Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around November 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Avir At Graham during CMS and state inspections, most recent first.
The facility failed to maintain the reach-in freezer at the required temperature, resulting in food not being stored safely. Observations showed the freezer's temperature was consistently above the required zero degrees Fahrenheit, with food items not frozen solid. The Dietary Manager and Maintenance Supervisor identified deteriorating gasket seals as a contributing factor, but even after replacement, the freezer did not reach the proper temperature. The facility's policy required maintaining a temperature of zero degrees Fahrenheit or below, which was not adhered to, leading to the Corporate Maintenance Supervisor determining the freezer needed replacement.
The facility failed to maintain the kitchen's reach-in freezer at the required temperature, resulting in improperly stored food. The freezer's temperature was consistently above zero degrees Fahrenheit, with food items not frozen solid. Despite replacing door gaskets, the freezer doors did not seal properly, contributing to the issue. The Corporate Maintenance Supervisor later determined the freezer was beyond repair and required replacement.
A facility failed to accurately document a resident's medication status in their MDS assessment, incorrectly marking an antiplatelet medication as an anticoagulant. The error was acknowledged by the Clinical Care Manager, who was responsible for the assessment's accuracy. The facility followed the RAI Manual, which specifies that antiplatelet medications should not be coded as anticoagulants.
A facility failed to change a resident's oxygen tubing weekly as required, risking infection. The resident, with a history of respiratory issues, was observed with undated oxygen equipment and a nasal cannula on the floor. The ADON confirmed the facility's policy for weekly changes and proper storage was not followed.
A facility failed to maintain an effective infection control program when a nurse did not follow Enhanced Barrier Precautions (EBP) for a resident with a gastrostomy tube and tracheostomy. Despite EBP signage, the nurse did not wear a gown during high-contact activities, risking cross-contamination. The resident had multiple diagnoses, including tracheostomy and malnutrition, and the care plan lacked specific EBP interventions. Interviews confirmed the nurse's awareness of EBP guidelines, yet they were not implemented, contrary to facility policy and CDC guidelines.
Improper Freezer Temperature Management
Penalty
Summary
The facility failed to maintain the reach-in freezer at the required temperature of zero degrees Fahrenheit or below, resulting in food not being stored in accordance with professional standards for food service safety. Observations revealed that the freezer's interior thermometer measured 22 degrees Fahrenheit, and food items such as French toast, turkey breast, ham, corndogs, and lime sherbet were not frozen solid. The temperature logs documented a consistent freezer temperature of 10 degrees Fahrenheit from May through mid-July, indicating a prolonged period of non-compliance with temperature requirements. Interviews with the Dietary Manager and Maintenance Supervisor revealed that the freezer's gasket seals were cracked and deteriorating, which contributed to the freezer's inability to maintain the proper temperature. The Maintenance Supervisor replaced the gaskets, but the freezer still did not reach the required temperature. The Dietary Manager attempted to mitigate the issue by transferring food to other chest freezers, but the reach-in freezer continued to operate above the recommended temperature. The facility's policy and procedure for food storage, dated 2018, required that freezers maintain a temperature of zero degrees Fahrenheit or below to ensure food safety. Despite this policy, the facility failed to adhere to these guidelines, as evidenced by the temperature logs and observations. The Dietary Manager and Maintenance Supervisor acknowledged the issue, and the Corporate Maintenance Supervisor later determined that the freezer unit was old and could not be repaired, necessitating its replacement.
Freezer Temperature Maintenance Failure
Penalty
Summary
The facility failed to maintain the reach-in freezer in the kitchen at the required temperature of zero degrees Fahrenheit or below, resulting in food not being stored at the proper temperature. On observation, the freezer's interior thermometer showed a temperature of 22 degrees Fahrenheit, and food items such as French toast, turkey breast, ham, corndogs, and lime sherbet were not frozen solid. The temperature logs indicated that the freezer had been consistently documented at 10 degrees Fahrenheit from the beginning of July, and the temperature had risen to 20 degrees on the day of observation. The Dietary Manager and Maintenance Supervisor were aware of the issue, with the Maintenance Supervisor having replaced the freezer's door gaskets the day before the observation. However, the new gaskets were not properly installed, causing the doors not to seal correctly, which contributed to the freezer's inability to maintain the required temperature. The Dietary Manager attempted to mitigate the issue by moving the food to a chest freezer in her office, which had been defrosted overnight and was empty. Further interviews revealed that the freezer had been consistently operating at 10 degrees Fahrenheit for the past two months, as documented in the temperature logs. The Corporate Maintenance Supervisor later assessed the freezer and determined it could not be repaired due to its age, necessitating a replacement. The facility's policy and procedure for food storage required freezers to maintain a temperature of zero degrees Fahrenheit or below, which was not adhered to in this case.
