Nursing homes across Smith County, Texas, graded on the federal inspection
record, nurse staffing and staff turnover. County rank is shown on each home's profile.
Meadow Lake runs a tight 20-bed operation in Tyler, and the clinical numbers are genuinely strong, perfect marks on health inspections and quality measures, with only four deficiencies on record and none at the harm level. Staffing sits slightly above the national average at 4.01 nurse hours per resident day, which matters in a small home where there's nowhere to hide. Two things pull against that: weekend coverage drops about 16% below weekday levels, and annual turnover of 56.3% runs well past the national 45.8%, so the faces around a resident change often. The abuse-related deficiencies are worth asking about directly. A recent inspection in September 2025 helps.
The Center At Grande has a clean recent inspection record, 9 deficiencies, none at the harm level, with the most recent survey in March 2025. Its 5-star inspection and quality ratings back that up. But look at staffing: the 1-star rating reflects 54.2% annual turnover, well above the 45.8% national average, and weekend coverage drops about 20% below weekday levels even though overall nurse hours (4.19 per resident day) sit above the national figure. One abuse-related deficiency is on the record too. For-profit, LLC-owned. The care may be decent on paper, but consistent staffing is the question worth asking when you visit.
Nurse staffing at this Tyler home runs 6.31 hours per resident day, about 64% above the national average, and 33.6% of staff left last year against a national 45.8%, that's a real edge in keeping people. Weekends drop roughly 13% below weekday coverage, so ask how weekends are actually covered. The inspection record is where it gets harder: 17 deficiencies, three at harm or jeopardy level, one tied to abuse, and two fines totaling $214,759. Quality measures score 2 of 5. The last inspection was June 2025, so the record is current, not stale. Strong floor staff, thinner weekends, and a serious citation history worth asking about directly before you sign anything.
The Waterton is a hospital-district home in Tyler, and its inspection record is its strongest feature, a four-star health inspection rating, with the most recent visit in May 2026. But ten deficiencies sit on the current record, two of them serious enough to reach harm or jeopardy level, and CMS has fined the home twice for a combined $23,389.
The bigger issue is the floor. At 3.38 nurse hours per resident day, staffing falls about 13 percent under the national average, weekend coverage drops roughly 11 percent below the home's own weekday level, and turnover runs near 51 percent against a national 45.8. A hospital district can bring stability that for-profit chains often can't, but the numbers here still point to a thin, churning direct-care staff.
Briarcliff Health Center runs 230 beds in Tyler under corporate ownership, and the numbers show a home that's struggling on care quality even where it looks average on paper. Nurse staffing sits at 3.67 hours per resident day, about 5% under the national figure, and weekends drop roughly 11% below its own weekday levels, so coverage thins out exactly when families tend to visit. The inspection record is the bigger concern: 14 deficiencies, five serious enough to put residents at harm or jeopardy, three tied to abuse, and two fines totaling $51,034. Staff turnover at 41% is slightly better than the national rate, but that's small comfort against a quality-measure score at the bottom of the scale and a citation history this recent.
Providence Park runs 3.24 nurse hours per resident per day, about 16 percent under the national average, and weekends drop another 13 percent below its own weekday staffing. The 125-bed for-profit has 23 deficiencies on its current record, two of them at the harm or jeopardy level, with two fines totaling $188,361. Its most recent inspection was June 18, 2025, and the health inspection rating sits at 2 of 5 stars. Staff turnover of 40.9 percent is slightly better than the 45.8 percent national figure, but a 2-star staffing rating paired with that many deficiencies is the real story here.
Greenbrier runs on 3.06 nurse hours per resident per day, roughly a fifth below the national average, and weekends drop another 14% under its own weekday level. That thin coverage shows up in the staffing rating, which sits at the bottom of CMS's scale. Annual turnover of 96.6%, more than double the national figure, means the people caring for residents are constantly new. Its current record carries 28 deficiencies, two tied to abuse, though none reached the harm or jeopardy level. The most recent inspection was March 2026. For-profit corporate ownership rounds out the picture. Ask about actual weekend coverage and how long aides tend to stay.
Avir At Petal Hill runs 3.50 nurse hours per resident day, about 9% under the national average, and weekend coverage drops roughly 14% below what the home staffs on weekdays. Its record shows 33 deficiencies, four of them at the harm or jeopardy level and two tied to abuse, with $31,256 in fines across two penalties. Staff turnover sits at 43.9%, a touch better than the 45.8% national figure. All three CMS ratings, health inspection, quality measures, staffing, land at 2 out of 5, and the most recent inspection was March 5, 2026. For a 120-bed for-profit corporate home, the pattern is thin staffing, repeated serious findings, and middle-to-low marks across the board.
