nursing home in Fredericksburg, TX

Avir at Enchanted Rock

210 West Windcrest St, Fredericksburg, TX 78624 · (830) 637-7885

★★★★★2
Below average
CMS overall star rating
  • Health inspections★★★★★2
  • Staffing★★★★★2
  • Quality measures★★★★★4

Source: Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. We refresh our information from this source. About our data

Avir at Enchanted Rock at a glance

Avir at Enchanted Rock is a 120-bed government nursing home in Fredericksburg, Texas (Gillespie County).

CMS gives it 2 out of 5 stars on its overall star rating, worse than the Texas average of 2.7.

Residents receive about 3.4 hours of nursing care per day (0.5 of them from registered nurses), close to the state average of 3.4 hours.

Its most recent standard health inspection (May 2, 2026) found 13 health citations. The Texas average is 9.4.

Federal regulators fined it 2 times in the past three years, totaling $63,121.

Nursing staff turnover is 78.9% per year (state average 55.3%).

Facility details

Type
Nursing home
Ownership
Government - Hospital District
Beds
120
Certified for
Medicare and Medicaid
Chain / affiliated entity
Avir Health Group
Medicare-certified since
July 26, 1991
Resident/family council
Resident
County
Gillespie County
CMS Certification Number
455941

Ratings

MeasureThis facilityTexas avg.U.S. avg.vs. U.S.
Overall star rating ⓘ (higher is better)2 / 52.7 / 53 / 5Worse
Health inspection rating ⓘ (higher is better)2 / 52.8 / 52.8 / 5Worse
Staffing rating ⓘ (higher is better)2 / 51.9 / 52.9 / 5Worse
Quality measures rating ⓘ (higher is better)4 / 53.7 / 53.6 / 5Average
Long-stay quality rating (higher is better)5 / 54 / 53.8 / 5Better
Short-stay (rehab) quality rating (higher is better)2 / 53.2 / 53.3 / 5Worse

Staffing

This facility3.44 hrsTexas average3.39 hrsU.S. average3.86 hrs
Total nurse staff hours per resident per day: this facility vs. Texas and U.S. averages
MeasureThis facilityTexas avg.U.S. avg.vs. U.S.
Total nurse staff hours per resident per day ⓘ (higher is better)3.44 hrs3.39 hrs3.86 hrsWorse
Registered nurse hours per resident per day (higher is better)0.47 hrs0.43 hrs0.69 hrsWorse
Nurse aide hours per resident per day (higher is better)1.91 hrs2.01 hrs2.32 hrsWorse
Weekend nurse staff hours per resident per day (higher is better)2.94 hrs2.98 hrs3.42 hrsWorse
Nursing staff turnover (yearly) (lower is better)78.9%55.3%45.8%Worse
Registered nurse turnover (yearly) (lower is better)80%54.6%42.9%Worse
Administrators who left in the past year (lower is better)111Worse

Inspections

This facility13Texas average9U.S. average9
Health citations in the most recent inspection: this facility vs. Texas and U.S. averages
MeasureThis facilityTexas avg.U.S. avg.vs. U.S.
Health citations in the most recent inspection (lower is better)1399Worse
Citations from complaint investigations (latest cycle) (lower is better)343Worse
Weighted health inspection score ⓘ (lower is better)151.510280.6Worse

Penalties

This facility2Texas average1U.S. average1
Fines in the past 3 years: this facility vs. Texas and U.S. averages
MeasureThis facilityTexas avg.U.S. avg.vs. U.S.
Fines in the past 3 years (lower is better)211Worse
Total fines in the past 3 years (lower is better)$63,121$44,141$30,972Worse
All federal penalties in the past 3 years (lower is better)221Worse

Size

MeasureThis facilityTexas avg.U.S. avg.vs. U.S.
Certified beds120113107
Average residents per day437686
Occupancy35.5%67.6%80.9%

Long-stay residents

This facility5.4%Texas average3.3%U.S. average3.2%
Long-stay residents with a fall causing major injury: this facility vs. Texas and U.S. averages
MeasureThis facilityTexas avg.U.S. avg.vs. U.S.
Long-stay residents with a fall causing major injury (lower is better)5.4%3.3%3.2%Worse
Long-stay residents with pressure ulcers (lower is better)1.7%3.8%4.6%Better
Long-stay residents given antipsychotic medication (lower is better)4.6%9.6%15.4%Better
Long-stay residents with a urinary tract infection (lower is better)0.6%0.8%1.6%Better
Long-stay residents with a catheter left in the bladder (lower is better)0%0.3%0.8%Better
Long-stay residents needing more help with daily activities (lower is better)14.6%15.8%13.9%Worse
Long-stay residents whose walking worsened (lower is better)15.3%14%14.1%Worse
Long-stay residents who lose too much weight (lower is better)4.2%3%5.2%Better
Long-stay residents with depressive symptoms (lower is better)0.7%2.4%12.8%Better
Long-stay residents who were physically restrained (lower is better)0%0%0.1%Better
Long-stay residents given anti-anxiety or sleep medication (lower is better)24.5%18%19.5%Worse
Long-stay residents with new or worse incontinence (lower is better)13.1%13.4%19%Better
Long-stay residents given a flu vaccine (higher is better)100%98%95.5%Average
Long-stay residents given a pneumonia vaccine (higher is better)95.2%96.6%93.6%Average

