Gregg County, Texas · Nursing home
Truman W Smith Children's Care Center
5 of 5 overall from CMS
2200 W Upshur Ave, Gladewater, TX 75647
At a glance
- Overall rating 5 of 5 Above the state average of 2.7
- Nurse time per resident, per day 4.78 hours Above the state average of 3.39
- Nursing staff who left in a year 35.0% Below the state average of 55.3%
- Health citations, last 3 inspection cycles 13 None at the harm level or above
- Fines in 3 years None None listed by CMS
- Certified beds in use 82.8% of 120 beds, on an average day
Arrows only show whether a figure is above or below the state average. They are not a judgment of the home.
Truman W Smith Children's Care Center is a 120-bed nursing home in Gladewater, Texas (Gregg County). CMS rates it 5 of 5 stars overall as of Sep 2026. It reports 4.78 nurse staffing hours per resident per day, above the Texas average of 3.39. CMS lists no fines in the past three years.
- Certified beds
- 120
- Residents per day (average)
- 99.3
- Certified since
- 1999 (27 yrs)
For profit - Corporation Participates in Medicaid
Bed use is this site's calculation: average residents per day divided by certified beds. It is an average, so it does not show today's openings.
Terms used on this page
- CMS
- The Centers for Medicare & Medicaid Services, the federal agency that publishes the ratings, staffing figures, inspection results and penalties shown here.
- Certified beds
- The number of federally certified beds CMS lists for the home.
- Deficiency or citation
- A federal requirement that inspectors found the home did not meet. Each one gets a letter from A to L for how serious it was and how many residents were affected. What the letters mean
- Actual harm
- Letters G, H and I: actual harm to a resident that is not immediate jeopardy.
- Immediate jeopardy
- Letters J, K and L: the problem caused, or was likely to cause, serious injury, harm, impairment or death to a resident.
- Inspection cycle
- A standard inspection plus the complaint and infection-control citations CMS assigns to it. This page shows the three most recent cycles.
- Special Focus Facility (SFF)
- A home CMS has placed under closer oversight because of its inspection record. More about the program
Questions to ask Truman W Smith Children's Care Center
Chosen from this home's public data.
- Reported nurse staffing is 4.13 hours per resident on weekends against 4.78 overall. Who covers Saturdays and Sundays?Weekend staffing in CMS data
- What is the daily private-pay rate, and are Medicaid beds available now?CMS does not publish prices
- Can we visit at a mealtime and again on a weekend?General
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 5 of 5 Texas average 2.7
- Health inspections 5 of 5 Texas average 2.8
- Staffing 2 of 5 Texas average 1.9
- Quality measures 5 of 5 Texas average 3.7
The vertical line marks the Texas average. Ratings run from 1 to 5. How to read CMS star ratings
Nurse staffing
Hours of care per resident per day, as the home reported to CMS.
What these roles do
Nurse aides give most hands-on daily care, such as help with bathing, dressing and meals. Licensed practical nurses give medications and routine nursing care. Registered nurses assess residents and direct their care.
- All nursing staff 4.78 h Texas average 3.39
- Nurse aides 2.76 h Texas average 2.01
- Licensed practical nurses 1.31 h Texas average 0.95
- Registered nurses 0.71 h Texas average 0.43
- All staff, weekends 4.13 h Texas average 2.98
How much nurse staffing is enough? All bars share one scale, 0 to 11 hours. The vertical line marks the Texas average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnover35.0%
- Texas average55.3%
- Registered nurse turnover26.3%
- Texas average54.6%
- Administrators who left1
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the Texas and national averages. marks the measures CMS uses in its quality star rating; for those, the rating gives more points for a lower rate.
Long-stay residents
| Measure | This home | Texas | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 12.0% | 15.8% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 0.0% | 3.0% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.4% | 0.3% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 0.0% | 0.8% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 0.0% | 2.4% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 0.0% | 0.0% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 0.0% | 3.3% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% | 96.6% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 7.2% | 14.0% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 61.3% | 18.0% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 98.0% | 98.0% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 0.1% | 3.8% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 1.3% | 13.4% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 11.8% | 9.6% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | Too few residents or stays to report | 2.17 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | Too few residents or stays to report | 2.06 | 1.78 |
Short-stay residents
| Measure | This home | Texas | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Too few residents or stays to report | 88.9% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | Too few residents or stays to report | 1.5% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Too few residents or stays to report | 88.0% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | Data missing or not submitted | 25.7% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | Data missing or not submitted | 12.3% | 12.0% |
Measure periods: April 2025 to March 2026 for most measures; July 2024 to June 2025 for the flu vaccine measures; January to December 2025 for the hospital and emergency department measures, which CMS risk-adjusts. See the measures on Medicare.gov
Inspection history
Inspectors cited 13 health deficiencies in the three most recent inspection cycles. None was graded as actual harm or immediate jeopardy. 3 were cited in connection with a complaint investigation.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Nov 18, 2025 | 4 | 1 |
| Jan 14, 2025 | 3 | 2 |
| Dec 6, 2023 | 6 | 1 |
Texas homes averaged 9.4 health deficiencies in the latest cycle; the national average is 9.2. Each cycle's health count covers the standard inspection on that date plus the complaint and infection-control citations CMS assigns to that cycle.
