Amarillo, TX

Legacy Rehabilitation and Living

4-star overall rating with 4-star inspections with 4 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle

4033 W 51ST Ave, Amarillo, TX

(806) 355-4488

Compare this facility

Overall

4 / 5

CMS overall stars

Health inspections

4 / 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

150

Certified beds

Average residents

105

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

The Ensign Group

Operator or chain grouping

Approved since

2004-03-29

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Staffing

Hours and turnover

RN hours / resident day

0.52

Registered nurse staffing

LPN hours / resident day

1.04

Licensed practical nurse staffing

Aide hours / resident day

1.88

Nurse aide staffing

Weekend hours

2.95

Weekend nurse staffing

RN turnover

67%

Annual RN turnover

Total nurse turnover

61%

Annual nurse turnover

Quality measures

Resident outcomes and process scores

Measure Facility State National Note
Number of hospitalizations per 1000 long-stay resident days 1.4
2.1
0.7 pts better
1.9
0.5 pts better
Long Stay · 20240701-20250630
Number of outpatient emergency department visits per 1000 long-stay resident days 1.0
2.1
1.1 pts better
1.8
0.8 pts better
Long Stay · 20240701-20250630
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine 99.5%
97.1%
2.4 pts better
93.4%
6.1 pts better
Long Stay · 2024Q4-2025Q3
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine 99.1%
97.9%
1.2 pts better
95.5%
3.6 pts better
Long Stay · 2024Q3-2025Q2
Percentage of long-stay residents experiencing one or more falls with major injury 4.7%
3.3%
1.4 pts worse
3.3%
1.4 pts worse
Long Stay · 2024Q4-2025Q3
Percentage of long-stay residents who have depressive symptoms 0.7%
2.7%
2 pts better
11.4%
10.7 pts better
Long Stay · 2024Q4-2025Q3
Percentage of long-stay residents who lose too much weight 0.6%
3.3%
2.7 pts better
5.4%
4.8 pts better
Long Stay · 2024Q4-2025Q3
Percentage of long-stay residents who received an antianxiety or hypnotic medication 11.0%
18.9%
7.9 pts better
19.6%
8.6 pts better
Long Stay · 2024Q4-2025Q3
Percentage of long-stay residents who received an antipsychotic medication 8.5%
10.8%
2.3 pts better
16.7%
8.2 pts better
Long Stay · 2024Q4-2025Q3
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
Percentage of long-stay residents whose ability to walk independently worsened 6.7%
15.4%
8.7 pts better
16.3%
9.6 pts better
Long Stay · 2024Q4-2025Q3
Percentage of long-stay residents whose need for help with daily activities has increased 13.8%
16.1%
2.3 pts better
14.9%
1.1 pts better
Long Stay · 2024Q4-2025Q3
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
Percentage of long-stay residents with a urinary tract infection 0.8%
0.8%
About the same
1.7%
0.9 pts better
Long Stay · 2024Q4-2025Q3
Percentage of long-stay residents with new or worsened bowel or bladder incontinence 17.3%
15.0%
2.3 pts worse
19.8%
2.5 pts better
Long Stay · 2024Q4-2025Q3
Percentage of long-stay residents with pressure ulcers 4.9%
4.2%
0.7 pts worse
5.1%
0.2 pts better
Long Stay · 2024Q4-2025Q3
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine 94.0%
89.7%
4.3 pts better
81.7%
12.3 pts better
Short Stay · 2024Q4-2025Q3
Percentage of short-stay residents who had an outpatient emergency department visit 6.3%
12.0%
5.7 pts better
12.0%
5.7 pts better
Short Stay · 20240701-20250630
Percentage of short-stay residents who newly received an antipsychotic medication 1.5%
1.5%
About the same
1.6%
0.1 pts better
Short Stay · 2024Q4-2025Q3
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine 89.8%
88.0%
1.8 pts better
79.7%
10.1 pts better
Short Stay · 2024Q3-2025Q2
Percentage of short-stay residents who were rehospitalized after a nursing home admission 21.0%
25.9%
4.9 pts better
23.9%
2.9 pts better
Short Stay · 20240701-20250630

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-07-31 · Fire 2025-07-31

4 health deficiencies

Top issue: Infection Control (1 deficiency)

2 fire-safety deficiencies

Top issue: Emergency Preparedness (1 deficiency)

Cycle 2 Health 2024-06-07 · Fire 2024-06-07

7 health deficiencies

Top issue: Resident Rights (3 deficiencies)

1 fire-safety deficiencies

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

Cycle 3 Health 2023-04-14 · Fire 2023-04-14

9 health deficiencies

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

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Fire safety

Fire-safety citations

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

E4 · Emergency Preparedness Deficiencies

Fire Safety

Develop and maintain an Emergency Preparedness Program (EP).