Short-stay residents

This facility1.6%Texas average1.5%U.S. average1.6%
Short-stay residents newly given antipsychotic medication: this facility vs. Texas and U.S. averages
MeasureThis facilityTexas avg.U.S. avg.vs. U.S.
Short-stay residents newly given antipsychotic medication (lower is better)1.6%1.5%1.6%Average
Short-stay residents given a flu vaccine (higher is better)71.1%88%79.8%Worse
Short-stay residents given a pneumonia vaccine (higher is better)36.2%88.9%82%Worse

Inspection citations

State inspectors cited this home for 48 health deficiencies and 11 fire safety deficiencies in the inspection records CMS currently publishes. 5 citations involved actual harm, including 5 rated "immediate jeopardy".

DateCitationSeverityStatus
June 22, 2026
Complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies · Tag F0755
D
Potential harm, isolated
Corrected June 24, 2026
May 13, 2026
Complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · Tag F0842
D
Potential harm, isolated
Corrected May 16, 2026
May 2, 2026
Fire safety
Install proper backup exit lighting.
Egress Deficiencies · Tag K0281
E
Potential harm, pattern
Corrected May 4, 2026
May 2, 2026
Fire safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Egress Deficiencies · Tag K0211
E
Potential harm, pattern
Corrected May 4, 2026
May 2, 2026
Fire safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Smoke Deficiencies · Tag K0321
E
Potential harm, pattern
Corrected May 4, 2026
May 2, 2026
Fire safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Smoke Deficiencies · Tag K0372
E
Potential harm, pattern
Corrected May 4, 2026
May 2, 2026
Fire safety
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Smoke Deficiencies · Tag K0374
E
Potential harm, pattern
Corrected May 4, 2026
May 2, 2026
Fire safety
Have approved installation, maintenance and testing program for fire alarm systems.
Smoke Deficiencies · Tag K0345
D
Potential harm, isolated
Corrected May 4, 2026
May 2, 2026
Standard
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · Tag F0689
J
Immediate jeopardy, isolated
Corrected May 4, 2026
May 2, 2026
Standard
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · Tag F0684
E
Potential harm, pattern
Corrected May 4, 2026
May 2, 2026
Standard
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.
Nursing and Physician Services Deficiencies · Tag F0727
E
Potential harm, pattern
Corrected May 4, 2026
May 2, 2026
Standard
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · Tag F0656
E
Potential harm, pattern
Corrected May 4, 2026
May 2, 2026
Standard
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · Tag F0812
D
Potential harm, isolated
Corrected May 4, 2026
May 2, 2026
Standard
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Tag F0880
D
Potential harm, isolated
Corrected May 4, 2026
May 2, 2026
Standard
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · Tag F0842
D
Potential harm, isolated
Corrected May 4, 2026
May 2, 2026
Standard
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · Tag F0760
D
Potential harm, isolated
Corrected May 4, 2026
May 2, 2026
Standard
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies · Tag F0690
D
Potential harm, isolated
Corrected May 4, 2026
May 2, 2026
Standard
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610
D
Potential harm, isolated
Corrected May 4, 2026
May 2, 2026
Standard
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609
D
Potential harm, isolated
Corrected May 4, 2026
January 8, 2026
Complaint
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Tag F0880
E
Potential harm, pattern
Corrected January 10, 2026
July 10, 2025
Complaint
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies · Tag F0644
D
Potential harm, isolated
Corrected July 11, 2025
July 10, 2025
Complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies · Tag F0755
D
Potential harm, isolated
Corrected July 11, 2025
July 10, 2025
Complaint
Post nurse staffing information every day.
Nursing and Physician Services Deficiencies · Tag F0732
C
No harm, widespread
Corrected July 11, 2025
February 12, 2025
Fire safety
Install proper backup exit lighting.
Egress Deficiencies · Tag K0281
E
Potential harm, pattern
Corrected February 12, 2025
February 12, 2025
Fire safety
Have properly installed electrical wiring and gas equipment.
Services Deficiencies · Tag K0511
D
Potential harm, isolated
Corrected February 12, 2025
February 12, 2025
Standard
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning Deficiencies · Tag F0655
E
Potential harm, pattern
Corrected February 13, 2025
February 12, 2025
Standard
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610
D
Potential harm, isolated
Corrected February 13, 2025
February 12, 2025
Standard
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Tag F0880
D
Potential harm, isolated
Corrected February 13, 2025
February 12, 2025
Standard
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies · Tag F0755
