Texas ›Fredericksburg

Avir at Fredericksburg

1117 S. Adams St., Fredericksburg, TX 78624 · Gillespie County · 90 certified beds · avg 49 residents/day · certified since Aug 12, 1993

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

2/5
Health inspection rating (on-site)
2
Serious findings on record
$23,520
Fines, last 3 years
3.42
Nurse hours/resident/day (adjusted)

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

Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 3/5

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 self-reported quality measures.

Most serious findings (actual harm or immediate jeopardy)

▲ Immediate jeopardy, one-off · May 27, 2026 · F-0760 · triggered by a complaint

The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication.

Why it matters: A serious medication error can cause real harm, hospitalization, or worse.

Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.

▲ Immediate jeopardy, one-off · Mar 26, 2023 · F-0684

The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.

Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.

Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.

Corrected: Apr 14, 2023 (Deficient, Provider has date of correction)

All citations in the current public record (48)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

DateSeverityWhat the facility was cited for
Jun 26, 2026D · Potential for harm, one-offThe facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint
May 27, 2026▲ J · Immediate jeopardy, one-offThe facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint
Dec 4, 2025D · Potential for harm, one-offThe 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
Jun 20, 2025E · Potential for harm, repeatedThe facility used physical restraints — devices that limit a resident's movement — when they weren't needed for medical treatment.
Jun 20, 2025E · Potential for harm, repeatedThe 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
Jun 20, 2025E · Potential for harm, repeatedThe facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service. · from a complaint
Jun 20, 2025E · Potential for harm, repeatedThe facility did not serve meals and snacks at times that fit residents' needs, preferences, and requests, or did not offer nourishing alternatives for residents who want to eat outside scheduled meal times.
Jun 20, 2025E · Potential for harm, repeatedThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Jun 20, 2025E · Potential for harm, repeatedThe 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.
Jun 20, 2025D · Potential for harm, one-offThe facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand.
Jun 20, 2025D · Potential for harm, one-offThe facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · from a complaint
Jun 20, 2025D · Potential for harm, one-offThe 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.
Jun 20, 2025D · Potential for harm, one-offThe 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. · from a complaint
Jun 20, 2025D · Potential for harm, one-offThe facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident.
Jun 20, 2025D · Potential for harm, one-offThe 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. · from a complaint
Jun 20, 2025D · Potential for harm, one-offThe facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Jun 20, 2025B · Minimal risk, repeatedThe facility had resident rooms smaller than required — at least 80 square feet per person in shared rooms and 100 square feet in single rooms.
May 17, 2024E · Potential for harm, repeatedThe facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights.
May 17, 2024E · Potential for harm, repeatedThe 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.
May 17, 2024E · Potential for harm, repeatedThe 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.
May 17, 2024E · Potential for harm, repeatedThe facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident.
May 17, 2024E · Potential for harm, repeatedThe 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.
May 17, 2024E · Potential for harm, repeatedThe facility did not provide food that accounts for each resident's allergies, intolerances, and personal preferences, or did not offer appealing alternatives.
May 17, 2024E · Potential for harm, repeatedThe facility did not serve meals and snacks at times that fit residents' needs, preferences, and requests, or did not offer nourishing alternatives for residents who want to eat outside scheduled meal times.
May 17, 2024E · Potential for harm, repeatedThe facility did not dispose of garbage and refuse properly.
May 17, 2024E · Potential for harm, repeatedThe 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.
May 17, 2024E · Potential for harm, repeatedThe facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices.
May 17, 2024D · Potential for harm, one-offThe facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
May 17, 2024D · Potential for harm, one-offWhen a resident had a planned discharge, the facility did not make sure the necessary information was communicated to the resident and to the doctors or facility taking over their care.
May 17, 2024D · Potential for harm, one-offThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
May 17, 2024D · Potential for harm, one-offThe 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.
May 17, 2024D · Potential for harm, one-offThe 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.
May 17, 2024D · Potential for harm, one-offThe facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication.
May 17, 2024D · Potential for harm, one-offThe facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service.
May 17, 2024D · Potential for harm, one-offThe facility did not prepare and serve food in a form that meets each resident's individual needs — for example, chopped, pureed, or softened food for residents with chewing or swallowing problems.
May 17, 2024B · Minimal risk, repeatedThe facility had resident rooms smaller than required — at least 80 square feet per person in shared rooms and 100 square feet in single rooms.
Mar 7, 2024D · Potential for harm, one-offThe 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
Mar 26, 2023▲ J · Immediate jeopardy, one-offThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Mar 26, 2023E · Potential for harm, repeatedThe 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.
Mar 26, 2023E · Potential for harm, repeatedThe 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.
Mar 26, 2023E · Potential for harm, repeatedThe facility did not provide the social services residents need — such as counseling, help with adjustment, or connecting to outside resources — to achieve the best possible quality of life.
Mar 26, 2023E · Potential for harm, repeatedThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards.
Mar 26, 2023E · Potential for harm, repeatedThe facility did not develop, carry out, or maintain an effective training program for all new and existing staff members.
Mar 26, 2023D · Potential for harm, one-offThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation.
Mar 26, 2023D · Potential for harm, one-offThe facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
Mar 26, 2023D · Potential for harm, one-offThe facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service.
Mar 26, 2023D · Potential for harm, one-offThe facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Mar 26, 2023B · Minimal risk, repeatedThe facility had resident rooms smaller than required — at least 80 square feet per person in shared rooms and 100 square feet in single rooms.

