Federal inspection record · CMS data as of October 1, 2026
North Star Ranch Rehabilitation and Healthcare Cen
709 W Fifth St, Bonham, TX · (903) 583-8551
- Certified beds
- 65
- Residents per day
- 43
- Ownership
- For-Profit
- Chain
- Nexion Health
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- March 30, 1995
1
How this home got 2 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
★★★★★+1 star
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
North Star Ranch Rehabilitation and Healthcare Cen carries 232.25 inspection points. That is fewer than 7% 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
61 health citations on record since 2024. 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)
-
K
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.
-
J
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
J
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Nutrition and Dietary12F
- E
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.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
- D
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
- D
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- D
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.
- D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
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.
- D
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Quality of Life and Care10E
- E
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide appropriate foot care.
- D
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.
- E
Provide enough food/fluids to maintain a resident's health.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide or get specialized rehabilitative services as required for a resident.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Resident Rights8E
- E
Keep residents' personal and medical records private and confidential.
- D
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- 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
Ensure that residents are fully informed and understand their health status, care and treatments.
- D
Reasonably accommodate the needs and preferences of each resident.
- D
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
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- 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.
Resident Assessment and Care Planning7E
- E
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
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.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Pharmacy Service7F
- 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.
- 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.
- F
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
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Administration3D
- 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.
- D
Provide timely, quality laboratory services/tests to meet the needs of residents.
- D
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
Nursing and Physician Services3F
- F
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- C
Post nurse staffing information every day.
- E
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Freedom from Abuse, Neglect, and Exploitation3D
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Environmental2F
- F
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
- D
Have policies on smoking.
Infection Control1D
- D
Provide and implement an infection prevention and control program.
Inspection history
2026-07-02
23 health deficiencies · 5 fire-safety deficiencies
Top issue: Quality of Life and Care (7 deficiencies)
2025-04-24
24 health deficiencies · 6 fire-safety deficiencies
Top issue: Resident Rights (5 deficiencies)
2024-03-06
14 health deficiencies · 4 fire-safety deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 29 min of nursing staff time a day, 14 min of it from a registered nurse.
This home
3 h 29 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 47% of nursing staff and 0% 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
$278,005 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-02-27 | Fine | $168,236 |
| 2024-01-12 | Fine | $109,769 |
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. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3 pts better | 99.4% | 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 injury3.2 pts better | 0.0% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms1.7 pts better | 0.6% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.2 pts better | 2.7% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication0.9 pts better | 16.9% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication3.9 pts worse | 13.7% | 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 worsened9.5 pts worse | 22.4% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased6.6 pts worse | 22.4% | 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 incontinence0.9 pts better | 11.6% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.6 pts better | 2.1% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine2.7 pts worse | 86.0% | 88.7% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.4 pts better | 0.0% | 1.4% | 1.5% |
·
Who owns and runs it
43 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 |
| Correra, Kristy | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Correra, Kristy | Adp Of The SNF · Individual | 0% | 2 facilities |
| Fallon, John | Operational/Managerial Control · Individual | 0% | 20 facilities |
| Fallon, John | Adp Of The SNF · Individual | 0% | 20 facilities |
| Fannin County Hospital Authority | Operational/Managerial Control · Organization | 0% | 54 facilities |
| Fannin County Hospital Authority | Adp Of The SNF · Organization | 0% | 54 facilities |
| Holt, Erin | Managing Control - Governing Body · Individual | 0% | 16 facilities |
| Keeton, Wendy | Managing Control - Governing Body · Individual | 0% | 16 facilities |
| Kersten, Christopher | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Kersten, Christopher | Adp Of The SNF · Individual | 0% | 1 facilities |
| Kirley, Francis | Operational/Managerial Control · Individual | 0% | 50 facilities |
| Kirley, Francis | Adp Of The SNF · Individual | 0% | 50 facilities |
| Kissling, Monica | Managing Control - Governing Body · Individual | 0% | 16 facilities |
| Liberatore, Dante | Managing Control - Governing Body · Individual | 0% | 2 facilities |
| Liberatore, Dante | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Liberatore, Dante | Adp Of The SNF · Individual | 0% | 2 facilities |
| Mcbean, Patricia | Managing Control - Governing Body · Individual | 0% | 16 facilities |
| Mitchell, Ryan | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Mitchell, Ryan | Adp Of The SNF · Individual | 0% | 2 facilities |
| Nexion Health At Bonham, Inc. | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Nexion Health At Bonham, Inc. | Adp Of The SNF · Organization | 0% | 1 facilities |
| Nexion Health Leasing, Inc. | Operational/Managerial Control · Organization | 0% | 33 facilities |
| Nexion Health Leasing, Inc. | Adp Of The SNF · Organization | 0% | 33 facilities |
| Nexion Health Of Ohi Inc | Operational/Managerial Control · Organization | 0% | 31 facilities |
| Nexion Health Of Ohi Inc | Adp Of The SNF · Organization | 0% | 31 facilities |
| Nexion Health, Inc. | Operational/Managerial Control · Organization | 0% | 33 facilities |
| Nexion Health, Inc. | Adp Of The SNF · Organization | 0% | 33 facilities |
| Owens, Angela | Managing Control - Governing Body · Individual | 0% | 3 facilities |
| Pierce, Daniel | Operational/Managerial Control · Individual | 0% | 16 facilities |
| Pierce, Daniel | Adp Of The SNF · Individual | 0% | 16 facilities |
| Riner, Meera | Managing Control - Governing Body · Individual | 0% | 46 facilities |
| Riner, Meera | Operational/Managerial Control · Individual | 0% | 46 facilities |
| Riner, Meera | Adp Of The SNF · Individual | 0% | 46 facilities |
| Sanderson, Clark | Managing Control - Governing Body · Individual | 0% | 58 facilities |
| Sanderson, Clark | Corporate Officer · Individual | 0% | 58 facilities |
| Sanderson, Clark | Operational/Managerial Control · Individual | 0% | 58 facilities |
| Sanderson, Clark | Adp Of The SNF · Individual | 0% | 58 facilities |
| Shah, Jagdish | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Shah, Jagdish | Adp Of The SNF · Individual | 0% | 2 facilities |
| Thomison, Isaac | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Thomison, Isaac | Adp Of The SNF · Individual | 0% | 1 facilities |
| Trompler, Kelly | Managing Control - Governing Body · Individual | 0% | 16 facilities |
·
Fire safety
15 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke7F
- F
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Provide properly protected cooking facilities.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Provide properly protected cooking facilities.
- D
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Services4D
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- D
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.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Egress3C
- C
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- C
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- C
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Gas, Vacuum, and Electrical Systems1E
- E
Ensure precautions for handling oxygen cylinders and equipment are correctly followed.
·
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★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 2 h 51 min
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- $0
-
Clyde W Cosper Texas State Veterans Home
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-
Mullican Care Center
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