Texas ›Fredericksburg

Avir at Enchanted Rock

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210 West Windcrest St, Fredericksburg, TX 78624 (opens Google Maps) · Gillespie County · (830) 637-7885· 120 certified beds · avg 43 residents/day · certified since Jul 26, 1991 · Medicare and Medicaid certified

Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →

Part of chain: AVIR HEALTH GROUP (116 facilities, chain avg rating 2.3★)

2/5
Health inspection rating (on-site)
inspected May 2, 2026
5
Serious findings on record
most recent May 2, 2026
$63,121
Fines, last 3 years
3.67
Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

New to these records? How to read an inspection report →

Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5 · how star ratings work →

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and quality measures from resident assessments and claims.

Most serious findings (actual harm or immediate jeopardy)

▲ Immediate jeopardy, isolated · May 2, 2026 · F-0689

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: May 4, 2026 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, pattern · Jan 19, 2025 · F-0689 · triggered by a complaint

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (K): Immediate jeopardy to resident health or safety was cited. The scope was a pattern: more than a limited occurrence, without being widespread. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Feb 9, 2025 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, isolated · Jan 13, 2024 · F-0607

The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection.

Why it matters: Without working prevention policies, mistreatment is more likely to happen and less likely to be caught.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Feb 15, 2024 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, isolated · Jan 13, 2024 · F-0610

The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do.

Why it matters: When allegations aren't investigated, harm to residents can continue unchecked.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Feb 15, 2024 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, isolated · Jan 13, 2024 · F-0689

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Feb 15, 2024 (Deficient, Provider has date of correction)

Inspection findings in the public record

Showing the latest 3 of 48 inspection findings. Open the full record below to read every finding.

  1. D · Potential for more than minimal harm, isolated

    The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint F-0755

  2. D · Potential for more than minimal harm, isolated

    The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint F-0842

  3. J · Immediate jeopardy, isolated

    The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. F-0689

View all 48 inspection findingsShow only the latest 3 findings

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.

DateSeverityWhat the facility was cited for
Jun 22, 2026D · Potential for more than minimal harm, isolatedThe facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint · F-0755
May 13, 2026D · Potential for more than minimal harm, isolatedThe facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint · F-0842
May 2, 2026▲ J · Immediate jeopardy, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
May 2, 2026E · Potential for more than minimal harm, patternThe facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · F-0656
May 2, 2026E · Potential for more than minimal harm, patternThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684
May 2, 2026E · Potential for more than minimal harm, patternThe facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. · F-0727
May 2, 2026D · Potential for more than minimal harm, isolatedThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · F-0609
May 2, 2026D · Potential for more than minimal harm, isolatedThe facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · F-0610
May 2, 2026D · Potential for more than minimal harm, isolatedThe facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. · F-0690
May 2, 2026D · Potential for more than minimal harm, isolatedThe facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · F-0760
May 2, 2026D · Potential for more than minimal harm, isolatedThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
May 2, 2026D · Potential for more than minimal harm, isolatedThe facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · F-0842
May 2, 2026D · Potential for more than minimal harm, isolatedThe facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
Jan 8, 2026E · Potential for more than minimal harm, patternThe facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · from a complaint · F-0880
Jul 10, 2025D · Potential for more than minimal harm, isolatedThe facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. · from a complaint · F-0644
Jul 10, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint · F-0755
Jul 10, 2025C · Potential for minimal harm, widespreadThe facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. · from a complaint · F-0732
Feb 12, 2025E · Potential for more than minimal harm, patternThe facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable. · F-0655
Feb 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. · F-0558
Feb 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. · F-0578
Feb 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · F-0609
Feb 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · F-0610
Feb 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641
Feb 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · F-0656
Feb 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · F-0755
Feb 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
Jan 19, 2025▲ K · Immediate jeopardy, patternThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Jan 19, 2025E · Potential for more than minimal harm, patternThe facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · from a complaint · F-0656
Jan 19, 2025D · Potential for more than minimal harm, isolatedThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609
Jun 22, 2024D · Potential for more than minimal harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Jan 13, 2024▲ J · Immediate jeopardy, isolatedThe facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · F-0607
Jan 13, 2024▲ J · Immediate jeopardy, isolatedThe facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · F-0610
Jan 13, 2024▲ J · Immediate jeopardy, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Jan 13, 2024E · Potential for more than minimal harm, patternThe facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584
Jan 13, 2024E · Potential for more than minimal harm, patternThe facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · F-0656
Jan 13, 2024E · Potential for more than minimal harm, patternThe facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · F-0657
Jan 13, 2024E · Potential for more than minimal harm, patternThe facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. · F-0759
Jan 13, 2024E · Potential for more than minimal harm, patternThe facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · F-0760
Jan 13, 2024E · Potential for more than minimal harm, patternThe facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · F-0761
Jan 13, 2024E · Potential for more than minimal harm, patternThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Jan 13, 2024E · Potential for more than minimal harm, patternThe facility did not have a working call system — the button or cord residents use to summon help — in each resident's bathroom and bathing area. · F-0919
Jan 13, 2024D · Potential for more than minimal harm, isolatedThe facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · F-0580
Jan 13, 2024D · Potential for more than minimal harm, isolatedThe facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly. · F-0585
Jan 13, 2024D · Potential for more than minimal harm, isolatedThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · F-0609
Jan 13, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · F-0686
Jan 13, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. · F-0695
Jan 13, 2024D · Potential for more than minimal harm, isolatedThe facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
Jan 13, 2024B · Potential for minimal harm, patternThe facility's menus did not meet residents' nutritional needs, or were not prepared in advance, followed as written, kept up to date, or reviewed by a dietician. · F-0803

