Federal inspection record · CMS data as of October 1, 2026
Legend Healthcare And Rehabilitation - Paris
520 Se 8th St, Paris, TX · (903) 737-9820
- Certified beds
- 120
- Residents per day
- 79
- Ownership
- For-Profit
- Chain
- The Ensign Group
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- January 30, 2005
1
How this home got 3 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.
-
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
★★★★★3 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Legend Healthcare And Rehabilitation - Paris carries 79 inspection points. That is fewer than 45% 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
42 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 (1)
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Pharmacy Service8E
- E
Ensure medication error rates are not 5 percent or greater.
- E
Ensure that residents are free from significant medication errors.
- 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 each resident’s drug regimen must be free from unnecessary drugs.
- D
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E
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.
Resident Rights7E
- E
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 dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- E
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.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
- 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.
Resident Assessment and Care Planning7E
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- E
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
- E
Assure that each resident’s assessment is updated at least once every 3 months.
- E
Ensure each resident receives an accurate assessment.
- 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 the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Infection Control5E
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Implement a program that monitors antibiotic use.
- E
Provide and implement an infection prevention and control program.
- E
Implement a program that monitors antibiotic use.
Quality of Life and Care5E
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
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 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.
Nutrition and Dietary4F
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Administration2E
- E
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
- E
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.
Environmental2D
- D
Have policies on smoking.
- D
Have policies on smoking.
Nursing and Physician Services1D
- D
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Inspection history
2026-02-05
14 health deficiencies · 0 fire-safety deficiencies
Top issue: Pharmacy Service (4 deficiencies)
2024-11-20
9 health deficiencies · 1 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2023-10-12
19 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Rights (4 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 17 min of nursing staff time a day, 34 min of it from a registered nurse.
This home
3 h 17 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 22% of nursing staff and 14% 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
$16,149 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2024-11-20 | Fine | $16,149 |
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 days0.2 pts better | 1.8 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.2 pts better | 1.8 | 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 injury1.4 pts better | 1.8% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms1.1 pts better | 1.2% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.8 pts better | 2.1% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication2.8 pts worse | 20.6% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication0.5 pts worse | 10.3% | 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 worsened1.9 pts worse | 14.8% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased0.6 pts worse | 16.4% | 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 incontinence2.2 pts better | 10.3% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2.6 pts better | 1.1% | 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 visit0.6 pts better | 11.6% | 12.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.9 pts worse | 2.3% | 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 admission2 pts better | 23.5% | 25.5% | 23.4% |
·
Who owns and runs it
15 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 |
| Burnam, Soon | Corporate Officer · Individual | 0% | 353 facilities |
| Burns, Stephen | Managing Control - Governing Body · Individual | 0% | 3 facilities |
| Burns, Stephen | Operational/Managerial Control · Individual | 0% | 3 facilities |
| Burns, Stephen | Adp Of The SNF · Individual | 0% | 3 facilities |
| Eiffel Healthcare LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Ensign Services Inc | Adp Of The SNF · Organization | 0% | 299 facilities |
| Keetch, Chad | Corporate Officer · Individual | 0% | 301 facilities |
| Lawrence, Ra | Managing Control - Governing Body · Individual | 0% | 2 facilities |
| Lawrence, Ra | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Lawrence, Ra | Adp Of The SNF · Individual | 0% | 2 facilities |
| Sanderson, Clark | Corporate Officer · Individual | 0% | 58 facilities |
| Sherman Health Holdings LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Standard Bearer Healthcare Op, LP | Adp Of The SNF · Organization | 0% | 78 facilities |
| The Ensign Group Inc | Adp Of The SNF · Organization | 0% | 135 facilities |
·
Fire safety
1 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke1E
- E
Provide properly protected cooking facilities.
·
Other homes nearby
-
Brentwood Terrace Healthcare And Rehabilitation
Paris, TX · Creative Solutions In Healthcare
★★★★★- Worst citation, 3 yrs
- L
- Nursing / resident / day
- 3 h 6 min
- Fines
- $234,447
-
Avir at Paris
Paris, TX · Avir Health Group
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 11 min
- Fines
- $0
-
Stillhouse Rehabilitation And Healthcare Center
Paris, TX · The Ensign Group
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 19 min
- Fines
- $8,162