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4/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
4/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
With a Type B license in Denton County, Rambling Oaks Courtyard Assisted Living Residence is a senior care community in Highland Village, Texas, offering assisted living and rehabilitation services. Managed by Rambling Oaks Courtyard ALR Highland Village LLC, this 79-bed community reflects a domestic atmosphere, focusing on personalized attention and resident ease within a community-scale layout.
The most recent HHSC inspection on June 9, 2022, concluded with two findings, which included one health-related infraction and one life safety code issue, both of which are significantly lower than the Texas state averages of 6 total findings and 2 health findings. The life safety matter involved construction standards for hazardous zones and had been previously noted and partially resolved. There are no enforcement actions, and no federal financial penalties have been issued over the last three years. With a record of zero citations per evaluation in comparative data, the community maintains a generally positive regulatory history.
A remarkably thorough selection of features is available for a community of this size, such as three private courtyards, a day room, a sunroom, and a hair salon and barbershop. An ultrasound bath, a dedicated space for physical therapy and wellness, and a classic screened-in porch are among the amenities available, as well as a traditional dining area that focuses on nutritious, home-style cooking. Rehabilitative support is provided, and the memory care wing holds an official Alzheimer’s certification. While administrative offices are open during standard weekday hours, personal care is delivered around the clock.
Rambling Oaks Courtyard Assisted Living Residence is an excellent option for families in the Highland Village and North Dallas region looking for a cozy, residential-style setting that offers both daily assistance and memory care. Its unique features, specifically secured courtyards and the health room, serve older adults who appreciate outdoor access and active recovery.
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 122nd out of 289 homes in Texas for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | 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.
| 42m per day | ▲ 66% State avg: 25m 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.
| 1h 21m per day | ▲ 43% 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.
| 1h 15m per day | ▼ 38% State avg: 2h 1m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
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 52m per day | ▼ 5% State avg: 3h 0m per day · National avg: 3h 27m 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.
| 0m per day | ▼ 95% State avg: 4m per day · National avg: 4m per day |
|
Weekend RN
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.
| 52m per day | ▲ 158% State avg: 20m per day · National avg: 29m per day |
Similar to the Texas average: 63.5%Rambling Oaks Courtyard Assisted Living Residence is legally operated by Rambling Oaks Courtyard Alr Highland Village Llc.
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.
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
| This Facility | TX Average | vs. TX Avg |
|---|---|---|---|
|
Total citations
Formal regulatory issues recorded by inspectors across all inspection types.
| 2 | 6 | This facility has 67% fewer total citations than a typical Texas nursing home (2 vs. TX avg 6).↓ 67% better |
|
Health citations
Violations related to resident care, clinical practices, and day-to-day operations.
| 1 | 2 | This facility has 50% fewer health citations than a typical Texas nursing home (1 vs. TX avg 2).↓ 50% better |
|
Life safety citations
Violations related to building safety — fire prevention, emergency egress, and similar.
| 1 | 6 | This facility has 83% fewer life safety citations than a typical Texas nursing home (1 vs. TX avg 6).↓ 83% better |
|
Citations per year
Average citations per year since 2022.
| 0.5 | 1.5 | This facility has 67% fewer citations per year than a typical Texas nursing home (0.5 vs. TX avg 1.5).↓ 67% better |
Inspections
| This Facility | TX Average | vs. TX Avg |
|---|---|---|---|
|
Inspections with citations
Inspections that resulted in at least one regulatory citation.
| 2 | 1 | This facility has 100% more inspections with citations than a typical Texas nursing home (2 vs. TX avg 1).↑ 100% worse |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
Texas average 7.4
Last Health inspection on Sep 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.
19 of 26 citations resulted from standard inspections; and 7 of 26 resulted from complaint investigations.
50% better than Texas averageTexas average: 2
100% better than Texas averageTexas average: 0.4
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
0% compared with Texas average
9% better than Texas average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
All 10 RN Staff are full-time employees. No contractors work on this role.
10
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.4 hoursAssists with medical care and medications.
9 total: 8 full-time employees and 1 contractor.
9
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.9 hoursHelps with daily care and mobility.
23 total: 19 full-time employees and 4 contractors.
