The nursing home failed to ensure residents were free from significant medication errors. Cited July 2025 — isolated incident, actual harm.
View the original federal record
F-Tag 760 — 42 CFR §483.45(f)(2) — S/S: G
Nursing home report
Town Hall Estates Keene, Inc.
Keene, TX · Medicare-certified · 126 beds
Needs attention
Non-profit
Data as of July 1, 2026
2 of 5 overall
Town Hall Estates Keene, Inc. has a 2-star overall rating, with very weak staffing (1 star) and reported nurse staffing below the federal benchmark (3.18 vs. 4.1 hours per resident per day). It also had $8,402 in fines in the last 24 months and a recent federal penalty, while its health inspection and quality measures ratings were both 3 stars.
Facility ratings
Health inspections
Staffing
3.1756 hrs/resident/day
Quality measures
Last inspection: July 31, 2025Penalties, last 24 months: $8,402recent federal penalty
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 3.1756.
Staffing detail
- Registered nurses
- 0.21
- Licensed practical nurses
- 0.90
- Nurse aides
- 2.06
- Weekend nursing
- 2.85
Hours per resident per day.
Total staff turnover: 46%
Registered nurse turnover: 63%
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
20.3%14.3%Improving
Residents with a fall causing major injury
6.4%4.1%Improving
Residents with pressure ulcers (bedsores)
5.4%4.7%Improving
Residents with a urinary tract infection
0%0%No change
Residents who lost too much weight
4.2%5%Worsening
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
25%22.4%Improving
Residents whose ability to walk got worse
27.1%8.3%Improving
Long-stay residents on antianxiety or sleep medication
15.3%12.5%Improving
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
21.2%14.3%Improving
Residents with depressive symptoms
1.1%6.7%Worsening
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%—
Long-stay residents given the pneumonia vaccine
95.7%99%Improving
Short-stay residents given the seasonal flu vaccine
—66.3%—
Short-stay residents given the pneumonia vaccine
49.3%50.7%Improving
What the inspectors found
The nursing home failed to keep the area free of hazards and provide enough supervision to prevent accidents. Cited October 2023 — isolated incident, actual harm.
View the original federal record
F-Tag 689 — 42 CFR §483.25(d) — S/S: G
The home failed to protect residents’ right to organize and take part in resident and family groups. Cited July 2025 — limited pattern, potential for harm.
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F-Tag 565 — 42 CFR §483.10 — S/S: E
The home failed to provide enough food and fluids to keep residents healthy. Cited July 2025 — limited pattern, potential for harm.
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F-Tag 692 — 42 CFR §483.25(g) — S/S: E
The home failed to make sure food was safely sourced, stored, prepared, and served according to professional standards. Cited July 2025 — limited pattern, potential for harm.
View the original federal record
F-Tag 812 — 42 CFR §483.60(i) — 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 6 health deficiencies.
See what inspectors found
- PENALTY
A federal fine of $8,402 was recorded.
- PENALTY
A federal fine of $8,278 was recorded.
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
Penalties & enforcement
On record with Medicare: 2 fines · $16,209 in total fines.
- $8,402
Federal fine
Jul 9, 2025
- $7,807
Federal fine
Oct 20, 2023
Operator & ownership
- Ownership
- Non profit - Corporation
- Occupancy
- 100.3 residents on an average day (80% of 126 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 21 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.