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Nursing HomeMedicaid Investigative

Magnolia Manor

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

4400 Gulf Street, Groves, TX 77619126 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
4.6/5

based on 13 Google reviews

5
4
3
2
1
Magnolia Manor Nursing Home in Groves, TX — Street View
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3/ 10
moderate Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low staffing rating (2/5 stars)
  • Above-median deficiencies (12 vs median 8.0)
  • High staff turnover (56%)

Above average in Texas · Critically understaffed (RN) · $229,827 in fines

Source: Medicare data

What this means for your family

The facility is highly regarded for its cleanliness and the dedication of its nursing leadership. However, because of a documented report of severe neglect and falls, families should conduct an in-person visit and ask specific questions regarding their fall prevention protocols and monitoring.

Google Reviews

Google Reviews

13 reviews on Google
Magnolia Manor is frequently praised for its cleanliness and the professional, friendly nature of its staff, with specific recognition given to leadership. However, a critical review highlights a severe instance of patient neglect involving multiple falls, which should be investigated by any prospective family.

Quality Themes

Tap a score for details
FoodN/AStaff9.0Clean10.0ActivitiesN/AMedsN/AMemoryN/ACommsN/AValueN/A

Strengths

  • Clean and well-maintained facility
  • Friendly and professional staff
  • Dedicated leadership/ADON

Concerns

  • Severe patient neglect and safety issues

Rating Trends

Tap a year to see what changed

2344.02016(1)5.02019(3)5.02022(1)1.02024(1)5.02025(5)5.02026(3)

Distribution · 14 analyzed

5
12
4
1
3
0
2
0
1
1

How They Respond to Reviews

0%response rate

Questions for Your Tour

  • 1We've heard wonderful things about the cleanliness of the facility and the professionalism of the leadership team; how does the administration ensure that high standard of care is maintained daily?
  • 2With the recent focus on improving health inspection outcomes, what specific steps is Magnolia Manor taking to address recent deficiencies and enhance resident safety?
  • 3How does the nursing team manage staffing levels during overnight shifts to ensure every resident receives attentive, personalized care?
  • 4What is the protocol for handling a medical emergency after hours, and how quickly can a physician be reached?
  • 5We would love to hear more about the daily schedule—what kind of social activities or outings are available to keep the residents engaged?
  • 6How does the staff ensure that residents' individual needs are met promptly to prevent any lapses in personal care or attention?

Personalized based on this facility's data


Key Review Excerpts

Great establishment and professional workers. One stood out in particular, ADON Ramona Barnes was literally working throughout the facility. Ramona is well respected at Magnolia Manor and her work ethic and dedication and the respect that she gives is definitely why.

Family member · 2025★★★★★

Horrible beyond words. My mother was so neglected! Broke her hip twice within 6 months. Awful place.

Resident's family · 2024☆☆☆☆
Source: 13 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.23hrs
31%
Registered nurses for medical care
Total Nursing
3.00hrs
73%
All nurses + aides combined
Staff Turnover
46%
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
4/ 5
Better Than Avg

14

measures

Worse Than Avg

2

measures

Mixed Results

1

measures

Long-Stay Residents
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
93.4%
TX
96.9%
Jefferson
85.6%
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility6.4%
Better than Avg
Here
6.4%
US
15.4%
TX
9.4%
Jefferson
19.5%
😔

Residents with depression symptoms

↓ Lower is better
This Facility0.0%
Better than Avg
Here
0.0%
US
12.1%
TX
2.5%
Jefferson
5.6%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

💉

Residents vaccinated for the flu

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
95.5%
TX
98.0%
Jefferson
92.9%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility12.7%
Better than Avg
Here
12.7%
US
19.4%
TX
14.2%
Jefferson
16.3%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility10.5%
Better than Avg
Here
10.5%
US
15.3%
TX
14.9%
Jefferson
12.9%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
79.7%
TX
88.0%
Jefferson
73.6%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility99.7%
Better than Avg
Here
99.7%
US
81.8%
TX
89.2%
Jefferson
74.6%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility1.5%
Better than Avg
Here
1.5%
US
1.6%
TX
1.5%
Jefferson
2.0%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

6deficiencies
2penalties
Near state avg (9.1)
9 complaint-triggered
$229,827 in fines

Magnolia Manor has significant concerns with families filing multiple complaints that triggered inspections revealing serious issues in abuse prevention, pain management, and resident rights. The facility shows recurring problems across care planning, medication management, and fire safety systems that persist across multiple surveys from 2023 to 2025. While the facility addresses deficiencies when cited, the pattern of repeated violations and family-initiated complaints suggests ongoing quality concerns that warrant careful consideration.

Jul 2, 2025Routine
9
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.

0223Potential for harm · PatternCorrected

Egress Deficiencies

Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.

0641Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

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

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.

0757Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure each resident’s drug regimen must be free from unnecessary drugs.

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.

0353Potential for harm · IsolatedCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0521Minimal · Widespread

Services Deficiencies

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

Mar 11, 2025Complaint
6
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.

0609Immediate jeopardy · IsolatedResolved (past non-compliance)

Freedom from Abuse, Neglect, and Exploitation Deficiencies

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

0697Actual harm · PatternCorrected

Quality of Life and Care Deficiencies

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

0580Actual harm · IsolatedCorrected

Resident Rights Deficiencies

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

0726Potential for harm · PatternCorrected

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 · PatternCorrected

Pharmacy Service Deficiencies

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

Apr 24, 2024Routine
12
0908Potential for harm · WidespreadCorrected

Environmental Deficiencies

Keep all essential equipment working safely.

0557Potential for harm · PatternCorrected

Resident Rights Deficiencies

Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.

0372Potential for harm · PatternCorrected

Smoke Deficiencies

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

0374Potential for harm · PatternCorrected

Smoke Deficiencies

Install smoke barrier doors that can resist smoke for at least 20 minutes.

0578Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

0580Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0321Potential for harm · IsolatedCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0353Potential for harm · IsolatedCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0521Minimal · Widespread

Services Deficiencies

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

0732Minimal · WidespreadCorrected

Nursing and Physician Services Deficiencies

Post nurse staffing information every day.

0511Minimal · WidespreadCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

Apr 24, 2024Complaint
1
0609Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

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

Mar 21, 2024Complaint
2
0622Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.

0644Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Feb 15, 2023Routine
5
0374Potential for harm · PatternCorrected

Smoke Deficiencies

Install smoke barrier doors that can resist smoke for at least 20 minutes.

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.

0688Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

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.

Federal Penalties

Fine

Mar 11, 2025

$225,929

Fine

Mar 21, 2024

$4,350

Ownership & Operations

Who Operates This Facility

Owner / Operator

Tyler County Hospital District

Organization Type

for profit

Management Company

CRESTHAVEN HEALTH CARE CENTER LTD CO

Administrator

DELPHIA L SMITH

Chain Affiliation

Chain Name

Cantex Continuing Care

Chain Size

38 facilities nationwide

Chain avg rating: 3.2/5 · Rank 24 of 37

Ownership & Management

Owners

Tyler County Hospital District

Owner · Organization

100%

Key personnel

Williams, SondraOfficer / DirectorCresthaven Health Care Center Ltd CoManagerSmith, DelphiaManagerCresthaven Health Care Center Ltd CoAdp of the SnfDela Cruz, KristopherAdp of the Snf
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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