23
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.1 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
430 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 19 | 4 | 23 | 4,805 | 92 | 100% | 9.1 |
| Licensed Practical Nurse | 8 | 1 | 9 | 3,856 | 92 | 100% | 10.9 |
| Registered Nurse | 10 | 0 | 10 | 2,125 | 78 | 85% | 9.4 |
| RN Director of Nursing | 3 | 0 | 3 | 1,386 | 64 | 70% | 8.1 |
| Nurse Practitioner | 1 | 0 | 1 | 512 | 64 | 70% | 8 |
| Dietitian | 1 | 0 | 1 | 497 | 69 | 75% | 7.2 |
| Mental Health Service Worker | 1 | 0 | 1 | 496 | 62 | 67% | 8 |
| Physical Therapy Assistant | 3 | 0 | 3 | 460 | 63 | 68% | 7.3 |
| Administrator | 1 | 0 | 1 | 384 | 48 | 52% | 8 |
| Speech Language Pathologist | 3 | 0 | 3 | 375 | 53 | 58% | 7.1 |
| Clinical Nurse Specialist | 0 | 1 | 1 | 88 | 11 | 12% | 8 |
| Qualified Social Worker | 1 | 0 | 1 | 78 | 24 | 26% | 3.2 |
| Feeding Assistant | 0 | 3 | 3 | 77 | 27 | 29% | 2.1 |
| Occupational Therapy Aide | 0 | 2 | 2 | 49 | 13 | 14% | 3.8 |
| Medical Director | 0 | 1 | 1 | 48 | 12 | 13% | 4 |
| Physical Therapy Aide | 1 | 0 | 1 | 26 | 6 | 7% | 4.4 |
| Diagnostic X-ray Services Staff | 0 | 1 | 1 | 26 | 8 | 9% | 3.2 |
| Other Physician | 0 | 2 | 2 | 23 | 11 | 12% | 2.1 |
| Respiratory Therapy Technician | 1 | 0 | 1 | 13 | 4 | 4% | 3.4 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 4 | 3 | 3% | 1.3 |
Includes penalties issued in 2024
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)
73% lower than Texas averageTexas average: $80K
60% fewer 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.
1 penalty in the past 3 years
Jun 14, 2024 · $22K
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jun 14, 2024Last updated: Jan 2026
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.
8.0
7% better than Texas averageTexas average: 8.6
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
13.5
16% better than Texas averageTexas average: 16.0
Percent of long-stay residents whose need for help with daily activities has increased
16.5%
In line with Texas averageTexas average: 16.2%
Percent of long-stay residents whose ability to move independently worsened
6.5%
60% better than Texas averageTexas average: 16.2%
Percent of low risk long-stay residents who lose control of their bowels or bladder
17.5%
12% worse than Texas averageTexas average: 15.7%
Percent of long-stay residents experiencing one or more falls with major injury
4.0%
25% worse than Texas averageTexas average: 3.2%
Percent of long-stay high risk residents with pressure ulcers
12.9%
192% worse than Texas averageTexas average: 4.4%
Percent of long-stay residents with a urinary tract infection
0.0%
100% better than Texas averageTexas average: 0.8%
Percent of long-stay residents who lose too much weight
0.0%
100% better than Texas averageTexas average: 3.5%
Percent of long-stay residents who have depressive symptoms
3.5%
20% worse than Texas averageTexas average: 2.9%
Percent of long-stay residents who received an antipsychotic medication
4.0%
49% better than Texas averageTexas average: 7.9%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
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%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
11% better than Texas averageTexas average: 90.4%
Percent of short-stay residents who newly received an antipsychotic medication
0.8%
47% better than Texas averageTexas average: 1.4%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
14% better than Texas averageTexas average: 88.0%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
82% of new residents, usually for short-term rehab.
17% of new residents, often for short stays.
1% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
47Residents 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.
Historical financial and operational data for Rambling Oaks Courtyard Assisted Living Residence from 2011–2023, based on CMS SNF Cost Reports.
Based on the 2023 CMS SNF Cost Report.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #256 / 297Payroll — State benchmarkedThis home is ranked 256th out of 297 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.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Most residents typically stay for a few weeks or months before returning home or moving on.
Most new residents arrive under Medicare (82% of admissions), and a typical Medicare stay runs around 1 - 2 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
182.4 miles from city center
Estimated distance in miles from Highland Village's city center to Rambling Oaks Courtyard Assisted Living Residence's address, calculated via Google Maps.
Add your location
Rambling Oaks Courtyard Assisted Living Residence is located in HIGHLAND VILLAGE, Texas.
Here are the financial assistance programs available to residents in Texas.
The information below is reported by the Texas Health and Human Services Commission.
| The Legacy Midtown Park |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Dallas (Vickery Meadow) | 98
Facility
98
TX AVG
80
Rank
#376 / 988 |
87.5%
Facility
87.5%
TX AVG
63.5%
Rank
#31 / 297 | +38% | 5.42
Facility
5.42
TX AVG
3.63
Rank
#14 / 289 | +1% | +49% | $27.5k
Facility
$27.5k
TX AVG
$81.8k
Rank
#159 / 294 | 4
Facility
4
TX AVG
25.9
Rank
#2 / 292 | 1.3
Facility
1.3
TX AVG
3.7
Rank
#2 / 292 | - | 48 | - |
45
Facility
45
TX AVG
41
Rank
#628 / 1391 | The Legacy Midtown Park Inc | $36.9M
Facility
$36.9M
TX AVG
$8.4M
Rank
#9 / 297 | $15.3M
Facility
$15.3M
TX AVG
$3.5M
Rank
#9 / 297 | 41.6%
Facility
41.6%
TX AVG
47%
Rank
#209 / 297 | 676489 | ||||
| Caraday of Houston |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk.
