Texas › Guadalupe County › Schertz
Silver Tree Nursing and Rehabilitation Center
930 Roy Richard Dr, Schertz, TX 78154
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.
Certified for 120 beds, Silver Tree Nursing and Rehabilitation Center serves Schertz in Guadalupe County, Texas and has taken Medicare and Medicaid residents since 2006.
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 60 health deficiencies across the three most recent survey cycles (17, 25, 18 by cycle, most recent first), 4 of them at the actual-harm or immediate-jeopardy level. That is 50.0 per 100 beds, more than the state median of 22.5.
CMS lists 3 penalties in the period covered: fines totalling $114K.
Reported nurse staffing is 3.3 hours per resident per day (0.5 RN), close to the Texas median of 3.3; nursing staff turnover is 93.3%.
Compared with county, state and nation
| Measure | This facility | Guadalupe Co. median | Texas median | US average |
|---|---|---|---|---|
| Overall star rating | 2 | 2 | 3 | 3.0 |
| Health citations, 3 cycles | 60 | 49 | 25 | 28.7 |
| Citations per 100 beds | 50.0 | 35.1 | 22.5 | 26.8 |
| Total nurse hours per resident day | 3.3 | 3.3 | 3.3 | 3.9 |
| RN hours per resident day | 0.5 | 0.3 | 0.4 | 0.7 |
| Nursing staff turnover | 93.3% | 60.8% | 52.1% | 45.8% |
| Fines listed | $114,303 | $24,499 | $16,801 | — |
County and state figures are medians across facilities (8 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: 12 Jun 2026, 18 Apr 2025.
Severity mix: J ×4 D ×42 E ×12 F ×1 B ×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 |
|---|---|---|---|---|---|
| 12 Jun 2026 | F0641 | Ensure each resident receives an accurate assessment. | E | Standard survey | 13 Jun 2026 |
| 12 Jun 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 | 13 Jun 2026 |
| 12 Jun 2026 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | Standard survey | 13 Jun 2026 |
| 12 Jun 2026 | 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 | 13 Jun 2026 |
| 12 Jun 2026 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | Standard survey | 13 Jun 2026 |
| 12 Jun 2026 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Standard survey | 13 Jun 2026 |
| 12 Jun 2026 | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment. | D | Standard survey | 13 Jun 2026 |
| 12 Jun 2026 | F0645 | PASARR screening for Mental disorders or Intellectual Disabilities | D | Standard survey | 13 Jun 2026 |
| 12 Jun 2026 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard survey | 13 Jun 2026 |
| 12 Jun 2026 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 13 Jun 2026 |
| 28 Jan 2026 | F0641 | Ensure each resident receives an accurate assessment. | D | Complaint investigation | 29 Jan 2026 |
| 28 Jan 2026 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Complaint investigation | 29 Jan 2026 |
| 28 Jan 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 | 29 Jan 2026 |
| 1 Dec 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 | Complaint investigation | 2 Dec 2025 |
| 10 Oct 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Complaint investigation | 29 Aug 2025 |
| 10 Oct 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 | Complaint investigation | 11 Oct 2025 |
| 10 Oct 2025 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Complaint investigation | 11 Oct 2025 |
| 27 Apr 2025 | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | J | Complaint investigation | 25 Apr 2025 |
| 27 Apr 2025 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | Complaint investigation | 25 Apr 2025 |
| 18 Apr 2025 | 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 | 19 Apr 2025 |
| 18 Apr 2025 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0940 | Develop, implement, and/or maintain an effective training program for all new and existing staff members. | E | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0946 | Provide training in compliance and ethics. | E | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0583 | Keep residents' personal and medical records private and confidential. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Standard survey | 19 Apr 2025 |
| 18 Apr 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 | 19 Apr 2025 |
| 18 Apr 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | 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 | 19 Apr 2025 |
| 18 Apr 2025 | F0693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0694 | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0941 | Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0942 | Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0947 | Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0949 | Provide behavior health training consistent with the requirements and as determined by a facility assessment. | D | Standard survey | 19 Apr 2025 |
| 18 Apr 2025 | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | B | Standard survey | 19 Apr 2025 |
| 17 Jan 2025 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint investigation | 18 Jan 2025 |
| 17 Jan 2025 | F0602 | Protect each resident from the wrongful use of the resident's belongings or money. | D | Complaint investigation | 1 Aug 2024 |
| 17 Jan 2025 | 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. | D | Complaint investigation | 18 Jan 2025 |
