Nursing home · SNF / NF

Legend Healthcare and Rehabilitation - Paris

Federal · CMSActive CMS certificationCCN 676049For profit CMS overall

520 SE 8th St, Paris, TX 75460 · Operated by Fannin County Hospital Authority · Chain The Ensign Group

Source: CMS Provider Data Catalog, release Oct 1, 2026 · provenance

$25 Full Intelligence Report

Certified beds

120

Avg residents / day

Inspections

Citations

Harm-level

Fines

$16k

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 120 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: 79.1 CMS, MDS-derived
CMS Certification Number: 676049
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Jan 30, 2005
Ownership type: For profit - Limited Liability company
Operator (legal business name): Fannin County Hospital Authority
CMS chain: The Ensign Group 347 facilities
Phone: (903) 737-9820
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

latest Feb 5, 2026

Citations

42 health · 1 fire

Harm or worse

1 immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J1	K·	L·
Actual harm	G·	H·	I·
Potential harm	D21	E20	F1
Minimal	A·	B·	C·

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

Staffing

Quality measures

Penalties · about the last 3 years

Fines

$16,149

Payment denials

Latest

Nov 20, 2024

Date	Domain	Survey types	Citations	Most severe	Open
Feb 5, 2026	Fire safety	Fire Safety Standard	0	No citations	—	Open →
Feb 5, 2026	Health	Health Complaint, Health Standard	14	Potential harm	—	Open →
Jul 24, 2025	Health	Health Complaint	1	Potential harm	—	Open →
Nov 20, 2024	Fire safety	Fire Safety Standard	1	Potential harm	—	Open →
Nov 20, 2024	Health	Health Standard	8	Immediate jeopardy	—	Open →
Oct 12, 2023	Fire safety	Fire Safety Standard	0	No citations	—	Open →
Oct 12, 2023	Health	Health Standard	19	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.

Date	Type	Amount	Payment denial	Record
Nov 20, 2024	Civil money penalty (fine)	$16,149	—	676049\|Fine\|113436

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J1	K·	L·
Actual harm	G·	H·	I·
Potential harm	D21	E20	F1
Minimal	A·	B·	C·

