Avir at River Valley — nursing home in Gainesville, TX

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 116 CMS-certified beds (not state-licensed beds)
Licensed beds: State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.
Average residents per day: 42.6 CMS, MDS-derived
CMS Certification Number: 455970
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Jan 1, 1992
Ownership type: For profit - Corporation
Operator (legal business name): Dallas County Hospital District
CMS chain: Avir Health Group 118 facilities
Phone: (940) 665-0386
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

9

latest Jul 27, 2026

Citations

41

20 health · 21 fire

Harm or worse

0

no immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G·	H·	I·
Potential harm	D10	E11	F14
Minimal	A·	B·	C6

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

CMS Five-Star ratings

Federal · CMS

Overall

Health inspections

Staffingfn 24

Quality measures

Penalties · about the last 3 years

Fines

0

$0

Payment denials

0

Latest

—

Federal certification

Federal · CMS

Authority: Centers for Medicare & Medicaid Services (CMS), surveyed by the state survey agency
CCN: 455970
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 116
First approved: Jan 1, 1992
Located in a hospital: No
Status: Active CMS certification as of CMS release Oct 1, 2026
Evidence: Verified

State license

State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead. State coverage for Texas.

Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

Date	Domain	Survey types	Citations	Most severe	Open
Jul 27, 2026	Health	Health Complaint	1	Potential harm	—	Open →
May 19, 2026	Fire safety	Fire Safety Standard	11	Potential harm	—	Open →
May 19, 2026	Health	Health Standard	5	Potential harm	—	Open →
Nov 26, 2025	Health	Health Complaint	1	Potential harm	—	Open →
Feb 27, 2025	Fire safety	Fire Safety Standard	3	Potential harm	—	Open →
Feb 27, 2025	Health	Health Complaint, Health Standard	6	Potential harm	—	Open →
Jan 16, 2025	Health	Health Complaint	2	Potential harm	—	Open →
Dec 22, 2023	Fire safety	Fire Safety Standard	7	Potential harm	—	Open →
Dec 22, 2023	Health	Health Standard	5	Potential harm	—	Open →

Enforcement

Penalties

Civil money penalties and denials of payment for new admissions, as published by CMS (about the last three years). Amounts may change on appeal.

No fines or payment denials in the CMS Penalties file for this CCN.

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G·	H·	I·
Potential harm	D10	E11	F14
Minimal	A·	B·	C6