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision. | Houston (Northside / Northline) | 150
Facility
150
TX AVG
80
Rank
#63 / 988 | - | - | 3.76
Facility
3.76
TX AVG
3.63
Rank
#88 / 289 | -32% | +4% | $0
Facility
$0
TX AVG
$81.8k
Rank
#1 / 294 | 15
Facility
15
TX AVG
25.9
Rank
#64 / 292 | 3.8
Facility
3.8
TX AVG
3.7
Rank
#196 / 292 | - | 12 | - |
41
Facility
41
TX AVG
41
Rank
#709 / 1391 | E&R Cunningham Investments, LP | $3.6M
Facility
$3.6M
TX AVG
$8.4M
Rank
#292 / 297 | $1.8M
Facility
$1.8M
TX AVG
$3.5M
Rank
#290 / 297 | 50.6%
Facility
50.6%
TX AVG
47%
Rank
#99 / 297 | 676470 | ||||
| Sun Valley Rehabilitation and Healthcare Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk.
NC Nursing Care
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision. | Harlingen (Estrellita Subdivision) | 124
Facility
124
TX AVG
80
Rank
#178 / 988 |
76.4%
Facility
76.4%
TX AVG
63.5%
Rank
#96 / 297 | +20% | 3.79
Facility
3.79
TX AVG
3.63
Rank
#88 / 289 | -15% | +4% | $0
Facility
$0
TX AVG
$81.8k
Rank
#1 / 294 | 5
Facility
5
TX AVG
25.9
Rank
#6 / 292 | 2.5
Facility
2.5
TX AVG
3.7
Rank
#62 / 292 | - | 94 | - |
37
Facility
37
TX AVG
41
Rank
#808 / 1391 | Av Rehab LLC | $10.2M
Facility
$10.2M
TX AVG
$8.4M
Rank
#171 / 297 | $4.9M
Facility
$4.9M
TX AVG
$3.5M
Rank
#158 / 297 | 47.8%
Facility
47.8%
TX AVG
47%
Rank
#125 / 297 | 676493 | ||||
| Houston Transitional Care |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk.
NC Nursing Care
PC Palliative Care
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision. | Houston (Braeburn) | 70
Facility
70
TX AVG
80
Rank
#517 / 988 |
90.3%
Facility
90.3%
TX AVG
63.5%
Rank
#18 / 297 | +42% | 3.17
Facility
3.17
TX AVG
3.63
Rank
#215 / 289 | +22% | -13% | $0
Facility
$0
TX AVG
$81.8k
Rank
#1 / 294 | 16
Facility
16
TX AVG
25.9
Rank
#74 / 292 | 5.3
Facility
5.3
TX AVG
3.7
Rank
#268 / 292 | - | 67 | - |
75
Facility
75
TX AVG
41
Rank
#67 / 1391 | Ahmad El-Saadi | $21.9M
Facility
$21.9M
TX AVG
$8.4M
Rank
#31 / 297 | $5.3M
Facility
$5.3M
TX AVG
$3.5M
Rank
#129 / 297 | 24.4%
Facility
24.4%
TX AVG
47%
Rank
#294 / 297 | 676435 | ||||
| Rambling Oaks Courtyard Assisted Living Residence |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Highland Village | 79
Facility
79
TX AVG
80
Rank
#482 / 988 |
60.8%
Facility
60.8%
TX AVG
63.5%
Rank
#189 / 297 | -4% | 3.59
Facility
3.59
TX AVG
3.63
Rank
#122 / 289 | +90% | -1% | $21.6k
Facility
$21.6k
TX AVG
$81.8k
Rank
#138 / 294 | 26
Facility
26
TX AVG
25.9
Rank
#190 / 292 | 3.3
Facility
3.3
TX AVG
3.7
Rank
#149 / 292 | 1 | 42 | - |
1
Facility
1
TX AVG
41
Rank
#1346 / 1391 | Rambling Oaks Courtyard Alr Highland Village LLC | $6.5M
Facility
$6.5M
TX AVG
$8.4M
Rank
#259 / 297 | $3.2M
Facility
$3.2M
TX AVG
$3.5M
Rank
#256 / 297 | 48.6%
Facility
48.6%
TX AVG
47%
Rank
#116 / 297 | 676168 |
The legal owner and operator of Rambling Oaks Courtyard Assisted Living Residence is Rambling Oaks Courtyard Alr Highland Village Llc.
Rambling Oaks Courtyard Assisted Living Residence has a walk score of 1. Car-dependent. Most errands require a car, with limited nearby walkable options.
Rambling Oaks Courtyard Assisted Living Residence's occupancy is 61%.
Rambling Oaks Courtyard Assisted Living Residence has 79 beds.
Rambling Oaks Courtyard Assisted Living Residence has had 2 recently reported deficiencies.
Yes — there are 8 photos of Rambling Oaks Courtyard Assisted Living Residence in the photo gallery on this page.
Rambling Oaks Courtyard Assisted Living Residence is located at 110 BARNETT BLVD.
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