The Heights Of Tyler in Tyler, Smith County, Texas

Tyler, Smith County, Texas 75703

Status Medicare and Medicaid certifiedMedicare CCN 676262

HHSC license rosteras of November 9, 2026CMS nursing home filerelease October 28, 2026; processing date October 1, 2026CMS processing date for this home October 1, 2026

Verify on TULIP View on Medicare.gov

Location and contact

Address: 2650 Elkton Trail
Tyler, TX 75703
Open map (OpenStreetMap)
Phone: (903) 266-7200
HHSC facility ID: 104599
License number: 147602

Medicare ratings

Star ratings below are copied from the CMS Provider Information file (official release October 28, 2026; processing date October 1, 2026). They are not assigned by NursingCareLookup. See how to read ratings and CMS Five-Star documentation.

Overall: 3 of 5Overall: 3 of 5 stars
Health inspection: 4 of 5Health inspection: 4 of 5 stars
Staffing: 1 of 5Staffing: 1 of 5 stars
Quality measures: 4 of 5Quality measures: 4 of 5 stars
Long-stay quality measures: 5 of 5Long-stay quality measures: 5 of 5 stars
Short-stay quality measures: 2 of 5Short-stay quality measures: 2 of 5 stars

Staffing hours

Hours are the facility’s reported nurse staffing hours per resident per day from the CMS file. The Texas average is computed on this site from Texas rows in that same file that include a numeric value. It is not copied from another website. Method: Methodology.

Staffing hours per resident per day
Measure	This facility	Texas average (this site)
Total nurse staffing	3.37 hours	3.42 hours n=1,152
Registered nurse	0.37 hours	0.44 hours
LPN	0.76 hours	0.95 hours
Nurse aide	2.24 hours	2.03 hours
Weekend nurse staffing	2.97 hours	2.99 hours

0.04 hours below this site’s computed Texas average.

Total nursing staff turnover: 51.4% (Texas average computed on this site: 50.8%, n=1,096)
RN turnover: 66.7%
Average residents per day: 108.7
Certified beds (CMS): 120

MDS quality measures

These figures are the four-quarter averages published in the CMS MDS Quality Measures file (official release October 28, 2026; measure period 2025Q3-2026Q2; processing date October 1, 2026). They are not a grade this site assigned. A “used in Five-Star” flag is the published CMS field that says whether that measure feeds the quality-measure star rating. Quarterly scores are collapsed under each measure. Official definitions are on the CMS Five-Star page.

