Federal inspection record · CMS data as of October 1, 2026
Greenbrier Nursing & Rehabilitation Center of Pale
2404 State Highway 155, Palestine, TX · (903) 729-6024
- Certified beds
- 120
- Residents per day
- 52
- Ownership
- For-Profit
- Chain
- Creative Solutions In Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- December 21, 1999
1
How this home got 4 stars
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.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Texas.
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Staffing
★★★★★−1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★4 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Greenbrier Nursing & Rehabilitation Center of Pale carries 19 inspection points. That is fewer than 93% 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
12 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.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Quality of Life and Care4D
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 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.
- 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.
Infection Control4E
- 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.
- D
Provide and implement an infection prevention and control program.
Resident Rights1D
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Environmental1F
- F
Keep all essential equipment working safely.
Freedom from Abuse, Neglect, and Exploitation1D
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Resident Assessment and Care Planning1D
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspection history
2026-01-29
4 health deficiencies · 2 fire-safety deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
2024-11-06
4 health deficiencies · 3 fire-safety deficiencies
Top issue: Infection Control (2 deficiencies)
2023-09-20
4 health deficiencies · 3 fire-safety deficiencies
Top issue: Environmental (1 deficiency)
4
Nursing time per resident, per day
Each resident here gets about 2 h 53 min of nursing staff time a day, 17 min of it from a registered nurse.
This home
2 h 53 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 44% 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
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| 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 injury0.4 pts worse | 3.6% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms3.1 pts worse | 5.4% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.4 pts better | 1.5% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication3.9 pts better | 13.9% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication1.6 pts better | 8.2% | 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 worsened5.7 pts better | 7.2% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased5.3 pts worse | 21.1% | 15.8% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.3 pts better | 0.0% | 0.3% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.8 pts better | 0.0% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.1 pts worse | 12.6% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.6 pts better | 3.1% | 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 visit7.4 pts worse | 19.6% | 12.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.4 pts better | 0.0% | 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 admission9.2 pts worse | 34.7% | 25.5% | 23.4% |
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Who owns and runs it
29 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 |
|---|---|---|---|
| Fannin County Hospital Authority | 5% Or Greater Direct Ownership Interest · Organization | 100% | 54 facilities |
| 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 |
| Blake, Malisa | Adp Of The SNF · Individual | 0% | 139 facilities |
| Hekimian, Khoren | Adp Of The SNF · Individual | 0% | 11 facilities |
| Holt, Erin | Managing Control - Governing Body · Individual | 0% | 16 facilities |
| Holt, Erin | Corporate Director · Individual | 0% | 16 facilities |
| Honor X Enterprises, LLC | Indirect Ownership Interest · Organization | 0% | 7 facilities |
| Honor X Enterprises, LLC | Adp Of The SNF · Organization | 0% | 7 facilities |
| Huggins, Linda | Corporate Director · Individual | 0% | 138 facilities |
| Huggins, Linda | Operational/Managerial Control · Individual | 0% | 138 facilities |
| Huggins, Linda | Adp Of The SNF · Individual | 0% | 138 facilities |
| Johnson, Juanita | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Johnson, Juanita | Adp Of The SNF · Individual | 0% | 1 facilities |
| Keeton, Wendy | Managing Control - Governing Body · Individual | 0% | 16 facilities |
| Keeton, Wendy | Corporate Director · Individual | 0% | 16 facilities |
| Kissling, Monica | Managing Control - Governing Body · Individual | 0% | 16 facilities |
| Kissling, Monica | Corporate Director · Individual | 0% | 16 facilities |
| Mcbean, Patricia | Managing Control - Governing Body · Individual | 0% | 16 facilities |
| Mcbean, Patricia | Corporate Director · Individual | 0% | 16 facilities |
| Palestine I Enterprises, LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Palestine I Enterprises, LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Sanderson, Clark | Managing Control - Governing Body · Individual | 0% | 58 facilities |
| Sanderson, Clark | Corporate Director · Individual | 0% | 58 facilities |
| Trompler, Kelly | Managing Control - Governing Body · Individual | 0% | 16 facilities |
| Trompler, Kelly | Corporate Officer · Individual | 0% | 16 facilities |
| Willig, Zachary | Operational/Managerial Control · Individual | 0% | 84 facilities |
| Willig, Zachary | Adp Of The SNF · Individual | 0% | 84 facilities |
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Fire safety
8 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Services4F
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- F
Have properly installed electrical wiring and gas equipment.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Smoke3F
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Gas, Vacuum, and Electrical Systems1E
- E
Ensure precautions for handling oxygen cylinders and equipment are correctly followed.
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Other homes nearby
-
Legacy At Town Creek
Palestine, TX · Southwest Ltc
★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 3 h 12 min
- Fines
- $294,608
-
Trucare Living Centers
Palestine, TX
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 21 min
- Fines
- $0
-
Avir at Town Creek
Palestine, TX · Avir Health Group
★★★★★- Worst citation, 3 yrs
- H
- Nursing / resident / day
- 3 h 45 min
- Fines
- $49,065