Inspection trend by year

Citations from standard inspections stayed about the same across the last two inspection cycles (9 → 11).

Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2024
All citations: 19
Serious citations (G–L): 3
2025
All citations: 15
Serious citations (G–L): 1
2026
All citations: 14
Serious citations (G–L): 1

All bars start at zero. Exact values and supporting details remain below.

YearCitationsSerious (G–L)Worst severity that year
2024193J ▲
2025151K ▲
2026141J ▲

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

How to file a complaint about care →

2 fines totaling $63,121.

Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.

DateTypeAmount / length
Jan 19, 2025Fine$49,205
Jan 13, 2024Fine$13,916

Nurse staffing (from payroll records, adjusted for how much care residents need)

What these staffing numbers mean →

Nurse time, in contextAdjusted hours per resident per day · Source: CMS, 2026-08-01
This facilityTexas averageU.S. average
Total nurse staffing (hours per resident per day)
This facility: 3.67
Texas average: 3.46
U.S. average: 3.95
Registered Nurse hours
This facility: 0.50
Texas average: 0.44
U.S. average: 0.69
Weekend total nurse staffing
This facility: 3.14
Texas average: 3.04
U.S. average: 3.50

All bars start at zero. Exact values and supporting details remain below.

MeasureThis facilityTexas avgU.S. avgWhere it stands
Total nurse staffing (hours per resident per day)3.673.463.95top 26% in Texas; bottom 45% in the U.S.
Registered Nurse hours0.500.440.69top 25% in Texas; bottom 38% in the U.S.
Weekend total nurse staffing3.143.043.50top 32% in Texas; bottom 39% in the U.S.
Weekend RN hours (not acuity-adjusted)0.370.340.48top 31% in Texas; bottom 46% in the U.S.
Total nursing staff turnover (%)78.955.345.8bottom 14% in Texas; bottom 2% in the U.S.
RN turnover (%)80.054.642.9bottom 21% in Texas; bottom 6% in the U.S.

Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.44, RN 0.47, weekend 2.94.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.44 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 2/5.

Quality measures: assessments & claims

Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.

