Skilled nursing facility · CMS certification number 676193
The Waterton Healthcare & Rehabilitation
Tyler, Texas · Medicare and Medicaid · 92 certified beds in Care Compare
In Care Compare’s provider information: Penalties: 2 · Fines: 2 · Fines, total amount: $23,389.00 · Payment denials: 0. The most recent penalty on file: April 23, 2026, Fine, $14,380. Every penalty on file ↓
The Waterton Healthcare & Rehabilitation: its citable report, full history — $295 · an email when it changes — $99/month
What stands out
- Its latest cost report on file is for fiscal year 2024, covering January 1, 2024 to December 31, 2024 (365 days), and CMS processed it on August 28, 2025.
- Net patient revenue rose from $8.9M in fiscal year 2023 to $10.0M in fiscal year 2024.
- Its result from service to patients: $452K (2022), $522K (2023), $986K (2024).
- Its cost reports on file run from fiscal year 2008 to fiscal year 2024.
- Since its cost report for fiscal year 2024 was filed on August 28, 2025, 1 change is listed on this record: a deficiency.
- Its net patient revenue of $10.0M ranks 156th of the 681 nursing facilities in Texas whose latest cost report on file is fiscal year 2024.
- 3 of the 5 nursing facilities in Texas closest in size to it, whose latest cost report on file is fiscal year 2024, also report a gain on service to patients.
The Waterton Healthcare & Rehabilitation: Medicare cost reports
| Form CMS-2540-10 | 2024 · report 1436062 | 2023 · report 1381985 | 2022 · report 1360492 | 2021 · report 1368880 | 2020 · report 1298206 | 2019 · report 1274724 | 2018 · report 1256221 | 2017 · report 1210608 | 2016 · report 1216710 | 2015 · report 1181710 | 2014 · report 1148896 | 2013 · report 1108207 | 2012 · report 1045235 | 2011 · report 1006103 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Period began | January 1, 2024 | January 1, 2023 | March 1, 2022 | January 1, 2021 | January 1, 2020 | January 1, 2019 | January 1, 2018 | January 1, 2017 | January 1, 2016 | January 1, 2015 | April 1, 2014 | January 1, 2013 | May 1, 2012 | January 1, 2011 |
| Period ended | December 31, 2024 | December 31, 2023 | December 31, 2022 | December 31, 2021 | December 31, 2020 | December 31, 2019 | December 31, 2018 | December 31, 2017 | December 31, 2016 | December 31, 2015 | December 31, 2014 | December 31, 2013 | December 31, 2012 | December 31, 2011 |
| Days, where not a full year | — | — | — | — | — | — | — | — | — | — | 274 | — | 244 | — |
| Report status | settled | settled | settled | settled | settled | settled | settled | settled | settled | settled | settled | settled | settled | as submitted |
| Processed by CMS | August 28, 2025 | June 7, 2024 | July 31, 2023 | November 29, 2023 | September 1, 2021 | December 2, 2020 | May 27, 2020 | August 24, 2018 | December 20, 2018 | December 29, 2017 | December 15, 2016 | August 19, 2015 | August 1, 2013 | September 17, 2012 |
| Total patient revenue | $15,191,435 | $13,563,556 | $7,540,922 | $5,057,775 | $5,092,560 | $5,113,877 | $10,462,612 | $10,887,446 | $12,924,078 | $12,352,087 | $7,805,307 | $4,529,880 | $2,481,420 | $4,828,249 |
| Contractual allowances and discounts | $5,181,282 | $4,647,215 | $1,555,654 | — | — | — | $4,371,034 | $4,578,283 | $5,738,363 | $5,822,720 | $3,489,141 | −$367,094 | $231,431 | $1,178,191 |
| Net patient revenue | $10,010,153 | $8,916,341 | $5,985,268 | $5,057,775 | $5,092,560 | $5,113,877 | $6,091,578 | $6,309,163 | $7,185,715 | $6,529,367 | $4,316,166 | $4,896,974 | $2,249,989 | $3,650,058 |
| Total operating expenses | $9,023,754 | $8,394,263 | $5,532,985 | $6,052,215 | $6,217,505 | $6,663,907 | $7,180,168 | $7,217,384 | $7,141,553 | $6,536,291 | $4,019,666 | $4,379,115 | $2,664,452 | $4,162,903 |
