Texas › Gillespie County › Fredericksburg
Avir At Enchanted Rock
210 West Windcrest St, Fredericksburg, TX 78624
Ratings are based on the most recent data available; a facility's ratings may have changed since the last update. The health inspection rating is based on the three most recent standard surveys and complaint investigations. CMS processed this record on 1 Aug 2026. View the Care Compare record.
Avir At Enchanted Rock, in Fredericksburg, Texas, is certified for 120 beds under government, hospital district ownership and belongs to the Avir Health Group chain.
CMS gives it 2 of 5 stars overall, below the Texas median of 3; the health inspection rating is 2, staffing 2 and quality measures 4.
Inspectors recorded 48 health deficiencies across the three most recent survey cycles (14, 15, 19 by cycle, most recent first), 5 of them at the actual-harm or immediate-jeopardy level. That is 40.0 per 100 beds, more than the state median of 22.5.
CMS lists 2 penalties in the period covered: fines totalling $63K.
Reported nurse staffing is 3.4 hours per resident per day (0.5 RN), close to the Texas median of 3.3; nursing staff turnover is 78.9%.
Compared with county, state and nation
| Measure | This facility | Gillespie Co. median | Texas median | US average |
|---|---|---|---|---|
| Overall star rating | 2 | 3 | 3 | 3.0 |
| Health citations, 3 cycles | 48 | 48 | 25 | 28.7 |
| Citations per 100 beds | 40.0 | 53.3 | 22.5 | 26.8 |
| Total nurse hours per resident day | 3.4 | 3.1 | 3.3 | 3.9 |
| RN hours per resident day | 0.5 | 0.5 | 0.4 | 0.7 |
| Nursing staff turnover | 78.9% | 78.9% | 52.1% | 45.8% |
| Fines listed | $63,121 | $32,094 | $16,801 | — |
County and state figures are medians across facilities (4 in the county, 1177 in the state); the US column is the CMS national average where CMS publishes one.
Citations by survey cycle
Dark bar: this facility. Grey bar: Texas average per facility for the same cycle, as published by CMS. Standard health survey dates: 2 May 2026, 12 Feb 2025.
Severity mix: J ×4 K ×1 D ×27 E ×14 B ×1 C ×1
Health deficiencies
Every health citation in the current CMS record (three survey cycles), most recent first. Tag text is the CMS requirement summary, not the inspection narrative.
Scope and severity letters (A–L)
| Survey date | Tag | What the tag requires | Severity | Type | Corrected |
|---|---|---|---|---|---|
| 22 Jun 2026 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Complaint investigation | 24 Jun 2026 |
| 13 May 2026 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Complaint investigation | 16 May 2026 |
| 2 May 2026 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Standard survey | 4 May 2026 |
| 2 May 2026 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Standard survey | 4 May 2026 |
| 2 May 2026 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | E | Standard survey | 4 May 2026 |
| 2 May 2026 | F0727 | 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. | E | Standard survey | 4 May 2026 |
| 2 May 2026 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Standard survey | 4 May 2026 |
| 2 May 2026 | F0610 | Respond appropriately to all alleged violations. | D | Standard survey | 4 May 2026 |
| 2 May 2026 | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Standard survey | 4 May 2026 |
| 2 May 2026 | F0760 | Ensure that residents are free from significant medication errors. | D | Standard survey | 4 May 2026 |
| 2 May 2026 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | Standard survey | 4 May 2026 |
| 2 May 2026 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Standard survey | 4 May 2026 |
| 2 May 2026 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 4 May 2026 |
| 8 Jan 2026 | F0880 | Provide and implement an infection prevention and control program. | E | Complaint investigation | 10 Jan 2026 |
| 10 Jul 2025 | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | Complaint investigation | 11 Jul 2025 |
| 10 Jul 2025 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Complaint investigation | 11 Jul 2025 |
| 10 Jul 2025 | F0732 | Post nurse staffing information every day. | C | Complaint investigation | 11 Jul 2025 |
| 12 Feb 2025 | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | E | Standard survey | 13 Feb 2025 |
| 12 Feb 2025 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Standard survey | 13 Feb 2025 |
| 12 Feb 2025 | F0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | Standard survey | 13 Feb 2025 |
| 12 Feb 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Standard survey | 13 Feb 2025 |
| 12 Feb 2025 | F0610 | Respond appropriately to all alleged violations. | D | Standard survey | 13 Feb 2025 |
| 12 Feb 2025 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 13 Feb 2025 |
| 12 Feb 2025 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard survey | 13 Feb 2025 |
| 12 Feb 2025 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Standard survey | 13 Feb 2025 |
| 12 Feb 2025 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 13 Feb 2025 |
| 19 Jan 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | K | Complaint investigation | 9 Feb 2025 |
| 19 Jan 2025 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Complaint investigation | 20 Jan 2025 |
| 19 Jan 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | 20 Jan 2025 |
| 22 Jun 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 24 Jun 2024 |
| 13 Jan 2024 | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | J | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0610 | Respond appropriately to all alleged violations. | J | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | E | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0759 | Ensure medication error rates are not 5 percent or greater. | E | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0760 | Ensure that residents are free from significant medication errors. | E | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0761 | 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. | E | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. | E | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | D | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 15 Feb 2024 |
| 13 Jan 2024 | F0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | B | Standard survey | 15 Feb 2024 |
Penalties
| Date | Type | Amount | Detail |
|---|---|---|---|
| 19 Jan 2025 | Fine | $49,205 | |
| 13 Jan 2024 | Fine | $13,916 |
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the Texas average. Turnover: nursing staff 78.9%, RNs 80.0%; 1 administrator left in the reporting year.
