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The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Nestled in the heart of Sugar Land, Texas, Paradigm at First Colony stands as a shining example of exceptional senior care—where compassion, innovation, and community come together under one roof. As part of Paradigm Healthcare, LLC, this community reflects the organization’s deep commitment to elevating the standard of care for seniors across Texas.
Guided by steady, dedicated leadership, Paradigm at First Colony has cultivated an environment where residents feel genuinely seen, supported, and valued. This thoughtful, people‑first approach has fostered a culture that blends clinical excellence with heartfelt hospitality—ensuring that every resident receives not only the care they need, but the dignity they deserve.
What truly makes Paradigm at First Colony special is its vibrant, home‑like atmosphere. Residents enjoy a warm and engaged community paired with a comprehensive range of services tailored to their physical, emotional, and social well‑being. From specialized nursing and rehabilitation services to thoughtfully curated activities that enrich daily life, the community is designed to empower residents to thrive.
Located in one of Sugar Land’s most welcoming neighborhoods, Paradigm at First Colony is more than a senior care facility—it’s a place where families find peace of mind, and residents find a renewed sense of purpose. Its dedication to outstanding care continues to set the bar for senior living in the region, solidifying its reputation as a trusted leader in compassionate service.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 141st out of 240 homes in Texas.| Staff type | Hours / day | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 30m per day | ▲ 15% State avg: 26m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 43m per day | ▼ 25% State avg: 57m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 2h 12m per day | ▲ 9% State avg: 2h 1m per day · National avg: 2h 21m per day |
|
Total Nursing (Weekend)
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 2h 43m per day | ▼ 9% State avg: 2h 59m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 4m per day | ■ Avg State avg: 4m per day · National avg: 4m per day |
|
RN (Weekend)
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 25m per day | ▲ 19% State avg: 21m per day · National avg: 29m per day |
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
13% of new residents, usually for short-term rehab.
54% of new residents, often for short stays.
32% of new residents, often for long-term daily care.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #61 / 252Payroll — state benchmarkedThis home is ranked 61st out of 252 homes in Texas.Shows total annual staff payroll benchmarked to the Texas average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Lower than the Texas average: 63.5%Paradigm at First Colony is administrated by Johnny Richardson.
Key information about the people who lead and staff this community.
Housing Options: Private / Semi-Private Rooms
Building Type: Single-story
Dining Services
Beauty Services
Transportation Services
Housekeeping Services
Social and Recreational Activities
Rehabilitative Support
On-site Medical Care and Health Services
In Texas, the Health and Human Services Commission (HHSC) is the primary regulatory body that conducts unannounced inspections and publishes quality reports for all long-term care homes.
Enforcement actions are formal penalties or interventions imposed by Texas regulators when a nursing home fails to meet state or federal care, safety, or regulatory standards. They may include directed plans of correction, civil monetary penalties, denial of payment, or appointment of temporary management.
This facility has 1 enforcement action. 86% of Texas nursing homes have zero, and the statewide average is 0.2.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Texas state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Citations are formal regulatory issues recorded during state inspections.
| Metric | This Facility | TX Average | vs. TX Avg |
|---|---|---|---|
|
Total citations
Formal regulatory issues recorded by inspectors across all inspection types.
| 5 | 6 | This facility has 17% fewer total citations than a typical Texas nursing home (5 vs. TX avg 6).↓ 17% better |
|
Health citations
Violations related to resident care, clinical practices, and day-to-day operations.
| 5 | 2 | This facility has 150% more health citations than a typical Texas nursing home (5 vs. TX avg 2).↑ 150% worse |
|
Life safety citations
Violations related to building safety — fire prevention, emergency egress, and similar.
| 5 | 6 | This facility has 17% fewer life safety citations than a typical Texas nursing home (5 vs. TX avg 6).↓ 17% better |
|
Citations per year
Average citations per year since 2022.
| 1.3 | 1.5 | This facility has 13% fewer citations per year than a typical Texas nursing home (1.3 vs. TX avg 1.5).↓ 13% better |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
The most recent inspection on December 1, 2025, identified a deficiency related to the facility’s failure to allow a resident’s representative to exercise the resident’s rights. Earlier inspections showed a pattern of deficiencies involving resident rights, care planning, supervision, medication administration, infection control, and safety practices. Inspectors frequently cited issues with failure to develop and implement comprehensive care plans, inadequate supervision, delayed or improper treatment, and lapses in infection prevention and privacy protections. Several complaint investigations were substantiated, including neglect, failure to report abuse timely, and inadequate notification to family members, though immediate jeopardy findings were removed after corrective actions and no fines or license suspensions were listed in the available reports. The facility’s inspection history reflects ongoing challenges with compliance, with some corrective actions noted but no clear sustained improvement trend.
Read the full inspection reports for this facility, including detailed findings and corrective actions.
Show Inspection ReportsTexas average 7.4
Last Health inspection on Nov 2025
Texas average 25.9
Texas average 3.67
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
14 of 49 citations resulted from standard inspections; 26 of 49 resulted from complaint investigations; and 9 of 49 came from combined inspections (standard and complaint).
350% worse than Texas averageTexas average: 2
0
100% better than Texas averageTexas average: 0.4
Issues related to resident's rights, including dignity, privacy, and the ability to make decisions about their care.
Nov 14, 2025
Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment.
Sep 08, 2025
Corrected
Issues related to medication management, including how drugs are stored, administered, and monitored.