Inaccurate MDS Assessment for Resident's Medication Status
Penalty
Summary
The facility failed to ensure that a resident's Minimum Data Set (MDS) assessment accurately reflected their medication status. Specifically, the MDS for a resident indicated that they were taking an anticoagulant, which was incorrect. The resident was actually on clopidogrel, an antiplatelet medication, not an anticoagulant. This error was identified during a review of the resident's records and confirmed through interviews with the resident's family member and facility staff. The Clinical Care Manager (CCM) admitted to marking the MDS incorrectly, stating it was a documentation error due to a lack of attention. The CCM acknowledged responsibility for the accuracy of the MDS and noted that no one else monitored her work for accuracy. The Assistant Director of Nursing (ADON) expected the MDS to accurately reflect the resident's condition and confirmed that the CCM was responsible for monitoring the assessment's accuracy. The facility followed the Resident Assessment Instrument (RAI) Manual for completing resident assessments, which specifies that antiplatelet medications should not be coded as anticoagulants.
Failure to Change Oxygen Tubing Weekly
Penalty
Summary
The facility failed to provide appropriate respiratory care for a resident, specifically in changing oxygen tubing weekly as required. The resident, a cognitively intact female with a history of respiratory failure, myocardial infarction, hypertension, and depression, was observed receiving humidified oxygen via nasal cannula. However, the oxygen tubing and humidifier bottle were not dated, and the resident could not recall when the tubing was last changed. This oversight was contrary to the care plan and physician's orders, which specified weekly changes. Further observations revealed that the nasal cannula was lying on the floor, indicating improper handling and storage. The Assistant Director of Nursing (ADON) confirmed that the facility's policy required weekly changes of oxygen tubing and proper storage of nebulizer masks to prevent contamination. The facility's policy on respiratory therapy, revised in 2011, also mandated changing the oxygen cannula and tubing every seven days or as needed, and storing unused equipment in a plastic bag. These lapses in following established protocols could potentially place residents at risk for infections and communicable diseases.
Failure to Follow Enhanced Barrier Precautions
Penalty
Summary
The facility failed to maintain an effective infection control program, as evidenced by the actions of RN A, who did not adhere to Enhanced Barrier Precautions (EBP) when providing care to a resident with a gastrostomy tube and a tracheostomy. Despite the presence of EBP signage indicating the need for gown use during high-contact activities, RN A did not don a gown while administering medication via the gastrostomy tube or while performing tracheostomy care. This oversight was observed on two separate occasions, raising concerns about potential cross-contamination and infection risks. The resident involved was an elderly male with multiple diagnoses, including diarrhea, acute upper respiratory infection, tracheostomy, protein-calorie malnutrition, and aphasia. The resident's care plan did not include specific interventions for EBP, despite the presence of indwelling medical devices. Interviews with RN A and the ADON/Infection Preventionist confirmed that RN A was aware of the EBP guidelines but failed to implement them, acknowledging the risk of cross-contamination. The facility's policy on EBP, dated March 2024, mandates gown use for high-contact activities involving residents with indwelling medical devices, aligning with CDC guidelines to prevent the transmission of multidrug-resistant organisms.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Graham
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Graham Oaks Care Center | 1 mi | — | 4 | 2 |
| Olney Rehabilitation And Care Center | 22.6 mi | — | 8 | 0 |
| Avir At Jacksboro | 26.1 mi | — | 12 | 0 |
| Villa Haven Health And Rehabilitation Center | 29.1 mi | — | 8 | 0 |
| Palo Pinto Nursing Center | 31.9 mi | — | 4 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.