Quality measures
| Measure | Residents | This facility | Texas median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 14.6% | 14.9% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.0% | 0.0% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 0.6% | 0.3% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 5.4% | 3.0% | 2.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 1.6% | 0.7% | 1.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 15.3% | 12.4% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 1.7% | 3.4% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 4.6% | 8.3% | 13.4% |
Four-quarter averages for the measures CMS uses in the quality-measure star rating (2025Q2-2026Q1). Lower is better for every measure listed. Medians are computed across facilities on this site.
Ownership
Ownership type: government, hospital district. Legal business name: Uvalde County Hospital Authority. Chain: Avir Health Group (116 facilities).
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Uvalde County Hospital District | 5% or greater direct ownership interest | 100% | 03/01/2025 |
| Welltower Inc | 5% or greater security interest | NOT APPLICABLE | 03/01/2025 |
| Welltower Nnn Group, LLC | 5% or greater security interest | NOT APPLICABLE | 03/01/2025 |
| Welltower Op, LLC | 5% or greater security interest | NOT APPLICABLE | 03/01/2025 |
| 210 West Windcrest Street Opco, LLC | Operational/managerial control | NOT APPLICABLE | 03/01/2025 |
| Welltower Inc | Adp of the snf | NOT APPLICABLE | 03/01/2025 |
| Welltower Nnn Group, LLC | Adp of the snf | NOT APPLICABLE | 03/01/2025 |
| Welltower Op, LLC | Adp of the snf | NOT APPLICABLE | 03/01/2025 |
Only organisations are shown. CMS also records individual owners, officers and managing employees; this site does not publish people's names.
Other nursing homes in Gillespie County
| Facility | City | Beds | Overall | Health | Staffing | Citations | Per 100 beds | Fines | Last survey |
|---|---|---|---|---|---|---|---|---|---|
| Avir At Fredericksburg | Fredericksburg | 90 | 3 | 2 | 2 | 48 | 53.3 | $24K | 26 Jun 2026 |
| Knopp Healthcare and Rehab Center Inc | Fredericksburg | 119 | 3 | 4 | 3 | 25 | 21.0 | — | 9 Jan 2026 |
| Knopp Nursing & Rehab Center Inc | Fredericksburg | 60 | 1 | 2 | 1 | 34 | 56.7 | $32K | 21 Jan 2026 |
All 4 facilities in Gillespie County
Questions and answers
How many deficiencies has Avir At Enchanted Rock been cited for?
48 health deficiencies across the three most recent survey cycles, 5 at the actual-harm or immediate-jeopardy level. The Texas median is 25 per facility.
Has Avir At Enchanted Rock been fined?
Yes. CMS lists fines totalling $63K in the period covered.
How does staffing at Avir At Enchanted Rock compare?
Reported total nurse staffing is 3.4 hours per resident per day against a Texas median of 3.3 and a national average of 3.9.
Who operates Avir At Enchanted Rock?
It is part of the Avir Health Group chain. Ownership type is government, hospital district. Organisations in the CMS ownership record include Uvalde County Hospital District and 210 West Windcrest Street Opco, LLC. Individual owners and managers are not listed on this site.
When was Avir At Enchanted Rock last inspected?
The most recent survey or investigation in the CMS record is dated 22 Jun 2026; the most recent standard health survey was 2 May 2026.
Where does this data come from?
All figures are from the Centers for Medicare & Medicaid Services Care Compare datasets (provider information, health deficiencies, penalties, ownership and quality measures), processed 1 Aug 2026. Ratings and citations may change; the Care Compare record is authoritative.
Provenance
Source: Centers for Medicare & Medicaid Services, Care Compare nursing home datasets (provider information, health deficiencies, penalties, ownership, MDS quality measures, state and national averages), public domain, processed by CMS on 1 Aug 2026. Facility record: Care Compare. Errors in processing are corrected at the next daily build; see corrections.