| Net income from service to patients | $986,399 | $522,078 | $452,283 | −$994,440 | −$1,124,945 | −$1,550,030 | −$1,088,590 | −$908,221 | $44,162 | −$6,924 | $296,500 | $517,859 | −$414,463 | −$512,845 |
| Total other income | $1,204 | $161 | $785 | $1,030,124 | $2,851 | $4,001 | $24,197 | $9,146 | $241 | −$147 | — | — | — | $2,448 |
| Net income after other income | $987,603 | $522,239 | $453,068 | $35,684 | −$1,122,094 | −$1,546,029 | −$1,064,393 | −$899,075 | $44,403 | −$7,071 | $296,500 | $517,859 | −$414,463 | −$510,397 |
| Net income | $987,603 | $522,239 | $453,068 | $35,684 | −$1,122,094 | −$1,546,029 | −$1,064,393 | −$899,075 | $44,403 | −$7,071 | $296,500 | $517,859 | −$414,463 | −$510,397 |
| Total facility beds, all components | 74 | 74 | 74 | 92 | 92 | 92 | 92 | 92 | 92 | 92 | 92 | 92 | 92 | 83 |
| Bed days available, all components | 27,084 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicare (Title XVIII) patient days | 2,401 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicaid (Title XIX) patient days | 14,503 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Other-payer patient days | 6,314 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Total patient days, all components | 23,218 | 22,136 | 17,456 | 20,122 | 20,573 | 20,625 | 23,295 | 24,225 | 22,823 | 18,253 | 14,225 | 17,963 | 10,889 | 14,541 |
| Medicare discharges | 64 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicaid discharges | 51 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Other-payer discharges | 193 | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Total discharges, all components | 308 | 196 | 199 | 313 | 276 | 335 | 381 | 470 | 416 | 363 | 196 | 169 | 97 | 187 |
| Average length of stay, Medicare, in days | 37.52 | 53.7 | 46.89 | 30.71 | 30.39 | 20.24 | 29.97 | 21.86 | 29.67 | 30.8 | 44.09 | 93.44 | 93.81 | 35.85 |
| Average length of stay, Medicaid, in days | 284.37 | 433.97 | 281.66 | 287.78 | 237.79 | 228.29 | 236.54 | 384.97 | 72 | 83.81 | 170.85 | 420.71 | 462.8 | 274.33 |
| Average length of stay, all patients, in days | 75.38 | 112.94 | 87.72 | 64.29 | 74.54 | 61.57 | 61.14 | 51.54 | 54.86 | 50.28 | 72.58 | 106.29 | 112.26 | 77.76 |
Net income, fiscal years 2024, 2023, 2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015, 2014, 2013, 2012, 2011. Checked against the form’s own arithmetic: what that check shows.
Form CMS-2540-96: every report is settled.
| Form CMS-2540-96 | 2010 · report 416732 | 2009 · report 386123 | 2008 · report 353103 |
|---|---|---|---|
| Period began | January 1, 2010 | January 1, 2009 | September 3, 2008 |
| Period ended | December 31, 2010 | October 31, 2009 | December 31, 2008 |
| Days, where not a full year | — | — | 119 |
| Processed by CMS | August 31, 2011 | August 24, 2010 | July 29, 2009 |
| Net patient revenue | $3,958,529 | $4,396,998 | $98,987 |
| Total operating expenses | $4,414,413 | $3,610,218 | $881,318 |
| Net income from service to patients | −$455,884 | $786,780 | −$782,331 |
| Total other income | $24 | $12,767 | — |
| Net income | −$455,860 | $799,547 | −$782,331 |
| Total facility beds, all components | 83 | 83 | 83 |
| Total patient days, all components | 16,371 | 9,155 | 2,874 |
| Total discharges, all components | 191 | 224 | 56 |
| Average length of stay, Medicare, in days | 39.35 | 37.41 | 37.49 |
| Average length of stay, Medicaid, in days | 258.44 | 365 | 365 |
| Average length of stay, all patients, in days | 85.71 | 40.87 | 51.32 |
Net income, fiscal years 2010, 2009, 2008. Checked against the form’s own arithmetic: what that check shows.