Reunion Plaza is run by a hospital district, and its inspection record is genuinely clean, five deficiencies on the books, none causing harm or involving abuse, and a recent survey from August 2025. The problem sits elsewhere. Nurse staffing runs 3.20 hours per resident day against a national average of 3.86, and weekends drop roughly 9% below the home's own weekday coverage, so the hours thin out exactly when families tend to visit. Annual turnover of 66.3% is well above the 45.8% national figure, which means aides and nurses are cycling through regularly. Good inspections, thin and unsettled staffing, that combination is what a C reflects here.
The Heights of Tyler runs 3.13 nurse hours per resident day, roughly 19 percent under the national average, and weekend coverage dips about 12 percent below what it manages on weekdays. That thin margin sits behind a staffing rating of 1 out of 5 even though the home's last inspection in February 2026 produced a 4-star health inspection result. Turnover adds another layer: 56.1 percent of staff leave annually, well above the 45.8 percent national figure. The current record lists 21 deficiencies, one involving harm or jeopardy and one abuse-related, plus a $14,276 fine. Ownership is for-profit partnership. The inspection picture looks better than the day-to-day staffing reality.
Colonial Nursing & Rehabilitation Center runs 90 certified beds in Lindale under individual for-profit ownership, and its staffing sits at 3.51 nurse hours per resident day, roughly 9% under the national average of 3.86. Weekends drop about 7% below the home's own weekday coverage, so the thinnest shifts get thinner.
The inspection record is the bigger concern. Twenty-three deficiencies are on file, three of them serious enough to involve harm or jeopardy, and two tied to abuse. One federal fine totals $247,572, a figure usually reserved for repeat or high-severity problems. The last inspection was March 18, 2026, so the record is recent, not stale.
If you're weighing this one, ask the administrator directly how those abuse deficiencies were resolved and what weekend nurse coverage looks like on a typical Saturday.
Park Place runs lean on the people who actually deliver care. At 3.41 nurse hours per resident day, it sits about 12 percent under the national average, and weekends drop roughly another 18 percent below its own weekday coverage. The staffing picture gets harder when you look at turnover: 63.8 percent of staff left last year, against a national rate near 46 percent, meaning the aides and nurses caring for your relative are, statistically, likely to be new to the building. The government's own inspectors rated staffing and health inspections each 1 out of 5, and the record shows 32 deficiencies, three of them serious enough to put residents in harm's way and three tied to abuse. Two fines total $287,159. Texas corporate ownership, 120 beds, last inspected May 2025.
Avir At Azalea Heights runs 120 certified beds in Tyler under for-profit LLC ownership, and its nurse staffing sits at 2.60 hours per resident day, roughly a third below the national average of 3.86. Weekends dip about 11% below its own weekday levels, so coverage thins out exactly when families tend to visit. The inspection record shows 25 deficiencies, three of them serious enough to put residents at harm or jeopardy, with two fines totaling $27,550 and a December 2025 inspection. Staff turnover of 43.8% is close to the national 45.8%, so the problem isn't retention so much as how few hands are scheduled per resident.
Oak Brook Health Care Center in Whitehouse is run by a hospital district, and its inspection record is genuinely strong, a five-star health inspection rating and only four deficiencies on the current record, with one at the harm level and none related to abuse. The problem sits with staffing. At 3.05 nurse hours per resident day, this home runs about 21 percent below the national average, and weekends dip roughly 17 percent below its own weekday coverage. Turnover is 66.4 percent against a national 45.8 percent. That combination, solid inspections, thin and churning staff, is what pulls the overall picture down to average.
Avir At Lindale runs on thinner nursing coverage than most homes nationally, 3.60 nurse hours per resident day against a 3.86 average, and weekends dip about 8% below its own weekday level, so the thinnest shifts come when families often visit. Staff turnover sits at 60%, well above the 45.8% national figure, meaning many of the people caring for residents are still new to the building. The inspection record is the sharper concern: 34 deficiencies, 8 of them at harm or jeopardy level and 3 abuse-related, with five fines totaling $754,374 and a February 2026 inspection. Government hospital-district ownership hasn't shielded it from any of that.
Avir At Rose Trail carries a record that should give any family pause. The Tyler home runs 3.04 nurse staffing hours per resident day against a national average of 3.86, and weekends drop about 16% below its own weekday level, so the thinnest coverage lands exactly when families tend to visit. Staff turnover sits at 69.6% against a national 45.8%, meaning most of the people caring for your relative will likely be gone within the year.
The inspection record is worse: 59 deficiencies, 10 of them at the harm or jeopardy level and 10 tied to abuse, with $442,321 in federal fines. CMS has placed it in the Special Focus Facility program, reserved for the country's most troubled homes.
Bluebonnet Point Wellness runs on 2.80 nurse hours per resident day, roughly 27% under the national average, and weekends drop about 12% below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 97.8% against a national 45.8%, meaning nearly the entire nursing workforce cycles out each year. The current record shows 34 deficiencies, six serious enough to cause harm or jeopardy and one tied to abuse, with five fines totaling $181,947. Inspectors last visited in August 2025. With 119 certified beds under corporate for-profit ownership, ask specifically who is on duty nights and weekends before you decide.