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Nursing HomeMedicaid Investigative

Paradigm at the Pines

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

705 Hwy 418 W, Silsbee, TX 7765690 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
4.4/5

based on 23 Google reviews

5
4
3
2
1
Paradigm at the Pines Nursing Home in Silsbee, 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.

  • Abuse citation on record
  • Low staffing rating (2/5 stars)
  • Above-median deficiencies (15 vs median 8.0)
  • High staff turnover (62%)

Above average in Texas · Critically understaffed (RN) · Chain outperformer · $12,740 in fines · Abuse citation

Source: Medicare data

What this means for your family

This facility is an excellent choice for patients focused on intensive rehabilitation and physical therapy. However, families should closely monitor nursing communication and be prepared to advocate for their loved one during night shifts, as recent reviews indicate potential lapses in care and staffing during those hours.

Google Reviews

Google Reviews

23 reviews analyzed
Families can expect a facility that excels in rehabilitation and physical therapy, with several reviewers noting significant improvements in mobility and care quality. However, there are serious concerns regarding nursing professionalism, communication, and potential understaffing during night shifts.

Quality Themes

Tap a score for details
Food1.0Staff7.0Clean4.0ActivitiesN/AMedsN/AMemoryN/AComms3.0ValueN/A

Strengths

  • Effective rehabilitation and therapy teams
  • Compassionate and welcoming staff members
  • Improved facility cleanliness and maintenance
  • Dedicated administrative and liaison staff

Concerns

  • Nursing professionalism and communication issues (mentioned by 2 reviewers)
  • Potential understaffing during night/overnight hours (mentioned by 2 reviewers)

Rating Trends

Tap a year to see what changed

2344.72023(3)5.02024(10)2.32025(6)4.72026(12)

Distribution

5
11
4
1
3
0
2
0
1
3

How They Respond to Reviews

70%response rate
Good

The owner provides personalized, empathetic responses to negative reviews by acknowledging specific grievances and attempting to move the conversation offline. For positive reviews, the responses vary between personalized praise for staff and repetitive, templated gratitude.

Questions for Your Tour

  • 1I noticed the administration team is very active in responding to feedback; how do you typically share updates or important news with families regarding a resident's care?
  • 2With the focus on rehabilitation mentioned by many, could you tell me more about how the therapy team works with residents to meet their mobility goals?
  • 3What specific steps are being taken to ensure consistent communication between the nursing staff and family members, especially during shift changes?
  • 4How is the dining experience structured here, and are there plans to expand the variety or quality of the meal options?
  • 5Can you walk me through the protocol for handling medical emergencies or urgent care needs during the overnight hours?
  • 6What kind of daily activities or social engagement programs are available to help residents stay connected with one another?

Personalized based on this facility's data


Key Review Excerpts

I came In on crutches and leaving walking out ! Great Therapy team !!!

Rehab patient · 2024★★★★★

My sister has had to stay here twice to recover from illness. both times she received the BEST care possible. The staff has gone above and beyond to help her rehabilitate her to the point that she was stronger and better than ever since her disability.

Long-term resident's family · 2023★★★★★

We have seen improvements in daytime staffing support (we're there during the day only) since Paradigm has taken over. Furthermore; the facilities have undergone improvements and seem to be kept cleaner.

Long-term resident's family · 2023★★★★
Source: 23 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.26hrs
35%
Registered nurses for medical care
Total Nursing
2.98hrs
73%
All nurses + aides combined
Staff Turnover
65%
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
5/ 5
Better Than Avg

15

measures

Mixed Results

2

measures

Long-Stay Residents
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility4.6%
Better than Avg
Here
4.6%
US
15.4%
TX
9.4%
Hardin
18.4%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility6.5%
Better than Avg
Here
6.5%
US
19.4%
TX
14.2%
Hardin
18.9%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility5.8%
Better than Avg
Here
5.8%
US
15.3%
TX
14.9%
Hardin
16.1%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility19.6%
Mixed vs Avgs
Here
19.6%
US
19.5%
TX
18.4%
Hardin
29.6%
😔

