Avir At Cowhorn Creek
5524 COWHORN CREEK, Texarkana, TX, 75503
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 Abuse Flag
CMS has flagged this facility for a substantiated finding of resident abuse, neglect, or exploitation in its current or recent inspection cycle. Ask the facility for the specific citation and corrective-action plan during your visit, and consider contacting your state's long-term care ombudsman for context.
Source: CMS Care Compare.
CMS Star Ratings
Facility & Staffing
- Ownership
- For profit - Limited Liability company · Chain: Avir Health Group
- Certified beds
- 76 · avg 71 residents/day
- Total nursing staff turnover
- 57.8% — higher than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 66.7% — higher 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)
- 1 fine · $32,715 total
- Payment denials
- 1 denial
State licensing & capacity
- License number
- 312703
- Service type
- Medicare/medicaid
- Licensed capacity
- 76 beds
- Bed type breakdown
- 76 Medicaid/Medicare
- Current license effective
- September 1, 2025
- Current license expires
- September 1, 2028
- Initial license date
- February 21, 2006
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Guadalupe County Hospital Board (HOSPITAL DISTRICT/AUTHORITY)
- Operator / manager
- 5524 Cowhorn Creek Opco, Llc
- Administrator
- Britney Betts Cleveland
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Disclosed owners (10 on record)
- 5524 Cowhorn Creek Property Owner, Llc
5% or Greater Security Interest · 100% · since 2025
- Aaron Travitsky
Operational/managerial Control · since 2025
- Angela Wade
Corporate Officer · since 2025
- Britney Betts
Adp of The Snf · since 2025
- Clay Walt Ferguson
Operational/managerial Control · since 2025
- Hccf Management Group xi Llc
5% or Greater Security Interest · 100% · since 2025
+ 4 additional owners on the federal record.
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners, 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 53)
- D0838·Aug 15, 2025Complaint
Administration Deficiencies
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
- D0806·Aug 15, 2025Complaint
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
- D0677·Aug 15, 2025Complaint
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
- K0675·Aug 15, 2025Complaint
Quality of Life and Care Deficiencies
Honor each resident's preferences, choices, values and beliefs.
- K0600·Aug 15, 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.
- E0585·Aug 15, 2025Complaint
Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
- D0561·Aug 15, 2025Complaint
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
- D0600·Apr 9, 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
- 20251 fine · $33K · 1 payment denial
Most recent events
- Aug 15, 2025Payment denial · 5 days · starting Sep 13, 2025
- Aug 15, 2025Fine · $33K
Fire-safety citations
3 Life-Safety-Code citations on file. Most recent: Nov 16, 2023. 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
Avir at Cowhorn Creek is a 76-bed nursing home in Texarkana, TX, operating under the Avir Health Group chain. CMS rates it 1 star overall, with a 1-star health inspection rating and a substantiated finding of resident abuse or neglect within the past 36 months. Staffing is also rated 1 star. The facility holds a $32,715 CMS fine. Quality measure ratings are mixed — 4 stars overall, 5 stars for long-stay residents, and 2 stars for short-stay.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates this facility 1 star on staffing — the bottom tier in Texas. Each resident receives about 188 minutes of total nursing care per day, roughly 53 minutes less than at a 4-star-staffing facility in Texas. Of that, only 12 minutes per day comes from a registered nurse, compared to 37 minutes at a 4-star-staffing facility in the state. Residents here require more hands-on care than at a typical facility — less mobile or more medically complex on average — so those staffing hours stretch thinner than the raw numbers already suggest.
CMS has substantiated findings of resident abuse or neglect at this facility within the past 36 months. This is recorded on the federal Care Compare database and reflects findings from inspections, complaints, or both.
CMS issued one fine totaling $32,715. About 30% of Texas nursing homes received no fines in this period; this facility's fine is above the Texas median of $20,699.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
Details behind the abuse finding
CMS has a substantiated abuse or neglect finding on record here — ask what happened, what staff were involved, and what specific policy changes followed.
RN coverage on a typical day
CMS data shows only 12 minutes of registered nurse time per resident per day — ask how many RNs are on shift, and during which hours.
Staffing on nights and weekends
Weekend nursing hours at this facility run lower than weekday hours; ask how many aides and nurses are on duty Saturday and Sunday nights specifically.
The $32,715 CMS fine
A fine above the Texas median was issued — ask what deficiency it was tied to and whether the underlying issue has been corrected.
Resident Council access and meeting schedule
The facility has a Resident Council but no Family Council — ask how family members can raise concerns and how frequently the Resident Council meets.
Management company role in daily operations
The licensed owner is a hospital district authority, but day-to-day operations are managed by 5524 Cowhorn Creek Opco, LLC — ask which entity sets staffing levels and handles complaints.
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.