Government - Hospital district · 120 certified beds · CMS number 676121
Silver Tree Nursing and Rehabilitation Center, Schertz, TX
CMS records 60 health deficiencies at Silver Tree Nursing and Rehabilitation Center in Schertz, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Jun 12, 2026. The highest severity cited is J (immediate jeopardy to resident health or safety). 4 citations were at the immediate jeopardy level, 3 of them recorded as past non-compliance (fixed before the inspection). CMS lists 3 fines totaling $114,303 in the last three years.
- 60deficiencies, 3 cycles (TX median 25)
- 17in the latest cycle (TX median 8)
- Jhighest severity · Immediate jeopardy
- $114,303fines, last 3 years
- 2CMS overall rating (of 5)
Inspections and deficiencies
CMS findings for Silver Tree Nursing and Rehabilitation Center as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and Silver Tree Nursing and Rehabilitation Center may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare
Most recent cycle (17 deficiencies)
Standard inspection Jun 12, 2026. CMS counts 17 health deficiencies and 8 fire safety deficiencies in this cycle.
Jun 12, 2026 · Standard inspection
10 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 Jun 13, 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
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jun 13, 2026
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 Jun 13, 2026
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
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jun 13, 2026
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
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 13, 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 Jun 13, 2026
F645 · Pre-admission screening for mental disorder or intellectual disability
Requirement cited (CMS): PASARR screening for Mental disorders or Intellectual Disabilities
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 13, 2026
F641 · Accurate resident assessments
Requirement cited (CMS): Ensure each resident receives an accurate assessment.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jun 13, 2026
F640 · Submitting assessment data on time
Requirement cited (CMS): Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 13, 2026
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 Jun 13, 2026
Jan 28, 2026 · Complaint inspection
3 deficiencies, 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 Jan 29, 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
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jan 29, 2026
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 Jan 29, 2026
Dec 1, 2025 · Complaint inspection
1 deficiency, highest D
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 Dec 2, 2025
Oct 10, 2025 · Complaint inspection
3 deficiencies, highest J
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 Oct 11, 2025
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
- Past non-compliance (fixed before the inspection), Aug 29, 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 Oct 11, 2025
Previous cycle: 25 deficiencies (standard inspection Apr 18, 2025)
Standard inspection Apr 18, 2025. CMS counts 25 health deficiencies and 7 fire safety deficiencies in this cycle.
Apr 27, 2025 · Complaint inspection
2 deficiencies, highest J
F684 · Quality of care
Requirement cited (CMS): Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection), Apr 25, 2025
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
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Past non-compliance (fixed before the inspection), Apr 25, 2025
Apr 18, 2025 · Standard inspection
19 deficiencies, highest E
F949 · Behavioral health training
Requirement cited (CMS): Provide behavior health training consistent with the requirements and as determined by a facility assessment.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 19, 2025
F947 · Ongoing nurse aide training
Requirement cited (CMS): Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 19, 2025
F946 · Compliance and ethics training
Requirement cited (CMS): Provide training in compliance and ethics.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 19, 2025
F942 · Resident rights training for staff
Requirement cited (CMS): Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 19, 2025
F941 · Communication training for caregivers
Requirement cited (CMS): Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 19, 2025
F940 · Staff training program
Requirement cited (CMS): Develop, implement, and/or maintain an effective training program for all new and existing staff members.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 19, 2025
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 Apr 19, 2025
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 Apr 19, 2025
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 Apr 19, 2025
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 Apr 19, 2025
F694 · IV fluid administration
Requirement cited (CMS): Provide for the safe, appropriate administration of IV fluids for a resident when needed.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 19, 2025
F693 · Feeding tube use and care
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 19, 2025
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 Apr 19, 2025
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 Apr 19, 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 Apr 19, 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
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 19, 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 Apr 19, 2025
F583 · Personal privacy and confidential records
Requirement cited (CMS): Keep residents' personal and medical records private and confidential.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 19, 2025
F582 · Notice of covered and extra charges
Requirement cited (CMS): Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- Severity
- B No actual harm, potential for minimal harm, pattern
- Status
- Correction date Apr 19, 2025
Jan 17, 2025 · Complaint inspection
4 deficiencies, highest D
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 Jan 18, 2025
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
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jan 18, 2025
F602 · Protecting residents' money and belongings
Requirement cited (CMS): Protect each resident from the wrongful use of the resident's belongings or money.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Past non-compliance (fixed before the inspection), Aug 1, 2024
F600 · Freedom from abuse and neglect
Requirement cited (CMS): Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jan 18, 2025
Earlier cycle: 18 deficiencies (standard inspection Mar 7, 2024)
Standard inspection Mar 7, 2024. CMS counts 18 health deficiencies and 1 fire safety deficiency in this cycle.
