Humble, TX

Deerbrook Skilled Nursing and Rehab Center

1-star overall rating with 1-star inspections with $78,411 in total fines with 16 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle

9250 Humble-Westfield Rd, Humble, TX

(281) 446-5160

Compare this facility

Overall

1 / 5

CMS overall stars

Health inspections

1 / 5

Survey and complaint cycles

Staffing

2 / 5

RN + nurse staffing

Quality measures

4 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

124

Certified beds

Average residents

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Hmg Healthcare

Operator or chain grouping

Approved since

2010-12-02

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

33 facilities

Chain averages 3 overall / 3 health / 2 staffing / 4 quality stars

Changed ownership

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.37

Registered nurse staffing · state 0.44 · national 0.68

LPN hours / resident day

0.96

Licensed practical nurse staffing · state 0.95 · national 0.87

Aide hours / resident day

2.07

Nurse aide staffing · state 2.01 · national 2.35

Total nurse hours

3.40

All reported nurse hours · state 3.40 · national 3.89

Licensed hours

1.33

RN + LPN hours · state 1.38 · national 1.54

Weekend hours

3.11

Weekend nurse staffing · state 2.99 · national 3.43

Weekend RN hours

0.27

Weekend registered nurse coverage · state 0.34 · national 0.47

Physical therapist

0.06

Reported PT staffing · state 0.07 · national 0.07

Adjusted RN hours

0.38

CMS adjusted RN staffing hours

Adjusted total hours

3.54

CMS adjusted total nurse staffing hours

Case-mix index

1.31

Higher values indicate more complex resident acuity

RN turnover

64%

Annual RN turnover · state 52% · national 45%

Total nurse turnover

63%

Annual nurse turnover · state 52% · national 46%

SNF VBP

Value-based purchasing

Program rank

6,417

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

32.92

Composite VBP score used to determine payment impact.

Payment multiplier

0.9874

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

3.95

Baseline 23.27% · Performance 20.49% · Measure score 3.95 · Achievement 2.03 · Improvement 3.95

Healthcare-associated infections

5.68

Baseline 7.95% · Performance 6.14% · Measure score 5.68 · Achievement 5.68 · Improvement 5.65

Total nurse turnover

1.60

Baseline 75.00% · Performance 64.49% · Measure score 1.60 · Achievement 0 · Improvement 1.60

Adjusted total nurse staffing

1.94

Baseline 3.28 hours · Performance 3.63 hours · Measure score 1.94 · Achievement 1.94 · Improvement 0.89

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	11.12%	10.72% 0.4 pts worse	No Different than the National Rate · Eligible stays 78 · Observed rate 15.38% · Lower 95% interval 8.12%
Discharge to community	57.13%	50.57% 6.6 pts better	No Different than the National Rate · Eligible stays 67 · Observed rate 44.78% · Lower 95% interval 45.5%
Medicare spending per beneficiary	1	1.02 About the same
Drug regimen review with follow-up	100%	95.27% 4.7 pts better	Numerator 69 · Denominator 69
Falls with major injury	0%	0.77% 0.8 pts better	Numerator 0 · Denominator 69
Discharge self-care score	31.25%	53.69% 22.4 pts worse	Numerator 15 · Denominator 48
Discharge mobility score	31.25%	50.94% 19.7 pts worse	Numerator 15 · Denominator 48
Pressure ulcers or injuries, new or worsened	0%	2.29% 2.3 pts better	Numerator 0 · Denominator 69 · Adjusted rate 0%
Healthcare-associated infections requiring hospitalization	6.14%	7.12% 1 pts better	No Different than the National Rate · Eligible stays 44 · Observed rate 4.55% · Lower 95% interval 2.99%
Staff COVID-19 vaccination coverage	0%	8.2% 8.2 pts worse	Numerator 0 · Denominator 142
Staff flu vaccination coverage	42.74%	42% 0.7 pts better	Numerator 50 · Denominator 117
Discharge function score	43.75%	56.45% 12.7 pts worse	Numerator 21 · Denominator 48
Transfer of health information to provider	100%	95.95% 4 pts better	Numerator 60 · Denominator 60
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator Not Available · Newly certified or not enough cases to report.
Resident COVID-19 vaccinations up to date	13.89%	25.2% 11.3 pts worse	Numerator 5 · Denominator 36

