Westward Trails Nursing And Rehabilitation
3001 WESTWARD DRIVE, Nacogdoches, TX, 75964
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
- 108 · avg 83 residents/day
- Total nursing staff turnover
- 36% — lower than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 50% — near the Texas averageTexas 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)
- 3 fines · $33,060 total
State licensing & capacity
- License number
- 308307
- Service type
- Medicare/medicaid
- Licensed capacity
- 108 beds
- Bed type breakdown
- 108 Medicaid/Medicare
- Current license effective
- May 1, 2025
- Current license expires
- May 1, 2028
- Initial license date
- November 15, 1991
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Westward I Enterprises, Llc (Limited Liability Company (LLC))
- Operator / manager
- Creative Solutions In Healthcare, Inc
- Administrator
- Justin C Eastepp
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)
- Creative Solutions in Healthcare Inc
Operational/managerial Control · 100% · since 2021
- Gary r Blake
5% or Greater Indirect Ownership Interest · 50% · since 2021
- Honor x Enterprises, Llc
5% or Greater Direct Ownership Interest · 100% · since 2021
- Linda f Huggins
W-2 Managing Employee · since 2021
- Malisa a Blake
5% or Greater Indirect Ownership Interest · 50% · since 2021
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 24)
- F0812·Nov 20, 2025Complaint
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- J0689·Jun 25, 2025Complaint
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D0677·May 22, 2025Complaint
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D0755·Mar 31, 2025Complaint
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E0690·Mar 31, 2025Complaint
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- J0689·Mar 31, 2025Complaint
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D0609·Mar 31, 2025Complaint
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D0600·Mar 31, 2025Complaint
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Federal penalties
By year
- 20253 fines · $33K
Most recent events
- Jun 25, 2025Fine · $23K
- Mar 31, 2025Fine · $5,649
- Mar 31, 2025Fine · $4,486
Largest single fine on record: $23K.
Fire-safety citations
4 Life-Safety-Code citations on file. Most recent: Jun 25, 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
Westward Trails Nursing And Rehabilitation is a 108-bed nursing home in Nacogdoches, TX, licensed for Medicare and Medicaid and managed by Creative Solutions In Healthcare. CMS rates it 3 stars overall, with a 2-star staffing rating and a 4-star quality-measures rating for long-stay residents. Three CMS fines totaling $33,060 have been assessed. The facility is operating at roughly 77% of licensed capacity.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here 2 stars — about 209 minutes of nursing care per resident per day, roughly 32 minutes less than at a 4-star-staffing facility in Texas. That places this facility among the bottom 32% of Texas nursing homes on staffing. RN coverage is 11 minutes per resident per day, compared to 37 minutes at a 4-star-staffing Texas facility.
About 4 in 10 nursing staff left in the past year — below Texas's 25th-percentile cutoff of 42%, meaning staff turnover here is better than roughly three-quarters of nursing homes in the state. That level of continuity is meaningful when lower staffing hours are already a factor.
Three CMS fines totaling $33,060 have been assessed. Texas's median fine total across fined facilities is about $20,699, so this facility's total runs above the state midpoint. Roughly 30% of Texas nursing homes have no fines at all during the same period.
CMS rates the long-stay quality measures 4 stars — outcomes for residents who live here long-term, such as rates of pressure sores, falls, and mobility decline, are above the level most Texas facilities reach. Short-stay quality measures rate 3 stars.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
Staffing levels on nights and weekends
Weekend nursing hours average 2.78 hours per resident per day — below the weekday figure; ask how many nurses and aides are on duty during nights and weekends specifically.
RN coverage during a typical shift
Reported RN time is 11 minutes per resident per day; ask how many hours a registered nurse is physically on the floor each day and whether an RN is present overnight.
Details behind the three CMS fines
Three fines totaling $33,060 have been assessed; ask what deficiencies triggered each fine and what changes were made in response.
How care plans are reviewed
Long-stay quality measures rate 4 stars while staffing rates 2 stars; ask how frequently care plans are updated and who leads those reviews when RN hours are limited.
Resident Council participation
The facility has a Resident Council but no Family Council; ask how families are notified of concerns raised in council meetings and how they can raise issues independently.
Bed availability and waitlist
83 of 108 beds are occupied on an average day; ask whether specific room types or care levels have a waitlist and what the typical admission timeline looks like.
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.