The nursing home failed to protect residents from abuse and neglect by others. Cited June 2024 — limited pattern, immediate jeopardy to residents.
View the original federal record
F-Tag 600 — 42 CFR §483.12 — S/S: K
Nursing home report
LEGACY AT TOWN CREEK
PALESTINE, TX · Medicare-certified · 199 beds
Needs attention
Government-runChain member
1 of 5 overall
Legacy at Town Creek has a 1 out of 5 overall rating, with 1-star staffing and 2-star health inspection and quality ratings. It has reported nurse staffing below the federal benchmark (3.38 vs 4.1 hours per resident per day), $294,608 in fines in the last 24 months, and a recent federal penalty; cited concerns included abuse/neglect prevention and response.
Facility ratings
Health inspections
Staffing
3.3754 hrs/resident/day
Quality measures
Last inspection: January 7, 2026Penalties, last 24 months: $294,608recent federal penalty
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 3.3754.
Staffing detail
- Registered nurses
- 0.31
- Licensed practical nurses
- 0.95
- Nurse aides
- 2.11
- Weekend nursing
- 3.05
Hours per resident per day.
Total staff turnover: 61%
Registered nurse turnover: 67%
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
2.2%7.1%Worsening
Residents with a fall causing major injury
8.1%3.8%Improving
Residents with pressure ulcers (bedsores)
5.7%3.8%Improving
Residents with a urinary tract infection
0%1.3%Worsening
Residents who lost too much weight
4.7%5.9%Worsening
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
29.5%32.7%Worsening
Residents whose ability to walk got worse
—47.8%—
Long-stay residents on antianxiety or sleep medication
29.2%35.2%Worsening
Short-stay residents newly given an antipsychotic
0%2.2%Worsening
Residents with a long-term catheter
3.7%0.8%Improving
Residents with new or worsening incontinence
33.5%22.1%Improving
Residents with depressive symptoms
0%0%No change
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
—99.1%—
Long-stay residents given the pneumonia vaccine
98.8%98.8%No change
Short-stay residents given the seasonal flu vaccine
—91.5%—
Short-stay residents given the pneumonia vaccine
87.6%89.1%Improving
What the inspectors found
The home failed to have policies and procedures in place to prevent abuse, neglect, and theft. Cited June 2024 — limited pattern, immediate jeopardy to residents.
View the original federal record
F-Tag 607 — 42 CFR §483.12 — S/S: K
The home failed to respond appropriately to all reported abuse or neglect concerns. Cited June 2024 — limited pattern, immediate jeopardy to residents.
View the original federal record
F-Tag 610 — 42 CFR §483.12 — S/S: K
The home failed to provide safe and appropriate breathing care when a resident needed it. Cited October 2025 — isolated incident, actual harm.
View the original federal record
F-Tag 695 — 42 CFR §483.25(i) — S/S: G
The nursing home failed to keep the area free of hazards and provide enough supervision to prevent accidents. Cited June 2024 — isolated incident, actual harm.
View the original federal record
F-Tag 689 — 42 CFR §483.25(d) — S/S: G
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
- PENALTY
A federal fine of $10,358 was recorded.
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
- INSPECTION
Health inspection found 4 health deficiencies.
See what inspectors found
- PENALTY
A federal fine of $284,250 was recorded.
Penalties & enforcement
On record with Medicare: 2 fines · $294,608 in total fines.
- $10,358
Federal fine
Oct 8, 2025
- $284,250
Federal fine
Jun 6, 2024
Operator & ownership
- Ownership
- Government - Hospital district
- Chain
- Part of SOUTHWEST LTC · 13 homes · 3.2 stars avg
- Occupancy
- 86.1 residents on an average day (43% of 199 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 22 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.