The Waterton Healthcare & Rehabilitation: nurse staffing hours by quarter →
Who owns The Waterton Healthcare & Rehabilitation, as filed with CMS
Care Compare
- 5% OR GREATER DIRECT OWNERSHIP INTEREST: FANNIN COUNTY HOSPITAL AUTHORITY (organization), 100%%, since 03/01/2022
- ADP OF THE SNF: CHICKADEE HEALTHCARE LLC (organization), NOT APPLICABLE, since 05/14/2025; COSTA, CHARLIE (individual), NOT APPLICABLE, since 05/14/2025; ENSIGN SERVICES INC (organization), NOT APPLICABLE, since 03/01/2022; ROSE HEALTH HOLDINGS LLC (organization), NOT APPLICABLE, since 03/01/2022; STANDARD BEARER HEALTHCARE OP, LP (organization), NOT APPLICABLE, since 03/01/2022; THE ENSIGN GROUP INC (organization), NOT APPLICABLE, since 03/01/2022; WILSON, JENNIFER (individual), NOT APPLICABLE, since 04/27/2025
- CORPORATE OFFICER: BURNAM, SOON (individual), NOT APPLICABLE, since 03/01/2022; SANDERSON, CLARK (individual), NOT APPLICABLE, since 10/29/2012
- MANAGING CONTROL - GOVERNING BODY: COSTA, CHARLIE (individual), NOT APPLICABLE, since 03/01/2022; WILSON, JENNIFER (individual), NOT APPLICABLE, since 03/01/2022
- OPERATIONAL/MANAGERIAL CONTROL: CHICKADEE HEALTHCARE LLC (organization), NOT APPLICABLE, since 03/01/2022; COSTA, CHARLIE (individual), NOT APPLICABLE, since 03/01/2022
Medicare enrollment
As filed in the CMS file dated October 1, 2026 (Medicare enrollment ownership), under the enrollment of FANNIN COUNTY HOSPITAL AUTHORITY (enrollment ID O20220325001793).
- 5% OR GREATER DIRECT OWNERSHIP INTEREST: FANNIN COUNTY HOSPITAL AUTHORITY (organization), 100.00%, since 03/01/2022
- ADP OF THE SNF: CHARLIE COSTA (individual), since 05/14/2025; CHICKADEE HEALTHCARE LLC (organization), since 05/14/2025; ENSIGN SERVICES INC (organization), since 03/01/2022; JENNIFER M WILSON (individual), since 04/27/2025; ROSE HEALTH HOLDINGS LLC (organization), since 03/01/2022; STANDARD BEARER HEALTHCARE OP, LP (organization), since 03/01/2022; THE ENSIGN GROUP INC (organization), since 03/01/2022
- CORPORATE OFFICER: CLARK SANDERSON (individual), 0.00%, since 10/29/2012; SOON BURNAM (individual), 0.00%, since 03/01/2022
- MANAGING CONTROL - GOVERNING BODY: CHARLIE COSTA (individual), since 03/01/2022; JENNIFER M WILSON (individual), since 03/01/2022
- OPERATIONAL/MANAGERIAL CONTROL: CHARLIE COSTA (individual), since 03/01/2022; CHICKADEE HEALTHCARE LLC (organization), since 03/01/2022
Paused by CMS: Form CMS-855A, December 11, 2025.
Private equity company, real estate investment trust and holding company: No: FANNIN COUNTY HOSPITAL AUTHORITY; CHICKADEE HEALTHCARE LLC; ENSIGN SERVICES INC; ROSE HEALTH HOLDINGS LLC; STANDARD BEARER HEALTHCARE OP, LP; THE ENSIGN GROUP INC; CHICKADEE HEALTHCARE LLC.
Private equity company, real estate investment trust and holding company: Paused by CMS: CHARLIE COSTA; JENNIFER M WILSON; CLARK SANDERSON; SOON BURNAM; CHARLIE COSTA; JENNIFER M WILSON; CHARLIE COSTA.