Health citations, three most recent inspection cycles (13)
-
EPotential for more than minimal harm, pattern
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.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Mar 21, 2026)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights · Deficient, Provider has date of correction (Nov 19, 2025)
-
DPotential for more than minimal harm, isolated
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.
Quality of Life and Care · Deficient, Provider has date of correction (Nov 19, 2025)
-
DPotential for more than minimal harm, isolated
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Environmental · Deficient, Provider has date of correction (Nov 19, 2025)
-
EPotential for more than minimal harm, pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Complaint investigation · Nutrition and Dietary · Deficient, Provider has date of correction (Jan 15, 2025)
Show 8 more
-
EPotential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Jan 15, 2025)
-
DPotential for more than minimal harm, isolated
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.
Resident Rights · Deficient, Provider has date of correction (Jan 15, 2025)
-
EPotential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Complaint investigation · Infection Control · Deficient, Provider has date of correction (Mar 1, 2024)
-
EPotential for more than minimal harm, pattern
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.
Quality of Life and Care · Deficient, Provider has date of correction (Dec 8, 2023)
-
EPotential for more than minimal harm, pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Dec 8, 2023)
-
DPotential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care · Deficient, Provider has date of correction (Dec 8, 2023)
-
DPotential for more than minimal harm, isolated
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Nutrition and Dietary · Deficient, Provider has date of correction (Dec 8, 2023)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Dec 8, 2023)
What severity letters A to L mean
Each sentence above is the requirement that was not met, in CMS's wording. For the inspection results as Medicare publishes them, open this home's page on Medicare.gov and look under "Health inspections".
Penalties, past three years
CMS lists no fines or payment denials for this home in the past three years.
Texas homes averaged 1.5 fines and $44,141 in fine amounts; the national averages are 0.9 and $30,972.
Cost
Not in the public data. CMS does not publish what a nursing home charges.
Ask the home for its daily private-pay rate and whether a bed is open for your coverage. See what Medicare covers and how Medicaid pays for a nursing home.
Compared within Texas
- Size456 of 1177 by certified beds
- Texas average residents per day75.8
- ChainNone listed
- Resident or family councilResident
- Homes in Gregg County12
Common questions
What is the CMS star rating for Truman W Smith Children's Care Center?
Truman W Smith Children's Care Center has an overall rating of 5 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 5, staffing is 2 and quality measures is 5.
How many beds does Truman W Smith Children's Care Center have?
Truman W Smith Children's Care Center has 120 certified beds. It averages 99.3 residents per day, about 82.8% of its certified beds.
How much nursing care do residents get at Truman W Smith Children's Care Center?
The home reports 4.78 hours of nurse staffing per resident per day, including 0.71 hours from registered nurses. The Texas average is 3.39 hours and 0.43 hours from registered nurses.
Has Truman W Smith Children's Care Center been fined?
CMS lists no fines for this home in the past three years.
Does Truman W Smith Children's Care Center accept Medicare or Medicaid?
CMS lists its participation as "Medicaid". Ask the home whether a bed is open for your coverage.
Guides for families looking at this home
- Understanding the recordWhat to ask on a nursing home tourQuestions that turn a home's public record into a useful conversation when you tour, plus what to look for yourself.
- Understanding the recordInspection severity letters A to LHow inspectors grade each deficiency by harm and by how many residents were affected.
- Understanding the recordHow to read CMS star ratingsWhat the overall, health inspection, staffing and quality measure ratings cover, and what they leave out.
Nearest nursing homes
- 2 of 5 Legend Oaks Healthcare and Rehabilitation Center G 100beds 74.9%in use 3.11nurse hours a day
- 1 of 5 Pine Tree Lodge Nursing Center 92beds 64.1%in use 3.29nurse hours a day
- 4 of 5 Buckner Westminster Place 20beds 100.0%in use 5.28nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Gregg County
Who to call in Texas
These offices serve residents of every nursing home in Texas.
- Long-term care ombudsman Office of the State Long-Term Care Ombudsman 1-800-252-2412 An advocate for residents and their families.
- File a complaint about a nursing home Complaint and Incident Intake 1-800-458-9858 (Monday to Friday, 7 a.m. to 7 p.m. Central) The state agency that inspects nursing homes.
Texas staffing, bed-hold and Medicaid rules · Residents' rights in every state
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 45F470. See this home's official record on Medicare.gov
See something shown incorrectly? Tell us. This site shows each record as CMS publishes it and cannot change the underlying record.