Texas·Tarrant County·Mansfield
The Pavilion At Creekwood in Mansfield, Tarrant County, Texas
Mansfield, Tarrant County, Texas 76063
Location and contact
- Address
- 2100 Cannon Dr
Mansfield, TX 76063
Open map (OpenStreetMap) - Phone
- (817) 779-6500
- HHSC facility ID
- 106248
- License number
- 145851
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.
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.
| Measure | This facility | Texas average (this site) |
|---|---|---|
| Total nurse staffing | 3.19 hours | 3.42 hours n=1,152 |
| Registered nurse | 0.30 hours | 0.44 hours |
| LPN | 0.97 hours | 0.95 hours |
| Nurse aide | 1.92 hours | 2.03 hours |
| Weekend nurse staffing | 2.86 hours | 2.99 hours |
0.23 hours below this site’s computed Texas average.
- Total nursing staff turnover
- 41.9% (Texas average computed on this site: 50.8%, n=1,096)
- RN turnover
- 53.8%
- Average residents per day
- 93.9
- Certified beds (CMS)
- 126
Penalties in the CMS Provider Information file: 3 finestotaling $39,674; 3 total penalties. These are the figures CMS published in this release. Confirm current figures on Medicare.gov.
Fines and payment denials
Individual fines and payment denials below come from the CMS Penalties file (official release October 28, 2026; processing date October 1, 2026). Dates and amounts are copied as published. They can lag later actions or successful appeals. Confirm current figures on Medicare.gov.
| Date | Type | Fine amount | Payment denial |
|---|---|---|---|
| January 5, 2025 | Fine · Fine ID 113505 | $14,901 | — |
| January 5, 2025 | Fine · Fine ID 113504 | $14,901 | — |
| August 27, 2024 | Fine · Fine ID 113235 | $9,872 | — |
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.
| Measure | Stay | Four-quarter average | Used in Five-Star QM rating |
|---|---|---|---|
Percentage of long-stay residents whose need for help with daily activities has increasedQuarterly scoresQ1 23.2% · Q2 17.5% · Q3 8.3% · Q4 5.8% · Period 2025Q3-2026Q2 · Measure code 401 | Long Stay | 13.8% | Yes, as published by CMS |
Percentage of long-stay residents with a catheter inserted and left in their bladderQuarterly scoresQ1 0.0% · Q2 0.0% · Q3 1.3% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 406 | Long Stay | 0.3% | Yes, as published by CMS |
Percentage of long-stay residents with a urinary tract infectionQuarterly scoresQ1 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 injuryQuarterly scoresQ1 2.9% · Q2 1.6% · Q3 3.0% · Q4 3.2% · Period 2025Q3-2026Q2 · Measure code 410 | Long Stay | 2.7% | Yes, as published by CMS |
Percentage of long-stay residents whose ability to walk independently worsenedQuarterly scoresQ1 — (CMS footnote 9) · Q2 — (CMS footnote 9) · Q3 — (CMS footnote 9) · Q4 — (CMS footnote 9) · Period 2025Q3-2026Q2 · Measure code 451 | Long Stay | 28.8% | Yes, as published by CMS |
Percentage of long-stay residents with pressure ulcersQuarterly scoresQ1 4.3% · Q2 0.0% · Q3 4.0% · Q4 1.5% · Period 2025Q3-2026Q2 · Measure code 479 | Long Stay | 2.5% | Yes, as published by CMS |
Percentage of long-stay residents who received an antipsychotic medicationQuarterly scoresQ1 2.2% · Q2 4.2% · Q3 5.6% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 481 | Long Stay | 3.1% | Yes, as published by CMS |
Percentage of long-stay residents who lose too much weightQuarterly scoresQ1 0.0% · Q2 1.8% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 404 | Long Stay | 0.4% | No, as published by CMS |
Percentage of long-stay residents who have depressive symptomsQuarterly scoresQ1 0.0% · Q2 3.2% · Q3 3.1% · Q4 1.7% · Period 2025Q3-2026Q2 · Measure code 408 | Long Stay | 2.0% | No, as published by CMS |
Percentage of long-stay residents who were physically restrainedQuarterly scoresQ1 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 vaccineQuarterly scoresQ1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · Period 2025Q3-2026Q2 · Measure code 415 | Long Stay | 100.0% | No, as published by CMS |
Percentage of long-stay residents who received an antianxiety or hypnotic medicationQuarterly scoresQ1 12.1% · Q2 6.8% · Q3 7.8% · Q4 8.8% · Period 2025Q3-2026Q2 · Measure code 452 | Long Stay | 8.8% | No, as published by CMS |
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccineQuarterly scoresQ1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 454 | Long Stay | 100.0% | No, as published by CMS |
Percentage of long-stay residents with new or worsened bowel or bladder incontinenceQuarterly scoresQ1 21.0% · Q2 14.8% · Q3 7.2% · Q4 16.1% · Period 2025Q3-2026Q2 · Measure code 480 | Long Stay | 14.8% | No, as published by CMS |
Percentage of short-stay residents who newly received an antipsychotic medicationQuarterly scoresQ1 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 vaccineQuarterly scoresQ1 98.8% · Q2 97.9% · Q3 98.9% · Q4 99.2% · Period 2025Q3-2026Q2 · Measure code 430 | Short Stay | 98.7% | No, as published by CMS |
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccineQuarterly scoresQ1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 472 | Short Stay | 86.1% | No, as published by CMS |
Inspection citations
26 health citations in the CMS file (13 from complaint surveys). Highest scope/severity letter in the file: J — Isolated, immediate jeopardy. 1 not recorded as corrected.