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	99.6%	97.1% 2.5 pts better	93.4% 6.2 pts better	Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 98.7% · 4Q avg 99.6%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	100.0%	97.9% 2.1 pts better	95.5% 4.5 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0%
Percentage of long-stay residents experiencing one or more falls with major injury	0.4%	3.3% 2.9 pts better	3.3% 2.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 1.5% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.4% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	2.3%	2.7% 0.4 pts better	11.4% 9.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 3.3% · Q2 4.8% · Q3 0.0% · Q4 1.4% · 4Q avg 2.3%
Percentage of long-stay residents who lose too much weight	9.1%	3.3% 5.8 pts worse	5.4% 3.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 13.1% · Q2 15.2% · Q3 4.5% · Q4 4.3% · 4Q avg 9.1%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	11.4%	18.9% 7.5 pts better	19.6% 8.2 pts better	Long Stay · 2024Q4-2025Q3 · Q1 16.4% · Q2 12.1% · Q3 7.6% · Q4 9.9% · 4Q avg 11.4%
Percentage of long-stay residents who received an antipsychotic medication	11.7%	10.8% 0.9 pts worse	16.7% 5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 9.8% · Q2 9.4% · Q3 11.8% · Q4 15.5% · 4Q avg 11.7% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.0% About the same	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	3.1%	15.4% 12.3 pts better	16.3% 13.2 pts better	Long Stay · 2024Q4-2025Q3 · Q1 5.0% · Q2 0.0% · Q3 4.1% · Q4 3.6% · 4Q avg 3.1% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	2.3%	16.1% 13.8 pts better	14.9% 12.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 1.9% · Q2 0.0% · Q3 3.5% · Q4 3.3% · 4Q avg 2.3% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	0.0%	0.5% 0.5 pts better	1.0% 1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	0.0%	0.8% 0.8 pts better	1.7% 1.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	1.9%	15.0% 13.1 pts better	19.8% 17.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 1.5% · Q2 0.0% · Q3 1.2% · Q4 4.6% · 4Q avg 1.9%
Percentage of long-stay residents with pressure ulcers	9.5%	4.2% 5.3 pts worse	5.1% 4.4 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 9.1% · Q2 7.5% · Q3 9.5% · Q4 11.9% · 4Q avg 9.5% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	98.1%	89.7% 8.4 pts better	81.7% 16.4 pts better	Short Stay · 2024Q4-2025Q3 · Q1 99.5% · Q2 97.7% · Q3 97.1% · Q4 98.3% · 4Q avg 98.1%
Percentage of short-stay residents who had an outpatient emergency department visit	6.9%	12.0% 5.1 pts better	12.0% 5.1 pts better	Short Stay · 20240701-20250630 · Adjusted 6.9% · Observed 8.3% · Expected 13.5% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	0.4%	1.5% 1.1 pts better	1.6% 1.2 pts better	Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.8% · Q4 0.9% · 4Q avg 0.4% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	96.9%	88.0% 8.9 pts better	79.7% 17.2 pts better	Short Stay · 2024Q3-2025Q2 · 4Q avg 96.9%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	31.6%	25.9% 5.7 pts worse	23.9% 7.7 pts worse	Short Stay · 20240701-20250630 · Adjusted 31.6% · Observed 41.7% · Expected 31.4% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-02-28 · Fire 2025-02-28

16 health deficiencies

Top issue: Quality of Life and Care (5 deficiencies)

1 fire-safety deficiencies

Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)

Cycle 2 Health 2023-11-16 · Fire 2023-11-16

12 health deficiencies

Top issue: Quality of Life and Care (5 deficiencies)

2 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Cycle 3 Health 2022-09-14 · Fire 2022-09-14

5 health deficiencies

Top issue: Quality of Life and Care (2 deficiencies)

1 fire-safety deficiencies

Top issue: Egress (1 deficiency)

Fire safety

Fire-safety citations

E · Potential for more than minimal harm 2025-02-28

K929 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure precautions for handling oxygen cylinders and equipment are correctly followed.

Corrected 2025-02-27

F · Potential for more than minimal harm 2023-11-16

K352 · Smoke Deficiencies

Fire Safety

Properly install and monitor supervisory attachments on automatic sprinkler systems.

Corrected 2023-11-28

E · Potential for more than minimal harm 2023-11-16

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2023-11-28

D · Potential for more than minimal harm 2022-09-14

K222 · Egress Deficiencies

Fire Safety

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

Corrected 2022-09-26

Inspection history

Recent health citations

D · Potential for more than minimal harm 2025-11-20

F627 · Resident Rights Deficiencies

Health

Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.

Corrected 2025-11-21

D · Potential for more than minimal harm 2025-11-20

F656 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2025-11-21

D · Potential for more than minimal harm 2025-11-20

F677 · Quality of Life and Care Deficiencies

Health

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

Corrected 2025-11-21

D · Potential for more than minimal harm 2025-11-20

F810 · Nutrition and Dietary Deficiencies

Health

Provide special eating equipment and utensils for residents who need them and appropriate assistance.