CMS MDS quality measures, four-quarter averages
Measure	Stay	Four-quarter average	Used in Five-Star QM rating
Percentage of long-stay residents whose need for help with daily activities has increased Quarterly scores Q1 6.1% · Q2 7.4% · Q3 7.6% · Q4 9.2% · Period 2025Q3-2026Q2 · Measure code 401	Long Stay	7.5%	Yes, as published by CMS
Percentage of long-stay residents with a catheter inserted and left in their bladder Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 406	Long Stay	0.0%	Yes, as published by CMS
Percentage of long-stay residents with a urinary tract infection Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 407	Long Stay	0.0%	Yes, as published by CMS
Percentage of long-stay residents experiencing one or more falls with major injury Quarterly scores Q1 6.2% · Q2 3.9% · Q3 5.9% · Q4 5.2% · Period 2025Q3-2026Q2 · Measure code 410	Long Stay	5.3%	Yes, as published by CMS
Percentage of long-stay residents whose ability to walk independently worsened Quarterly scores Q1 4.3% · Q2 10.1% · Q3 9.5% · Q4 6.7% · Period 2025Q3-2026Q2 · Measure code 451	Long Stay	7.9%	Yes, as published by CMS
Percentage of long-stay residents with pressure ulcers Quarterly scores Q1 1.7% · Q2 0.8% · Q3 1.4% · Q4 1.9% · Period 2025Q3-2026Q2 · Measure code 479	Long Stay	1.4%	Yes, as published by CMS
Percentage of long-stay residents who received an antipsychotic medication Quarterly scores Q1 1.6% · Q2 7.7% · Q3 4.4% · Q4 4.9% · Period 2025Q3-2026Q2 · Measure code 481	Long Stay	4.7%	Yes, as published by CMS
Percentage of long-stay residents who lose too much weight Quarterly scores Q1 1.2% · Q2 1.2% · Q3 1.2% · Q4 1.2% · Period 2025Q3-2026Q2 · Measure code 404	Long Stay	1.2%	No, as published by CMS
Percentage of long-stay residents who have depressive symptoms Quarterly scores Q1 0.0% · Q2 0.0% · Q3 2.2% · Q4 1.1% · Period 2025Q3-2026Q2 · Measure code 408	Long Stay	0.8%	No, as published by CMS
Percentage of long-stay residents who were physically restrained Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 409	Long Stay	0.0%	No, as published by CMS
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Quarterly scores Q1 66.0% · Q2 82.4% · Q3 100.0% · Q4 100.0% · Period 2025Q3-2026Q2 · Measure code 415	Long Stay	87.2%	No, as published by CMS
Percentage of long-stay residents who received an antianxiety or hypnotic medication Quarterly scores Q1 17.0% · Q2 17.6% · Q3 21.2% · Q4 19.5% · Period 2025Q3-2026Q2 · Measure code 452	Long Stay	18.8%	No, as published by CMS
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Quarterly scores Q1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 454	Long Stay	96.4%	No, as published by CMS
Percentage of long-stay residents with new or worsened bowel or bladder incontinence Quarterly scores Q1 6.3% · Q2 8.8% · Q3 9.9% · Q4 5.1% · Period 2025Q3-2026Q2 · Measure code 480	Long Stay	7.6%	No, as published by CMS
Percentage of short-stay residents who newly received an antipsychotic medication Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 434	Short Stay	0.0%	Yes, as published by CMS
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine Quarterly scores Q1 71.1% · Q2 65.9% · Q3 65.4% · Q4 75.2% · Period 2025Q3-2026Q2 · Measure code 430	Short Stay	69.7%	No, as published by CMS
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine Quarterly scores Q1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 472	Short Stay	47.1%	No, as published by CMS

Inspection citations

18 health citations in the CMS file (6 from complaint surveys). Highest scope/severity letter in the file: D — Isolated, potential for more than minimal harm.

The list below is drawn from the CMS Health Deficiencies file. We show the tag, a plain-language reading of the scope and severity letter, whether the survey was a standard or complaint survey, the survey date, and whether CMS recorded a correction. We do not reprint the official deficiency narrative here. Read that text on TULIP or Medicare.gov. A facility may appeal a finding; a successful appeal can alter or remove a citation.

Scope and severity letters (A–L)

CMS assigns one letter from a grid of scope (how widely a problem was found) and severity (how serious the harm was or could be). The short labels below are our wording of that grid, not a different rating system.

Scope and severity letters used in CMS health citations
Severity	Isolated	Pattern	Widespread
Potential for minimal harm	A	B	C
No actual harm, potential for more than minimal harm	D	E	F
Actual harm	G	H	I
Immediate jeopardy	J	K	L

2026 — 7 citations

Tag 0656D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: March 24, 2026

CMS records a correction date (March 26, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0812E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: February 25, 2026

CMS records a correction date (March 3, 2026)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0755D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: February 25, 2026

CMS records a correction date (March 3, 2026)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0695E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: February 25, 2026

CMS records a correction date (March 3, 2026)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0658D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: February 25, 2026

CMS records a correction date (March 3, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0641D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: February 25, 2026

CMS records a correction date (March 3, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0584E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: February 25, 2026

CMS records a correction date (March 3, 2026)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

2024 — 7 citations

Tag 0880D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: October 30, 2024

CMS records a correction date (October 30, 2024)

More detail

Infection Control Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0755D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: October 30, 2024

CMS records a correction date (October 30, 2024)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0576D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: October 30, 2024

CMS records a correction date (October 30, 2024)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0842E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: October 4, 2024

CMS records a correction date (October 23, 2024)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0755D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: October 4, 2024

CMS records a correction date (October 23, 2024)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0600D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: September 18, 2024

Past non-compliance, as recorded by CMS (September 27, 2023)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0880D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: August 28, 2024

CMS records a correction date (August 29, 2024)

More detail

Infection Control Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

2023 — 4 citations

Tag 0868C

C — Widespread, potential for minimal harm

Standard survey

Survey date: September 20, 2023

CMS records a correction date (October 1, 2023)