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Jul 27, 2026	F-0727	Have 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. Nursing and Physician Services Deficiencies · Staffing & supervision	F · Potential harm Widespread	Corrected Sep 5, 2026	Complaint
May 19, 2026	E-0006	Conduct risk assessment and an All-Hazards approach. Emergency Preparedness Deficiencies · Emergency preparedness	F · Potential harm Widespread	Corrected Jun 26, 2026
May 19, 2026	E-0037	Establish staff and initial training requirements. Emergency Preparedness Deficiencies · Emergency preparedness	F · Potential harm Widespread	Corrected Jun 26, 2026
May 19, 2026	K-0291	Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jun 26, 2026
May 19, 2026	K-0324	Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jun 26, 2026
May 19, 2026	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jun 26, 2026
May 19, 2026	K-0351	Install an approved automatic sprinkler system. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jun 26, 2026
May 19, 2026	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jun 26, 2026
May 19, 2026	K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jun 26, 2026
May 19, 2026	K-0522	Have an externally vented heating system. Services Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jun 26, 2026
May 19, 2026	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jun 26, 2026
May 19, 2026	F-0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Jun 26, 2026
May 19, 2026	F-0755	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Jun 26, 2026
May 19, 2026	F-0761	Ensure 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. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Jun 26, 2026
May 19, 2026	F-0926	Have policies on smoking. Environmental Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jun 26, 2026
May 19, 2026	K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies · Environment & life safety	C · Minimal Widespread	Corrected Jun 26, 2026
May 19, 2026	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety	C · Minimal Widespread	Corrected Jun 26, 2026
Nov 26, 2025	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	D · Potential harm Isolated	Corrected Dec 1, 2025	Complaint
Feb 27, 2025	K-0222	Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. Egress Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Mar 6, 2025
Feb 27, 2025	F-0607	Develop and implement policies and procedures to prevent abuse, neglect, and theft. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Feb 28, 2025
Feb 27, 2025	F-0690	Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Mar 12, 2025
Feb 27, 2025	F-0727	Have 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. Nursing and Physician Services Deficiencies · Staffing & supervision	E · Potential harm Pattern	Corrected Feb 28, 2025
Feb 27, 2025	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Feb 28, 2025	Complaint
Feb 27, 2025	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	D · Potential harm Isolated	Corrected Feb 28, 2025
Feb 27, 2025	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	E · Potential harm Pattern	Corrected Mar 12, 2025
Feb 27, 2025	K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies · Environment & life safety	C · Minimal Widespread	Corrected Feb 27, 2025
Feb 27, 2025	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety	C · Minimal Widespread	Corrected Feb 27, 2025
Jan 16, 2025	F-0622	Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. Resident Rights Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Feb 5, 2025	Complaint
Jan 16, 2025	F-0755	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Jan 22, 2025	Complaint
Dec 22, 2023	K-0324	Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jan 29, 2024
Dec 22, 2023	K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jan 29, 2024
Dec 22, 2023	K-0374	Install smoke barrier doors that can resist smoke for at least 20 minutes. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jan 19, 2024
Dec 22, 2023	K-0741	Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jan 19, 2024
Dec 22, 2023	K-0916	Have a battery powered remote alarm panel in a location accessible by operating personnel. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jan 19, 2024
Dec 22, 2023	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Jan 19, 2024
Dec 22, 2023	F-0727	Have 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. Nursing and Physician Services Deficiencies · Staffing & supervision	F · Potential harm Widespread	Corrected Jan 19, 2024
Dec 22, 2023	F-0755	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Jan 19, 2024
Dec 22, 2023	F-0761	Ensure 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. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Jan 19, 2024
Dec 22, 2023	F-0908	Keep all essential equipment working safely. Environmental Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Jan 19, 2024
Dec 22, 2023	K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies · Environment & life safety	C · Minimal Widespread	Corrected Jan 22, 2024
Dec 22, 2023	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety	C · Minimal Widespread	Corrected Jan 19, 2024

“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.

Five-Star ratings

Federal · CMS

Overallstate 2.8

Health inspectionsstate 2.8

Staffingstate 1.9

Quality measuresstate 3.8

Long-stay QM

Short-stay QMNot rated

CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.

Nurse staffing · hours per resident per day

Total nurse staffing2.86

State avg 3.42US avg 3.90

Registered nurse (RN)0.22

State avg 0.44US avg 0.69

Licensed practical nurse1.24

State avg 0.94US avg 0.86

Nurse aide1.41

State avg 2.03US avg 2.35

Weekend total nurse2.49

State avg 2.99US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 2.67 (case-mix index 1.50).

Staff turnover

Total nursing staff turnover68.0%

State avg 50.8%US avg 45.3%

Registered nurse turnoverNot reported

State avg 49.8%US avg 42.5%

Administrators who left1

State avg 1US avg 1

Health survey score

Cycle 1 standard survey: May 19, 2026
Cycle 1 health score: 48
Total weighted score: 50

Operating entity

Dallas County Hospital District

CMS legal business name of the certified provider. Operates 37 facilities.

VerifiedLinked by exact legal name

CMS chain

Avir Health Group

118 facilities in 1 states. CMS chain ID 719.

VerifiedAssigned by CMS

Chain average overall rating (CMS): 2.2

Ownership disclosures

Disclosures

17

Organizations

5

Individuals

11

Direct & indirect ownership

Owners of record

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Dallas County Hospital District	Organization	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	Jun 1, 2019

CMS Ownership file

All disclosed roles

Operator, owners, managers, officers and lenders are distinct roles and are never flattened into one entity. Organizations link across facilities by exact normalized legal name; individuals are listed per facility only.

