The nursing home failed to protect residents from abuse and neglect by others. Cited August 2025 — limited pattern, immediate jeopardy to residents.
View the original federal record
F-Tag 600 — 42 CFR §483.12 — S/S: K
Nursing home report
Waterton Plaza at Cowhorn Creek
Registered name: AVIR AT COWHORN CREEK
TEXARKANA, TX · Medicare-certified · 76 beds
Needs attention
Abuse citationGovernment-runChain member
Data as of July 1, 2026
1 of 5 overall
Waterton Plaza at Cowhorn Creek in Texarkana, TX has a 1 out of 5 overall rating, with 1-star health inspection and staffing ratings and 3-star quality measures. It has a recent abuse citation, $30,105 in fines over the last 24 months, and reported nurse staffing of 3.26 hours per resident per day versus the 4.1 federal benchmark.
Facility ratings
Health inspections
Staffing
3.2649 hrs/resident/day
Quality measures
Last inspection: April 13, 2026Penalties, last 24 months: $30,105recent abuse citation
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 3.2649.
Staffing detail
- Registered nurses
- 0.38
- Licensed practical nurses
- 0.94
- Nurse aides
- 1.94
- Weekend nursing
- 2.93
Hours per resident per day.
Total staff turnover: 68%
Resident outcomes
Each measure compares a year ago with the most recent quarter. Green means the facility moved the right way; red means the wrong way.
Negative outcomes
Lower is better — fewer affected residents. A decrease is good (green); an increase is concerning (red).
Long-stay residents on antipsychotic medication
0%0%No change
Residents with a fall causing major injury
0%1.7%Worsening
Residents with pressure ulcers (bedsores)
5.6%5%Improving
Residents with a urinary tract infection
0%1.8%Worsening
Residents who lost too much weight
0%0%No change
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
16.3%22%Worsening
Residents whose ability to walk got worse
—21.5%—
Long-stay residents on antianxiety or sleep medication
13.6%23.3%Worsening
Short-stay residents newly given an antipsychotic
0%0%No change
Residents with a long-term catheter
0%0%No change
Residents with new or worsening incontinence
1.9%6.2%Worsening
Residents with depressive symptoms
4%0%Improving
Positive outcomes
Higher is better — e.g. vaccinations. An increase is good (green); a decrease is concerning (red).
Long-stay residents given the seasonal flu vaccine
—95.4%—
Long-stay residents given the pneumonia vaccine
100%100%No change
Short-stay residents given the seasonal flu vaccine
—95.6%—
Short-stay residents given the pneumonia vaccine
100%97.9%Worsening
What the inspectors found
The home failed to honor each resident’s preferences, choices, values, and beliefs. Cited August 2025 — limited pattern, immediate jeopardy to residents.
View the original federal record
F-Tag 675 — 42 CFR §483.24 — S/S: K
The home failed to have a registered nurse on duty enough hours each day and to keep a registered nurse as the full-time director of nursing. Cited February 2026 — widespread issue, potential for harm.
View the original federal record
F-Tag 727 — 42 CFR §483.35 — S/S: F
The home failed to make sure food was safely sourced, stored, prepared, and served according to professional standards. Cited February 2026 — widespread issue, potential for harm.
View the original federal record
F-Tag 812 — 42 CFR §483.60(i) — S/S: F
The home failed to provide pharmacy services and a licensed pharmacist needed to meet each resident’s medication needs. Cited February 2026 — limited pattern, potential for harm.
View the original federal record
F-Tag 755 — 42 CFR §483.45 — S/S: E
Recent history
- STAFFING
Reported nurse staffing was below the federal recommendation of 4.1 hours per resident per day.
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
- STAFFING
Reported nurse staffing was below the federal recommendation of 4.1 hours per resident per day.
- INSPECTION
Health inspection found 20 health deficiencies.
See what inspectors found
- PENALTY
A federal fine of $30,105 was recorded.
- PENALTY
A federal payment denial was recorded.
- PENALTY
A federal fine of $46,315 was recorded.
- INSPECTION
Health inspection found 7 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 3 health deficiencies.
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Penalties & enforcement
On record with Medicare: 1 fine · $30,105 in total fines · 1 payment denial.
- 5 days
Medicare/Medicaid payment denial
Aug 15, 2025
- $30,105
Federal fine
Aug 15, 2025
Operator & ownership
- Ownership
- Government - Hospital district
- Chain
- Part of AVIR HEALTH GROUP · 119 homes · 2.3 stars avg
- Occupancy
- 67.8 residents on an average day (89% of 76 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 23 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.