 The Ensign Group already operates nursing homes in Texas. It is the largest operator of skilled nursing facilities in the country, with 334 CMS-certified locations across 17 states, according to April 2026 CMS data. On April 30, 2026, Ensign announced the acquisition of 17 additional Texas facilities in Dallas, Houston, Kerrville, Fort Worth, San Antonio, and other cities, effective May 1, 2026. The company is not entering this state. It is growing its footprint here.
A five-month investigation published June 8, 2026, by Hunterbrook Media found that Ensign's growth model is built on a specific pattern: buy struggling nursing homes, cut nursing staff hours, pocket the savings, and inflate self-reported quality metrics. Patients died. Federal inspectors documented maggot infestations inside residents' bodies. A nonverbal Alzheimer's patient was found covered in ants at an Ensign facility in Texas, an infestation her family discovered, not the staff. That Texas facility is Park Village Healthcare and Rehabilitation, located at 207 E Parkerville Rd, DeSoto, TX 75115. According to ProPublica Nursing Home Inspect data current as of March 2026, Park Village has accumulated 52 total deficiencies and $266,405 in total fines over the past three years. Nurse turnover stands at 68.6 percent. The state average is 51.5 percent. Texans who are placing a loved one in a nursing home need to understand what the Ensign record actually looks like, not what Ensign tells investors it looks like. What Did the Hunterbrook Investigation Find About Ensign? Hunterbrook Media, an investigative news organization affiliated with a short-selling investment fund, published its findings on June 8, 2026, after a five-month examination of millions of CMS data points, thousands of pages of documents, and interviews with attorneys, academics, healthcare professionals, former employees, residents, and family members. The core finding: Ensign's profits are substantially tied to providing less nursing care than its patients require, according to the investigation. Hunterbrook calculated that between July and November 2024, Ensign residents received more than 5 million fewer hours of nursing care than their documented medical acuity required. Using Ensign's own payroll cost data, Hunterbrook estimated this gap saved Ensign approximately $161 million during that five-month window, roughly $386 million annualized. Ensign's net income for all of 2024 was $298 million. The investigation's findings are organized around four structural practices. First, understaffing. Federal law under 42 CFR §483.35 requires Medicare and Medicaid-funded facilities to maintain sufficient nursing staff to meet each resident's needs. Texas mirrors this obligation under 26 Tex. Admin. Code §554.1001. Hunterbrook found that Ensign facilities violated state minimum staffing floors in California, Kansas, Tennessee, and Washington on more than 18,000 cumulative days from 2020 through 2025. Second, metric manipulation. Ensign's most-publicized quality scores come from self-reported data with no independent verification requirement. Hunterbrook separated CMS metrics into three tiers: independently verified by unannounced inspectors, self-reported but auditable via payroll records, and self-assessed with no documentation requirements. On independently verified metrics, Ensign performed worse than the national average. On the self-reported metrics it touts to investors, it outperformed by as much as 24 percent. Third, tunneling. Ensign paid more than $339 million in 2024 to entities it also owns or controls, including landlords, insurers, and management companies. That figure exceeded Ensign's total reported net income that year. A 2024 congressional letter cited this practice as a tactic to conceal profit by making individual nursing homes appear financially strapped. Fourth, acquisition-driven deterioration. Hunterbrook tracked 161 facilities before and after Ensign acquired them, comparing against roughly 15,000 other nursing facilities nationally, and found that total nursing hours fall after acquisition and continue falling over time. Registered nurse hours, which represent the most skilled and most expensive category of care, drop most sharply. What Is Happening at Park Village Healthcare and Rehabilitation in DeSoto, Texas? Park Village Healthcare and Rehabilitation, 207 E Parkerville Rd, DeSoto, TX 75115, is an Ensign-affiliated facility, listed under Ensign Services Inc. in CMS ownership records. According to ProPublica Nursing Home Inspect data current as of March 2026, the facility's record includes the following. Total deficiencies: 52. Total fines over three years: $266,405. Nurse turnover: 68.6 percent, compared to a state average of 51.5 percent. Nurse hours per resident per day: 3.28, below