Federal inspection record · CMS data as of October 1, 2026
Truman W Smith Children's Care Center
2200 W Upshur Ave, Gladewater, TX · (903) 845-2181
- Certified beds
- 120
- Residents per day
- 101
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicaid
- Certified since
- December 16, 1999
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
★★★★★−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.
-
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
★★★★★5 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Truman W Smith Children's Care Center carries 22 inspection points. That is fewer than 92% 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
13 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 Care4E
- E
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.
- 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 appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nutrition and Dietary3E
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Infection Control3E
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Resident Rights2D
- 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 a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Environmental1D
- D
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspection history
2025-11-18
4 health deficiencies · 1 fire-safety deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
2025-01-14
3 health deficiencies · 2 fire-safety deficiencies
Top issue: Infection Control (1 deficiency)
2023-12-06
6 health deficiencies · 1 fire-safety deficiencies
Top issue: Infection Control (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 4 h 42 min of nursing staff time a day, 36 min of it from a registered nurse.
This home
4 h 42 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 33% of nursing staff and 38% 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. |
|---|---|---|---|
| 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 vaccine0.1 pts better | 97.1% | 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 symptoms2.3 pts better | 0.0% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight2.9 pts better | 0.0% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication44.4 pts worse | 62.2% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication3.5 pts worse | 13.3% | 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 worsened9.5 pts better | 3.4% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased0.4 pts worse | 16.2% | 15.8% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.4 pts worse | 0.7% | 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 incontinence11.3 pts better | 1.2% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers3.4 pts better | 0.3% | 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% |
·
Fire safety
4 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke4F
- E
Inspect, test, and maintain automatic sprinkler systems.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
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