D
Potential harm, isolated
Corrected February 13, 2025
February 12, 2025
Standard
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · Tag F0656
D
Potential harm, isolated
Corrected February 13, 2025
February 12, 2025
Standard
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.
Resident Rights Deficiencies · Tag F0578
D
Potential harm, isolated
Corrected February 13, 2025
February 12, 2025
Standard
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609
D
Potential harm, isolated
Corrected February 13, 2025
February 12, 2025
Standard
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · Tag F0641
D
Potential harm, isolated
Corrected February 13, 2025
February 12, 2025
Standard
Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies · Tag F0558
D
Potential harm, isolated
Corrected February 13, 2025
January 19, 2025
Complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · Tag F0689
K
Immediate jeopardy, pattern
Corrected February 9, 2025
January 19, 2025
Complaint
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · Tag F0656
E
Potential harm, pattern
Corrected January 20, 2025
January 19, 2025
Complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609
D
Potential harm, isolated
Corrected January 20, 2025
June 22, 2024
Complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · Tag F0689
D
Potential harm, isolated
Corrected June 24, 2024
January 13, 2024
Fire safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Egress Deficiencies · Tag K0211
D
Potential harm, isolated
Corrected February 15, 2024
January 13, 2024
Fire safety
Have properly installed electrical wiring and gas equipment.
Services Deficiencies · Tag K0511
D
Potential harm, isolated
Corrected February 15, 2024
January 13, 2024
Fire safety
Have properly located and lighted "Exit" signs.
Egress Deficiencies · Tag K0293
D
Potential harm, isolated
Corrected February 15, 2024
January 13, 2024
Standard
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0607
J
Immediate jeopardy, isolated
Corrected February 15, 2024
January 13, 2024
Standard
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610
J
Immediate jeopardy, isolated
Corrected February 15, 2024
January 13, 2024
Standard
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · Tag F0689
J
Immediate jeopardy, isolated
Corrected February 15, 2024
January 13, 2024
Standard
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies · Tag F0759
E
Potential harm, pattern
Corrected February 15, 2024
January 13, 2024
Standard
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · Tag F0812
E
Potential harm, pattern
Corrected February 15, 2024
January 13, 2024
Standard
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.
Pharmacy Service Deficiencies · Tag F0761
E
Potential harm, pattern
Corrected February 15, 2024
January 13, 2024
Standard
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · Tag F0760
E
Potential harm, pattern
Corrected February 15, 2024
January 13, 2024
Standard
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · Tag F0657
E
Potential harm, pattern
Corrected February 15, 2024
January 13, 2024
Standard
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · Tag F0656
E
Potential harm, pattern
Corrected February 15, 2024
January 13, 2024
Standard
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.
Resident Rights Deficiencies · Tag F0584
E
Potential harm, pattern
Corrected February 15, 2024
January 13, 2024
Standard
Make sure that a working call system is available in each resident's bathroom and bathing area.
Environmental Deficiencies · Tag F0919
E
Potential harm, pattern
Corrected February 15, 2024
January 13, 2024
Standard
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · Tag F0686
D
Potential harm, isolated
Corrected February 15, 2024
January 13, 2024
Standard
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · Tag F0695
D
Potential harm, isolated
Corrected February 15, 2024
January 13, 2024
Standard
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.
Resident Rights Deficiencies · Tag F0585
D
Potential harm, isolated
Corrected February 15, 2024
January 13, 2024
Standard
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609
D
Potential harm, isolated
Corrected February 15, 2024
January 13, 2024
Standard
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Tag F0880
D
Potential harm, isolated
Corrected February 15, 2024
January 13, 2024
Standard
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies · Tag F0580
D
Potential harm, isolated
Corrected February 15, 2024
January 13, 2024
Standard
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.
Nutrition and Dietary Deficiencies · Tag F0803
B
No harm, pattern
Corrected February 15, 2024

Severity letters follow the CMS scope-and-severity grid: A–C no actual harm with potential for minimal harm; D–F potential for more than minimal harm; G–I actual harm; J–L immediate jeopardy to resident health or safety. How to read inspection citations.