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Dallas County Hospital District	Organization	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	Jun 1, 2019
Amitai Dagan	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Apr 14, 2026
Abraham Goldberger	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Apr 14, 2026
Faigy Goldberger	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Apr 14, 2026
Edmundo Castaneda	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Jan 10, 2022
1907 Refinery Rd Opco, LLC	Organization	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Oct 1, 2025
Nochum Freund	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Oct 1, 2025
Ron Hatton	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Nov 1, 2025
Larry Sears	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jun 1, 2019
Aaron Travitsky	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Oct 1, 2025
Edmundo Castaneda	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Jan 10, 2022
1907 Refinery Rd Opco, LLC	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Mar 10, 2026
Welltower Inc	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Oct 1, 2025
Welltower Nnn Group, LLC	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Oct 1, 2025
Welltower Op LLC	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Oct 1, 2025
Ron Hatton	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Nov 10, 2025
Larry Sears	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Jun 1, 2019

Other facilities operated by Dallas County Hospital District

All 36 →

Facility	Beds	Last inspection	Citations (window)	Fines
Windsor Gardens 2535 W Pleasant Run, Lancaster, TX 75146 CCN 455832	150	Jul 20, 2026	342 IJ	$14k
Denton Rehabilitation and Nursing Center 3345 Medpark Dr., Denton, TX 76210 CCN 675136	94	Jul 16, 2026	32	—
Meadowbrook Care Center 632 Windsor Way, Van Alstyne, TX 75495 CCN 675151	60	May 5, 2026	251 IJ	$14k
The Manor at Seagoville 2416 Elizabeth Ln, Seagoville, TX 75159 CCN 675418	90	Apr 1, 2026	382 IJ	$98k
Renaissance Care Center 1400 Blackshill Dr, Gainesville, TX 76240 CCN 675441	91	Jun 4, 2026	42	—
Beacon Hill 3515 S Park Ave, Denison, TX 75020 CCN 675503	150	May 26, 2026	28	—
Williamsburg Village Healthcare Campus 940 York Drive, Desoto, TX 75115 CCN 675756SFF Candidate	242	Jul 30, 2026	939 IJ	$150k
The Villa at Mountain View 2918 Duncanville Rd, Dallas, TX 75211 CCN 675783	120	Aug 28, 2026	512 IJ1 harm3 open	$25k

Same chain in Texas

All 117 in chain →

Facility	Beds	Last inspection	Citations (window)	Fines
Avir at Beaumont 4195 Milam Street, Beaumont, TX 77707 CCN 455001Abuse icon	214	Aug 24, 2026	582 IJ2 open	$40k
Avir at New Braunfels 821 US Hwy 81 W, New Braunfels, TX 78130 CCN 455020Abuse icon	154	Jul 10, 2026	755 IJ	$158k
Avir at Rose Trail 930 S Baxter, Tyler, TX 75701 CCN 455429SFF Candidate	172	Aug 14, 2026	639 IJ3 harm	$484k
Avir at Petal Hill 900 S Baxter Ave, Tyler, TX 75701 CCN 455485Abuse icon	120	May 13, 2026	352 IJ	$26k
Avir at Jeffrey Place 820 Jeffrey Dr, Waco, TX 76710 CCN 455489	95	Apr 9, 2026	452 IJ	$22k
Avir at Temple West 1700 Marlandwood Rd, Temple, TX 76502 CCN 455522	104	Dec 18, 2025	312 IJ1 open	$7,257
Avir at Center 280 Moffitt Dr, Center, TX 75935 CCN 455550	137	Jul 23, 2025	271 IJ	$9,113
Avir at Graham 1224 Corvadura St, Graham, TX 76450 CCN 455555	116	Aug 14, 2025	33	—

No building or property record is linked to this facility yet. Parcel, assessor and building-permit joins will be added only where a valid site match exists.

Coordinates as published by CMS.

Address: 1907 Refinery Rd, Gainesville, TX 76240
ZIP: 76240
County: Cooke County FIPS 48097
State: Texas
Urban / rural (CMS): Rural

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	Last inspection	Citations (window)	Fines
Avir at Gainesville 1900 O'neal St., Gainesville, TX 76240 CCN 675067	2.9 km	112	Aug 25, 2026	894 IJ	$99k
Pecan Tree Rehab and Healthcare Center 1900 E California St, Gainesville, TX 76240 CCN 675550	3.4 km	122	May 12, 2026	342 IJ	$17k
Renaissance Care Center 1400 Blackshill Dr, Gainesville, TX 76240 CCN 675441	3.7 km	91	Jun 4, 2026	42	—

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	455970	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	455970	ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only.	Verified	Oct 1, 2026	Nov 7, 2026

Record-level source links for CCN 455970

First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction