Paradigm At First Colony
4710 LEXINGTON BLVD, Missouri City, TX, 77459
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: Paradigm Healthcare
- Certified beds
- 150 · avg 106 residents/day
- Total nursing staff turnover
- 63.9% — higher than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 80% — higher than most Texas nursing homesTexas avg: 50.5% · National avg: 43.6% · per CMS Care Compare
- Administrators who left
- 3 departed — near the Texas averageTexas avg: 0.6 · National avg: 0.5 · per CMS Care Compare
Enforcement & Citations
- Fines (past 3 years)
- 3 fines · $211,113 total
- Infection control citations
- 1
State licensing & capacity
- License number
- 144408
- Service type
- Medicare/medicaid
- Licensed capacity
- 150 beds
- Bed type breakdown
- 47 Medicare-only · 103 Medicaid/Medicare
- Current license effective
- February 28, 2025
- Current license expires
- February 28, 2028
- Initial license date
- May 16, 1991
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Oakbend Medical Center (COUNTY)
- Operator / manager
- First Colony Nursing & Rehabilitation, Llc
- Administrator
- Victoria Johnson Clark
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Chain affiliation
Part of the Paradigm Healthcare chain — 18 facilities across 2 states. Chain-wide average overall rating 2.1 / 5.
Disclosed owners (13 on record)
- Oakbend Medical Center
5% or Greater Direct Ownership Interest · 100% · since 2015
- Ssc Missouri City Operating Company Llc
Operational/managerial Control · since 2015
- Melissa Martin
Corporate Director · 9% · since 2015
- Ruthanne Mefford
Corporate Director · 9% · since 2015
- James r Mcclamroch
Corporate Director · 9% · since 2013
- Jeff Council
Corporate Director · 9% · since 2013
+ 7 additional owners on the federal record.
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Chain Performance Measures, as of April 2026.
Federal inspection record
Immediate-jeopardy citations (CMS scope/severity J–L) are the most serious category federal inspectors issue — meaning a deficiency placed residents in immediate risk of serious harm. Ask the facility for the corrective-action plan filed with CMS, and consider contacting your state long-term care ombudsman for context.
Recent health-deficiency citations (most recent 8 of 41)
- D0551·Dec 1, 2025Complaint
Resident Rights Deficiencies
Give the resident's representative the ability to exercise the resident's rights.
- D0558·Nov 14, 2025Complaint
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
- E0610·Sep 8, 2025Complaint
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
- D0755·Jun 1, 2025Complaint
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- K0689·Nov 27, 2024Complaint
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- K0684·Nov 27, 2024Complaint
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- C0732·Nov 19, 2024Complaint
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
- C0583·Nov 19, 2024Complaint
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Federal penalties
By year
- 20242 fines · $65K
- 20231 fine · $147K
Most recent events
- Nov 27, 2024Fine · $20K
- Oct 24, 2024Fine · $45K
- Aug 15, 2023Fine · $147K
Largest single fine on record: $147K.
Fire-safety citations
10 Life-Safety-Code citations on file. Most recent: Jan 22, 2026. 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
Paradigm At First Colony is a 150-bed nursing home in Missouri City, Fort Bend County, managed by First Colony Nursing & Rehabilitation, LLC under county licensee Oakbend Medical Center. CMS rates it 1 star overall — the lowest rating — with 1-star scores on both health inspections and staffing. Three CMS fines total $211,113 since the facility's current data period. Occupancy runs at about 71% of licensed beds, below typical levels for the area.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here at 1 star — the bottom tier, shared by about 38% of Texas nursing homes. Each resident receives roughly 205 minutes of total nursing care per day, about 36 minutes less than at a 4-star-staffing facility in Texas. Residents here require more hands-on care than at a typical facility — less mobile or more medically complex on average — so those 205 minutes stretch thinner than the raw number suggests. RN coverage specifically runs to about 30 minutes per resident per day, compared to 37 minutes at the 4-star threshold.
About 6 in 10 nursing staff left in the past year — above the state's 75th-percentile cutoff of 60%, meaning turnover here exceeds most Texas nursing homes. RN turnover is higher still: roughly 8 in 10 registered nurses left in the same period. A long-stay resident will likely go through two or three primary caregivers in a year, and the RN responsible for overseeing care plans will likely change as well.
Three administrators have left in the past year. That level of leadership turnover tends to ripple through staffing decisions, care protocols, and day-to-day operations that residents experience directly.
CMS recorded 3 fines totaling $211,113. The state median fine total among penalized Texas nursing homes is about $20,699 — this facility's total is roughly ten times that figure. About 30% of Texas nursing homes have no fines at all in the current period.
The facility is operating at about 71% of its 150 licensed beds, with roughly 106 residents on an average day. That low occupancy, paired with the staffing, turnover, and fine signals above, is a pattern that warrants direct questions during any visit.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
Three administrators in one year
CMS data shows three administrator changes in the past 12 months — ask who is currently leading the facility and how long they have been in the role.
Staffing on nights and weekends
Reported weekend nursing hours run to about 183 minutes per resident per day — ask how many nurses and aides are on the floor on a Saturday night shift.
Why occupancy is at 71%
The facility has roughly 44 empty beds on any given day — ask whether recent regulatory activity or staffing changes have affected admissions.
What the $211,113 in fines covered
Three CMS fines totaling $211,113 were recorded — ask what deficiencies triggered them and what specific changes were made in response.
RN oversight of care plans
Eight in ten registered nurses left in the past year — ask which RN is currently assigned to oversee your family member's care plan and how long that person has been on staff.
Resident Council access and frequency
The facility has a Resident Council but no Family Council — ask how often the council meets and how family members can surface concerns without one.
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.