El Paso County, Texas · Nursing home
Avir at Tierra Este
1 of 5 overall from CMS
14300 Pebble Hills Blvd., El Paso, TX 79938
At a glance
- Overall rating 1 of 5 Below the state average of 2.7
- Nurse time per resident, per day 3.05 hours Below the state average of 3.39
- Nursing staff who left in a year 56.9% Above the state average of 55.3%
- Health citations, last 3 inspection cycles 65 3 at the harm level or above
- Fines in 3 years $53,957 8 fines
- Certified beds in use 83.2% 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.
Avir at Tierra Este is a 120-bed nursing home in El Paso, Texas (El Paso County). CMS rates it 1 of 5 stars overall as of Sep 2026. It reports 3.05 nurse staffing hours per resident per day, below the Texas average of 3.39. CMS lists 8 fines totaling $53,957 in the past three years.
- Certified beds
- 120
- Residents per day (average)
- 99.8
- Certified since
- 2023 (3 yrs)
For profit - Limited Liability company Participates in Medicare and MedicaidPart of Avir Health Group (118 homes)
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 Avir at Tierra Este
Chosen from this home's public data.
- CMS lists 8 fines totaling $53,957 in the past three years. What changed after the most recent one?Penalties in CMS data
- CMS counts 13 health deficiencies in the latest inspection cycle (the standard inspection on Sep 5, 2025 plus complaint and infection-control inspections); the Texas average is 9.4. Which have been corrected?Inspection results in CMS data
- Nursing staff turnover is 56.9%, above the Texas average of 55.3%. How often would the same aides care for my relative?Turnover in CMS data
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 1 of 5 Texas average 2.7
- Health inspections 1 of 5 Texas average 2.8
- Staffing 1 of 5 Texas average 1.9
- Quality measures 3 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 3.05 h Texas average 3.39
- Nurse aides 1.88 h Texas average 2.01
- Licensed practical nurses 1.04 h Texas average 0.95
- Registered nurses 0.13 h Texas average 0.43
- All staff, weekends 2.83 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 turnover56.9%
- Texas average55.3%
- Registered nurse turnover71.4%
- Texas average54.6%
- Administrators who left0
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 | 9.4% | 15.8% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 0.4% | 3.0% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.7% | 0.3% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 0.3% | 0.8% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 1.0% | 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 | 3.1% | 3.3% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 92.6% | 96.6% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 6.5% | 14.0% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 26.5% | 18.0% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 80.2% | 98.0% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 6.5% | 3.8% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 18.6% | 13.4% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 24.4% | 9.6% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | 1.71 | 2.17 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | 1.54 | 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 | 57.9% | 88.9% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | 3.1% | 1.5% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 89.6% | 88.0% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | 28.0% | 25.7% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | 8.1% | 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 65 health deficiencies in the three most recent inspection cycles. Of these, 1 was at the immediate jeopardy level and 2 involved actual harm; the rest were graded as no actual harm. 34 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on May 18, 2026: Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Sep 5, 2025 | 13 | 8 |
| Aug 2, 2024 | 22 | 3 |
| May 19, 2023 | 30 | 0 |
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 (65)
-
JImmediate jeopardy, isolated
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (May 20, 2026)
-
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 (May 20, 2026)
-
DPotential for more than minimal harm, isolated
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (May 20, 2026)
-
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 20, 2026)
-
DPotential for more than minimal harm, isolated
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Jan 20, 2026)
Show 25 more
-
EPotential for more than minimal harm, pattern
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 (Sep 30, 2025)
-
EPotential for more than minimal harm, pattern
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care · Deficient, Provider has date of correction (Sep 30, 2025)
-
EPotential for more than minimal harm, pattern
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care · Deficient, Provider has date of correction (Sep 30, 2025)
-
EPotential for more than minimal harm, pattern
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 · Deficient, Provider has date of correction (Sep 30, 2025)
-
DPotential for more than minimal harm, isolated
Reasonably accommodate the needs and preferences of each resident.