the 3.48 hours CMS research determined was needed to meet residents' actual acuity requirements. The facility's inspection history includes multiple Immediate Jeopardy citations. On July 23, 2025, CMS issued an Immediate Jeopardy citation under Tag F0925, failure to maintain a pest control program, paired with a $17,345 fine. The Hunterbrook investigation reported that a nonverbal resident with Alzheimer's disease was found covered in ants at a DeSoto Ensign facility in July 2025, with bites across her face, neck, legs, and eyes swollen shut. Her family discovered the infestation. Staff did not. On November 15, 2025, CMS issued two additional Immediate Jeopardy citations at Park Village: Tag F0600, failure to protect residents from abuse, neglect, and exploitation, and Tag F0610, failure to respond appropriately to alleged violations. On October 1, 2025, the facility received a $128,620 fine tied to a separate abuse citation. The March 24, 2025, standard inspection resulted in a K-level citation, the highest scope/severity possible, for Tag F0880, failure to implement an infection prevention and control program, along with a $62,762 fine. CMS characterizes Immediate Jeopardy as a situation in which the facility's noncompliance has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident. That is the verified record at this one Ensign facility in Texas. The Hunterbrook investigation identified Park Village by name in its analysis of Ensign's star rating manipulation, noting that the facility carries five stars on self-reported quality measures while carrying one-star ratings on health inspections and staffing, the metrics with independent verification. What Texas Facilities Did Ensign Just Acquire? According to Ensign's April 30, 2026 investor press release, the following skilled nursing facilities became Ensign-operated as of May 1, 2026: Country Village Care / Country Village Senior Living, 136 skilled nursing beds with assisted living and memory care, Angleton, La Dora Nursing and Rehabilitation Center, 62 beds, Bedford, Mustang Park Therapy and Living Center, 120 beds, Carrollton, TruCare Living Centers Columbus, 104 beds, Columbus, Southern Oaks Therapy and Living Center, 150 beds, Dallas, Mallard Creek Therapy and Living Center, 120 beds, Fort Worth, Eagle Crest Rapid Recovery, 125 beds, Houston, Falcon Point Post Acute, 130 beds, Katy, Hilltop Village Nursing and Rehabilitation Center, 150 beds, Kerrville, River Hills Health and Rehabilitation Center, 150 beds, Kerrville, Parks Health Center / Parks Assisted Living Center, 90 skilled nursing beds with assisted living and independent living, Odessa, TruCare Living Centers Palestine, 120 beds, Palestine, Harbor Valley Health and Rehabilitation, 120 beds, San Antonio, River Bend Healthcare, 115 beds, Seguin, TruCare Living Centers Selma, 128 beds, Selma Willow Creek Lodge, 135 beds, Tomball, and Willow Park Rehabilitation and Care Center, 125 beds, Willow Park. These facilities were previously under different operators. The Hunterbrook investigation found that nursing hours fall at facilities after Ensign takes them over, and that the staffing decline widens over time. Ensign already operates other Texas nursing homes, and the same pattern applies to those. If you have a family member at any of these newly acquired facilities, or at any existing Ensign-operated location in Texas, you are dealing with a company whose national record is documented above. Did Ensign Respond to the Investigation? Ensign did not respond to Hunterbrook's repeated requests for comment. The company's silence is itself a documented finding in the investigation. Ensign CEO Barry Port did speak to The Arizona Republic in 2023, stating that staffing decisions are made at the individual facility level. The Hunterbrook investigation found that assertion contradicted by Ensign's own 10-K filings, which describe centralized software systems installed at each facility to monitor and increase billing, and by earnings call statements in which Port cited access to patient-level data and facility-level decision-making. Ensign has settled federal fraud claims twice before. In one settlement, Ensign paid $48 million to resolve allegations that six California facilities billed Medicare for unnecessary treatment. In a second settlement, Ensign paid more than $47 million to resolve claims involving alleged illegal kickbacks for patient referrals. Those settlements did not include admissions of liability. What Does Texas Law Require of Nursing Homes? The Texas Health and Safety Code Chapter 242, Texas Administrative Code Chapter 554, and Texas Civil Practice and Remedies Code Chapter 74 establish the legal standards governing nursing facilities in Texas. The parallel federal requirements for Medicare and Medicaid-participating