Quality measures rating: 4/5 · long-stay residents: 5/5 · short-stay residents: 2/5

Costs & payment

Price evidence · separate from quality

No verified facility-specific private-pay price is available in our data for Avir at Enchanted Rock. CMS inspection and staffing records do not tell us what this home will charge you.

Calculate a stay from a quote you receive

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Understand who pays for care · How we handle price evidence · Report an incorrect price

Who owns this facility

How to read ownership records →

Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →

Government - Hospital district

Owner / managerTypeRoleStakeSince
Uvalde County Hospital DistrictOrganization5% or Greater Direct Ownership Interest100%03/01/2025
210 West Windcrest Street Opco, LLCOrganizationOperational/Managerial ControlNOT APPLICABLE03/01/2025
Apolinar, AdamIndividualCorporate OfficerNOT APPLICABLE07/23/2015
Dagan, AmitaiIndividualIndividual Is an Owner, Partner or Trustee of Any ADP of the SNFNOT APPLICABLE04/25/2025
Freund, NochumIndividualOperational/Managerial ControlNOT APPLICABLE03/01/2025
Goldberger, AbrahamIndividualIndividual Is an Owner, Partner or Trustee of Any ADP of the SNFNOT APPLICABLE04/25/2025
Herren, RichardIndividualADP of the SNFNOT APPLICABLE03/01/2025
Padilla, AdrianIndividualOperational/Managerial ControlNOT APPLICABLE03/01/2025
Padilla, AdrianIndividualADP of the SNFNOT APPLICABLE03/01/2025
Travitsky, AaronIndividualOperational/Managerial ControlNOT APPLICABLE03/01/2025
Welltower INCOrganization5% or Greater Security InterestNOT APPLICABLE03/01/2025
Welltower INCOrganizationADP of the SNFNOT APPLICABLE03/01/2025
Welltower NNN Group, LLCOrganization5% or Greater Security InterestNOT APPLICABLE03/01/2025
Welltower NNN Group, LLCOrganizationADP of the SNFNOT APPLICABLE03/01/2025
Welltower Op, LLCOrganization5% or Greater Security InterestNOT APPLICABLE03/01/2025
Welltower Op, LLCOrganizationADP of the SNFNOT APPLICABLE03/01/2025

All 16 owning or managing parties CMS has on file are shown — none excluded.

Other facilities in the same chain

CMS lists this facility under the chain Avir Health Group — 116 facilities in the current records. Chain membership says who operates these homes. It says nothing about how any individual one of them was inspected; each has its own record.

Listed by state, then facility name — not a ranking. Showing 8 of the 115 others, continuing from this facility's own place in that list.

Questions to ask on your visit

Full visit checklist →

Print visit checklist

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

  • "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
  • "What specific steps do you take to prevent abuse and neglect, and how are staff trained on them?"
  • "If someone reports suspected abuse or neglect here, what happens in the first 24 hours?"
  • "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
  • "How do you keep residents' medical records accurate, complete, and secure?"
  • "Can you show me an example care plan, and how are families included when it's created and updated?"
  • "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
  • "How many hours a day is a registered nurse physically in the building, including weekends?"

Also worth asking anywhere

  • "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
  • "Can I see the plan of correction for the findings in your most recent state inspection?"
  • "CMS reports 79% total nursing staff turnover here — who on the care team has been with you longest?"
  • "The ownership record on file lists 16 owning or managing parties — who makes the decisions about staffing levels?"
  • "Can I visit again unannounced, at a mealtime or on a weekend?"

Nearby facilities (within 20 miles)

FacilityDistanceCityOverallInspectionFlags
Avir at Fredericksburg0.3 miFredericksburg, TX★★★☆☆2/5
Knopp Nursing & Rehab Center INC0.5 miFredericksburg, TX★☆☆☆☆2/5
Knopp Healthcare and Rehab Center INC1.9 miFredericksburg, TX★★★☆☆4/5

Compare this facility with the 3 closest →

All facilities in Fredericksburg →

Facility data as of CMS processing date 2026-08-01. CCN 455941.

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