in the state
State median: 33
Federal fines, 3 years
$294,608
More than 98% of nursing homes in the state
State median: $15,642
Nurse staffing, hours per resident per day
3.2
Higher than 39% of nursing homes in the state
State median: 3.3
Nursing staff turnover, annual
51%
Higher than 51% 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 6 and worse on 11. Differences within 10% of the average are shown as near average.

Long-stay residentsThis facilityStateUSCompared with state
Need for help with daily activities has increased27.5%15.8%13.5%Worse than state
Lose too much weight8.5%2.9%5.1%Worse than state
With a catheter inserted and left in their bladder0.6%0.3%0.7%Worse than state
With a urinary tract infection0.3%0.8%1.5%Better than state
Have depressive symptoms0.0%2.3%13.5%Better than state
Were physically restrained0.0%0.0%0.1%Better than state
Experiencing one or more falls with major injury2.6%3.2%3.2%Better than state
Assessed and appropriately given the pneumococcal vaccine99.3%96.4%93.7%Near state average
Ability to walk independently worsened26.5%12.9%12.7%Worse than state
Received an antianxiety or hypnotic medication31.8%17.8%19.5%Worse than state
Assessed and appropriately given the seasonal influenza vaccine98.8%97.0%95.3%Near state average
With pressure ulcers5.5%3.7%4.5%Worse than state
With new or worsened bowel or bladder incontinence19.2%12.5%18.3%Worse than state
Received an antipsychotic medication6.9%9.8%15.4%Better than state
Hospitalizations per 1000 long-stay resident days3.562.051.81Worse than state
Outpatient emergency department visits per 1000 long-stay resident days3.711.971.69Worse than state
Short-stay residentsThis facilityStateUSCompared with state
Assessed and appropriately given the pneumococcal vaccine90.9%88.7%82.3%Near state average
Newly received an antipsychotic medication1.1%1.4%1.5%Better than state
Were assessed and appropriately given the seasonal influenza vaccine88.7%85.4%80.1%Near state average
Were rehospitalized after a nursing home admission28.0%25.5%23.4%Worse than state
Had an outpatient emergency department visit17.0%12.2%11.8%Worse 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-0880 4 inspections. Provide and implement an infection prevention and control program.
  • F-0695 3 inspections. Provide safe and appropriate respiratory care for a resident when needed.
  • F-0755 3 inspections. Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
  • F-0812 2 inspections. Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  • F-0689 2 inspections. Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0761 2 inspections. 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.

What its owners also hold

  • Liberty County Hospital District No 1 has an ownership stake on file at 35 nursing homes, averaging 2.9 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

  • Palestine Regional Medical Center, about 1.5 miles. CMS rating 1 of 5.
  • Ut Health East Texas Jacksonville Hospital, about 27 miles.
  • Christus Mother Frances Hospital- Jacksonville, about 27 miles.
Source: CMS Hospital General Information. Straight-line distance.

Nearby facilities with inspection records

Visitor reviews

What people say on Google.
4.2115 ratings on Google
★★★★Cindy Bell · 2022-11-27 · via Google

“I was with 3 other ladies and we did a card class for the residents to make Christmas cards. Everyone was friendly as we toured the facility. The residents were so nice and I am ready to be back next month to do it again. Great place and great people.”

★Leia Adams · 2025-07-22 · via Google

“My mother has been living here the past two years and the food has gone downhill every single day. She was fed two sandwiches today for lunch and dinner. One sandwich was just a BLT with bacon bits and one slice of tomato. They gave her a lot of lettuce which she can’t chew due to having no teeth. Which she has told them for over a year. She had to teach them how to make toast. And no this is. It …”

★★★★★Alex Foster · 2023-08-16 · via Google

“I have a family member who is currently at this facility. He seems to be well taken care of, and often states how nice he thinks the staff and the facility is. Chelsie Cagle is one of his nurses and she is taking EXCELLENT care of him. She is always very informative when I ask about how my family member is doing. She is compassionate, organized, warm and welcoming each time I visit the facility. T…”

Ratings and reviews are from Google and reflect visitor opinions, not our verification. See all reviews on Google

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 41 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
Google Business Profile
Photos, reviews & hours
Displayed with attribution · refreshed on re-run
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