Creative Solutions in Healthcare Nursing Homes: Chain Profile, Quality Record, and Lawsuits

Who Is Creative Solutions in Healthcare?

Creative Solutions in Healthcare is a for-profit, privately held, family-owned long-term care company based in Texas. By number of CMS-affiliated skilled nursing facilities, it is the fifth-largest nursing home chain in the United States and the largest skilled nursing operator in Texas.^[4][3]

The company was founded in 2000 by Gary and Malisa Blake, beginning with the acquisition of Granbury Care Center, and is headquartered in Fort Worth, Texas. Gary Blake serves as its chief executive. The company has grown rapidly through acquisitions and describes itself as a private, family-owned business.^[4][5]

What Kind of Chain Is Creative Solutions in Healthcare?

Creative Solutions is primarily a skilled nursing facility (SNF) chain operating exclusively in Texas. Skilled nursing facilities care for patients who need 24-hour nursing care, often after a hospital stay. The company also operates assisted living communities; because assisted living is regulated at the state level and is not rated on the federal CMS five-star scale, the company's own count of total long-term care communities is larger than the number of CMS-certified nursing homes affiliated with the chain.^[4]

How Big Is the Creative Solutions in Healthcare Nursing Home Chain?

Creative Solutions by the Numbers

Federal CMS data describes a large, Texas-wide operation:

Facility, state, and bed counts are from the CMS Nursing Home Chain Performance Measures dataset (most recent 2026 release); the company is privately held and does not publicly report revenue.^[3]

• The most recent federal CMS chain-level data affiliates 149 nursing homes in Texas with the chain (CMS chain ID 169) — making it the fifth-largest nursing home chain in the United States by number of facilities, ranked #5 of the 611 chains CMS tracks, and the largest skilled nursing operator in Texas.^[3]
• The affiliated homes hold about 17,670 certified beds.^[3]
• The company reports a larger total of long-term care communities when its assisted living settings are included; those are not CMS-rated nursing homes and are not counted in the chain figure above.^[4]

Is Creative Solutions in Healthcare For-Profit or Nonprofit?

Creative Solutions is a for-profit, family-owned company. It is privately held rather than publicly traded, and it does not publicly report revenue or profit.^[4][5] Within the CMS data, the affiliated facilities are operated as for-profit entities.^[1] Like other large nursing home operators, the company depends heavily on government healthcare programs; Medicare and Medicaid reimbursement account for a substantial share of skilled nursing revenue industrywide.

Creative Solutions in Healthcare Quality and Staffing Record

Federal data shows a chain that performs well below national averages on the measures CMS tracks. Across the chain in the most recent CMS Nursing Home Chain Performance Measures release (149 facilities in Texas):

• The average overall star rating was about 2.1 of 5 — below the national chain average of 3.0. The chain-level averages CMS publishes were 2.7 for health inspections, 1.1 for staffing (the lowest rating band), and 3.2 on the quality measure rating.^[3]
• About 62 of the chain's 149 facilities (41.6%) carried a one-star ("much below average") overall rating — roughly double the 20.5% national rate — and 19 facilities (12.8%) carried a CMS abuse icon, above the 9.7% national rate.^[3]
• Reported average nursing-staff turnover was about 93.4%, far above the national figure of about 45.8%, and average total nurse staffing was about 3.1 hours per resident per day, below the national average of roughly 3.9.^[3]
• The affiliated facilities collectively recorded 243 fines totaling about $8.21 million and 18 Medicare payment denials in the most recent three-year window reflected in the data.^[3][2]

Creative Solutions in Healthcare Nursing Home Facilities

The table below is the complete roster of the 149 nursing facilities affiliated with Creative Solutions in Healthcare (CMS chain ID 169), taken directly from the federal CMS Provider Information dataset (May 2026 release). It lists each facility's name, city and state, street address, and phone number, along with any current CMS quality flag. The chain-level totals cited above reflect the most recent CMS Nursing Home Chain Performance Measures release, which affiliates the same 149 facilities with the chain. The company's facility list changes as it acquires and divests properties, so this roster should be refreshed from the CMS data on each republish.^[1]