Resident Rights · Deficient, Provider has date of correction (Sep 30, 2025)
-
DPotential for more than minimal harm, isolated
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Sep 30, 2025)
-
DPotential for more than minimal harm, isolated
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service · Deficient, Provider has date of correction (Sep 30, 2025)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Sep 30, 2025)
-
FPotential for more than minimal harm, widespread
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.
Complaint investigation · Nursing and Physician Services · Deficient, Provider has date of correction (Apr 9, 2025)
-
DPotential for more than minimal harm, isolated
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Feb 21, 2025)
-
DPotential for more than minimal harm, isolated
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Nov 29, 2024)
-
FPotential for more than minimal harm, widespread
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 (Aug 7, 2024)
-
EPotential for more than minimal harm, pattern
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 (Aug 7, 2024)
-
EPotential for more than minimal harm, pattern
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service · Deficient, Provider has date of correction (Aug 7, 2024)
-
EPotential for more than minimal harm, pattern
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Pharmacy Service · Deficient, Provider has date of correction (Aug 7, 2024)
-
EPotential for more than minimal harm, pattern
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service · Deficient, Provider has date of correction (Aug 7, 2024)
-
EPotential for more than minimal harm, pattern
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 · Deficient, Provider has date of correction (Aug 7, 2024)
-
EPotential for more than minimal harm, pattern
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary · Deficient, Provider has date of correction (Aug 7, 2024)
-
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 (Aug 7, 2024)
-
EPotential for more than minimal harm, pattern
Dispose of garbage and refuse properly.
Nutrition and Dietary · Deficient, Provider has date of correction (Aug 7, 2024)
-
EPotential for more than minimal harm, pattern
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Administration · Deficient, Provider has date of correction (Aug 7, 2024)
-
EPotential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Aug 7, 2024)
-
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 (Aug 7, 2024)
-
DPotential for more than minimal harm, isolated
Reasonably accommodate the needs and preferences of each resident.
Resident Rights · Deficient, Provider has date of correction (Aug 7, 2024)
-
DPotential for more than minimal harm, isolated
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights · Deficient, Provider has date of correction (Aug 7, 2024)
Showing the 30 most recent of 65.
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
| Date | Type | Amount |
|---|---|---|
| May 18, 2026 | Fine | $22,205 |
| Feb 20, 2024 | Fine | $4,178 |
| Feb 12, 2024 | Fine | $3,798 |
| Jan 22, 2024 | Fine | $9,116 |
| Jan 8, 2024 | Fine | $2,279 |
| Jan 2, 2024 | Fine | $1,764 |
| Dec 11, 2023 | Fine | $3,174 |
| Nov 9, 2023 | Fine | $7,443 |
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
- Size594 of 1177 by certified beds
- Texas average residents per day75.8
- ChainAvir Health Group
- Chain average overall rating2.3 of 5
- Resident or family councilResident
- Homes in El Paso21
- Homes in El Paso County22
Common questions
What is the CMS star rating for Avir at Tierra Este?
Avir at Tierra Este has an overall rating of 1 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 1, staffing is 1 and quality measures is 3.
How many beds does Avir at Tierra Este have?
Avir at Tierra Este has 120 certified beds. It averages 99.8 residents per day, about 83.2% of its certified beds.
How much nursing care do residents get at Avir at Tierra Este?
The home reports 3.05 hours of nurse staffing per resident per day, including 0.13 hours from registered nurses. The Texas average is 3.39 hours and 0.43 hours from registered nurses.
Has Avir at Tierra Este been fined?
Yes. CMS lists 8 fines totaling $53,957 in the past three years.
Does Avir at Tierra Este accept Medicare or Medicaid?
CMS lists its participation as "Medicare and 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
- 4 of 5 Center at Zaragoza, LLC 80beds 86.0%in use 4.79nurse hours a day
- 1 of 5 Ignite Medical Resort El Paso, LLC 60beds 85.7%in use 3.24nurse hours a day
- 1 of 5 El Paso Health & Rehabilitation Center 150beds 60.6%in use 3.12nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in El Paso 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 745038. 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.