Cedar Lake Nursing Center
1611 W ROYALL BLVD., Malakoff, TX, 75148
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 - Limited Liability company · Chain: Fannin County Hospital District
- Certified beds
- 90 · avg 41 residents/day
- Total nursing staff turnover
- 45.5% — lower than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 20% — lower than most Texas nursing homesTexas avg: 50.5% · National avg: 43.6% · per CMS Care Compare
- Administrators who left
- 0 departed — near the Texas averageTexas avg: 0.6 · National avg: 0.5 · per CMS Care Compare
Enforcement & Citations
- Fines (past 3 years)
- 5 fines · $31,850 total
State licensing & capacity
- License number
- 311791
- Service type
- Medicare/medicaid
- Licensed capacity
- 90 beds
- Bed type breakdown
- 3 Medicare-only · 87 Medicaid/Medicare
- Current license effective
- January 1, 2024
- Current license expires
- January 1, 2027
- Initial license date
- September 1, 1971
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Fannin County Hospital Authority (HOSPITAL DISTRICT/AUTHORITY)
- Operator / manager
- Rusk Nursing & Rehab Center Llc
- Administrator
- Douglas Humble
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Chain affiliation
Part of the Fannin County Hospital District chain — 5 facilities. Chain-wide average overall rating 2.8 / 5.
Disclosed owners (9 on record)
- Clark r Sanderson
Corporate Director · since 2024
- David Paul Sanner
Adp of The Snf · since 2024
- Douglas Francis Humble
Adp of The Snf · since 2024
- Edward Blalock
Operational/managerial Control · since 2024
- Fannin County Hospital Authority
5% or Greater Direct Ownership Interest · 100% · since 2024
- Michael Bumpass
5% or Greater Mortgage Interest · 50% · since 2024
+ 3 additional owners on the federal record.
Recent change of ownership
January 2024 (2 years ago) · acquired from Cedar Lake Nursing Home
Transaction type: Change of Ownership
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Chain Performance Measures + Change of Ownership, as of April 2026.
Federal inspection record
Recent health-deficiency citations (most recent 8 of 8)
- D0880·Sep 10, 2025
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
- D0812·Sep 10, 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.
- D0842·Aug 7, 2024
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- F0812·Aug 7, 2024
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D0641·Aug 7, 2024
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
- E0812·Jul 12, 2023
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E0803·Jul 12, 2023
Nutrition and Dietary Deficiencies
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.
- E0576·Jul 12, 2023
Resident Rights Deficiencies
Ensure residents have reasonable access to and privacy in their use of communication methods.
Federal penalties
By year
- 20235 fines · $32K
Most recent events
- Aug 21, 2023Fine · $4,545
- Aug 14, 2023Fine · $4,545
- Aug 7, 2023Fine · $4,545
- Jul 17, 2023Fine · $14K
- Mar 20, 2023Fine · $4,580
Largest single fine on record: $14K.
Fire-safety citations
6 Life-Safety-Code citations on file. Most recent: Sep 10, 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
Cedar Lake Nursing Center is a 90-bed nursing home in Malakoff, Henderson County, Texas, licensed since 1971 and currently operating at about 46% of capacity. CMS rates it 4 stars overall, with 5 stars on health inspections and 4 stars on staffing — but 1 star on quality measures, the lowest possible. Five CMS fines totaling $31,850 have been issued. Licensed to Fannin County Hospital Authority and managed by Rusk Nursing & Rehab Center LLC.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here at 4 stars — roughly the top 9% of Texas nursing homes on staffing. Each resident receives about 291 minutes of nursing care per day. Staff hours per resident exceed what the current resident mix would typically require, so those minutes are not being stretched thin by unusually high care needs.
RN turnover here is exceptionally low: roughly 2 in 10 registered nurses left in the past year, below the state's 25th-percentile cutoff — better than about three-quarters of nursing homes in Texas. Administrator turnover is zero over the same period.
CMS issued 5 fines totaling $31,850 since the facility's last inspection cycle. The state median for fined facilities in Texas is about $20,699; this facility's total runs above that midpoint. About 30% of Texas nursing homes had no fines at all in the same period.
The quality measures rating is 1 star — the lowest CMS assigns — on both long-stay and short-stay measures. These scores reflect tracked outcomes such as pressure wounds, falls, pain management, and rehospitalization rates, independent of staffing levels.
The facility is operating at roughly 46% of its 90 licensed beds, with about 41 residents on an average day. Paired with the 1-star quality measures and the fine history, that low census is part of a facility picture where staffing levels and inspection scores diverge sharply from resident outcomes.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
What explains the 1-star quality measures
CMS rates this facility 1 star on both long-stay and short-stay quality measures — ask which specific outcomes drove that rating and what has changed in response.
Details on the five CMS fines
Five fines totaling $31,850 have been issued — ask what deficiencies triggered each fine and whether the cited practices have been corrected.
Why is occupancy at 46%
With roughly 41 residents in a 90-bed building, ask whether the low census reflects recent referral patterns, discharge trends, or something else affecting the facility's standing locally.
Management company's role day to day
The facility is licensed to Fannin County Hospital Authority but managed by Rusk Nursing & Rehab Center LLC — ask who sets staffing levels, care policies, and responds to complaints.
How the Resident Council operates
A Resident Council is listed but no Family Council — ask how often it meets, who facilitates it, and how concerns raised there reach administration.
Staffing consistency on nights and weekends
Weekend nursing hours run about 270 minutes per resident per day compared to the overall 291 — ask how staffing levels and staff assignments shift on evenings and weekends.
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.