The "CMS Flag" column marks homes that CMS has identified as a Special Focus Facility, a Special Focus Facility Candidate, behind on inspections ("Delayed inspection"), or carrying an abuse icon. Rows shaded gold indicate a current Special Focus designation.^[1]

Source: Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Home "Provider Information" dataset (NH_ProviderInfo_May2026.csv), filtered to Creative Solutions in Healthcare, chain ID 169. Inclusion on this list reflects CMS chain-affiliation data and does not by itself indicate that any particular facility committed wrongdoing.^[1]

Special Focus Facilities and SFF Candidates in Creative Solutions in Healthcare

The Special Focus Facility (SFF) program is run by CMS. It identifies nursing homes with a history of serious quality problems; CMS describes these facilities as among the poorest-performing nursing homes in the country.^[7] A "Special Focus Facility Candidate" is a home with a history of serious quality issues that has not yet been formally placed in the program.^[7]

According to the federal CMS Provider Information dataset (May 2026 release), the chain included 0 Special Focus Facilities, 6 Special Focus Facility Candidates, and 1 home whose most recent standard health inspection was more than two years ago. CMS data also showed 25 facilities carrying an abuse icon, meaning they were cited for abuse or neglect at or above a defined harm level.^[1]

These designations are reassessed by CMS monthly and can change. The most recent CMS Nursing Home Chain Performance Measures release reports 0 Special Focus Facilities and 7 SFF candidates for the chain; the specific facilities named below reflect the CMS May 2026 provider-level release.^[3]

Creative Solutions Special Focus Facility Candidates (May 2026)

These Creative Solutions facilities were listed as Special Focus Facility Candidates in the May 2026 CMS data:^[1]

• Estates Healthcare and Rehabilitation Center — Fort Worth, TX
• Park Place Care Center — Georgetown, TX
• Afton Oaks Nursing and Rehabilitation Center — Houston, TX
• Whispering Pines Lodge — Longview, TX
• Kennedy Health & Rehab — Lufkin, TX
• Buena Vida Nursing and Rehab-san Antonio — San Antonio, TX

Creative Solutions Facilities With a CMS Abuse Icon

These 25 Creative Solutions facilities carried a CMS abuse icon in the May 2026 data, meaning they were cited for abuse or neglect at or above a defined harm level:^[1]

• Alvarado Meadows Nursing & Rehabilitation — Alvarado, TX
• Five Points Nursing & Rehabilitation of College St — College Station, TX
• La Hacienda De Paz Rehabilitation and Care Center — Eagle Pass, TX
• Mountain View Health & Rehabilitation — El Paso, TX
• Pebble Creek Nursing Center — El Paso, TX
• St. Teresa Nursing & Rehab Center — El Paso, TX
• Arlington Heights Health and Rehabilitation Center — Fort Worth, TX
• Downtown Health and Rehabilitation Center — Fort Worth, TX
• Estates Healthcare and Rehabilitation Center — Fort Worth, TX
• Marine Creek Nursing and Rehabilitation — Fort Worth, TX
• Park Place Care Center — Georgetown, TX
• Graham Oaks Care Center — Graham, TX
• Afton Oaks Nursing and Rehabilitation Center — Houston, TX
• Whispering Pines Lodge — Longview, TX
• Whisperwood Nursing & Rehabilitation Center — Lubbock, TX
• Kennedy Health & Rehab — Lufkin, TX
• Sienna Nursing and Rehabilitation — Odessa, TX
• Buena Vida Nursing and Rehab-san Antonio — San Antonio, TX
• Normandy Terrace Nursing & Rehabilitation Center — San Antonio, TX
• River City Care Center — San Antonio, TX
• Texoma Healthcare Center — Sherman, TX
• Countryview Nursing & Rehabilitation — Terrell, TX
• North Pointe Nursing and Rehabilitation — Watauga, TX
• Peach Tree Place — Weatherford, TX
• Parkview Manor Nursing and Rehabilitation — Weimar, TX

Creative Solutions in Healthcare Lawsuits, Federal Fines, and Regulatory Record

The items below are drawn from federal CMS enforcement data and court records. Where a lawsuit is described, its outcome is stated.

