Government - Hospital district · 120 certified beds · CMS number 455941
Avir at Enchanted Rock, Fredericksburg, TX
CMS records 48 health deficiencies at Avir at Enchanted Rock in Fredericksburg, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on May 2, 2026. The highest severity cited is K (immediate jeopardy to resident health or safety). 5 citations were at the immediate jeopardy level. CMS lists 2 fines totaling $63,121 in the last three years.
- 48deficiencies, 3 cycles (TX median 25)
- 14in the latest cycle (TX median 8)
- Khighest severity · Immediate jeopardy
- $63,121fines, last 3 years
- 2CMS overall rating (of 5)
Inspections and deficiencies
CMS findings for Avir at Enchanted Rock as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and Avir at Enchanted Rock may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare
Most recent cycle (14 deficiencies)
Standard inspection May 2, 2026. CMS counts 14 health deficiencies and 6 fire safety deficiencies in this cycle.
Jun 22, 2026 · Complaint inspection
1 deficiency, highest D
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 24, 2026
May 13, 2026 · Complaint inspection
1 deficiency, highest D
F842 · Complete, confidential medical records
Requirement cited (CMS): Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 16, 2026
May 2, 2026 · Standard inspection
11 deficiencies, highest J
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 4, 2026
F842 · Complete, confidential medical records
Requirement cited (CMS): Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 4, 2026
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 4, 2026
F760 · No significant medication errors
Requirement cited (CMS): Ensure that residents are free from significant medication errors.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 4, 2026
F727 · RN coverage and director of nursing
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 4, 2026
F690 · Bladder, bowel, and catheter care
Requirement cited (CMS): Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 4, 2026
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date May 4, 2026
F684 · Quality of care
Requirement cited (CMS): Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 4, 2026
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 4, 2026
F610 · Investigating and responding to allegations
Requirement cited (CMS): Respond appropriately to all alleged violations.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 4, 2026
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 4, 2026
Jan 8, 2026 · Complaint inspection
1 deficiency, highest E
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jan 10, 2026
Previous cycle: 15 deficiencies (standard inspection Feb 12, 2025)
Standard inspection Feb 12, 2025. CMS counts 15 health deficiencies and 2 fire safety deficiencies in this cycle.
Jul 10, 2025 · Complaint inspection
3 deficiencies, highest D
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
F732 · Daily posting of nurse staffing
Requirement cited (CMS): Post nurse staffing information every day.
- Severity
- C No actual harm, potential for minimal harm, widespread
- Status
- Correction date Jul 11, 2025
F644 · Coordinating with PASARR screening
Requirement cited (CMS): Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
Feb 12, 2025 · Standard inspection
9 deficiencies, highest E
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 13, 2025
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 13, 2025
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 13, 2025
F655 · Baseline care plan within 48 hours
Requirement cited (CMS): Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 13, 2025
F641 · Accurate resident assessments
Requirement cited (CMS): Ensure each resident receives an accurate assessment.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 13, 2025
F610 · Investigating and responding to allegations
Requirement cited (CMS): Respond appropriately to all alleged violations.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 13, 2025
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 13, 2025
F578 · Refusing treatment and advance directives
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 13, 2025
F558 · Accommodating individual needs and preferences
Requirement cited (CMS): Reasonably accommodate the needs and preferences of each resident.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 13, 2025
Jan 19, 2025 · Complaint inspection
3 deficiencies, highest K
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- K Immediate jeopardy to resident health or safety, pattern
- Status
- Correction date Feb 9, 2025
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jan 20, 2025
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jan 20, 2025
Earlier cycle: 19 deficiencies (standard inspection Jan 13, 2024)
Standard inspection Jan 13, 2024. CMS counts 19 health deficiencies and 3 fire safety deficiencies in this cycle.
Jun 22, 2024 · Complaint inspection
1 deficiency, highest D
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 24, 2024
Jan 13, 2024 · Standard inspection
18 deficiencies, highest J
F919 · Working call system
Requirement cited (CMS): Make sure that a working call system is available in each resident's bathroom and bathing area.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 15, 2024
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 15, 2024
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 15, 2024
F803 · Menus that meet nutritional needs
Requirement cited (CMS): 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.