Jun 01, 2025
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Nov 27, 2024
Corrected
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
Paradigm at First Colony is located in Missouri City, Texas.
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4.3 miles from city center
Estimated distance in miles from Missouri City's city center to Paradigm at First Colony's address, calculated via Google Maps.
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This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
18% worse than Texas averageTexas average ratio: 1.51:1
0% compared with Texas averageTexas average: 8.1 hours
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.2 hoursNo contractors work on this role.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.6 hoursNo contractors work on this role.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.7 hoursNo contractors work on this role.
Total hours from contractors
195 contractor hours this quarter
| Certified Nursing Assistant | 54 | 0 | 54 | 16,906 | 91 | 100% | 7.7 |
| Licensed Practical Nurse | 17 | 0 | 17 | 5,138 | 91 | 100% | 9.6 |
| Registered Nurse | 18 | 0 | 18 | 4,484 | 91 | 100% | 10.2 |
| Medication Aide/Technician | 11 | 0 | 11 | 2,750 | 90 | 99% | 11.2 |
| Physical Therapy Assistant | 4 | 0 | 4 | 1,203 | 65 | 71% | 6.8 |
| RN Director of Nursing | 2 | 0 | 2 | 1,014 | 65 | 71% | 7.9 |
| Physical Therapy Aide | 5 | 0 | 5 | 969 | 66 | 73% | 7.1 |
| Speech Language Pathologist | 3 | 0 | 3 | 940 | 67 | 74% | 7 |
| Clinical Nurse Specialist | 3 | 0 | 3 | 859 | 64 | 70% | 8.4 |
| Administrator | 2 | 0 | 2 | 696 | 65 | 71% | 8 |
| Nurse Aide in Training | 3 | 0 | 3 | 647 | 49 | 54% | 7.1 |
| Respiratory Therapy Technician | 5 | 0 | 5 | 595 | 80 | 88% | 6.2 |
| Nurse Practitioner | 1 | 0 | 1 | 520 | 65 | 71% | 8 |
| Dietitian | 1 | 0 | 1 | 498 | 66 | 73% | 7.5 |
| Mental Health Service Worker | 1 | 0 | 1 | 483 | 63 | 69% | 7.7 |
| Qualified Social Worker | 3 | 0 | 3 | 438 | 60 | 66% | 7.3 |
| Other Dietary Services Staff | 1 | 0 | 1 | 266 | 40 | 44% | 6.6 |
| Occupational Therapy Aide | 1 | 1 | 2 | 191 | 14 | 15% | 8 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 48 | 6 | 7% | 8 |
| Medical Director | 0 | 1 | 1 | 39 | 13 | 14% | 3 |
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
112Residents meet regularly to discuss policies, care quality, and activities
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
7.8
9% better than Texas averageTexas average: 8.6
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
11.4
29% better than Texas averageTexas average: 16.0
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
14.0%
13% better than Texas averageTexas average: 16.2%
Percent of long-stay residents whose ability to move independently worsened
5.8%
64% better than Texas averageTexas average: 16.2%
Percent of low risk long-stay residents who lose control of their bowels or bladder
14.4%
8% better than Texas averageTexas average: 15.7%
Percent of long-stay residents experiencing one or more falls with major injury
2.1%
36% better than Texas averageTexas average: 3.2%
Percent of long-stay high risk residents with pressure ulcers
10.0%
126% worse than Texas averageTexas average: 4.4%
Percent of long-stay residents with a urinary tract infection
1.1%
33% worse than Texas averageTexas average: 0.8%
Percent of long-stay residents who lose too much weight
7.1%
106% worse than Texas averageTexas average: 3.5%
Percent of long-stay residents who have depressive symptoms
1.2%
59% better than Texas averageTexas average: 2.9%
Percent of long-stay residents who received an antipsychotic medication
19.5%
148% worse than Texas averageTexas average: 7.9%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
98.2%
In line with Texas averageTexas average: 97.3%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
In line with Texas averageTexas average: 97.9%
Number of hospitalizations per 1,000 long-stay resident days.
2.28
7% worse than Texas averageTexas average: 2.13
Number of outpatient emergency department visits per 1,000 long-stay resident days.
5.71
176% worse than Texas averageTexas average: 2.07
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
99.5%
10% better than Texas averageTexas average: 90.4%
Percent of short-stay residents who newly received an antipsychotic medication
2.0%
35% worse than Texas averageTexas average: 1.4%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
97.1%
10% better than Texas averageTexas average: 88.0%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Texas averageTexas average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
65.4%
22% better than Texas averageTexas average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
42.3%
16% worse than Texas averageTexas average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
163% higher than Texas averageTexas average: $80K
21% more fines than Texas averageTexas average: 2.5
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than Texas averageTexas average: 0.2
Penalties are imposed by CMS for violations of federal nursing home regulations.
3 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Nov 27, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 24, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Aug 15, 2023Last updated: Jan 2026
Historical financial and operational data for Paradigm at First Colony based on CMS SNF Cost Reports.
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Paradigm at First Colony is in the Lexington Colony neighborhood of Missouri City.
The legal owner and operator of Paradigm at First Colony is Oakbend Medical Center.
Paradigm at First Colony has a walk score of 38. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.
According to TX state health department records, Paradigm at First Colony's license number is 144408.
According to TX state health department records, Paradigm at First Colony's license expires on February 28, 2028.
Paradigm at First Colony's occupancy is 29%.
Johnny Richardson is the administrator of Paradigm at First Colony.
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