More detail

Administration Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0812F

F — Widespread, potential for more than minimal harm

Standard survey

Survey date: September 20, 2023

CMS records a correction date (October 1, 2023)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0695D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: September 20, 2023

CMS records a correction date (October 1, 2023)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0645D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: September 20, 2023

CMS records a correction date (October 1, 2023)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

License and identity (HHSC)

License effective: April 1, 2026
License expires: April 1, 2029
Initial license date: December 7, 2010
Facility licensed: Yes
Facility certified (HHSC): Yes
Service type: MEDICARE/MEDICAID
Total licensed capacity: 120 beds
Bed mix (HHSC): Licensed only 0; Medicaid only 0; Medicare only 0; Medicare/Medicaid 120; ICF/IID 0
Alzheimer capacity: 0
Administrator: Richard J McGuire
Management company: Touchstone Strategies Tyler LLC

Ownership

Ownership below comes from the CMS file when a row joined on this home’s Medicare number. HHSC also records an owner and entity type; those appear after the CMS data. The HHSC entity type “HOSPITAL DISTRICT/AUTHORITY” is very common in the state roster and may not describe day-to-day control. It is not used as a headline here.

CMS ownership type: For profit - Partnership · Affiliated / chain name in the file: TOUCHSTONE COMMUNITIES (25 facilities in the chain, as listed)

CMS ownership records
Name	Role	Type	Share	Associated
LIBERTY COUNTY HOSPITAL DISTRICT NO 1	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	100%	since 04/01/2017
CAPITAL FUNDING GROUP, INC.	5% OR GREATER MORTGAGE INTEREST	Organization	NOT APPLICABLE	since 12/01/2014
STRATTON, CHARLES	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 05/01/2005
TOUCHSTONE STRATEGIES-TYLER LLC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 04/01/2017
BOENING, CHRISTOPHER	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/13/2020
CAMPBELL, LESLIE	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 04/01/2020
CASTILLO, LYNNEA	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 04/01/2017
MCGUIRE, RICHARD	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 07/08/2024
SEHLKE, BRYON	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 04/01/2017
SWEAT, STACY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 10/02/2025
ZUROVEC, DARRELL	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 08/01/2017
AEGIS THERAPIES, INC.	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/01/2017

16 more CMS ownership records

Additional CMS ownership records
Name	Role	Type	Share	Associated
CARVAJAL PHARMACY LTC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/01/2017
NUTRITIOUS LIFESTYLES, INC.	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/01/2017
PLANTE & MORAN PLLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/01/2017
TOUCHSTONE COMMUNITIES INC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/01/2017
TOUCHSTONE REALTY - SC LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/01/2017
TOUCHSTONE STRATEGIES-TYLER LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 07/24/2025
TRIDENT HEALTH SERVICES INC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/01/2017
BOENING, CHRISTOPHER	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/13/2020
CAMPBELL, LESLIE	ADP OF THE SNF	Individual	NOT APPLICABLE	since 04/01/2020
CASTILLO, LYNNEA	ADP OF THE SNF	Individual	NOT APPLICABLE	since 04/01/2017
FELLBAUM, ERNEST	ADP OF THE SNF	Individual	NOT APPLICABLE	since 04/01/2017
MCGUIRE, RICHARD	ADP OF THE SNF	Individual	NOT APPLICABLE	since 07/08/2024
SEHLKE, BRYON	ADP OF THE SNF	Individual	NOT APPLICABLE	since 04/01/2017
STUDER, STANLEY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 04/01/2017
SWEAT, STACY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 10/02/2025
ZUROVEC, DARRELL	ADP OF THE SNF	Individual	NOT APPLICABLE	since 08/01/2017

HHSC owner fields

Owner (HHSC): Liberty County Hospital District No 1
Type of entity (HHSC): HOSPITAL DISTRICT/AUTHORITY

Public data compiled by NursingCareLookup, not an endorsement or a recommendation, and not medical or legal advice. This site is not affiliated with HHSC, CMS, or Medicare. Figures can lag events at the facility, including surveys, corrections, and successful appeals (an appeal can alter or remove a citation). Verify current facts on TULIP and Medicare.gov, and visit in person before you decide. HHSC roster as of November 9, 2026 (America/Chicago). CMS file: official release October 28, 2026; processing date October 1, 2026.