Paradigm at the Pines
705 Hwy 418 W · Silsbee, TX · 77656 · 4093850033
90 certified beds Government - Hospital district Chain: Paradigm Healthcare
Why this verdict
- Carries CMS’s abuse warning icon.
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
- Inspection results are getting worse cycle over cycle, not better.
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Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
CMS abuse warning
CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.
1 immediate-jeopardy citation in the most recent inspection cycle
Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.
Cited under the freedom-from-abuse rule
Cited 2 times under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.
RN staffing in the bottom 10% nationally
0.26 registered-nurse hours per resident per day, vs a 0.58 national median and 0.75 benchmark.
Total nurse staffing below 3.0 hours per resident-day
2.98 reported hours vs the 3.48 minimum CMS's own staffing study recommends.
65% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 2 of 5 Inspections: 2 of 5 Staffing: 1 of 5 Quality measures: 5 of 5
| Total nurse hours / resident-day | 2.98 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.26 | 0.55–0.75 |
| Weekend hours / resident-day | 2.67 | ≈ weekday level |
| Nursing turnover / year | 65% | median 45% |
| Fines (3-yr window) | 1 · $12,740 |
Inspection citations (34 in the current record)
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Potential for harm · E December 10, 2025
Honor the resident's right to organize and participate in resident/family groups in the facility.
Corrected December 11, 2025 · Resident Rights
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Potential for harm · D December 10, 2025
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.
Corrected December 11, 2025 · Resident Rights
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Potential for harm · D December 10, 2025
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected December 11, 2025 · Quality of Life and Care
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Potential for harm · D December 10, 2025
Provide enough food/fluids to maintain a resident's health.
Corrected December 11, 2025 · Quality of Life and Care
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Potential for harm · D December 10, 2025
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected December 11, 2025 · Pharmacy Service
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Potential for harm · E December 10, 2025
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected December 11, 2025 · Nutrition and Dietary
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Potential for harm · D December 10, 2025
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Corrected December 11, 2025 · Nutrition and Dietary
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Potential for harm · E December 10, 2025
Provide and implement an infection prevention and control program.
Corrected December 11, 2025 · Infection Control
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Potential for harm · D December 10, 2025
Have policies on smoking.
Corrected December 11, 2025 · Environmental
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Immediate jeopardy · J September 10, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected September 7, 2025 · Quality of Life and Care
-
Potential for harm · E September 10, 2025 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected September 11, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D September 10, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected September 26, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E September 10, 2025 · found via complaint
Respond appropriately to all alleged violations.
Corrected September 26, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E September 10, 2025 · found via complaint
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected September 11, 2025 · Resident Assessment and Care Planning
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Potential for harm · D September 10, 2025 · found via complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected September 11, 2025 · Pharmacy Service
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Potential for harm · D October 2, 2024
Ensure each resident receives an accurate assessment.
Corrected November 1, 2024 · Resident Assessment and Care Planning
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Potential for harm · D October 2, 2024
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected November 1, 2024 · Resident Assessment and Care Planning
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Potential for harm · D October 2, 2024
Ensure 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.
Corrected November 1, 2024 · Nutrition and Dietary
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Potential for harm · E October 2, 2024
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected November 1, 2024 · Nutrition and Dietary
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Potential for harm · E October 2, 2024
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected November 1, 2024 · Nutrition and Dietary
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Potential for harm · D October 2, 2024 · found via complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected November 1, 2024 · Pharmacy Service
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Potential for harm · D September 19, 2024 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected October 19, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E September 20, 2023
Ensure each resident receives an accurate assessment.
Corrected September 26, 2023 · Resident Assessment and Care Planning
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Potential for harm · D September 20, 2023
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
Corrected September 26, 2023 · Resident Assessment and Care Planning
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Potential for harm · E September 20, 2023
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected October 6, 2023 · Quality of Life and Care
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| September 10, 2025 | Fine | $12,740 |
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 675391 · certified since September 21, 1994. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.