Quick answers
- Where is Avir at River Valley?
- 1907 Refinery Rd, Gainesville, TX 76240, in Cooke County, Texas.
- What is the phone number of Avir at River Valley?
- (940) 665-0386, as listed by Medicare (CMS).
- What is the Medicare star rating of Avir at River Valley?
- Medicare overall rating: 4 out of 5 stars (CMS data updated 2026-10-01).
- Has Avir at River Valley been fined?
- Medicare lists no fines for Avir at River Valley.
- What did inspectors find at Avir at River Valley?
- In its last three inspection cycles (December 22, 2023 to July 27, 2026), Medicare lists 20 health citations; the most serious was level F. See the list below (CMS data updated 2026-10-01).
Medicare ratings, explained
Star ratings are one piece of information. Visit, ask questions and talk with your doctor about what matters for your care.
Inspections, fines and staffing
In its last three inspection cycles (December 22, 2023 to July 27, 2026), Avir at River Valley had 20 health citations; the most serious was level F (no actual harm, potential for more than minimal harm). Medicare lists no fines or payment denials for it in the last three years. Nurse staffing is 2.86 hours per resident per day; the Texas average is 3.42 and the national average is 3.90.
Source: Medicare (CMS) Provider Data Catalog, data updated October 1, 2026, retrieved November 13, 2026.
Inspection history: last three cycles
State inspectors visit about once a year and also investigate complaints. Each citation (deficiency) has a tag number and a letter, A to L. The letter shows how serious the problem was and how many residents it affected.
What the letters A to L mean
| Seriousness | Isolated (a few residents) | Pattern (some) | Widespread (many) |
|---|---|---|---|
| No actual harm, potential for minimal harm | A | B | C |
| No actual harm, potential for more than minimal harm | D | E | F |
| Actual harm to residents | G | H | I |
| Immediate jeopardy to resident health or safety | J | K | L |
Source: the scope and severity grid Medicare (CMS) uses for nursing home citations.
Most recent cycle: May 19, 2026 — 7 health citations
Inspections in this cycle: November 26, 2025 (complaint investigation); May 19, 2026 (standard health inspection); July 27, 2026 (complaint investigation).
Show 7 citations (levels A to F, no actual harm)
F0727 Level F
“Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.”
F0689 Level E
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
F0755 Level E
“Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.”
F0656 Level D
“Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.”
F0761 Level D
“Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.”
F0926 Level D
“Have policies on smoking.”
F0880 Level D
“Provide and implement an infection prevention and control program.”
Previous cycle: February 27, 2025 — 8 health citations
Inspections in this cycle: January 16, 2025 (complaint investigation); February 27, 2025 (complaint investigation); February 27, 2025 (standard health inspection).
Show 8 citations (levels A to F, no actual harm)
F0607 Level E
“Develop and implement policies and procedures to prevent abuse, neglect, and theft.”
F0727 Level E
“Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.”
F0760 Level E
“Ensure that residents are free from significant medication errors.”
F0880 Level E
“Provide and implement an infection prevention and control program.”
F0622 Level E
“Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.”
F0755 Level E
“Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.”
F0690 Level D
“Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.”
F0812 Level D
“Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.”
Earlier cycle: December 22, 2023 — 5 health citations
Inspections in this cycle: December 22, 2023 (standard health inspection).
Show 5 citations (levels A to F, no actual harm)
F0727 Level F
“Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.”
F0656 Level E
“Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.”
F0908 Level E
“Keep all essential equipment working safely.”
F0755 Level D
“Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.”
F0761 Level D
“Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.”
Citation descriptions are Medicare’s official wording. “From a complaint” means the citation came from a complaint investigation instead of the regular yearly inspection.
Full inspection reports on Medicare Care Compare →
Fire safety citations (21)
E0006 Level F
“Conduct risk assessment and an All-Hazards approach.”
E0037 Level F
“Establish staff and initial training requirements.”
K0291 Level F
“Install emergency lighting that can last at least 1 1/2 hours.”
K0324 Level F
“Provide properly protected cooking facilities.”
K0345 Level F
“Have approved installation, maintenance and testing program for fire alarm systems.”
K0351 Level F
“Install an approved automatic sprinkler system.”
K0353 Level F
“Inspect, test, and maintain automatic sprinkler systems.”
K0522 Level F
“Have an externally vented heating system.”
K0372 Level D
“Ensure smoke barriers are constructed to a 1 hour fire resistance rating.”
K0211 Level C
“Keep aisles, corridors, and exits free of obstruction in case of emergency.”
K0521 Level C
“Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.”
K0222 Level E
“Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.”
K0211 Level C
“Keep aisles, corridors, and exits free of obstruction in case of emergency.”
K0521 Level C
“Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.”
K0324 Level F
“Provide properly protected cooking facilities.”
K0372 Level F
“Ensure smoke barriers are constructed to a 1 hour fire resistance rating.”
K0741 Level F
“Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.”
K0916 Level F
“Have a battery powered remote alarm panel in a location accessible by operating personnel.”