Inspection trend by year

Citations from standard inspections decreased between the last two inspection cycles (19 → 14).

YearCitationsSerious (G–L)Worst severity that year
2023111J ▲
2024200E
2025150E
202621J ▲

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)

1 fine totaling $23,520.

DateTypeAmount / length
May 27, 2026Fine$23,520

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

MeasureThis facilityTexas avgU.S. avgWhere it stands
Total nurse staffing (hours per resident per day)3.423.463.95top 41% in Texas; bottom 32% in the U.S.
Registered Nurse hours0.540.440.69top 22% in Texas; bottom 43% in the U.S.
Weekend total nurse staffing3.073.043.50top 37% in Texas; bottom 34% in the U.S.
Weekend RN hours (not acuity-adjusted)0.430.340.48top 22% in Texas; top 43% in the U.S.
Total nursing staff turnover (%)87.855.345.8bottom 11% in Texas; bottom 1% in the U.S.
RN turnover (%)77.854.642.9bottom 22% in Texas; bottom 7% in the U.S.

Hours are per resident per day, 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 2.86, RN 0.45, weekend 2.57. Staffing rating: 2/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

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

Who owns this facility

For profit - Corporation

Owner / managerTypeRoleStakeSince
Val Verde County Hospital DistrictOrganization5% or Greater Direct Ownership Interest100%11/01/2020
1117 S Adams Street Opco, LLCOrganizationOperational/Managerial ControlNOT APPLICABLE03/01/2025
1117 S Adams Street Property Owner, LLCOrganizationADP of the SNFNOT APPLICABLE03/01/2025
Dagan, AmitaiIndividualIndividual Is an Owner, Partner or Trustee of Any ADP of the SNFNOT APPLICABLE04/16/2025
Dennis, WandaIndividualADP of the SNFNOT APPLICABLE03/01/2025
Freund, NochumIndividualOperational/Managerial ControlNOT APPLICABLE03/01/2025
Goldberger, AbrahamIndividualIndividual Is an Owner, Partner or Trustee of Any ADP of the SNFNOT APPLICABLE04/16/2025
Jurado, JorgeIndividualCorporate OfficerNOT APPLICABLE06/01/2022
Kothmann, JohnIndividualOperational/Managerial ControlNOT APPLICABLE03/01/2025
Kothmann, JohnIndividualADP of the SNFNOT APPLICABLE04/16/2025
Travitsky, AaronIndividualOperational/Managerial ControlNOT APPLICABLE03/01/2025
Welltower INCOrganizationADP of the SNFNOT APPLICABLE03/01/2025
Welltower NNN Group, LLCOrganizationADP of the SNFNOT APPLICABLE03/01/2025
Welltower Op, LLCOrganizationADP of the SNFNOT APPLICABLE03/01/2025

Questions to ask on your visit

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

Nearby facilities (within 20 miles)

FacilityDistanceCityOverallInspectionFlags
Avir at Enchanted Rock0.3 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

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Facility data as of CMS processing date 2026-08-01. CCN 675169.