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Feb 5, 2026	F-0550	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Feb 13, 2026
Feb 5, 2026	F-0552	Ensure that residents are fully informed and understand their health status, care and treatments. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Feb 13, 2026
Feb 5, 2026	F-0580	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Feb 13, 2026
Feb 5, 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	D · Potential harm Isolated	Corrected Feb 13, 2026
Feb 5, 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	D · Potential harm Isolated	Corrected Feb 13, 2026
Feb 5, 2026	F-0759	Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Feb 13, 2026
Feb 5, 2026	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Feb 13, 2026
Feb 5, 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 Feb 13, 2026
Feb 5, 2026	F-0804	Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	D · Potential harm Isolated	Corrected Feb 13, 2026
Feb 5, 2026	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	E · Potential harm Pattern	Corrected Feb 13, 2026
Feb 5, 2026	F-0838	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. Administration Deficiencies · Administration & records	E · Potential harm Pattern	Corrected Feb 13, 2026
Feb 5, 2026	F-0842	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 · Clinical care	E · Potential harm Pattern	Corrected Feb 13, 2026	Complaint
Feb 5, 2026	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	E · Potential harm Pattern	Corrected Feb 13, 2026
Feb 5, 2026	F-0926	Have policies on smoking. Environmental Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Feb 13, 2026
Jul 24, 2025	F-0842	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 · Clinical care	D · Potential harm Isolated	Corrected Aug 15, 2025	Complaint
Nov 20, 2024	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	J · Immediate jeopardy Isolated	Past non-compliance Nov 14, 2024
Nov 20, 2024	K-0324	Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Nov 20, 2024
Nov 20, 2024	F-0636	Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. Resident Assessment and Care Planning Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Dec 24, 2024
Nov 20, 2024	F-0638	Assure that each resident’s assessment is updated at least once every 3 months. Resident Assessment and Care Planning Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Dec 24, 2024
Nov 20, 2024	F-0677	Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Dec 24, 2024
Nov 20, 2024	F-0757	Ensure each resident’s drug regimen must be free from unnecessary drugs. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Dec 24, 2024
Nov 20, 2024	F-0758	Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Dec 24, 2024
Nov 20, 2024	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	D · Potential harm Isolated	Corrected Dec 24, 2024
Nov 20, 2024	F-0881	Implement a program that monitors antibiotic use. Infection Control Deficiencies · Infection prevention	D · Potential harm Isolated	Corrected Dec 24, 2024
Oct 12, 2023	F-0550	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Nov 20, 2023
Oct 12, 2023	F-0561	Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Nov 20, 2023
Oct 12, 2023	F-0578	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. Resident Rights Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Nov 20, 2023
Oct 12, 2023	F-0584	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 · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Nov 20, 2023
Oct 12, 2023	F-0641	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Nov 20, 2023
Oct 12, 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	D · Potential harm Isolated	Corrected Nov 20, 2023
Oct 12, 2023	F-0657	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Nov 20, 2023
Oct 12, 2023	F-0677	Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Nov 20, 2023
Oct 12, 2023	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	E · Potential harm Pattern	Corrected Nov 20, 2023
Oct 12, 2023	F-0695	Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Nov 20, 2023
Oct 12, 2023	F-0712	Ensure that the resident and his/her doctor meet face-to-face at all required visits. Nursing and Physician Services Deficiencies · Staffing & supervision	D · Potential harm Isolated	Corrected Nov 20, 2023
Oct 12, 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	E · Potential harm Pattern	Corrected Nov 20, 2023
Oct 12, 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	E · Potential harm Pattern	Corrected Nov 20, 2023
Oct 12, 2023	F-0804	Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	E · Potential harm Pattern	Corrected Nov 20, 2023
Oct 12, 2023	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	F · Potential harm Widespread	Corrected Nov 20, 2023
Oct 12, 2023	F-0849	Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. Administration Deficiencies · Administration & records	E · Potential harm Pattern	Corrected Nov 20, 2023
Oct 12, 2023	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	E · Potential harm Pattern	Corrected Nov 20, 2023
Oct 12, 2023	F-0881	Implement a program that monitors antibiotic use. Infection Control Deficiencies · Infection prevention	E · Potential harm Pattern	Corrected Nov 20, 2023
Oct 12, 2023	F-0926	Have policies on smoking. Environmental Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Nov 20, 2023

“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.

Operating entity

Fannin County Hospital Authority

CMS legal business name of the certified provider. Operates 58 facilities.

VerifiedLinked by exact legal name

CMS chain

The Ensign Group

347 facilities in 17 states. CMS chain ID 507.

VerifiedAssigned by CMS

Chain average overall rating (CMS): 3.3

Ownership disclosures

Disclosures

Organizations

Individuals

Direct & indirect ownership

Owners of record

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Fannin County Hospital Authority	Organization	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	Apr 1, 2017

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
Fannin County Hospital Authority	Organization	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	Apr 1, 2017
Stephen Burns	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Aug 1, 2022
Ra Lawrence	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Apr 1, 2017
Eiffel Healthcare LLC	Organization	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Apr 1, 2017
Stephen Burns	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Aug 1, 2022
Ra Lawrence	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Apr 1, 2017
Soon Burnam	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Apr 1, 2017
Chad Keetch	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Apr 1, 2017
Clark Sanderson	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Oct 29, 2012
Ensign Services Inc	Organization	Additional disclosable party	ADP OF THE SNF	not provided	May 1, 2016
Sherman Health Holdings LLC	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Jan 1, 2022
Standard Bearer Healthcare Op, LP	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Jan 1, 2022
The Ensign Group Inc	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Jan 1, 2022
Stephen Burns	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Aug 1, 2022
Ra Lawrence	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Apr 1, 2017