Corrected 2025-08-31

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

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2025-09-13

F · Potential for more than minimal harm 2024-06-07

K923 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have proper medical gas storage and administration areas.

Corrected 2024-07-17

Inspection history

Recent health citations

D · Potential for more than minimal harm 2026-01-21

F695 · Quality of Life and Care Deficiencies

Health

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

Corrected 2026-01-23

E · Potential for more than minimal harm 2025-09-09

F757 · Pharmacy Service Deficiencies

Health

Ensure each resident’s drug regimen must be free from unnecessary drugs.

Corrected 2025-09-10

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

F576 · Resident Rights Deficiencies

Health

Ensure residents have reasonable access to and privacy in their use of communication methods.

Corrected 2025-09-13

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

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-09-13

D · Potential for more than minimal harm 2025-02-04

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 2025-02-02

E · Potential for more than minimal harm 2024-06-07

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 2024-07-17

E · Potential for more than minimal harm 2024-06-07

F803 · Nutrition and Dietary Deficiencies

Health

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

Corrected 2024-07-17

D · Potential for more than minimal harm 2024-06-07

F550 · Resident Rights Deficiencies

Health

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Corrected 2024-07-17

D · Potential for more than minimal harm 2024-06-07

F561 · Resident Rights Deficiencies

Health

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Corrected 2024-07-17

D · Potential for more than minimal harm 2024-06-07

F695 · Quality of Life and Care Deficiencies

Health

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

Corrected 2024-07-17

E · Potential for more than minimal harm 2024-05-17

F576 · Resident Rights Deficiencies

Health

Ensure residents have reasonable access to and privacy in their use of communication methods.

Corrected 2024-06-07

D · Potential for more than minimal harm 2023-09-06

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 2023-10-20

F · Potential for more than minimal harm 2023-04-14

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2023-05-26

E · Potential for more than minimal harm 2023-04-14

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2023-05-26

D · Potential for more than minimal harm 2023-04-14

F550 · Resident Rights Deficiencies

Health

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Corrected 2023-05-26

D · Potential for more than minimal harm 2023-04-14

F578 · Resident Rights Deficiencies

Health

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

Corrected 2023-05-26

D · Potential for more than minimal harm 2023-04-14

F636 · Resident Assessment and Care Planning Deficiencies

Health

Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

Corrected 2023-05-26

D · Potential for more than minimal harm 2023-04-14

F692 · Quality of Life and Care Deficiencies

Health

Provide enough food/fluids to maintain a resident's health.

Corrected 2023-05-26

D · Potential for more than minimal harm 2023-04-14

F695 · Quality of Life and Care Deficiencies

Health

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

Corrected 2023-05-26

D · Potential for more than minimal harm 2023-04-14

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 2023-05-26

Penalties and ownership

What sits behind the stars

Ownership

Stratford Hospital District

5% Or Greater Direct Ownership Interest · Organization

100% 28 facilities 2015-02-20
Brown, Rodger

Operational/Managerial Control · Individual

0% 2 facilities 2014-04-03
Burnam, Soon

Operational/Managerial Control · Individual

0% 323 facilities 2015-02-01
Chumley, Richard

Corporate Director · Individual

0% 30 facilities 2007-05-01
Tradewind Healthcare, Inc.

Operational/Managerial Control · Organization

0% 1 facilities 2015-02-20

Nearby options

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4-star overall rating with 3-star inspections with $8,031 in total fines with 6 recent health deficiencies

Overall
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Health
3 / 5
Staffing
2 / 5
Fines
$8,031
#2

Kirkland Court Health and Rehabilitation Center

Amarillo, TX

1-star overall rating with 1-star inspections with abuse icon flag with $25,480 in total fines with 14 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle

Overall
1 / 5
Health
1 / 5
Staffing
3 / 5
Fines
$25,480
#3

Hillside Heights Rehabilitation Suites

Amarillo, TX

3-star overall rating with 3-star inspections with $14,901 in total fines with 12 recent health deficiencies

Overall
3 / 5
Health
3 / 5
Staffing
2 / 5
Fines
$14,901

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