Federal Civil Money Penalties and Payment Denials

Federal CMS enforcement records show that, across the chain's Texas facilities, CMS imposed 243 fines totaling about $8.21 million and 18 Medicare payment denials in the most recent three-year window reflected in the data. These are regulatory penalties recorded by CMS and reflect the chain's inspection and compliance history.^[2][3]

2017–2023 — False Claims Act Lawsuit (Dismissed)

In December 2017, Integra Med Analytics, LLC, a private data-analytics company, filed a lawsuit alleging that Creative Solutions in Healthcare had billed Medicare and Medicaid for rehabilitation therapy that was unreasonable or unnecessary, seeking more than $94 million. In June 2023, a federal judge dismissed the lawsuit with prejudice, meaning the claims cannot be refiled. Creative Solutions denied the allegations and paid nothing to resolve the case.^[6] No court found Creative Solutions liable; the allegations were not proven. (The dismissal was announced by the company's defense counsel.)^[6]

It is important to be precise about what has and has not been established. The False Claims Act lawsuit described above was dismissed with prejudice and resulted in no finding of liability. The CMS ratings, fines, and Special Focus data on this page are federal regulatory records; they describe inspection findings and penalties, not court judgments of fraud.

How Michael Hill Trial Law Investigates Claims Against Creative Solutions in Healthcare

Michael Hill Trial Law focuses exclusively on nursing home abuse and neglect. The firm has handled more than 1,000 cases against nursing home operators and has recovered hundreds of millions of dollars for clients, including a $26 million verdict in Ohio.^[8]

Chronic understaffing and high staff turnover are among the strongest warning signs of preventable harm in a nursing home, because residents depend on consistent, adequate staffing for basic care. When we investigate a claim against a Creative Solutions facility, we compare the home's CMS staffing and inspection history against what happened to the resident, obtain the facility's care records and any available documentation, and work to identify which operating subsidiary, landlord, and management entity were responsible for the resident's care. The kinds of injuries and claims our firm investigates include:

• Bedsores and pressure injuries
• Falls and fractures
• Malnutrition and dehydration
• Infections and sepsis
• Medication errors
• Elopement (wandering away from a facility)
• Understaffing and neglect
• Physical or sexual assault
• Wrongful death

We are investigating claims against facilities operated by Creative Solutions in Healthcare. If your loved one was injured or died in a Creative Solutions nursing home, the public record on this page may be relevant to your situation. Our firm serves families nationwide.

Frequently Asked Questions About Creative Solutions in Healthcare

Who owns Creative Solutions in Healthcare?

Creative Solutions in Healthcare is a privately held, family-owned company founded in 2000 by Gary and Malisa Blake and headquartered in Fort Worth, Texas. Gary Blake serves as its chief executive. Because it is private, it does not publicly report its revenue.

How many nursing homes does Creative Solutions in Healthcare operate?

The most recent CMS chain-level data affiliates about 149 nursing homes with the chain, all in Texas, making it the fifth-largest nursing home chain in the United States by number of facilities — ranked #5 of the 611 chains CMS tracks, and the largest skilled nursing operator in Texas. The company reports a larger total of long-term care communities (including assisted living) when all settings are counted.

Is Creative Solutions in Healthcare for-profit or nonprofit?

Creative Solutions in Healthcare is a for-profit, family-owned company. It is privately held rather than publicly traded and does not publicly report financial results.

How is Creative Solutions in Healthcare rated by Medicare?