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.
| 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 — 9 citations
Tag 0755D
D — Isolated, potential for more than minimal harm
Complaint survey
Survey date: August 28, 2026
CMS records no plan of correction
More detail
Pharmacy Service Deficiencies
Survey type in the file: Health
Survey cycle in the file: 1
Tag 0689D
D — Isolated, potential for more than minimal harm
Complaint survey
Survey date: June 1, 2026
CMS records a correction date (June 2, 2026)
More detail
Quality of Life and Care 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: April 14, 2026
CMS records a correction date (April 15, 2026)
More detail
Nutrition and Dietary Deficiencies
Survey type in the file: Health
Survey cycle in the file: 1
Tag 0761E
E — Pattern, potential for more than minimal harm
Standard survey
Survey date: April 14, 2026
CMS records a correction date (April 15, 2026)
More detail
Pharmacy Service Deficiencies
Survey type in the file: Health
Survey cycle in the file: 1
Tag 0760D
D — Isolated, potential for more than minimal harm
Standard survey
Survey date: April 14, 2026
CMS records a correction date (April 15, 2026)
More detail
Pharmacy Service Deficiencies
Survey type in the file: Health
Survey cycle in the file: 1
Tag 0755E
E — Pattern, potential for more than minimal harm
Standard survey
Survey date: April 14, 2026
CMS records a correction date (April 15, 2026)
More detail
Pharmacy Service Deficiencies
Survey type in the file: Health
Survey cycle in the file: 1
Tag 0636D
D — Isolated, potential for more than minimal harm
Standard survey
Survey date: April 14, 2026
CMS records a correction date (April 15, 2026)
More detail
Resident Assessment and Care Planning Deficiencies
Survey type in the file: Health
Survey cycle in the file: 1
Tag 0558D
D — Isolated, potential for more than minimal harm
Standard survey
Survey date: April 14, 2026
CMS records a correction date (April 8, 2026)
More detail
Resident Rights Deficiencies
Survey type in the file: Health
Survey cycle in the file: 1
Tag 0550D
D — Isolated, potential for more than minimal harm
Standard survey
Survey date: April 14, 2026
CMS records a correction date (April 15, 2026)
More detail
Resident Rights Deficiencies
Survey type in the file: Health
Survey cycle in the file: 1
2025 — 9 citations
Tag 0686E
E — Pattern, potential for more than minimal harm
Complaint survey
Survey date: August 6, 2025
CMS records a correction date (August 7, 2025)
More detail
Quality of Life and Care Deficiencies
Survey type in the file: Health
Survey cycle in the file: 2
Tag 0684D
D — Isolated, potential for more than minimal harm
Complaint survey
Survey date: August 6, 2025
CMS records a correction date (August 7, 2025)
More detail
Quality of Life and Care Deficiencies
Survey type in the file: Health
Survey cycle in the file: 2
Tag 0759E
E — Pattern, potential for more than minimal harm
Standard survey
Survey date: February 26, 2025
CMS records a correction date (February 27, 2025)
More detail
Pharmacy Service 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: February 26, 2025
CMS records a correction date (February 27, 2025)
More detail
Pharmacy Service Deficiencies
Survey type in the file: Health
Survey cycle in the file: 2
Tag 0655D
D — Isolated, potential for more than minimal harm
Standard survey
Survey date: February 26, 2025
CMS records a correction date (February 27, 2025)
More detail
Resident Assessment and Care Planning Deficiencies
Survey type in the file: Health
Survey cycle in the file: 2
Tag 0585D
D — Isolated, potential for more than minimal harm
Standard survey
Survey date: February 26, 2025
CMS records a correction date (February 27, 2025)
More detail
Resident Rights Deficiencies
Survey type in the file: Health
Survey cycle in the file: 2
Tag 0742J
J — Isolated, immediate jeopardy
Complaint survey
Survey date: January 5, 2025
CMS records a correction date (January 6, 2025)
More detail
Quality of Life and Care Deficiencies
Survey type in the file: Health