Changes in ownership
- June 1, 2025, enrollment ownership file; no longer listed: SOON BURNAM (OPERATIONAL/MANAGERIAL CONTROL); CHARLIE COSTA (W-2 MANAGING EMPLOYEE); listed: CHARLIE COSTA (ADP OF THE SNF); CHICKADEE HEALTHCARE LLC (ADP OF THE SNF); first listed: SOON BURNAM (CORPORATE OFFICER), associated since March 1, 2022; CHARLIE COSTA (MANAGING CONTROL - GOVERNING BODY), associated since March 1, 2022; JENNIFER M WILSON (ADP OF THE SNF), associated since April 27, 2025; JENNIFER M WILSON (MANAGING CONTROL - GOVERNING BODY), associated since March 1, 2022; STANDARD BEARER HEALTHCARE OP, LP (ADP OF THE SNF), associated since March 1, 2022; FANNIN COUNTY HOSPITAL AUTHORITY (5% OR GREATER DIRECT OWNERSHIP INTEREST), associated since March 1, 2022; ROSE HEALTH HOLDINGS LLC (ADP OF THE SNF), associated since March 1, 2022; ENSIGN SERVICES, INC. (ADP OF THE SNF), associated since March 1, 2022; THE ENSIGN GROUP INC (ADP OF THE SNF), associated since March 1, 2022. Skilled_Nursing_Facility_All_Owners_:_2025-06-01.csv
Recent changes on this record
- August 20, 2026: A deficiency was cited under tag F 0609, scope and severity D. NH_HealthCitations_Oct2026.csv
Inspections of The Waterton Healthcare & Rehabilitation
- Cycle 1: health May 6, 2026 (6 deficiencies), fire safety May 6, 2026 (0)
- Cycle 2: health March 26, 2025 (2 deficiencies), fire safety March 26, 2025 (0)
- Cycle 3: health January 31, 2024 (3 deficiencies), fire safety January 31, 2024 (0)
Deficiencies cited at The Waterton Healthcare & Rehabilitation
11 deficiencies on file, by tag, newest citation first
every one from a health inspection; every one marked “Deficient, Provider has date of correction”; 3 cited from a complaint, marked below. Letter after a date: scope and severity grade.
- F 0609, freedom from abuse, neglect, and exploitation: August 20, 2026 (D, from a complaint, corrected August 21, 2026).
- F 0584, resident rights: May 6, 2026 (D, corrected May 7, 2026).
- F 0694, quality of life and care: May 6, 2026 (D, corrected May 7, 2026).
- F 0842, resident assessment and care planning: May 6, 2026 (D, corrected May 7, 2026).
- F 0880, infection control: May 6, 2026 (D, corrected May 7, 2026).
- F 0684, quality of life and care: April 23, 2026 (G, from a complaint, corrected April 27, 2026).
- F 0641, resident assessment and care planning: March 26, 2025 (E, corrected April 10, 2025).
- F 0692, quality of life and care: March 26, 2025 (E, corrected April 10, 2025).
- F 0576, resident rights: January 31, 2024 (D, corrected March 1, 2024).
- F 0921, environmental: January 31, 2024 (D, corrected March 1, 2024).
- F 0689, quality of life and care: January 8, 2024 (J, from a complaint, corrected January 9, 2024).
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| April 23, 2026 | Fine | $14,380 | 139005 | ||
| January 8, 2024 | Fine | $9,009 | 112117 |
From the Care Compare penalties file NH_Penalties_Oct2026.csv, processed on October 1, 2026.
The Waterton Healthcare & Rehabilitation in Care Compare
- Ownership Type: Government - Hospital district
- Legal Business Name: FANNIN COUNTY HOSPITAL AUTHORITY
- Date First Approved to Provide Medicare and Medicaid Services: 2008-09-03
- Provider Resides in Hospital: N
- Continuing Care Retirement Community: N
- Urban: Y
- County/Parish: Smith
- Telephone Number: 9035611300
- Chain Name: THE ENSIGN GROUP
- Chain ID: 507
- Provider Changed Ownership in Last 12 Months: N
- With a Resident and Family Council: Resident
- Automatic Sprinkler Systems in All Required Areas: Yes
- Average Number of Residents per Day: 70.4
- Overall Rating: 3
- Health Inspection Rating: 3
- QM Rating: 4
- Long-Stay QM Rating: 4
- Short-Stay QM Rating: 4
Care Compare, October 1, 2026: provider information NH_ProviderInfo_Oct2026.csv · inspections NH_SurveySummary_Oct2026.csv · citations NH_HealthCitations_Oct2026.csv · penalties NH_Penalties_Oct2026.csv · ownership NH_Ownership_Oct2026.csv.
Other nursing facilities in Tyler and Texas
Report a figure on The Waterton Healthcare & Rehabilitation’s record that differs from its CMS file, quoting 676193.