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Nursing HomeMedicaid Investigative

Avir at Citizens Trail

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

1008 Citizens Trail, Texarkana, TX 75501114 bedsLicensed & Active
1/5
Medicare
Inspection
Quality
Staffing
Google rating
4.2/5

based on 78 Google reviews

5
4
3
2
1
Avir at Citizens Trail Nursing Home in Texarkana, TX — Street View
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5/ 10
high Risk

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

Source: Medicare data

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 details
Food5.0Staff6.0Clean9.0Activities8.0Meds2.0MemoryN/AComms4.0ValueN/A

Strengths

  • 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

234'16(1)'18(2)'21(6)'23(28)'25(8)'26(2)

Distribution · 83 analyzed

5
55
4
9
3
5
2
3
1
11

How They Respond to Reviews

7%response rate

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!

Rehab patient's family · 2021☆☆☆☆

The building looks good and smells good. There's always some activity going on and just an overall great energy in the building.

Long-term resident's family · 2021★★★★★

Gave my sister wrong med doseage and wrong meds completely! Did not give her antibiotics IV for 9 days!

Long-term resident's family · 2025☆☆☆☆
Source: 78 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.50hrs
67%
Registered nurses for medical care
Total Nursing
3.28hrs
80%
All nurses + aides combined
Staff Turnover
55%
Lower is better (< 30% = good)
RN Turnover
33%
Lower is better (< 30% = good)

Both 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

Medicare Rating
2/ 5
Better Than Avg

10

measures

Worse Than Avg

3

measures

Mixed Results

4

measures

Long-Stay Residents
😔

Residents with depression symptoms

↓ Lower is better
This Facility0.0%
Better than Avg
Here
0.0%
US
12.1%
TX
2.5%
Bowie
1.5%

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

↓ Lower is better
This Facility19.1%
Mixed vs Avgs
Here
19.1%
US
19.4%
TX
14.2%
Bowie
11.2%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
93.4%
TX
96.9%
Bowie
97.6%
⚠️

Residents who fell and were seriously hurt

↓ Lower is better
This Facility7.7%
Worse than Avg
Here
7.7%
US
3.2%
TX
3.3%
Bowie
1.5%
🛏️

Residents needing more daily help over time

↓ Lower is better
This Facility10.9%
Better than Avg
Here
10.9%
US
14.4%
TX
16.1%
Bowie
14.3%
💉

Residents vaccinated for the flu

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
95.5%
TX
98.0%
Bowie
97.2%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility97.7%
Better than Avg
Here
97.7%
US
79.7%
TX
88.0%
Bowie
85.8%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility98.8%
Better than Avg
Here
98.8%
US
81.8%
TX
89.2%
Bowie
85.1%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility5.3%
Worse than Avg
Here
5.3%
US
1.6%
TX
1.5%
Bowie
1.0%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

26deficiencies
3penalties
Well above state avg (9.1)
8 complaint-triggered
$130,813 in fines

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, 2025Routine
28
0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0880Potential for harm · WidespreadCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0881Potential for harm · WidespreadCorrected

Infection Control Deficiencies

Implement a program that monitors antibiotic use.

0550Potential for harm · PatternCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0656Potential for harm · PatternCorrected

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.

0689Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0698Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Provide safe, appropriate dialysis care/services for a resident who requires such services.

0761Potential for harm · PatternCorrected

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.

0804Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

0558Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0584Potential for harm · IsolatedCorrected

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.

0628Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.

0658Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

0677Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

0684Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

0692Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide enough food/fluids to maintain a resident's health.

0693Potential for harm · IsolatedCorrected

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.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

0697Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe, appropriate pain management for a resident who requires such services.

0726Potential for harm · IsolatedCorrected

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.

0755Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

0760Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

0806Potential for harm · IsolatedCorrected

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.

0813Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

Have a policy regarding use and storage of foods brought to residents by family and other visitors.

0842Potential for harm · IsolatedCorrected

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.

0926Potential for harm · IsolatedCorrected

Environmental Deficiencies

Have policies on smoking.

0511Potential for harm · IsolatedCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0521Minimal · Widespread

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Aug 21, 2024Routine
9
0353Potential for harm · WidespreadCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0372Potential for harm · WidespreadCorrected

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

0929Potential for harm · PatternCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure precautions for handling oxygen cylinders and equipment are correctly followed.

0561Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

0584Potential for harm · IsolatedCorrected

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.

0655Potential for harm · IsolatedCorrected

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

0677Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

0758Potential for harm · IsolatedCorrected

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.

0521Minimal · Widespread

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Jul 17, 2024Complaint
2
0600Immediate jeopardy · IsolatedResolved (past non-compliance)

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.

0607Immediate jeopardy · IsolatedResolved (past non-compliance)

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

Feb 24, 2024Complaint
5
0600Immediate jeopardy · PatternCorrected

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.

0607Immediate jeopardy · PatternCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

0609Immediate jeopardy · PatternCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0689Actual harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0656Potential for harm · IsolatedCorrected

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, 2023Routine
16
0689Immediate jeopardy · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0725Potential for harm · WidespreadCorrected

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.

0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0222Potential for harm · WidespreadCorrected

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.

0372Potential for harm · WidespreadCorrected

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

0558Potential for harm · PatternCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0656Potential for harm · PatternCorrected

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.

0677Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

0755Potential for harm · PatternCorrected

Pharmacy Service Deficiencies

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

0641Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0679Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide activities to meet all resident's needs.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0692Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide enough food/fluids to maintain a resident's health.

0697Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe, appropriate pain management for a resident who requires such services.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0521Minimal · Widespread

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Jul 12, 2023Complaint
1
0584Potential for harm · PatternCorrected

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

Owner / Operator

Fannin County Hospital Authority

Organization Type

for profit

Management Company

1008 CITIZENS TRAIL OPCO LLC

Administrator

JEFFREY J BRADFORD

Chain Affiliation

Chain Name

Avir Health Group

Chain Size

117 facilities nationwide

Chain avg rating: 2.3/5 · Rank 86 of 90 (Worst)

Ownership & Management

Owners

Fannin County Hospital Authority

Owner · Organization

100%

Key personnel

Holt, ErinOfficer / DirectorKeeton, WendyOfficer / DirectorKissling, MonicaOfficer / DirectorMcbean, PatriciaOfficer / DirectorOwens, AngelaOfficer / Director
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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