| 17 Jan 2025 | F0880 | Provide and implement an infection prevention and control program. | D | Complaint investigation | 18 Jan 2025 |
| 14 Jun 2024 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Complaint investigation | 15 Jun 2024 |
| 7 Mar 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Complaint investigation | 8 Mar 2024 |
| 7 Mar 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 | Complaint investigation | 8 Mar 2024 |
| 7 Mar 2024 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Standard survey | 8 Mar 2024 |
| 7 Mar 2024 | F0638 | Assure that each resident’s assessment is updated at least once every 3 months. | D | Complaint investigation | 8 Mar 2024 |
| 7 Mar 2024 | F0641 | Ensure each resident receives an accurate assessment. | D | Complaint investigation | 8 Mar 2024 |
| 7 Mar 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. | D | Complaint investigation | 8 Mar 2024 |
| 7 Mar 2024 | F0693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | Complaint investigation | 8 Mar 2024 |
| 7 Mar 2024 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Complaint investigation | 8 Mar 2024 |
| 7 Mar 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. | D | Complaint investigation | 8 Mar 2024 |
| 7 Mar 2024 | F0805 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | D | Complaint investigation | 8 Mar 2024 |
| 7 Mar 2024 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Complaint investigation | 8 Mar 2024 |
| 7 Mar 2024 | F0880 | Provide and implement an infection prevention and control program. | D | Complaint investigation | 8 Mar 2024 |
| 1 Feb 2024 | F0880 | Provide and implement an infection prevention and control program. | D | Complaint investigation | 2 Feb 2024 |
| 22 Dec 2023 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | J | Complaint investigation | 31 Jan 2024 |
| 22 Dec 2023 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | Complaint investigation | 23 Dec 2023 |
| 22 Dec 2023 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Complaint investigation | 23 Dec 2023 |
| 22 Dec 2023 | F0880 | Provide and implement an infection prevention and control program. | D | Complaint investigation | 23 Dec 2023 |
Penalties
| Date | Type | Amount | Detail |
|---|---|---|---|
| 10 Oct 2025 | Fine | $16,471 | |
| 27 Apr 2025 | Fine | $15,156 | |
| 22 Dec 2023 | Fine | $82,676 |
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the Texas average. Turnover: nursing staff 93.3%, 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 | 10.3% | 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 | 0.0% | 0.3% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 2.8% | 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 | 3.6% | 12.4% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 2.7% | 3.4% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 6.1% | 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: West Wharton County Hospital District. Chain: Creative Solutions In Healthcare (149 facilities).
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Schertz I Enterprises, LLC | Operational/managerial control | NOT APPLICABLE | 09/01/2022 |
| Schertz I Enterprises, LLC | Adp of the snf | NOT APPLICABLE | 05/20/2025 |
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 Guadalupe County
| Facility | City | Beds | Overall | Health | Staffing | Citations | Per 100 beds | Fines | Last survey |
|---|---|---|---|---|---|---|---|---|---|
| Avir At Walnut Springs | Seguin | 113 | 4 | 4 | 1 | 14 | 12.4 | — | 18 Nov 2025 |
| Avir At Schertzabuse icon | Schertz | 96 | 2 | 1 | 1 | 65 | 67.7 | $35K | 21 Mar 2026 |
| Guadalupe Valley Nursing and Rehabilitation Center | Seguin | 148 | 2 | 2 | 2 | 52 | 35.1 | $75K | 30 Jun 2026 |
| Trucare Living Centers - Selma | Selma | 128 | 2 | 3 | 1 | 25 | 19.5 | — | 26 Apr 2026 |
| Windsor Nursing and Rehabilitation Center of Segui | Seguin | 122 | 2 | 3 | 1 | 33 | 27.0 | $24K | 31 Jul 2025 |
| Avir At Seguinabuse icon | Seguin | 134 | 1 | 2 | 1 | 47 | 35.1 | $14K | 24 Jun 2026 |
| River Bend Healthcare | Seguin | 115 | 1 | 2 | 1 | 49 | 42.6 | $18K | 13 Feb 2026 |
All 8 facilities in Guadalupe County
Questions and answers
How many deficiencies has Silver Tree Nursing and Rehabilitation Center been cited for?
60 health deficiencies across the three most recent survey cycles, 4 at the actual-harm or immediate-jeopardy level. The Texas median is 25 per facility.
Has Silver Tree Nursing and Rehabilitation Center been fined?
Yes. CMS lists fines totalling $114K in the period covered.
How does staffing at Silver Tree Nursing and Rehabilitation Center compare?
Reported total nurse staffing is 3.3 hours per resident per day against a Texas median of 3.3 and a national average of 3.9.
Who operates Silver Tree Nursing and Rehabilitation Center?
It is part of the Creative Solutions In Healthcare chain. Ownership type is government, hospital district. Organisations in the CMS ownership record include Schertz I Enterprises, LLC. Individual owners and managers are not listed on this site.
When was Silver Tree Nursing and Rehabilitation Center last inspected?
The most recent survey or investigation in the CMS record is dated 12 Jun 2026; the most recent standard health survey was 12 Jun 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.