Survey cycle in the file: 2
Tag 0689J
J — Isolated, immediate jeopardy
Complaint survey
Survey date: January 5, 2025
CMS records a correction date (January 6, 2025)
More detail
Quality of Life and Care Deficiencies
Survey type in the file: Health
Survey cycle in the file: 2
Tag 0684J
J — Isolated, immediate jeopardy
Complaint survey
Survey date: January 5, 2025
CMS records a correction date (January 6, 2025)
More detail
Quality of Life and Care Deficiencies
Survey type in the file: Health
Survey cycle in the file: 2
2024 — 5 citations
Tag 0578J
J — Isolated, immediate jeopardy
Complaint survey
Survey date: August 27, 2024
CMS records a correction date (August 28, 2024)
More detail
Resident Rights Deficiencies
Survey type in the file: Health
Survey cycle in the file: 3
Tag 0757D
D — Isolated, potential for more than minimal harm
Complaint survey
Survey date: May 20, 2024
CMS records a correction date (May 21, 2024)
More detail
Pharmacy Service Deficiencies
Survey type in the file: Health
Survey cycle in the file: 3
Tag 0755E
E — Pattern, potential for more than minimal harm
Complaint survey
Survey date: May 20, 2024
CMS records a correction date (May 21, 2024)
More detail
Pharmacy Service 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: January 25, 2024
CMS records a correction date (January 27, 2024)
More detail
Nutrition and Dietary Deficiencies
Survey type in the file: Health
Survey cycle in the file: 3
Tag 0558D
D — Isolated, potential for more than minimal harm
Standard survey
Survey date: January 25, 2024
CMS records a correction date (January 27, 2024)
More detail
Resident Rights Deficiencies
Survey type in the file: Health
Survey cycle in the file: 3
2023 — 3 citations
Tag 0695D
D — Isolated, potential for more than minimal harm
Complaint survey
Survey date: December 12, 2023
CMS records a correction date (December 13, 2023)
More detail
Quality of Life and Care Deficiencies
Survey type in the file: Health
Survey cycle in the file: 3
Tag 0919D
D — Isolated, potential for more than minimal harm
Complaint survey
Survey date: November 21, 2023
CMS records a correction date (November 22, 2023)
More detail
Environmental Deficiencies
Survey type in the file: Health
Survey cycle in the file: 3
Tag 0880E
E — Pattern, potential for more than minimal harm
Complaint survey, Infection-control inspection
Survey date: November 21, 2023
CMS records a correction date (December 18, 2023)
More detail
Infection Control Deficiencies
Survey type in the file: Health
Survey cycle in the file: 3
License and identity (HHSC)
- License effective
- August 3, 2025
- License expires
- August 3, 2028
- Initial license date
- August 3, 2015
- Facility licensed
- Yes
- Facility certified (HHSC)
- Yes
- Service type
- MEDICARE/MEDICAID
- Total licensed capacity
- 126 beds
- Bed mix (HHSC)
- Licensed only 0; Medicaid only 0; Medicare only 1; Medicare/Medicaid 125; ICF/IID 0
- Alzheimer capacity
- 0
- Administrator
- Ryan K Leblanc
- Management company
- —
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 - Limited Liability company · Affiliated / chain name in the file: FUNDAMENTAL HEALTHCARE (66 facilities in the chain, as listed)
| Name | Role | Type | Share | Associated |
|---|---|---|---|---|
| LEBLANC, RYAN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 01/01/2022 |
| THI OF TEXAS LLC | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 06/21/2007 |
| LEBLANC, RYAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2022 |
| FUNDAMENTAL ADMINISTRATIVE SERVICES LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/01/2007 |
| FUNDAMENTAL CLINICAL AND OPERATIONAL SERVICES, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/01/2007 |
| LEBLANC, RYAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2022 |
| RIGSBY, CAMELIA | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/01/2016 |
HHSC owner fields
- Owner (HHSC)
- Mansfield Long Term Care, LLC
- Type of entity (HHSC)
- Limited Liability Company (LLC)
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.