1900 Medical Parkway, San Marcos, TX 78666 (opens Google Maps) · Hays County · (512) 396-1888· 116 certified beds · avg 93 residents/day · certified since Oct 1, 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: THE ENSIGN GROUP (342 facilities, chain avg rating 3.2★)
New to these records? How to read an inspection report →
Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 3/5 · 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.
▲ Immediate jeopardy, isolated · May 2, 2024 · F-0600 · triggered by a complaint
The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors.
Why it matters: Abuse and neglect cause direct physical and emotional harm and are among the most serious failures a nursing home can have.
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 3, 2024 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, isolated · May 2, 2024 · F-0607 · triggered by a complaint
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: May 3, 2024 (Deficient, Provider has date of correction)
Showing the latest 3 of 26 inspection findings. Open the full record below to read every finding.
The 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
The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. F-0584
The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. F-0677
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.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Mar 5, 2026 | E · Potential for more than minimal harm, pattern | The 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 |
| Mar 5, 2026 | E · Potential for more than minimal harm, pattern | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584 |
| Mar 5, 2026 | E · Potential for more than minimal harm, pattern | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · F-0677 |
| Mar 5, 2026 | E · Potential for more than minimal harm, pattern | The 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 |
| Mar 5, 2026 | E · Potential for more than minimal harm, pattern | The 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 |
| Mar 5, 2026 | D · Potential for more than minimal harm, isolated | The facility did not provide special eating equipment and utensils — like adaptive cups or easy-grip silverware — for residents who need them, along with appropriate help at meals. · F-0810 |
| Jan 16, 2025 | E · Potential for more than minimal harm, pattern | The 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. · F-0550 |
| Jan 16, 2025 | E · Potential for more than minimal harm, pattern | The facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle. · F-0679 |
| Jan 16, 2025 | E · Potential for more than minimal harm, pattern | The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems. · F-0756 |
| Jan 16, 2025 | E · Potential for more than minimal harm, pattern | The 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 16, 2025 | D · Potential for more than minimal harm, isolated | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584 |
| Jan 16, 2025 | D · Potential for more than minimal harm, isolated | The 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 |
| Jul 9, 2024 | E · Potential for more than minimal harm, pattern | The 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 9, 2024 | D · Potential for more than minimal harm, isolated | The 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 |
| May 2, 2024 | ▲ J · Immediate jeopardy, isolated | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint · F-0600 |
| May 2, 2024 | ▲ J · Immediate jeopardy, isolated | 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. · from a complaint · F-0607 |
| May 2, 2024 | D · Potential for more than minimal harm, isolated | The 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 |
| Dec 14, 2023 | F · Potential for more than minimal harm, widespread | The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices. · F-0908 |
| Dec 14, 2023 | E · Potential for more than minimal harm, pattern | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584 |
| Dec 14, 2023 | E · Potential for more than minimal harm, pattern | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689 |
| Dec 14, 2023 | D · Potential for more than minimal harm, isolated | The facility did not provide activities that meet residents' needs and interests. Nursing homes must offer meaningful activity programs, not just leave residents idle. · F-0679 |
| Dec 14, 2023 | D · Potential for more than minimal harm, isolated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684 |
| Dec 14, 2023 | D · Potential for more than minimal harm, isolated | The 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 |
| Dec 14, 2023 | D · Potential for more than minimal harm, isolated | The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. · F-0692 |
| Nov 20, 2023 | E · Potential for more than minimal harm, pattern | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint · F-0677 |
| Sep 23, 2023 | D · Potential for more than minimal harm, isolated | The 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 · F-0761 |
Citations from standard inspections stayed about the same across the last two inspection cycles (6 → 6).
All bars start at zero. Exact values and supporting details remain below.
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 9 | 0 | F |
| 2024 | 5 | 2 | J ▲ |
| 2025 | 6 | 0 | E |
| 2026 | 6 | 0 | E |
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.
How to file a complaint about care →
1 fine totaling $8,226.
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.
| Date | Type | Amount / length |
|---|---|---|
| May 2, 2024 | