Town Hall Estates Keene, Inc.
207 S Old Betsy Rd · Keene, TX · 76059 · 8176458888
126 certified beds Non profit - Corporation
The complete Safety Report — $19
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
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
2.96 reported hours vs the 3.48 minimum CMS's own staffing study recommends.
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: 3 of 5 Staffing: 1 of 5 Quality measures: 2 of 5
| Total nurse hours / resident-day | 2.96 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.26 | 0.55–0.75 |
| Weekend hours / resident-day | 2.59 | ≈ weekday level |
| Nursing turnover / year | 50% | median 45% |
| Fines (3-yr window) | 2 · $16,209 |
Inspection citations (24 in the current record)
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Potential for harm · D July 31, 2025
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected August 30, 2025 · Resident Rights
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Potential for harm · E July 31, 2025
Honor the resident's right to organize and participate in resident/family groups in the facility.
Corrected August 30, 2025 · Resident Rights
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Potential for harm · D July 31, 2025
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected August 30, 2025 · Resident Assessment and Care Planning
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Potential for harm · D July 31, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected August 30, 2025 · Resident Assessment and Care Planning
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Potential for harm · E July 31, 2025
Provide enough food/fluids to maintain a resident's health.
Corrected August 30, 2025 · Quality of Life and Care
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Potential for harm · E July 31, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected August 30, 2025 · Nutrition and Dietary
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Actual harm · G July 9, 2025 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected July 31, 2025 · Pharmacy Service
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Potential for harm · D March 19, 2025 · found via complaint
Reasonably accommodate the needs and preferences of each resident.
Corrected March 31, 2025 · Resident Rights
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Potential for harm · D February 24, 2025 · found via complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected April 9, 2025 · Resident Rights
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Potential for harm · D February 24, 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 April 9, 2025 · Resident Assessment and Care Planning
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Potential for harm · D February 5, 2025 · found via complaint
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected February 28, 2025 · Quality of Life and Care
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Potential for harm · D January 16, 2025 · found via complaint
Provide and implement an infection prevention and control program.
Corrected January 31, 2025 · Infection Control
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Potential for harm · E June 6, 2024
Reasonably accommodate the needs and preferences of each resident.
Corrected June 28, 2024 · Resident Rights
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Potential for harm · D June 6, 2024
Ensure each resident receives an accurate assessment.
Corrected June 28, 2024 · Resident Assessment and Care Planning
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Potential for harm · E June 6, 2024
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected June 28, 2024 · Nutrition and Dietary
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Potential for harm · E June 6, 2024
Provide and implement an infection prevention and control program.
Corrected June 28, 2024 · Infection Control
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Actual harm · G October 20, 2023 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected October 24, 2023 · Quality of Life and Care
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Potential for harm · D June 2, 2023 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected June 30, 2023 · Resident Assessment and Care Planning
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Potential for harm · D April 27, 2023
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected May 24, 2023 · Resident Rights
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Potential for harm · E April 27, 2023
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected May 24, 2023 · Resident Rights
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Potential for harm · D April 27, 2023
Keep residents' personal and medical records private and confidential.
Corrected May 24, 2023 · Resident Rights
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Potential for harm · E April 27, 2023
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected May 24, 2023 · Resident Assessment and Care Planning
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Potential for harm · E April 27, 2023
Observe each nurse aide's job performance and give regular training.
Corrected May 24, 2023 · Nursing and Physician Services
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Potential for harm · E April 27, 2023
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected May 24, 2023 · Nutrition and Dietary
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| July 9, 2025 | Fine | $8,402 |
| October 20, 2023 | Fine | $7,807 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 676047 · certified since March 31, 2005. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.