CCN 455968 · Young County, Texas
Graham Oaks Care Center
1325 First St, Graham, TX 76450
Graham Oaks Care Center is a 110-bed for-profit nursing home in Graham, Texas, first certified for Medicare or Medicaid in 1991. CMS rates it 1 out of 5 stars overall in its September 2026 data, and it averaged 76.0 residents a day, about 69% of its certified beds. HUD's healthcare database shows an FHA-insured Section 232 loan for a project matching this facility, most recently $5.4 million in December 2012 (223(f) refinance or purchase), and none of them appears in HUD's active-loan file.
Facility facts
- Certified beds
- 110
- Average residents per day
- 76.0 (69.1% of beds)
- Ownership type
- For profit - Corporation
- Certification
- Medicare and Medicaid
- Legal business name
- County of Throckmorton
- Certified since
- Oct 28, 1991
- Chain or affiliated group
- Creative Solutions in Healthcare (149 facilities, chain average 2.1 stars)
- Location
- Rural
Ratings and staffing
Star ratings run from 1 to 5. Staffing is nurse hours per resident per day from CMS Payroll Based Journal data; turnover is the CMS annual nursing staff turnover rate. Occupancy is CMS's average daily census divided by certified beds.
| Measure | This facility | Texas median | US median |
|---|---|---|---|
| Overall rating | 1 of 5 | State spread: 322 at 1, 244 at 2, 247 at 3, 211 at 4, 141 at 5 | |
| Health inspections | 2 of 5 | ||
| Quality measures | 3 of 5 | ||
| Staffing | 1 of 5 | ||
| Total nurse hours per resident per day | 2.99 | 3.27 | 3.68 |
| RN hours per resident per day | 0.37 | 0.38 | 0.58 |
| Weekend nurse hours per resident per day | 2.57 | ||
| Nursing staff turnover | 94.4% | 52.1% | 44.9% |
| Occupancy (residents / beds) | 69.1% | 68.6% | 85.7% |
| Fines reported by CMS | 2 totaling $34,690 | ||
| Health deficiencies, latest standard survey | 6 (Apr 9, 2026) | ||
HUD 223(f) Express Lane: the CMS part
HUD gives 223(f) applications queue priority when the facility has CMS overall and health inspection ratings of at least 2 stars and no abuse icon, among other tests (ORCF criteria of March 31, 2026). Graham Oaks Care Center does not meet it today: overall rating 1, the abuse icon. The loan-to-value, coverage and operator tests depend on the deal. All the criteria.
Who owns and operates it
These are the owners and operators the facility reported to CMS: anyone with a 5% or greater direct or indirect stake, and any organization with operational or managerial control.
| Name | Role | Share | Since |
|---|---|---|---|
| County of ThrockmortonOrganization | Direct Ownership Interest | 100% | 07/01/2022 |
| Graham I Enterprises, LLCOrganization | Operational / Managerial Control | n/a | 01/01/2019 |
| Blake, GaryIndividual | Operational / Managerial Control | n/a | 01/01/2019 |
| Blake, MalisaIndividual | Operational / Managerial Control | n/a | 01/01/2019 |
Changes of ownership
No change of ownership for this facility appears in the CMS change-of-ownership file, which starts in January 2016.
HUD Section 232 loans
HUD's Office of Healthcare Programs lists these FHA-insured loans for a project we matched to this facility by name, city and bed count. Status, rate and balance come from HUD's insured-mortgage files as of September 30, 2026. Check the FHA number against the loan documents before relying on the match.
| Endorsed | Program | Original amount | Status | FHA number |
|---|---|---|---|---|
| Dec 19, 2012 | 223(f) refinance or purchaseHUD project name: LDEnterprises3-Graham Oaks Care Center, 113 beds. Lender at endorsement: Lancaster Pollard Mtge Co | $5,419,300 | Ended Oct 13, 2015Prepayment | 11322087 |
Sources and dates
Facility, rating, staffing and ownership data: CMS Provider Information and CMS Ownership, processing date September 2026. Private equity, REIT and mortgage-interest flags and changes of ownership: CMS Skilled Nursing Facility All Owners and Change of Ownership files (2026-10-01). FHA-insured loans: HUD Office of Healthcare Programs endorsement database, data run July 8, 2026. How we join them, and what the join can get wrong: methodology.
SNF Register is independent. It is not affiliated with or endorsed by CMS, HUD or FHA. Spotted an error? Write to hello@hudskillednursing.loan.