Deficiency Index

Baywind Village Skilled Nursing & Rehab

League City, Texas · CCN 675323

24 surveys since 2010. The first finding at harm level was recorded in 2019.

Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.

Citations on record
77
Surveys
24
Harm or worse
5
Immediate jeopardy
0
The record, 2010–2026
’10’15’20’25’26
No harm recordedHarm or worseNot surveyed
Harm or worse5

Findings where a surveyor recorded actual harm to a resident.

Beyond CMS’s monthly file16/24

Older surveys no longer in CMS’s monthly file or on Care Compare. They are shown here.

The facility

Certified beds
107
Ownership
For profit - Individual
Chain
CHAMBERS COUNTY PUBLIC HOSPITAL DISTRICT NO. 1
County
Galveston
Medicare-certified since
1994

CMS ratings

Overall
5
Health inspection
5
Staffing
4
Quality measures
3

CMS’s own Five-Star ratings.

Compared with similar facilities

Since 2021, this facility recorded fewer weighted findings than most of its peer group.

Weighted by harm level, against 377 for-profit facilities of 100–127 beds in Texas.

Last survey on record

May 22, 2026

171 days ago.

Counts surveys with at least one finding. A clean survey leaves no record here, so the real gap may be shorter.

Staffing

MeasureThis facilityPeer median
Nurse hours per resident day4.803.25
Registered-nurse hours per resident day0.98—
Annual nurse turnover63.3%54.0%

As reported by the facility to CMS, beside the peer-group median.

Enforcement

Fines
$4,139 across 1 penalty

Federal civil money penalties and remedies as CMS currently publishes them. Amounts may still be under appeal.

Severity of recent findings

Citations by CMS scope and severity. Rows are harm level, columns are how widespread the finding was.
SeverityIsolatedPatternWidespread
Immediate jeopardyJ—K—L—
Actual harmG—H—I—
No harm, potential for more than minimalD1386.7%E213.3%F—
No harm, potential for minimalA—B—C—
CMS’s current file: 15 of the 77 citations on record.

Most frequently cited here

In CMS’s current monthly file.

  • F7553×

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

  • F8802×

    Provide and implement an infection prevention and control program.

  • F5521×

    Ensure that residents are fully informed and understand their health status, care and treatments.

  • F5571×

    Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.

  • F5801×

    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

In the surveyor’s words

From the most serious findings on record at Baywind Village Skilled Nursing & Rehab, in the surveyor’s own words.

  • Actual harm, patternF691May 7, 2025

    Based on interviews and record review, the facility failed to ensure residents who needed colostomy care were provided such care, consistent with professional standards of practice for 2 of 4 (Resident #76 and Resident #293) residents reviewed for colostomies (surgical opening in which a piece of the colon was diverted to an artificial opening in the abdominal wall to bypass a damaged part of the colon). The facility failed to ensure training, care and documentation was consistent for Resident #76 and Resident #293 as bowel movements were not consistently documented, a colostomy was documented as an ileostomy/urostomy and colostomies were not consistently emptied. The failure could place residents at risk of complications related to a colostomy and emotional distress. […]

  • Actual harm, patternF865May 7, 2025

    Based on observations, interviews, and record review, the facility failed to ensure the facility's quality assurance and performance improvement (QAPI ) program identified and prioritized problems and opportunities that reflect organizational process, functions, and services provided to residents. The facility failed to identify inconsistencies regarding ostomy care and documentation before such concerns were identified by surveyor during survey from ,d+[DATE]-[DATE]. The failure could place residents at risk of emotional distress and inadequate ostomy care. […]

  • Actual harm, isolatedF600Apr 16, 2025

    Based on interview, and record reviews the facility failed to ensure the residents had the right to be free from abuse for 1 of 6 residents (CR#1) reviewed for abuse. The facility failed to ensure CR#1 was free from abuse when CNA A physically abused CR #1 on 04/24/24 and threatened CR #1's roommate. The noncompliance was identified as PNC. The noncompliance began on 04/24/24 and ended on 04/24/24. The facility had corrected the noncompliance before the survey began. This failure could place residents at risk of being abused. […]

  • No harm, potential for more than minimal, patternF880Jan 13, 2023

    Based on observation, interview, and record review, the facility did not maintain an infection prevention program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 2 (Residents #1 and #3) of 3 residents reviewed for infection control. -CNA-A did not wash or sanitize her hands in between assisting multiple residents with feeding. This failure could place residents who required feeding assistance with cross contamination and infection. Findings include: Observation on 01/13/2023 at 12:39pm of CNA-A in the dining area assisting residents with feeding. CNA-A was observed moving from one resident's table to another resident's table to assist with feeding. […]

  • No harm, potential for more than minimal, patternF880Feb 25, 2021

    Based on staff interviews, resident record review, policy review, and review of the Centers for Disease Control (CDC) guidelines, the facility failed to quarantine three of ten sampled residents (Resident(R)3, R5, and R8) following exposure from a roommate and/or staff who tested positive for COVID-19. Specifically, R3, R5, and R8 were not placed on quarantine for 14 days and staff did not wear all required Personal Protective Equipment (PPE) while providing care in accordance with the Centers for Disease Control (CDC) guidelines. R3, R5, and R8 tested positive for COVID-19 within 14 days of the last known exposure from the roommate. […]

Read 22 findings in full →The most serious and the most recent: 22 of 77 on record.

Every survey on record

FindingsAt actual harm or above

  • May 22, 2026Complaint1 finding
  • Nov 5, 2025Complaint1 finding
  • May 7, 2025Standard3 findings · 2 harm
  • Apr 16, 2025Complaint1 finding · 1 harm
  • Jul 24, 2024Complaint1 finding
  • May 24, 2024Complaint2 findings
  • Mar 20, 2024Complaint1 finding
  • Oct 4, 2023Complaint2 findings
Show the 16 earlier surveys
  • Jan 13, 2023Standard5 findings
  • Oct 14, 2021Standard2 findings
  • Feb 25, 2021Infection control2 findings
  • Dec 13, 2019Standard1 finding
  • Feb 22, 2019Complaint2 findings · 2 harm
  • Jan 11, 2018Standard4 findings
  • Jan 28, 2017Standard17 findings
  • May 24, 2016Complaint2 findings
  • Jan 28, 2016Standard7 findings
  • Jan 8, 2015Standard6 findings
  • Jan 31, 2014—2 findings
  • Jan 24, 2013—4 findings
  • Mar 12, 2012—1 finding
  • Jan 5, 2012—6 findings
  • Apr 4, 2011—1 finding
  • Dec 8, 2010—3 findings

Surveys that found no deficiencies are not in CMS’s files and do not appear here.

Comparable facilities

The nearest facilities to this one in the same peer group, by weighted findings.

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