Other facilities operated by Fannin County Hospital Authority

All 57 →

Facility	Beds	Last inspection	Citations (window)	Fines
Avir at the Meadow 8383 Meadow Road, Dallas, TX 75231 CCN 455463	184	Jul 27, 2026	693 IJ2 harm	$36k
Ennis Care Center 1200 S Hall St, Ennis, TX 75119 CCN 455486	155	May 20, 2026	502 IJ	$37k
Pleasant Springs Healthcare Center 2003 North Edwards Avenue, Mount Pleasant, TX 75455 CCN 455532SFF CandidateAbuse icon	90	Aug 7, 2026	774 IJ2 harm	$66k
Avir at Center 280 Moffitt Dr, Center, TX 75935 CCN 455550	137	Jul 23, 2025	271 IJ	$9,113
Texoma Healthcare Center 1000 US Highway 82 East, Sherman, TX 75090 CCN 455573	179	Aug 19, 2026	602 IJ6 open	$16k
Avir at Weatherford 521 W. 7th Street, Weatherford, TX 76086 CCN 455574Abuse icon	122	Feb 12, 2026	262 IJ	$22k
Grand Terrace Rehabilitation and Healthcare 812 W. Houston Ave., Mcallen, TX 78501 CCN 455586	93	Jun 17, 2026	16	—
Christian Care Communities and Services Mesquite 1000 Wiggins Parkway, Mesquite, TX 75150 CCN 455617	180	May 21, 2026	314 IJ	$29k

Same chain in Texas

All 346 in chain →

Facility	Beds	Last inspection	Citations (window)	Fines
Richland Hills Rehabilitation and Healthcare Cente 3109 Kings Ct, Fort Worth, TX 76118 CCN 455576	92	May 28, 2026	401 harm	$8,190
Grand Terrace Rehabilitation and Healthcare 812 W. Houston Ave., Mcallen, TX 78501 CCN 455586	93	Jun 17, 2026	16	—
Alta Vista Rehabilitation and Healthcare 510 Paredes Line Rd, Brownsville, TX 78521 CCN 455625	100	May 1, 2026	281 IJ	—
Wellington Rehabilitation and Healthcare 1802 S 31st, Temple, TX 76504 CCN 455637	124	Aug 6, 2026	404 IJ	$32k
Golden Palms Rehabilitation and Retirement 2101 Treasure Hills Boulevard, Harlingen, TX 78550 CCN 455672	60	May 13, 2026	271 IJ1 harm	$16k
Park Village Healthcare and Rehabilitation 207 E Parkerville Rd, Desoto, TX 75115 CCN 455727Abuse icon	150	Aug 25, 2026	636 IJ2 harm2 open	$221k
Kirkwood Manor 2590 Loop 337 N, New Braunfels, TX 78130 CCN 455732	162	Jun 17, 2026	691 IJ	$29k
Timberwood Nursing and Rehabilitation Center 4001 Hwy 59 North, Livingston, TX 77351 CCN 455745	120	Jan 14, 2026	181 IJ	$8,021

Coordinates as published by CMS.

Address: 520 SE 8th St, Paris, TX 75460
ZIP: 75460
County: Lamar County FIPS 48277
State: Texas
Urban / rural (CMS): Rural

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	Last inspection	Citations (window)	Fines
Brentwood Terrace Healthcare and Rehabilitation 2885 Stillhouse Road, Paris, TX 75460 CCN 676045	2.8 km	119	Jul 29, 2026	478 IJ	$234k
Avir at Paris 610 Deshong Dr., Paris, TX 75460 CCN 455831	3.5 km	98	Aug 26, 2026	444 IJ1 harm	—
Stillhouse Rehabilitation and Healthcare Center 2900 Stillhouse Road, Paris, TX 75462 CCN 676190	3.7 km	150	Jul 17, 2026	481 IJ	$8,162
Heritage House at Paris Rehab & Nursing 150 47th St. SE, Paris, TX 75462 CCN 676294	4.7 km	90	Feb 4, 2026	492 harm	$10k

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	676049	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	676049	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 676049

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

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Legend Healthcare and Rehabilitation - Paris

Federal certification

State license

Penalties

Owners of record

All disclosed roles

Other facilities operated by Fannin County Hospital Authority

Same chain in Texas

Nearby nursing homes

Legend Healthcare and Rehabilitation - Paris

Federal certification

State license

Penalties

Owners of record

All disclosed roles

Other facilities operated by Fannin County Hospital Authority

Same chain in Texas

Nearby nursing homes