Corrected 2025-11-21

D · Potential for more than minimal harm 2025-11-20

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-11-21

D · Potential for more than minimal harm 2025-11-20

F908 · Environmental Deficiencies

Health

Keep all essential equipment working safely.

Corrected 2025-11-21

D · Potential for more than minimal harm 2025-11-20

F919 · Environmental Deficiencies

Health

Make sure that a working call system is available in each resident's bathroom and bathing area.

Corrected 2025-11-21

J · Immediate jeopardy 2025-10-27

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2025-10-28

E · Potential for more than minimal harm 2025-10-27

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-11-21

D · Potential for more than minimal harm 2025-10-27

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

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

Corrected 2025-10-28

D · Potential for more than minimal harm 2025-10-27

F690 · Quality of Life and Care Deficiencies

Health

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 2025-10-28

D · Potential for more than minimal harm 2025-10-27

F755 · Pharmacy Service Deficiencies

Health

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

Corrected 2025-10-28

D · Potential for more than minimal harm 2025-07-31

F684 · Quality of Life and Care Deficiencies

Health

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Corrected 2025-08-01

J · Immediate jeopardy 2025-02-28

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2025-03-01

E · Potential for more than minimal harm 2025-02-28

F677 · Quality of Life and Care Deficiencies

Health

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

Corrected 2025-03-01

D · Potential for more than minimal harm 2025-02-28

F656 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2025-03-01

D · Potential for more than minimal harm 2025-02-28

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-03-01

J · Immediate jeopardy 2025-02-20

F695 · Quality of Life and Care Deficiencies

Health

Provide safe and appropriate respiratory care for a resident when needed.

Corrected 2024-06-13

K · Immediate jeopardy 2025-02-14

F684 · Quality of Life and Care Deficiencies

Health

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Corrected 2025-02-15

E · Potential for more than minimal harm 2023-11-16

F656 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2023-11-28

E · Potential for more than minimal harm 2023-11-16

F919 · Environmental Deficiencies

Health

Make sure that a working call system is available in each resident's bathroom and bathing area.

Corrected 2023-11-28

D · Potential for more than minimal harm 2023-11-16

F657 · Resident Assessment and Care Planning Deficiencies

Health

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Corrected 2023-12-08

D · Potential for more than minimal harm 2023-11-16

F658 · Resident Assessment and Care Planning Deficiencies

Health

Ensure services provided by the nursing facility meet professional standards of quality.

Corrected 2023-11-28

D · Potential for more than minimal harm 2023-11-16

F677 · Quality of Life and Care Deficiencies

Health

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

Corrected 2023-11-28

D · Potential for more than minimal harm 2023-11-16

F684 · Quality of Life and Care Deficiencies

Health

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Corrected 2023-11-28

D · Potential for more than minimal harm 2023-11-16

F759 · Pharmacy Service Deficiencies

Health

Ensure medication error rates are not 5 percent or greater.

Corrected 2023-11-28

D · Potential for more than minimal harm 2023-11-16

F760 · Pharmacy Service Deficiencies

Health

Ensure that residents are free from significant medication errors.

Corrected 2023-11-28

D · Potential for more than minimal harm 2023-11-16

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2023-11-28

E · Potential for more than minimal harm 2023-07-21

F677 · Quality of Life and Care Deficiencies

Health

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

Corrected 2023-07-24

D · Potential for more than minimal harm 2023-07-21

F690 · Quality of Life and Care Deficiencies

Health

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 2023-07-24

D · Potential for more than minimal harm 2023-07-21

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2023-07-25

E · Potential for more than minimal harm 2022-09-14

F583 · Resident Rights Deficiencies

Health

Keep residents' personal and medical records private and confidential.

Corrected 2022-09-15

D · Potential for more than minimal harm 2022-09-14

F761 · Pharmacy Service Deficiencies

Health

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 2022-09-15

Penalties and ownership

What sits behind the stars

$15,940 2025-10-27

Fine

Fine · fine $15,940

Fine

$17,345 2025-02-28

Fine

Fine · fine $17,345

Fine

$13,822 2025-02-20

Fine

Fine · fine $13,822

Fine

$31,304 2025-02-14

Fine

Fine · fine $31,304

Fine

Ownership

Hmg Park Manor Of Deerbrook, LLC

5% Or Greater Direct Ownership Interest · Organization

100% 1 facilities 2018-04-01

Balsamo, Krystal