Federal inspection record · CMS data as of October 1, 2026
Five Points at Lake Highlands Nursing and Rehab
315 East 19th Street, Dallas, TX · (214) 355-3300
- Certified beds
- 280
- Residents per day
- 179
- Ownership
- For-Profit
- Chain
- Creative Solutions In Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- October 4, 1990
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Texas.
-
Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Five Points at Lake Highlands Nursing and Rehab carries 160.25 inspection points. That is fewer than 16% of Texas's 1,166 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Texas: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–26 pts
- 4★ 26–51 pts
- 3★ 51–85 pts
- 2★ 85–145.75 pts
- 1★ over 145.75 pts
Bars show every rated home in Texas by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
54 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (5)
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
J
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Everything else, by area of care
Quality of Life and Care15E
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- E
Provide routine and 24-hour emergency dental care for each resident.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Pharmacy Service7E
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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.
- D
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.
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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.
- D
Ensure medication error rates are not 5 percent or greater.
Resident Rights7E
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
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.
- D
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.
- E
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.
- D
Keep residents' personal and medical records private and confidential.
- E
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.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Assessment and Care Planning5E
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
PASARR screening for Mental disorders or Intellectual Disabilities
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Nutrition and Dietary5E
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- E
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Infection Control5E
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Environmental3E
- D
Provide bedrooms that don't allow residents to see each other when privacy is needed.
- E
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
- E
Have policies on smoking.
Administration1D
- D
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Freedom from Abuse, Neglect, and Exploitation1E
- E
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Inspection history
2026-03-31
20 health deficiencies · 13 fire-safety deficiencies
Top issue: Quality of Life and Care (6 deficiencies)
2024-12-10
22 health deficiencies · 10 fire-safety deficiencies
Top issue: Quality of Life and Care (6 deficiencies)
2023-11-07
12 health deficiencies · 7 fire-safety deficiencies
Top issue: Quality of Life and Care (7 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 4 min of nursing staff time a day, 24 min of it from a registered nurse.
This home
3 h 4 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 43% of nursing staff and 20% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$50,638 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-12-11 | Fine | $16,149 |
| 2025-09-19 | Fine | $10,361 |
| 2025-07-08 | Fine | $15,143 |
| 2024-05-18 | Fine | $8,985 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.3 pts better | 1.7 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.3 pts better | 1.7 | 2.0 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3.6 pts better | 100.0% | 96.4% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine3 pts better | 100.0% | 97.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.1 pts better | 2.1% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms4.6 pts worse | 6.9% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.7 pts better | 1.2% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication8.1 pts better | 9.7% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication2.5 pts better | 7.3% | 9.8% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened7.3 pts worse | 20.2% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased6 pts worse | 21.8% | 15.8% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.2 pts better | 0.1% | 0.3% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.3 pts better | 0.5% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence1.8 pts worse | 14.3% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.5 pts worse | 4.2% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine11.3 pts better | 100.0% | 88.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit5.4 pts better | 6.8% | 12.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.1 pts worse | 1.5% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine14.6 pts better | 100.0% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission7.8 pts better | 17.7% | 25.5% | 23.4% |
·
Who owns and runs it
21 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Blake, Gary | Operational/Managerial Control · Individual | 0% | 139 facilities |
| Blake, Gary | Adp Of The SNF · Individual | 0% | 139 facilities |
| Blake, Malisa | Operational/Managerial Control · Individual | 0% | 139 facilities |
| Bowers, Sean | Managing Control - Governing Body · Individual | 0% | 40 facilities |
| Cisneros, Alfred | Managing Control - Governing Body · Individual | 0% | 42 facilities |
| Cobb, Travis | Managing Control - Governing Body · Individual | 0% | 42 facilities |
| Cooper, Stephen | Managing Control - Governing Body · Individual | 0% | 45 facilities |
| Dallas I Enterprises | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Dallas I Enterprises | Adp Of The SNF · Organization | 0% | 1 facilities |
| Fuller, Elise | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Fuller, Elise | Adp Of The SNF · Individual | 0% | 2 facilities |
| Hardin, Sherrie | Managing Control - Governing Body · Individual | 0% | 40 facilities |
| Huggins, Linda | Corporate Director · Individual | 0% | 138 facilities |
| Kerzee, Richard | Managing Control - Governing Body · Individual | 0% | 42 facilities |
| Korenek, Patricia | Managing Control - Governing Body · Individual | 0% | 40 facilities |
| Silva, Phillip | Operational/Managerial Control · Individual | 0% | 3 facilities |
| Silva, Phillip | Adp Of The SNF · Individual | 0% | 3 facilities |
| Soechting, Paul | Managing Control - Governing Body · Individual | 0% | 39 facilities |
| Strack, Joe | Managing Control - Governing Body · Individual | 0% | 40 facilities |
| Thompson, Johnny | Corporate Officer · Individual | 0% | 79 facilities |
| Willig, Zachary | Corporate Director · Individual | 0% | 84 facilities |
·
Fire safety
30 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke13F
- E
Have approved installation, maintenance and testing program for fire alarm systems.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Install an approved automatic sprinkler system.
- F
Install a fire alarm system that can be heard throughout the facility.
- D
Provide properly protected cooking facilities.
- D
Install an approved automatic sprinkler system.
- F
Install corridor and hallway doors that block smoke.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Egress6F
- E
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.
- E
Install emergency lighting that can last at least 1 1/2 hours.
- D
Have exits that are accessible at all times.
- D
Have properly located and lighted "Exit" signs.
- F
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
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.
Miscellaneous4F
- E
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- E
Have restrictions on the use of highly flammable decorations.
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Emergency Preparedness3F
- F
Establish staff and initial training requirements.
- F
Establish staff and initial training requirements.
- F
Conduct risk assessment and an All-Hazards approach.
Gas, Vacuum, and Electrical Systems3F
- E
Have proper medical gas storage and administration areas.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Have generator or other power source capable of supplying service within 10 seconds.
Services1F
- F
Have properly installed electrical wiring and gas equipment.
·
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