Fines and payment denials

CMS reports 2 federal penalties in the past three years, including $63,121 in fines.

DatePenaltyAmount / length
January 19, 2025Fine$49,205
January 13, 2024Fine$13,916

Owners and managers

Individuals and organizations reported to CMS as owning or operating this nursing home.

NameRoleShareSince
UVALDE COUNTY HOSPITAL DISTRICT
Organization
5% or greater direct ownership interest100%03/01/2025
WELLTOWER INC
Organization
5% or greater security interestNOT APPLICABLE03/01/2025
WELLTOWER NNN GROUP, LLC
Organization
5% or greater security interestNOT APPLICABLE03/01/2025
WELLTOWER OP, LLC
Organization
5% or greater security interestNOT APPLICABLE03/01/2025
HERREN, RICHARD
Individual
adp of the snfNOT APPLICABLE03/01/2025
PADILLA, ADRIAN
Individual
adp of the snfNOT APPLICABLE03/01/2025
WELLTOWER INC
Organization
adp of the snfNOT APPLICABLE03/01/2025
WELLTOWER NNN GROUP, LLC
Organization
adp of the snfNOT APPLICABLE03/01/2025
WELLTOWER OP, LLC
Organization
adp of the snfNOT APPLICABLE03/01/2025
APOLINAR, ADAM
Individual
corporate officerNOT APPLICABLE07/23/2015
DAGAN, AMITAI
Individual
individual is an owner, partner or trustee of any adp of the snfNOT APPLICABLE04/25/2025
GOLDBERGER, ABRAHAM
Individual
individual is an owner, partner or trustee of any adp of the snfNOT APPLICABLE04/25/2025
210 WEST WINDCREST STREET OPCO, LLC
Organization
operational/managerial controlNOT APPLICABLE03/01/2025
FREUND, NOCHUM
Individual
operational/managerial controlNOT APPLICABLE03/01/2025
PADILLA, ADRIAN
Individual
operational/managerial controlNOT APPLICABLE03/01/2025
TRAVITSKY, AARON
Individual
operational/managerial controlNOT APPLICABLE03/01/2025

Other nursing homes near Avir at Enchanted Rock

  1. Avir at Fredericksburg

    1117 S. Adams St., Fredericksburg, TX 78624 · under 1 mi

    For-profit · 90 beds · Part of Avir Health Group

    ★★★★★3Average
  2. Knopp Nursing & Rehab Center INC

    202 Billie Dr, Fredericksburg, TX 78624 · under 1 mi

    For-profit · 60 beds

    ★★★★★1Much below average
  3. Knopp Healthcare and Rehab Center INC

    1208 N Llano, Fredericksburg, TX 78624 · 1.9 mi

    For-profit · 119 beds

    ★★★★★3Average
  4. Avir at Comfort

    615 Faltin St., Comfort, TX 78013 · 20.2 mi

    For-profit · 76 beds · Part of Avir Health Group

    • CMS high performer
    ★★★★★5Much above average
  5. Hilltop Village Nursing and Rehabilitation

    1400 Hilltop Rd, Kerrville, TX 78028 · 20.9 mi

    For-profit · 150 beds · Part of Cross Healthcare Management

    ★★★★★2Below average
  6. Arbor View Nursing & Rehabilitation

    1213 Water St, Kerrville, TX 78028 · 21.7 mi

    For-profit · 179 beds

    • Special Focus candidate
    • Abuse citation
    ★★★★★1Much below average

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Frequently asked questions

What is Avir at Enchanted Rock's rating?

Avir at Enchanted Rock has 2 out of 5 stars on the CMS overall star rating. The average for Texas nursing homes is 2.7 stars.

How many inspection citations did Avir at Enchanted Rock receive?

Its most recent standard health inspection found 13 citations, compared with a Texas average of 9.4. Every citation is listed on this page with its severity.

Does Avir at Enchanted Rock accept Medicare and Medicaid?

CMS lists it as certified for: Medicare and Medicaid. Call the facility to confirm bed availability and whether it accepts your specific plan.

Who owns Avir at Enchanted Rock?

It is government - hospital district and part of Avir Health Group. The ownership section on this page lists the owners and managers reported to CMS.

Where is Avir at Enchanted Rock and how do I contact it?

Avir at Enchanted Rock is at 210 West Windcrest St, Fredericksburg, TX 78624. Phone: (830) 637-7885.

About this data

Ratings and measures come from the Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. They're based on state inspections, patient surveys and facility reports, and they describe the past. Facilities change, so visit in person and confirm details directly. About our data · Spotted an error? Let us know.