Cottonwood Nursing & Rehabilitation
2224 NORTH CARROLL BOULEVARD, Denton, TX, 76201
Federal Quality Data
Official records from CMS Care Compare — reported by the facility and audited by the Centers for Medicare & Medicaid Services. We present them unmodified. Refreshed March 2026.
CMS Star Ratings
Facility & Staffing
- Ownership
- For profit - Corporation · Chain: Creative Solutions In Healthcare
- Certified beds
- 60 · avg 43 residents/day
- Total nursing staff turnover
- 59.1% — higher than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 100% — higher than most Texas nursing homesTexas avg: 50.5% · National avg: 43.6% · per CMS Care Compare
State licensing & capacity
- License number
- 308091
- Service type
- Medicare/medicaid
- Licensed capacity
- 60 beds
- Bed type breakdown
- 2 Medicare-only · 58 Medicaid/Medicare
- Current license effective
- December 1, 2024
- Current license expires
- December 1, 2027
- Initial license date
- September 1, 1971
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Denton I Enterprises, Llc (Limited Liability Company (LLC))
- Operator / manager
- Creative Solutions In Healthcare, Inc
- Administrator
- Stacy Smith
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Chain affiliation
Part of the Creative Solutions in Healthcare chain — 149 facilities. Chain-wide average overall rating 2.7 / 5.
Disclosed owners (5 on record)
- Gary r Blake
Operational/managerial Control · 50% · since 2021
- Malisa a Blake
Operational/managerial Control · 50% · since 2021
- Creative Solutions in Healthcare Inc
Operational/managerial Control · 100% · since 2020
- Honor x Enterprises, Llc
5% or Greater Direct Ownership Interest · 100% · since 2020
- Linda f Huggins
W-2 Managing Employee · since 2020
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Chain Performance Measures, as of April 2026.
Federal inspection record
Recent health-deficiency citations (most recent 8 of 28)
- E0804·Jan 29, 2026Complaint
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- D0695·Jan 29, 2026Complaint
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
- E0689·Jan 29, 2026Complaint
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E0880·Aug 14, 2025
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
- F0812·Aug 14, 2025
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E0761·Aug 14, 2025
Pharmacy Service Deficiencies
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.
- D0755·Aug 14, 2025
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D0695·Aug 14, 2025
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Fire-safety citations
16 Life-Safety-Code citations on file. Most recent: Aug 14, 2025. Fire-safety inspections cover building-level Life Safety Code compliance, separate from the resident-care health survey.
Source: CMS Provider Data Catalog — Health Deficiencies, Fire Safety Deficiencies, and Penalties datasets, snapshot Mar 1, 2026.
About this community
Cottonwood Nursing & Rehabilitation is a 60-bed Medicare/Medicaid nursing home in Denton, TX, managed by Creative Solutions In Healthcare. CMS rates it 2 stars overall — staffing earns 1 star and quality measures 2 stars. The facility is operating at 72% of licensed capacity, with 43 of 60 beds occupied on an average day. No fines appear in the CMS record and no abuse findings have been substantiated.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here 1 star — the lowest tier, shared by about 38% of Texas nursing homes. Each resident receives roughly 196 minutes of nursing care per day, about 45 minutes less than at a 4-star-staffing facility in Texas. Residents here require more hands-on care than at a typical facility — more dependent or medically complex on average — so those 196 minutes stretch thinner than the number alone suggests. Of those 196 minutes, only 15 come from a registered nurse; a 4-star-staffing facility in Texas averages 37 RN minutes per resident per day.
Every registered nurse on staff left in the past year — a 100% RN turnover rate. That means residents relying on an RN for medication oversight, wound care, or care-plan coordination have cycled through an entirely new set of nurses within the last 12 months.
The facility is running at 72% of its 60 licensed beds, with roughly 43 residents on an average day. Low occupancy alongside 1-star staffing and complete RN turnover represents a pattern that warrants direct questions to administration.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
Current RN staffing situation
CMS records show 100% RN turnover in the past year — ask how many registered nurses are currently on staff and what their typical shift coverage looks like.
Why occupancy is at 72%
The facility averages 43 residents against 60 licensed beds — ask administration what is driving the vacancy and whether it affects staffing or service levels.
How care plans are reviewed
Quality measures rate 2 stars despite a resident population that needs more hands-on care than average — ask who leads care-plan reviews and how often they happen.
Weekend nursing coverage
CMS data shows weekend nursing hours drop to roughly 173 minutes per resident per day, well below the weekday figure — ask how RN or charge-nurse coverage is handled on Saturdays and Sundays.
Resident Council participation
The facility has a Resident Council but no Family Council — ask how family members are notified of council meetings or can raise concerns between visits.
Management company's role on-site
Creative Solutions In Healthcare manages day-to-day operations — ask how often a company representative is physically present and who the direct point of contact is for family concerns.
Where this information comes from
- License, capacity, ownership, administrator: Texas HHSC licensing registry, snapshot as of April 16, 2026.
- Star ratings, staffing, fines, deficiencies: CMS Care Compare, processed March 1, 2026.
- Summary, insights, and tour questions: Written from the state licensing and CMS records above, last updated April 19, 2026.
Read our methodology for how this information is collected and verified.