Westward Trails Nursing and Rehabilitation
3001 Westward Dr · Nacogdoches, TX · 75964 · 9365692631
108 certified beds For profit - Corporation Chain: Creative Solutions in Healthcare
Why this verdict
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
- Federal penalties on record: $33,060 in fines in the last 24 months.
- Inspection results have improved across recent cycles.
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
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 1 time under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.
RN staffing in the bottom 10% nationally
0.18 registered-nurse hours per resident per day, vs a 0.58 national median and 0.75 benchmark.
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: 3 of 5 Inspections: 4 of 5 Staffing: 1 of 5 Quality measures: 3 of 5
| Total nurse hours / resident-day | 3.39 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.18 | 0.55–0.75 |
| Weekend hours / resident-day | 2.71 | ≈ weekday level |
| Nursing turnover / year | — | median 45% |
| Fines (3-yr window) | 3 · $33,060 |
Inspection citations (24 in the current record)
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Potential for harm · F November 20, 2025 · found via complaint
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected November 21, 2025 · Nutrition and Dietary
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Immediate jeopardy · J June 25, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected May 28, 2025 · Quality of Life and Care
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Potential for harm · D May 22, 2025 · found via complaint
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected May 23, 2025 · Quality of Life and Care
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Immediate jeopardy · J March 31, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected February 25, 2025 · Quality of Life and Care
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Potential for harm · D March 31, 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 April 1, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 31, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected April 1, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E March 31, 2025 · found via complaint
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected April 1, 2025 · Quality of Life and Care
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Potential for harm · D March 31, 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 April 1, 2025 · Pharmacy Service
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Potential for harm · D April 24, 2024
Keep residents' personal and medical records private and confidential.
Corrected April 30, 2024 · Resident Rights
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Potential for harm · D April 24, 2024
Assess the resident when there is a significant change in condition
Corrected April 30, 2024 · Resident Assessment and Care Planning
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Potential for harm · D April 24, 2024
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected April 30, 2024 · Resident Assessment and Care Planning
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Potential for harm · D April 24, 2024
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 30, 2024 · Resident Assessment and Care Planning
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Potential for harm · D April 24, 2024
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected April 30, 2024 · Quality of Life and Care
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Potential for harm · D April 24, 2024
Provide enough food/fluids to maintain a resident's health.
Corrected April 30, 2024 · Quality of Life and Care
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Potential for harm · D April 24, 2024
Provide safe and appropriate respiratory care for a resident when needed.
Corrected April 30, 2024 · Quality of Life and Care
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Potential for harm · E April 24, 2024
Provide and implement an infection prevention and control program.
Corrected April 30, 2024 · Infection Control
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Potential for harm · D April 24, 2024
Make sure that a working call system is available in each resident's bathroom and bathing area.
Corrected April 30, 2024 · Environmental
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Potential for harm · D April 24, 2024
Have policies on smoking.
Corrected April 30, 2024 · Environmental
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Potential for harm · E March 15, 2023
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected April 8, 2023 · Resident Rights
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Potential for harm · E March 15, 2023
Assure that each resident’s assessment is updated at least once every 3 months.
Corrected April 8, 2023 · Resident Assessment and Care Planning
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Potential for harm · E March 15, 2023
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 8, 2023 · Resident Assessment and Care Planning
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Potential for harm · E March 15, 2023
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected April 8, 2023 · Quality of Life and Care
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Potential for harm · D March 15, 2023
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.
Corrected April 8, 2023 · Pharmacy Service
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Potential for harm · E March 15, 2023
Have policies on smoking.
Corrected April 8, 2023 · Environmental
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| June 25, 2025 | Fine | $22,925 |
| March 31, 2025 | Fine | $4,486 |
| March 31, 2025 | Fine | $5,649 |
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.
Sign in to share your family's experience — reviews are moderated and never affect the Safety Score.
Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 455959 · certified since November 15, 1991. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.