- Severity
- B No actual harm, potential for minimal harm, pattern
- Status
- Correction date Feb 15, 2024
F761 · Drug labeling and secure storage
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 15, 2024
F760 · No significant medication errors
Requirement cited (CMS): Ensure that residents are free from significant medication errors.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 15, 2024
F759 · Medication error rate under 5 percent
Requirement cited (CMS): Ensure medication error rates are not 5 percent or greater.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 15, 2024
F695 · Respiratory and oxygen care
Requirement cited (CMS): Provide safe and appropriate respiratory care for a resident when needed.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 15, 2024
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Feb 15, 2024
F686 · Pressure ulcer prevention and care
Requirement cited (CMS): Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 15, 2024
F657 · Care plan timing and team review
Requirement cited (CMS): Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 15, 2024
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 15, 2024
F610 · Investigating and responding to allegations
Requirement cited (CMS): Respond appropriately to all alleged violations.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Feb 15, 2024
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 15, 2024
F607 · Abuse prevention policies
Requirement cited (CMS): Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Feb 15, 2024
F585 · Grievances and how they are handled
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 15, 2024
F584 · Safe, clean, homelike surroundings
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Feb 15, 2024
F580 · Telling residents and families about changes
Requirement cited (CMS): Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 15, 2024
Tags cited in more than one inspection
9 tags cited on more than one inspection date at Avir at Enchanted Rock; each date counts once and does not mean the same incident. PNC = past non-compliance.
| Tag | Inspections | Dates |
|---|---|---|
| F609 Reporting suspected abuse and crimes | 4 | May 2, 2026; Feb 12, 2025; Jan 19, 2025; Jan 13, 2024 |
| F656 Comprehensive person-centered care plan | 4 | May 2, 2026; Feb 12, 2025; Jan 19, 2025; Jan 13, 2024 |
| F689 Accident prevention and supervision | 4 | May 2, 2026; Jan 19, 2025; Jun 22, 2024; Jan 13, 2024 |
| F880 Infection prevention and control program | 4 | May 2, 2026; Jan 8, 2026; Feb 12, 2025; Jan 13, 2024 |
| F610 Investigating and responding to allegations | 3 | May 2, 2026; Feb 12, 2025; Jan 13, 2024 |
| F755 Pharmacy services and a consultant pharmacist | 3 | Jun 22, 2026; Jul 10, 2025; Feb 12, 2025 |
| F760 No significant medication errors | 2 | May 2, 2026; Jan 13, 2024 |
| F812 Food safety and sanitation | 2 | May 2, 2026; Jan 13, 2024 |
| F842 Complete, confidential medical records | 2 | May 13, 2026; May 2, 2026 |
Fines and payment denials
| Date | Type | Amount / length |
|---|---|---|
| Jan 19, 2025 | Fine | $49,205 |
| Jan 13, 2024 | Fine | $13,916 |
Staffing and CMS ratings
- Total nurse staff hours per resident per day
- 3.44 h (above the Texas median of 3.27 h)
- RN hours per resident per day
- 0.47 h (above the Texas median of 0.38 h)
- Weekend nurse staff hours per resident per day
- 2.94 h
- Nursing staff turnover
- 78.9% (Texas median 52.1%)
- Administrators who left
- 1
- CMS overall rating
- 2 of 5
- Health inspection rating
- 2 of 5
- Staffing rating
- 2 of 5
- Quality measure rating
- 4 of 5
CMS figures for Avir at Enchanted Rock, copied as published; Texas medians are ours.
Facility details
- Address
- 210 West Windcrest St, Fredericksburg, TX 78624
- Phone
- (830) 637-7885
- County
- Gillespie
- Accepts
- Medicare and Medicaid
- Ownership
- Government - Hospital district
- Chain (CMS)
- Avir Health Group
- Certified beds
- 120
- Average residents per day
- 42.6
- In Medicare/Medicaid since
- Jul 26, 1991
- Inside a hospital
- No
- Continuing care retirement community
- No
- Resident and family council
- Resident
- Sprinklers in all required areas
- Yes
Questions to ask on a visit
Based on the tags cited most often here.
- Who at the home is responsible for reporting incidents to the state? (F609, cited 4 times)
- How are a resident's goals and preferences written into the care plan? (F656, cited 4 times)
- How does the home assess each resident's fall risk and plan to prevent falls? (F689, cited 4 times)
- How do staff track and report infections among residents? (F880, cited 4 times)
Other nursing homes in Fredericksburg and the same chain
- Avir at Fredericksburg
Fredericksburg · 48 deficiencies - Knopp Nursing & Rehab Center INC
Fredericksburg · 34 deficiencies - Knopp Healthcare and Rehab Center INC
Fredericksburg · 25 deficiencies - Avir at El Paso
El Paso · 93 deficiencies - Avir at Patriot
El Paso · 78 deficiencies - Avir at Cowhorn Creek
Texarkana · 68 deficiencies - Avir at Kerrville
Kerrville · 67 deficiencies
Source
CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.