Residents with depression symptoms

↓ Lower is better
This Facility2.2%
Better than Avg
Here
2.2%
US
12.1%
TX
2.5%
Hardin
10.4%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
93.4%
TX
96.9%
Hardin
96.8%
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%
Hardin
88.2%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
81.8%
TX
89.2%
Hardin
89.1%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility0.0%
Better than Avg
Here
0.0%
US
1.6%
TX
1.5%
Hardin
1.4%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

15deficiencies
1penalties
Well above state avg (9.1)
10 complaint-triggered
$12,740 in fines

Families have filed multiple complaints over the past three years, triggering investigations that found serious issues with abuse protection, accident prevention, and medication management. The facility shows recurring problems with safety hazards, dietary services, and abuse prevention policies across multiple surveys from 2023 through 2025. While all deficiencies show correction dates, the pattern of repeated issues in core care areas suggests ongoing challenges with consistent quality care.

Dec 10, 2025Routine
11
0565ModerateCorrected

Resident Rights Deficiencies

Honor the resident's right to organize and participate in resident/family groups in the facility.

0804ModerateCorrected

Nutrition and Dietary Deficiencies

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

0880ModerateCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0584MinorCorrected

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.

0689MinorCorrected

Quality of Life and Care Deficiencies

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

0692MinorCorrected

Quality of Life and Care Deficiencies

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

0755MinorCorrected

Pharmacy Service Deficiencies

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

0806MinorCorrected

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.

0926MinorCorrected

Environmental Deficiencies

Have policies on smoking.

0361MinorCorrected

Smoke Deficiencies

Ensure that waiting areas, nurse’s stations, gift shops, and cooking facilities, open to the corridor are properly protected.

0363MinorCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

Sep 10, 2025Complaint
6
0689Severe

Quality of Life and Care Deficiencies

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

0600ModerateCorrected

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.

0610ModerateCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

0657ModerateCorrected

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

0609MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

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

0755MinorCorrected

Pharmacy Service Deficiencies

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

Oct 2, 2024Routine
8
0804ModerateCorrected

Nutrition and Dietary Deficiencies

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

0812ModerateCorrected

Nutrition and Dietary Deficiencies

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

0347ModerateCorrected

Smoke Deficiencies

Properly provide smoke detection systems in areas open to corridors.

0361ModerateCorrected

Smoke Deficiencies

Ensure that waiting areas, nurse’s stations, gift shops, and cooking facilities, open to the corridor are properly protected.

0363ModerateCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

0641MinorCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0656MinorCorrected

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.

0803MinorCorrected

Nutrition and Dietary Deficiencies

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

Oct 2, 2024Complaint
1
0755MinorCorrected

Pharmacy Service Deficiencies

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

Sep 19, 2024Complaint
1
0600MinorCorrected

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.

Sep 20, 2023Routine
11
0727ModerateCorrected

Nursing and Physician Services Deficiencies

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

0801ModerateCorrected

Nutrition and Dietary Deficiencies

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

0812ModerateCorrected

Nutrition and Dietary Deficiencies

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

0851ModerateCorrected

Administration Deficiencies

Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

0641ModerateCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0689ModerateCorrected

Quality of Life and Care Deficiencies

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

0693ModerateCorrected

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.

0803ModerateCorrected

Nutrition and Dietary Deficiencies

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

0805ModerateCorrected

Nutrition and Dietary Deficiencies

Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

0321ModerateCorrected

Smoke Deficiencies

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

0646MinorCorrected

Resident Assessment and Care Planning Deficiencies

Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.

Federal Penalties

Fine

Sep 10, 2025

$12,740

Ownership & Operations

Who Operates This Facility

Owner / Operator

Oakbend Medical Center

Organization Type

government

Management Company

PINES NURSING & REHABILITATION LLC

Administrator

SCOTT HAGGARD

Chain Affiliation

Chain Name

Paradigm Healthcare

Chain Size

18 facilities nationwide

Chain avg rating: 2.1/5 · Rank 5 of 15

Ownership & Management

Key personnel

Freudenberger, JosephW-2 Managing EmployeeZerwas, JohnW-2 Managing EmployeeCouncil, JeffOfficer / DirectorCrayton, TomOfficer / DirectorDouds, RobertOfficer / 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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