Avir at Citizens Trail
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
based on 78 Google reviews

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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Low overall rating (1/5 stars)
- Low staffing rating (1/5 stars)
- Above-median deficiencies (26 vs median 8.0)
- High staff turnover (55%)
Bottom 25% in Texas · Below recommended RN staffing · Worst in AVIR HEALTH GROUP chain · $130,813 in fines
What this means for your family
This facility is an excellent choice for rehabilitation needs due to its highly-regarded therapy team and clean environment. However, families must be extremely vigilant regarding medication administration and should perform frequent unannounced visits to ensure nursing standards are being met during all shifts.
Google Reviews
Google Reviews
78 reviews on Google“AVIR AT CITIZENS TRAIL is frequently praised for its clean, welcoming environment and a highly skilled rehabilitation therapy team. However, families should be aware of serious allegations regarding medication errors, inconsistent nursing care during night shifts, and communication lapses regarding resident health status.”
Quality Themes
Tap a score for detailsStrengths
- Excellent rehabilitation and therapy services
- Clean and well-maintained facility
- Friendly and professional administrative staff
- Welcoming and secure atmosphere
Concerns
- Medication management errors and inconsistencies (mentioned by 2 reviewers)
- Inconsistent nursing care/staffing on night shifts (mentioned by 2 reviewers)
- Difficulty with facility entry/security check-in delays (mentioned by 2 reviewers)
- Lack of communication regarding resident illness (e.g., COVID-19)
Rating Trends
Tap a year to see what changed
Distribution · 83 analyzed
How They Respond to Reviews
This facility rarely responds to reviews.
Questions for Your Tour
- 1We've heard great things about the rehabilitation and therapy services here; could you tell us more about how the therapists work with residents to maintain their mobility?
- 2What specific protocols do you have in place to ensure medication is administered accurately and consistently for every resident?
- 3How does the nursing team manage resident care and monitoring during the overnight hours to ensure everyone is safe and well-attended to?
- 4If a resident becomes ill or if there is a health concern like a contagious virus, how does the facility communicate those updates to the family?
- 5We noticed the facility looks very clean and well-maintained; what kind of daily activities or social programs are available to keep residents engaged and active?
- 6What is the process for family members to enter the building, and are there any specific security check-in procedures we should be aware of for our visits?
Personalized based on this facility's data
Key Review Excerpts
“They have the best therapy department in Texarkana!”
“The building looks good and smells good. There's always some activity going on and just an overall great energy in the building.”
“Gave my sister wrong med doseage and wrong meds completely! Did not give her antibiotics IV for 9 days!”
Staffing
Staffing Hours
per resident/day · Medicare 2026Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 17 measures
10
measures
3
measures
4
measures
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents whose bladder or bowel control got worse
Residents vaccinated for pneumonia
Residents who fell and were seriously hurt
Residents needing more daily help over time
Residents vaccinated for the flu
Short-stay residents vaccinated for the flu
Short-stay residents vaccinated for pneumonia
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
Families have filed multiple reports about resident protection and safety concerns, with recent complaints triggering investigations for abuse prevention failures and accident hazards. The facility shows persistent problems across care planning, medication management, and daily living assistance, with 61 deficiencies spanning five surveys. While the facility has dates of correction for most issues, the pattern of recurring problems in fundamental care areas suggests ongoing quality challenges that families should carefully consider.
Nov 20, 2025Routine28
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Infection Control Deficiencies
Implement a program that monitors antibiotic use.
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Pharmacy Service Deficiencies
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.
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies
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
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Nutrition and Dietary Deficiencies
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Environmental Deficiencies
Have policies on smoking.
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Aug 21, 2024Routine9
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure precautions for handling oxygen cylinders and equipment are correctly followed.
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Resident Rights Deficiencies
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 Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Pharmacy Service Deficiencies
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.
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Jul 17, 2024Complaint2
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Feb 24, 2024Complaint5
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Jul 12, 2023Routine16
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Jul 12, 2023Complaint1
Resident Rights Deficiencies
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.
Federal Penalties
Fine
Jul 17, 2024
$16,055
Fine
Feb 24, 2024
$104,696
Fine
Jul 12, 2023
$10,062
Ownership & Operations
Who Operates This Facility
Fannin County Hospital Authority
for profit
1008 CITIZENS TRAIL OPCO LLC
JEFFREY J BRADFORD
Chain Affiliation
Avir Health Group
117 facilities nationwide
Chain avg rating: 2.3/5 · Rank 86 of 90 (Worst)
Ownership & Management
Owners
Fannin County Hospital Authority
Owner · Organization
Key personnel
Contact
Get in Touch
Contact this facility directly and verify the details that matter most to your family.
References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
78 reviews from families & visitors
Official Website
Visit avirhg.com
Medicare data downloads
Original nursing home datasets
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