facilities appear in 42 CFR Part 483. Both frameworks require that facilities provide each resident with the level of care and services necessary to attain or maintain the highest practicable physical, mental, and psychosocial well-being. Under 26 Tex. Admin. Code §554.1001, Texas requires that staffing be sufficient to meet resident needs. There is no fixed numeric hourly floor under Texas law that matches the federal standard, but the sufficiency requirement is enforceable. CMS research concluded that 3.48 nursing hours per resident per day represents the minimum needed to meet a typical resident's acuity level. Park Village Healthcare is currently providing 3.28 hours per resident per day. Texas residents in nursing facilities also have rights under Texas Health and Safety Code §242.501 et seq., including the right to be free from neglect, abuse, and exploitation, and the right to receive care that meets accepted professional standards. When a facility's conduct falls below those standards and a resident is harmed, that may give rise to a medical malpractice claim under Texas law. Texas Civil Practice and Remedies Code §74.001 et seq. governs medical malpractice claims in this state. Nursing home negligence claims are subject to specific procedural requirements, including a 180-day notice period and the requirement to provide a supporting expert report. What Should a Texas Family Do If They Suspect Nursing Home Neglect? If you believe a family member has been harmed by nursing home neglect, take these steps immediately.
We Can Help At The Borah Law Firm, PLLC, we represent patients and families across Texas in medical malpractice cases. We only handle these cases — nothing else. If you believe a loved one received substandard nursing home care, we can help you understand whether a case exists and what your options are. Contact us today for a confidential case review. Frequently Asked Questions Is the Ensign Group a licensed nursing home operator in Texas? Yes. Ensign Group-affiliated entities have operated nursing facilities in Texas for years, and as of May 1, 2026, the company expanded its Texas footprint by 17 additional facilities according to its own investor press release. What is an Immediate Jeopardy citation in a nursing home? An Immediate Jeopardy citation is issued by CMS when a nursing facility's noncompliance with federal standards has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident. It is the most serious citation level CMS issues. Park Village Healthcare and Rehabilitation in DeSoto, Texas, has received multiple Immediate Jeopardy citations since 2023, verified by ProPublica Nursing Home Inspect data. Can I sue a nursing home in Texas for neglect? Yes. Texas law permits claims against nursing homes and their parent companies for negligence and other causes of action when substandard care causes injury or death. These claims are subject to Texas Civil Practice and Remedies Code Chapter 74, which imposes specific procedural requirements including mandatory pre-suit notice and an expert report. What is tunneling in the nursing home context? Tunneling refers to the practice by which a nursing home pays other entities it controls, such as a landlord, insurer, or management company, at rates that may exceed fair market value. This practice moves revenue out of the nursing home and into affiliated entities, making the nursing home appear financially strapped while the parent company reports substantial profits. A 2024 congressional letter described this as a tactic nursing home chains use to conceal profit from regulators. How do I get nursing home inspection records in Texas? CMS publishes inspection records for all Medicare and Medicaid-certified nursing homes at Medicare.gov Care Compare. ProPublica's Nursing Home Inspect tool at projects.propublica.org/nursing-homes aggregates and presents the same CMS data in a searchable format. Both sources are publicly available. About the Author: J.T. Borah is a Texas medical malpractice attorney and founding attorney of The Borah Law Firm, PLLC, in Austin, Texas. His practice is limited exclusively to medical malpractice cases involving hospitals, nursing homes, and other medical institutions. He has been recognized as a Texas Super Lawyer. He is often asked to lecture at legal seminars on medical malpractice issues and has lectured to attorneys from 18 states. AI writing tools assisted Mr. Borah in preparing this article. All legal standards, citations, and factual claims were reviewed by Mr. Borah as a licensed Texas attorney. This article is for general informational purposes only and does not constitute legal advice. Reading this article does not create an attorney-client relationship. Comments are closed.
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