THE CENTER AT GRANDE
TYLER, TX · Smith County · For profit - Limited Liability company · 96 certified beds
📍 3219 East Grande Boulevard, Tyler, TX 75707 · 📞 (719) 522-2000
Medicare ID: 676443 · Last Medicare inspection: Nov 16, 2025
Score Breakdown
What the numbers mean
THE CENTER AT GRANDE scored 81 out of 100 — 26 points above the state average of 55.
📋 Inspections: 9 citations over the last 36 months — 21 fewer than the state average (30). None were rated as causing actual harm to residents.
⚠️ Staffing: Staffing levels are below average. Lower staffing is associated with longer response times, more pressure injuries, and higher hospitalization rates. Ask the facility directly about their RN-to-resident ratio and how they handle shortfalls.
⚖️ Penalties & enforcement: No significant federal fines or enforcement actions on record — a positive indicator of consistent regulatory compliance.
💬 Complaints: Low complaint activity — few formal complaints from residents or families have triggered inspections. Ask if there is a family council you can speak with.
⚠️ Resident quality outcomes: Some quality measures are below national benchmarks. Areas like fall prevention, pain management, or medication use may warrant closer attention.
🔍 Most cited areas: The facility had a problem with corridor doors, smoke doors, or hallway barriers that are supposed to slow smoke and fire spread so residents have time to evacuate or shelter safely.. The full report provides the complete citation record with dates, severity levels, and plain-English descriptions.
What inspectors found (last 3 surveys)
Top concern areas
⚖ Penalties & Enforcement
Federal civil monetary penalties (CMPs) are only issued after a facility has failed two levels of regulatory review — meaning problems were found on inspection and the facility could not rebut the findings. This is a serious escalation beyond a standard citation.
📅 Per-action enforcement records (date, fine amount, and penalty type for each individual action) are sourced from a separate CMS enforcement dataset and will be added in a future data update.
Resident Wellbeing — Key Indicators
These are the measures families ask about most. They come from CMS clinical assessments of every resident — not just inspection reports. Stars (★) count toward the official CMS quality star rating.
Source: CMS MDS Quality Measures & Medicare claims data. Scores shown are the most recent 4-quarter averages for long-stay residents.
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What to know about The Center At Grande
The Center At Grande is a Medicare-certified nursing home in Tyler, Tx with 96 certified beds. Its current Senior Care Report Card score is 81/100, placing it in the Generally Positive range. The latest CMS survey date in our data is Nov 16, 2025. Over the last 36 months, our CMS citation data shows 9 citations. Families comparing this facility should pay close attention to staffing, quality outcomes before scheduling a tour or accepting placement. Ownership type on file: For profit - Limited Liability company.
What this facility's data shows
▶ Score breakdown — the numbers behind this assessment
Each pillar scores 0–100 and is combined into the overall score. A strong overall can mask a weak pillar — compare all four and see how they stack against the state average in Section B.
🏗 How This Facility Compares to TX State Averages
Comparing a facility to others in the same state puts its score in context. A facility might have 8 citations and that could be above average in one state and below in another. Green means this facility is doing better than its peers; red means it's falling short.
| Metric | This facility | TX avg | vs. State |
|---|---|---|---|
|
Overall score
The combined Senior Care Report Card score out of 100.
|
81 | 55 | ▲ Better than state avg |
|
Inspection score
How well the facility performs on standard health surveys.
|
100 | 49 | ▲ Better than state avg |
|
Staffing score
RN hours, total nurse hours, and staff turnover from CMS payroll data.
|
59 | 38 | ▲ Better than state avg |
|
Penalty score
Fines, payment denials, and enforcement actions on file.
|
100 | 52 | ▲ Better than state avg |
|
Complaint score
Volume of complaint surveys and substantiated complaints.
|
95 | 81 | ▲ Better than state avg |
|
Quality score
Resident clinical outcomes vs national benchmarks: falls, antipsychotics, pain, vaccination, hospitalizations.
|
50 | 68 | ▼ Worse than state avg |
|
Citations (3 yrs)
Total number of deficiencies cited in the last 36 months.
|
9 | 29.9 | ▲ Better than state avg |
|
Serious citations
Citations rated severity G or higher (actual harm or immediate jeopardy).
|
0 | 2.3 | ▲ Better than state avg |
📅 Inspection Timeline
State health inspectors visit nursing homes on a regular cycle — typically every 12 to 15 months — and document every deficiency they find. The timeline below shows the date and scale of each inspection visit over the past several years. A pattern of worsening surveys is a red flag even if the most recent visit looks clean.
