Nursing home in Mansfield, Texas
The Pavilion at Creekwood
Medicare and Medicaid
2100 CANNON DR, Mansfield, TX 76063
(817) 779-6500
CMS star ratings
CMS gives this nursing home an overall star rating of 2 out of 5. Each rating is compared with the mean of rated nursing homes in Texas (1,165 for the overall rating) and in the U.S. (14,565). How to read an inspection report.
Overall rating
- This nursing home2
- Texas average2.7 (1,165 rated)
- U.S. average3.0 (14,565 rated)
Health inspections
- This nursing home2
- Texas average2.8 (1,165 rated)
- U.S. average2.8 (14,565 rated)
Staffing
- This nursing home2
- Texas average1.9 (1,163 rated)
- U.S. average2.9 (14,494 rated)
Quality measures
- This nursing home4
- Texas average3.7 (1,162 rated)
- U.S. average3.6 (14,495 rated)
Health inspections
Most recent standard health inspection (rating cycle 1): Apr 14, 2026. CMS counts 8 health deficiencies in rating cycle 1.
- This nursing home8
- Texas average9.4 (1,171 with data)
- U.S. average9.2 (14,652 with data)
Rating cycle 1 health deficiencies. Averages include every nursing home with a count in the CMS file; fewer is better.
Deficiencies since Sep 30, 2023
Inspectors cited 25 health deficiencies on 10 inspection dates since Sep 30, 2023. By level of harm: 4 immediate jeopardy, 21 potential for harm.
- 4 Immediate jeopardy to resident health or safety
- 0 Actual harm
- 21 No actual harm, potential for more than minimal harm
- 0 No actual harm, potential for minimal harm
| Date | Tag | Deficiency | Scope and severity | Inspection type | Status |
|---|---|---|---|---|---|
| Jun 1, 2026 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Jun 2, 2026 |
| Apr 14, 2026 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy Service Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Apr 15, 2026 |
| Apr 14, 2026 | F0761 | 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.Pharmacy Service Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Apr 15, 2026 |
| Apr 14, 2026 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and Dietary Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Apr 15, 2026 |
| Apr 14, 2026 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Apr 15, 2026 |
| Apr 14, 2026 | F0558 | Reasonably accommodate the needs and preferences of each resident.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Apr 8, 2026 |
| Apr 14, 2026 | F0636 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.Resident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Apr 15, 2026 |
| Apr 14, 2026 | F0760 | Ensure that residents are free from significant medication errors.Pharmacy Service Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Apr 15, 2026 |
| Aug 6, 2025 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and Care Deficiencies | E Potential for harm, pattern | Complaint | Deficient, Provider has date of correction Aug 7, 2025 |
| Aug 6, 2025 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Aug 7, 2025 |
Show the other 15 deficiencies
| Date | Tag | Deficiency | Scope and severity | Inspection type | Status |
|---|---|---|---|---|---|
| Feb 26, 2025 | F0759 | Ensure medication error rates are not 5 percent or greater.Pharmacy Service Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Feb 27, 2025 |
| Feb 26, 2025 | F0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Feb 27, 2025 |
| Feb 26, 2025 | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Feb 27, 2025 |
| Feb 26, 2025 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy Service Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Feb 27, 2025 |
| Jan 5, 2025 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and Care Deficiencies | J Immediate jeopardy, isolated | Complaint | Deficient, Provider has date of correction Jan 6, 2025 |
| Jan 5, 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and Care Deficiencies | J Immediate jeopardy, isolated | Complaint | Deficient, Provider has date of correction Jan 6, 2025 |
| Jan 5, 2025 | F0742 | Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.Quality of Life and Care Deficiencies | J Immediate jeopardy, isolated | Complaint | Deficient, Provider has date of correction Jan 6, 2025 |
| Aug 27, 2024 | F0578 | 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.Resident Rights Deficiencies | J Immediate jeopardy, isolated | Complaint | Deficient, Provider has date of correction Aug 28, 2024 |
| May 20, 2024 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy Service Deficiencies | E Potential for harm, pattern | Complaint | Deficient, Provider has date of correction May 21, 2024 |
| May 20, 2024 | F0757 | Ensure each resident’s drug regimen must be free from unnecessary drugs.Pharmacy Service Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction May 21, 2024 |
| Jan 25, 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and Dietary Deficiencies | F Potential for harm, widespread | Standard | Deficient, Provider has date of correction Jan 27, 2024 |
| Jan 25, 2024 | F0558 | Reasonably accommodate the needs and preferences of each resident.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jan 27, 2024 |
| Dec 12, 2023 | F0695 | Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Dec 13, 2023 |
| Nov 21, 2023 | F0880 | Provide and implement an infection prevention and control program.Infection Control Deficiencies | E Potential for harm, pattern | Complaint, Infection control | Deficient, Provider has date of correction Dec 18, 2023 |
| Nov 21, 2023 | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area.Environmental Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Nov 22, 2023 |
Staffing
Total nurse staffing
Reported hours per resident per day.
- This nursing home3.21 hours
- Texas average3.39 hours (1,148 with data)
- U.S. average3.86 hours (14,351 with data)
Registered nurse staffing
Reported hours per resident per day.
- This nursing home0.38 hours
- Texas average0.43 hours (1,148 with data)
- U.S. average0.69 hours (14,351 with data)
Nursing staff turnover
Share of nursing staff who left during the year, as reported to CMS.
- This nursing home47.0%
- Texas average55.3% (1,051 with data)
- U.S. average45.8% (13,538 with data)
Penalties
CMS lists 3 penalties for this nursing home: 3 fines totaling $39,674, and 0 payment denials. CMS counts penalties from the last 3 years.
Facility details
| Certified beds | 126 |
|---|---|
| Average residents per day | 97.3 |
| Ownership | For profit - Limited Liability company |
| Provider type | Medicare and Medicaid |
| Inside a hospital | No |
| Continuing care retirement community | No |
| Resident and family council | Resident |
| Automatic sprinklers in all required areas | Yes |
| Chain | Fundamental Healthcare (66 facilities) |
| Legal business name | MANSFIELD LONG TERM CARE, LLC |
| First approved for Medicare and Medicaid | Aug 3, 2015 |
| County | Tarrant |
| CMS certification number | 676388 |
Also in Mansfield
| Nursing home | CMS overall rating | Health inspection rating | Certified beds | Ownership |
|---|---|---|---|---|
| Avir at Mansfield | 127 | For profit - Corporation | ||
| Mansfield Medical Lodge | 118 | For profit - Limited Liability company |
| Hospital | CMS overall rating | Type | Emergency services |
|---|---|---|---|
| Texas Health Hospital Mansfield | Acute Care Hospitals | Yes | |
| Methodist Mansfield Medical Center | Acute Care Hospitals | Yes |