Across the chain, CMS reports a chain-average overall rating of about 2.1 of 5 — below the national average of 3.0 — with 2.7 for health inspections, 1.1 for staffing, and 3.2 on quality measures. About 62 of its 149 facilities (41.6%) carry a one-star overall rating, roughly double the 20.5% national rate, and reported nursing-staff turnover averaged about 93.4%, far above the 45.8% national figure. The most recent CMS chain summary reports 0 Special Focus Facilities and 7 SFF candidates for the chain.

Has Creative Solutions in Healthcare been sued or investigated?

A False Claims Act lawsuit filed in 2017 by a private data-analytics company alleged that Creative Solutions billed Medicare and Medicaid for unnecessary therapy and sought more than $94 million; the case was dismissed with prejudice in 2023, the company denied the allegations and paid nothing, and no court found it liable. Separately, CMS records show the chain's Texas facilities collectively incurred substantial federal fines and payment denials over the most recent three-year window.

What should I do if a loved one was harmed at a Creative Solutions facility?

Michael Hill Trial Law investigates abuse and neglect claims against nursing home operators nationwide, including facilities affiliated with Creative Solutions in Healthcare. You can contact the firm for a confidential review of your situation.

Sources

1. Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Home "Provider Information" dataset (NH_ProviderInfo_May2026.csv), filtered to Creative Solutions in Healthcare, chain ID 169 (facility counts, addresses, phone numbers, bed counts, ownership type, star ratings, abuse icons, Special Focus status, delayed inspections). https://data.cms.gov/provider-data/dataset/4pq5-n9py
2. Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Home "Penalties" file (May 2026 release) (fine amounts and payment denials). https://data.cms.gov/provider-data/
3. Centers for Medicare & Medicaid Services, Provider Data Catalog / data.gov, "Nursing Home Chain Performance Measures" (Affiliated Entity Performance Measures) dataset, most recent 2026 release, filtered to Creative Solutions in Healthcare (CMS chain ID 169): affiliated-facility count, state, bed count, chain-average star ratings, one-star share, abuse-icon share, Special Focus Facilities and candidates, fines, payment denials, staffing hours, and turnover. https://data.cms.gov/provider-data/ ; dataset listing: https://catalog.data.gov/dataset/nursing-home-chain-performance-measures
4. Creative Solutions in Healthcare, company "About" information (founded 2000 by Gary and Malisa Blake; family-owned; headquartered in Fort Worth, Texas; began with Granbury Care Center; grown to 170+ long-term care communities across Texas; the largest skilled nursing operator in Texas), per company press releases distributed via Business Wire (2025–2026). https://www.businesswire.com/news/home/20250701362347/en/Creative-Solutions-in-Healthcare-Acquires-Five-Texas-Skilled-Nursing-Facilities
5. Skilled Nursing News, coverage of Creative Solutions in Healthcare's growth and private, family ownership (CEO Gary Blake). https://skillednursingnews.com/2023/01/texas-snf-giant-creative-solutions-announces-more-growth-after-adding-20-facilities-in-2022/
6. GableGotwals, "GableGotwals Secures Dismissal of $94 Million False Claims Act Allegations Against Texas-Based Healthcare Provider" (announcing the June 2023 dismissal with prejudice of Integra Med Analytics, LLC's 2017 False Claims Act lawsuit against Creative Solutions in Healthcare, with no finding of liability). This is an announcement by the company's defense counsel. https://www.gablelaw.com/news-articles-blogs/press-releases/gablegotwals-secures-dismissal-of-94-million-false-claims-act-allegations-against-texas-based-healthcare-provider/
7. Centers for Medicare & Medicaid Services, "Special Focus Facility (SFF) Program" overview and monthly candidate/participant lists. https://www.cms.gov/medicare/health-safety-standards/certification-compliance/special-focus-facility
8. Michael Hill Trial Law. https://protectseniors.com/

This page is for general informational purposes and is not legal advice. It is attorney advertising. Ratings, fines, and Special Focus data are from federal CMS records and reflect inspection findings and regulatory penalties, not court judgments. The litigation described was dismissed with prejudice and resulted in no finding of liability. Facility data and litigation status change over time; verify current details before relying on them. Last reviewed: October 26, 2026.