Federal inspection record · CMS data as of October 1, 2026
Trucare Living Centers
2265 S Sycamore St, Palestine, TX · (903) 723-2592
- CMS high-performer trophy
- Certified beds
- 120
- Residents per day
- 81
- Ownership
- Government
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- July 22, 2010
1
How this home got 5 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
★★★★★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.
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Quality measures
★★★★★no change (already 5)
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
★★★★★5 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Trucare Living Centers 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
10 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
Resident Assessment and Care Planning4E
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Ensure each resident receives an accurate assessment.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Pharmacy Service2D
- 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.
Quality of Life and Care2E
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Infection Control1D
- D
Provide and implement an infection prevention and control program.
Nutrition and Dietary1D
- D
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Inspection history
2025-12-17
3 health deficiencies · 0 fire-safety deficiencies
Top issue: Infection Control (1 deficiency)
2024-09-18
6 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2023-08-16
1 health deficiencies · 0 fire-safety deficiencies
Top issue: Pharmacy Service (1 deficiency)
4
Nursing time per resident, per day
Each resident here gets about 3 h 21 min of nursing staff time a day, 17 min of it from a registered nurse.
This home
3 h 21 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 23% of nursing staff and 20% of registered nurses left in the past year.
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. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.6 pts better | 1.4 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.1 pts worse | 2.1 | 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 injury5.4 pts worse | 8.6% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms0.4 pts better | 1.9% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight2 pts better | 0.9% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication6.9 pts better | 10.9% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication5.7 pts better | 4.1% | 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 pts better | 5.9% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased4.2 pts better | 11.6% | 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 infection0.4 pts better | 0.4% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence1.3 pts worse | 13.8% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.9 pts better | 2.8% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine11.1 pts better | 99.8% | 88.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit1.6 pts better | 10.6% | 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 vaccine13.6 pts better | 99.0% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission6.3 pts worse | 31.8% | 25.5% | 23.4% |
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Who owns and runs it
16 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 | Operational/Managerial Control · Individual | 0% | 353 facilities |
| Byrum, Joe | Managing Control - Governing Body · Individual | 0% | 1 facilities |
| Byrum, Joe | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Byrum, Joe | Adp Of The SNF · Individual | 0% | 1 facilities |
| Ensign Services Inc | Adp Of The SNF · Organization | 0% | 299 facilities |
| Keetch, Chad | Corporate Officer · Individual | 0% | 301 facilities |
| Peterson, Marco | Managing Control - Governing Body · Individual | 0% | 1 facilities |
| Peterson, Marco | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Peterson, Marco | Adp Of The SNF · Individual | 0% | 1 facilities |
| Sanderson, Clark | Corporate Officer · Individual | 0% | 58 facilities |
| Sandstone Crest Healthcare LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Sandstone Crest Healthcare LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Standard Bearer Healthcare Op, LP | Adp Of The SNF · Organization | 0% | 78 facilities |
| Sycamore Street Health Holdings LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| The Ensign Group Inc | Adp Of The SNF · Organization | 0% | 135 facilities |
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