K0374 Level D
“Install smoke barrier doors that can resist smoke for at least 20 minutes.”
K0211 Level C
“Keep aisles, corridors, and exits free of obstruction in case of emergency.”
K0521 Level C
“Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.”
Staffing
Hours of nursing care per resident per day, from the payroll records nursing homes send to Medicare, next to the state and national averages.
| Measure | This home | Texas | National |
|---|---|---|---|
| Registered nurse (RN) hours per resident per day | 0.22 | 0.44 | 0.69 |
| Licensed practical nurse (LPN) hours per resident per day | 1.24 | 0.94 | 0.86 |
| Nurse aide hours per resident per day | 1.41 | 2.03 | 2.35 |
| Total nurse staff hours per resident per day | 2.86 | 3.42 | 3.90 |
| Total nurse staff hours per resident per day on the weekend | 2.49 | 2.99 | 3.43 |
| RN hours per resident per day on the weekend | 0.22 | 0.35 | 0.48 |
| Nursing staff turnover (per year) | 68.0% | 50.8% | 45.3% |
| Administrators who left in the last year | 1.0 | 0.6 | 0.5 |
Source: Medicare (CMS) Provider Information and State US Averages, data updated October 1, 2026.
Owners and operator
Part of a group of 118 nursing homes: Avir Health Group.
Legal business name: Dallas County Hospital District.
Owners and managers Medicare lists (2)
| Name | Role | Share | Since |
|---|---|---|---|
| Dallas County Hospital District | Direct owner | 100% | June 1, 2019 |
| 1907 Refinery Rd Opco, LLC | Management company (operational or managerial control) | NOT APPLICABLE | October 1, 2025 |
Source: Medicare (CMS) Ownership file, data updated October 1, 2026. Only owners with an ownership interest and management companies are shown.
Compare with other nursing homes
Key facts
| Type | Nursing home |
|---|---|
| Certified beds | 116 |
| Average residents per day | 42.6 |
| Takes part in | Medicare and Medicaid |
| Ownership | For profit – corporation |
| Group or chain (affiliated entity) | Avir Health Group |
| Legal business name | Dallas County Hospital District |
| First approved by Medicare/Medicaid | 1992-01-01 |
| Resident and family councils | Resident council |
| Sprinklers in all required areas | Yes |
| Changed ownership in the last 12 months | No |
| Address | 1907 Refinery Rd, Gainesville, TX 76240 |
| County | Cooke County |
| State | Texas |
| Phone | (940) 665‑0386 |
| CMS Certification Number | 455970 |
| Corrections | Report an error or suggest an update → |
What to ask when you call or visit
A general checklist for any nursing home, not advice about this one. Medicare also publishes guides on medicare.gov.
- Is the home certified by Medicare and/or Medicaid, and does it have a bed for the care you need (short-term rehab or long-term care)?
- Can you see the latest state inspection report? Ask how any problems found were fixed.
- How many nurses and aides work on each shift, at night and on weekends? Is there a registered nurse on site at all times?
- Which doctors see residents, and how often? What happens in a medical emergency, and which hospital is used?
- What therapy (physical, occupational, speech) is offered, and how many days a week?
- Are residents clean, dressed and taking part in activities? Do staff speak to them kindly and answer call lights quickly?
- What do the daily rate and extra services cost, and what do Medicare, Medicaid or your insurance pay? Ask for it in writing.
- Is there a resident council and a family council? How are complaints handled? Ask for the long-term care ombudsman’s contact.
- Are meals appetizing, and can the home meet special diets, language needs and religious or cultural preferences?
- Visit more than once, including at a mealtime or in the evening, without an appointment.
Other nursing homes nearby
By straight-line distance (not driving distance).
- Avir at Gainesville1.8 mi · Gainesville, TX · 1 of 5 stars
- Pecan Tree Rehab and Healthcare Center2.1 mi · Gainesville, TX · 1 of 5 stars
- Renaissance Care Center2.3 mi · Gainesville, TX · 3 of 5 stars
- Whitesboro Health and Rehabilitation Center15 mi · Whitesboro, TX · 2 of 5 stars
- Cedar Ridge Rehabilitation and Healthcare Center20 mi · Pilot Point, TX · 3 of 5 stars
Nearest hospital emergency rooms
- North Texas Medical Center1.9 mi · Gainesville, TX · Acute Care Hospital
- Muenster Memorial Hospital13 mi · Muenster, TX · Critical Access Hospital
- Mercy Hospital Marietta21 mi · Marietta, OK · Critical Access Hospital
Sources
- Provider Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-01, retrieved 2026-11-13
- Medicare Care Compare — official Medicare profile of this provider
- Health Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Fire Safety Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Penalties — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Ownership — CMS, data updated 2026-10-01, retrieved 2026-11-13
- State US Averages — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Survey Summary — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Citation Code Look-up — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Inspection Dates — CMS, data updated 2026-10-01, retrieved 2026-11-13