Starfile

Starfile / Texas

CARROLLTON HEALTH AND REHABILITATION CENTER

1618 KIRBY RD, CARROLLTON, TX 75006 · CCN 675972

Ratings

Overall
★★★☆☆ 3
Health inspection
★★★☆☆ 3
Quality measures
★★★☆☆ 3
Staffing
★★★☆☆ 3

Facility

Ownership type
For profit - Corporation
Certified beds
120
Avg residents/day
78.7
Phone
9722451573

Inspection history vs Texas & national averages

Cycle 1 is the most recent standard health inspection. Lower total deficiency counts are better.

CycleInspection dateThis facilityTexas avgNational avgvs state
12025-05-06139.19.5+3.9 worse
22024-04-1199.49.8-0.4 better
32023-03-02128.19.3+3.9 worse

Cycle 1 deficiencies by category

CategoryDeficiencies
Quality of life and care5
Resident rights1
Pharmacy service3
Environmental1
Administration1
Infection control2

Staffing (hours per resident per day)

MetricThis facilityTurnover
Total nurse staffing (reported)3.1660.0%
RN staffing (reported)0.8650.0%
Total nurse staffing (adjusted)3.38

Fines & penalties

Total fines
$19,185
Number of fines
2
Number of penalties
2
Payment denials
0

Chain

Chain
THE ENSIGN GROUP
Facilities in chain
329
Chain avg overall
3.20 / 5

Inspection citations (34)1 immediate jeopardy1 actual harm

  1. EF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2026-01-30 · Health

    Potential for more than minimal harm

  2. EF0695Provide safe and appropriate respiratory care for a resident when needed.2026-01-30 · Health

    Potential for more than minimal harm

  3. EF0919Make sure that a working call system is available in each resident's bathroom and bathing area.2026-01-30 · Health

    Potential for more than minimal harm

  4. EF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-12-01 · Health · corrected 2025-12-02

    Potential for more than minimal harm

  5. DF0583Keep residents' personal and medical records private and confidential.2025-11-20 · Health · corrected 2025-12-07

    Potential for more than minimal harm

  6. DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-11-20 · Health · corrected 2025-12-07

    Potential for more than minimal harm

  7. DF0761Ensure 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.2025-11-20 · Health · corrected 2025-12-07

    Potential for more than minimal harm

  8. DF0880Provide and implement an infection prevention and control program.2025-11-20 · Health · corrected 2025-12-07

    Potential for more than minimal harm

  9. EF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2025-05-06 · Health · corrected 2025-05-30

    Potential for more than minimal harm

  10. EF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2025-05-06 · Health · corrected 2025-05-30

    Potential for more than minimal harm

  11. EF0759Ensure medication error rates are not 5 percent or greater.2025-05-06 · Health · corrected 2025-05-30

    Potential for more than minimal harm

  12. EF0776Provide timely, approved x-ray services, or have an agreement with an approved provider to obtain them.2025-05-06 · Health · corrected 2025-05-30

    Potential for more than minimal harm

  13. DF0880Provide and implement an infection prevention and control program.2025-05-06 · Health · corrected 2025-05-30

    Potential for more than minimal harm

  14. GF0600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.2025-01-14 · Health · corrected 2024-05-20

    Actual harm

  15. DF0558Reasonably accommodate the needs and preferences of each resident.2024-04-11 · Health · corrected 2024-05-03

    Potential for more than minimal harm

  16. DF0584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.2024-04-11 · Health · corrected 2024-05-03

    Potential for more than minimal harm

  17. DF0641Ensure each resident receives an accurate assessment.2024-04-11 · Health · corrected 2024-05-03

    Potential for more than minimal harm

  18. EF0694Provide for the safe, appropriate administration of IV fluids for a resident when needed.2024-04-11 · Health · corrected 2024-05-03

    Potential for more than minimal harm

  19. DF0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.2024-04-11 · Health · corrected 2024-05-03

    Potential for more than minimal harm

  20. DF0760Ensure that residents are free from significant medication errors.2024-04-11 · Health · corrected 2024-05-03

    Potential for more than minimal harm

  21. DF0761Ensure 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.2024-04-11 · Health · corrected 2024-05-03

    Potential for more than minimal harm

  22. JF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2024-03-20 · Health · corrected 2024-01-05

    Immediate jeopardy

  23. DF0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  24. DF0584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  25. DF0607Develop and implement policies and procedures to prevent abuse, neglect, and theft.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  26. DF0609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  27. DF0677Provide care and assistance to perform activities of daily living for any resident who is unable.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  28. DF0693Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  29. FF0727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  30. DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  31. DF0761Ensure 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.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  32. DF0803Ensure 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.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  33. DF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2023-03-02 · Health · corrected 2023-04-02

    Potential for more than minimal harm

  34. DF0880Provide and implement an infection prevention and control program.2023-03-02 · Health · corrected 2023-04-06

    Potential for more than minimal harm

Ownership

OwnerTypeRolePercentSince
EASTLAND MEMORIAL HOSPITAL DISTRICTOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST100%2017-04-01
CARROLLTON HEIGHTS HEALTHCARE, INC.OrganizationOPERATIONAL/MANAGERIAL CONTROL2017-04-01
COIL, RYANIndividualOPERATIONAL/MANAGERIAL CONTROL2025-08-01
WARD, CHARLESIndividualOPERATIONAL/MANAGERIAL CONTROL2023-12-01
BURNAM, SOONIndividualCORPORATE OFFICER2017-04-01
KEETCH, CHADIndividualCORPORATE OFFICER2011-03-01
TAYLOR, STEPHENIndividualCORPORATE OFFICER2025-07-01

Other facilities in CARROLLTON

NameOverallBeds
THE MADISON ON MARSH★★★☆☆125

Source: CMS Provider Data Catalog, Nursing Home Care Compare files (processed 2026-03-01). Citations show the 3 most recent inspection cycles.