Jun 14, 2024 · 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 Jun 15, 2024
Mar 7, 2024 · Standard + complaint inspection
12 deficiencies, highest F
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 Mar 8, 2024
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 Mar 8, 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
- F No actual harm, potential for more than minimal harm, widespread
- Status
- Correction date Mar 8, 2024
F805 · Food prepared for individual needs
Requirement cited (CMS): Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 8, 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
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 8, 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 Mar 8, 2024
F693 · Feeding tube use and care
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 8, 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
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 8, 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 Mar 8, 2024
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 Mar 8, 2024
F638 · Quarterly assessment reviews
Requirement cited (CMS): Assure that each resident’s assessment is updated at least once every 3 months.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 8, 2024
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 Mar 8, 2024
Feb 1, 2024 · Complaint inspection
1 deficiency, highest D
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 2, 2024
Dec 22, 2023 · Complaint inspection
4 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 Dec 23, 2023
- Found in
- infection control inspection
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
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Dec 23, 2023
- Found in
- infection control inspection
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 Dec 23, 2023
- Found in
- infection control inspection
F686 · Pressure ulcer prevention and care
Requirement cited (CMS): Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Jan 31, 2024
- Found in
- infection control inspection
Tags cited in more than one inspection
11 tags cited on more than one inspection date at Silver Tree Nursing and Rehabilitation Center; each date counts once and does not mean the same incident. PNC = past non-compliance.
| Tag | Inspections | Dates |
|---|---|---|
| F656 Comprehensive person-centered care plan | 6 | Jun 12, 2026; Jan 28, 2026; Dec 1, 2025; Oct 10, 2025; Apr 18, 2025; Mar 7, 2024 |
| F842 Complete, confidential medical records | 6 | Jun 12, 2026; Jan 28, 2026; Oct 10, 2025; Jun 14, 2024; Mar 7, 2024; Dec 22, 2023 |
| F880 Infection prevention and control program | 6 | Jun 12, 2026; Apr 18, 2025; Jan 17, 2025; Mar 7, 2024; Feb 1, 2024; Dec 22, 2023 |
| F641 Accurate resident assessments | 4 | Jun 12, 2026; Jan 28, 2026; Apr 18, 2025; Mar 7, 2024 |
| F761 Drug labeling and secure storage | 4 | Jun 12, 2026; Apr 18, 2025; Jan 17, 2025; Mar 7, 2024 |
| F695 Respiratory and oxygen care | 3 | Apr 18, 2025; Mar 7, 2024; Dec 22, 2023 |
| F558 Accommodating individual needs and preferences | 2 | Jun 12, 2026; Mar 7, 2024 |
| F657 Care plan timing and team review | 2 | Jun 12, 2026; Mar 7, 2024 |
| F689 Accident prevention and supervision | 2 | Oct 10, 2025 (PNC); Apr 18, 2025 |
| F693 Feeding tube use and care | 2 | Apr 18, 2025; Mar 7, 2024 |
| F812 Food safety and sanitation | 2 | Apr 18, 2025; Mar 7, 2024 |
Fines and payment denials
| Date | Type | Amount / length |
|---|---|---|
| Oct 10, 2025 | Fine | $16,471 |
| Apr 27, 2025 | Fine | $15,156 |
| Dec 22, 2023 | Fine | $82,676 |
Staffing and CMS ratings
- Total nurse staff hours per resident per day
- 3.26 h (about the same as the Texas median of 3.27 h)
- RN hours per resident per day
- 0.53 h (above the Texas median of 0.38 h)
- Weekend nurse staff hours per resident per day
- 3.02 h
- Nursing staff turnover
- 93.3% (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 Silver Tree Nursing and Rehabilitation Center, copied as published; Texas medians are ours.
Facility details
- Address
- 930 Roy Richard Dr, Schertz, TX 78154
- Phone
- (210) 566-9100
- County
- Guadalupe
- Accepts
- Medicare and Medicaid
- Ownership
- Government - Hospital district
- Chain (CMS)
- Creative Solutions in Healthcare
- Certified beds
- 120
- Average residents per day
- 97.2
- In Medicare/Medicaid since
- Nov 21, 2006
- 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.
- How are a resident's goals and preferences written into the care plan? (F656, cited 6 times)
- Does the home use electronic health records, and can families get access through a portal? (F842, cited 6 times)
- How do staff track and report infections among residents? (F880, cited 6 times)
- How does the home check that resident assessments match what staff actually observe? (F641, cited 4 times)
Other nursing homes in Schertz and the same chain
- Avir at Schertz
Schertz · 65 deficiencies - Franklin Heights Nursing & Rehabilitation
El Paso · 76 deficiencies - St. Teresa Nursing & Rehab Center
El Paso · 75 deficiencies - Mountain View Health & Rehabilitation
El Paso · 72 deficiencies - Pleasant Springs Healthcare Center
Mount Pleasant · 66 deficiencies
Source
CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.