Bar length proportional to citation count. Red = serious findings (severity G+). Orange = elevated. Green = low.
📄 Full Citation Record
Every time state inspectors visit a nursing home, they write up anything that doesn’t meet federal standards. Each write-up is called a citation.
Each citation shows what the problem was and how serious it was, using a color-coded badge:
A Repeat tag means the same problem appeared in a previous inspection — it was not fully corrected the first time. Citations shown cover the last two years.
How Are Residents Doing?
Inspections tell you whether a facility followed the rules. These measures tell you how residents actually fared — whether they fell, experienced pain, lost weight, or were over-medicated. CMS collects this data through regular clinical assessments that nurses complete for every resident. Unlike inspections, which happen once a year, these assessments happen continuously.
How to read these cards: Each card shows one measure. Lower percentages are better for most (e.g. fewer falls), but higher is better for vaccination rates and community return. ★ Star rating marks measures CMS uses in its official quality star rating.
Source: CMS MDS Quality Measures (2025Q1-2025Q4). Collected via standardized clinical assessments — not inspector visits.
Hospitalization & ER Visits
These numbers come directly from Medicare claims — real billing records of every time a resident was hospitalized or sent to the emergency room. They\'re among the most objective measures of care quality because they can\'t be influenced by how a facility writes up an assessment. The adjusted score is the most meaningful number — it\'s been corrected to account for how sick residents were, so a facility treating frailer patients isn\'t unfairly penalized.
What to look for: An adjusted score significantly above the expected score means this facility hospitalizes residents more often than peer facilities with similar patient populations — that gap is worth asking about directly.
Source: CMS Medicare claims data. Scores are risk-adjusted — they account for how ill residents were when admitted so facilities treating sicker populations aren\'t penalized for it.
💬 Questions to Ask Before Touring
These questions are generated specifically from this facility's score profile and citation history — not a generic checklist. A facility's willingness to answer them openly, and the quality of their answers, is itself an important signal. Bring this list when you tour or call.
- What is your current RN-to-resident ratio on each shift, and what is your annual staff turnover rate among nursing staff?
- Some resident outcome measures are below average here. What is your current approach to fall prevention, pain management, and quarterly medication review?
- Can we speak privately with two or three current residents or their families?
👪 Family Decision Guide
This guide translates this facility's data into practical next steps for families. It is not a recommendation for or against placement — it is a structured framework for the conversations you need to have before making a decision.
✓ Positives to confirm
- Inspection record is above average — verify improvements are maintained
- No significant penalty history — a positive indicator of consistent compliance
- Low complaint activity — ask if there is a family council you can speak with
- No serious-harm citations (G+) in the public record
- No pattern of repeat violations detected
⚠ Areas to probe
- Staffing concerns — request staffing schedules and ask about agency nurse use
- Always speak with at least two current residents or family members independently
📈 Score History
The score is recalculated every time CMS releases updated data (typically monthly). A consistent downward trend is more concerning than a single low score. An improving trend after a period of poor performance may indicate management changes are taking effect. Use the free facility-watch form above to get email alerts when this facility's record changes materially.
🏢 Ownership & Operators
Ownership matters because large corporate chains sometimes prioritize cost controls over care quality. CMS requires every nursing home to disclose its owners, operators, and managing employees. Frequent ownership changes can disrupt staffing and operations — which is why we flag facilities that changed ownership in the past 12 months.
| Owner / Operator | Role | Ownership % | Effective |
|---|---|---|---|
| KELLY, JULIE | Individual | — | 1970-01-01 |
| MICHAELS, JAMES | Individual | — | 1970-01-01 |
| EAST TEXAS MEDICAL CENTER REGIONAL HEALTHCARE SYSTEM | Organization | — | 1970-01-01 |
| ESMAS, BARTOLOME | Individual | — | 1970-01-01 |
| VERITAS MANAGEMENT GROUP LLC | Organization | — | 1970-01-01 |
| GOLDEN ROAD INVESTMENTS LLC | Organization | — | 1970-01-01 |
| MURDOCK, MONTE | Individual | — | 1970-01-01 |
| SENKOFF, ALEXANDER | Individual | — | 1970-01-01 |
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We check CMS data monthly. Use the tracking form above and we will email you when new citations appear, scores change, or enforcement actions are added.
This report reflects publicly available CMS data only and is updated monthly. Severity codes and narratives are reproduced directly from the CMS health inspection database. Senior Care Report Card scores are independently computed and are not affiliated with or endorsed by CMS or Medicare.gov.