The Waterton Healthcare & Rehabilitation
Tyler, Smith County, Texas · CCN 676193 · Government (Hospital district) · part of The Ensign Group (342 facilities, chain average 3.2 stars)
CMS rates The Waterton Healthcare & Rehabilitation 4 of 5 overall as of August 2026. 92 certified beds, 67 residents a day on average. 10 citations on record from the current inspection cycles, 1 at immediate jeopardy; 2 fines totalling $23,389.
CMS’s ratings
The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.
| Overall | ★★★★☆ 4 of 5 |
|---|---|
| Health inspections | ★★★★☆ 4 of 5 |
| Staffing | ★★☆☆☆ 2 of 5 |
| Quality measures | ★★★★☆ 4 of 5 |
| Quality: long-stay / short-stay | 4 / 4 of 5 |
Staffing
| Total nurse staffing | 3.37774 hours per resident per day |
|---|---|
| Registered nurses | 0.50665 hours per resident per day |
| Weekend total | 3.00316 hours per resident per day |
| Nursing staff turnover | 50.7% (registered nurses 44.4%) |
| Administrators who left | 0 |
Citations from health inspections
Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.
| Survey | Finding | Severity | Status |
|---|---|---|---|
| 2026-05-06 | Honor 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. Resident Rights Deficiencies · tag F0584 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-05-07 |
| 2026-05-06 | Provide for the safe, appropriate administration of IV fluids for a resident when needed. Quality of Life and Care Deficiencies · tag F0694 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-05-07 |
| 2026-05-06 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · tag F0842 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-05-07 |
| 2026-05-06 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · tag F0880 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-05-07 |
| 2026-04-23 complaint survey |
Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · tag F0684 |
G Actual harm that is not immediate jeopardy; isolated | Deficient, Provider has date of correction 2026-04-27 |
| 2025-03-26 | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · tag F0641 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2025-04-10 |
| 2025-03-26 | Provide enough food/fluids to maintain a resident's health. Quality of Life and Care Deficiencies · tag F0692 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2025-04-10 |
| 2024-01-31 | Ensure residents have reasonable access to and privacy in their use of communication methods. Resident Rights Deficiencies · tag F0576 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-03-01 |
| 2024-01-31 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Environmental Deficiencies · tag F0921 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-03-01 |
| 2024-01-08 complaint survey |
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · tag F0689 |
J Immediate jeopardy to resident health or safety; isolated | Deficient, Provider has date of correction 2024-01-09 |
Fines and payment denials
| Date | Penalty | Amount |
|---|---|---|
| 2026-04-23 | Fine | $14,380 |
| 2024-01-08 | Fine | $9,009 |
Who owns and runs it
Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.
| Name | Role | Share | Since |
|---|---|---|---|
| Fannin County Hospital Authority Organization | 5% or greater direct ownership interest | 100% | 2022-03-01 |
| Chickadee Healthcare LLC Organization | adp of the snf | — | 2025-05-14 |
| Ensign Services Inc. Organization | adp of the snf | — | 2022-03-01 |
| Rose Health Holdings LLC Organization | adp of the snf | — | 2022-03-01 |
| Standard Bearer Healthcare Op, Lp Organization | adp of the snf | — | 2022-03-01 |
| The Ensign Group Inc. Organization | adp of the snf | — | 2022-03-01 |
| Chickadee Healthcare LLC Organization | operational/managerial control | — | 2022-03-01 |
| Costa, Charlie Individual | adp of the snf | — | 2025-05-14 |
| Wilson, Jennifer Individual | adp of the snf | — | 2025-04-27 |
| Burnam, Soon Individual | corporate officer | — | 2022-03-01 |
| Sanderson, Clark Individual | corporate officer | — | 2012-10-29 |
| Costa, Charlie Individual | managing control - governing body | — | 2022-03-01 |
| Wilson, Jennifer Individual | managing control - governing body | — | 2022-03-01 |
| Costa, Charlie Individual | operational/managerial control | — | 2022-03-01 |
What changed
Nothing has changed in this record since it was first loaded. The next CMS refresh is the next chance.
Tell me when this record changes
One email when the monthly CMS refresh brings a new citation, a fine or payment denial, a rating change, a flag, or a change of ownership for The Waterton Healthcare & Rehabilitation.
Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Smith County.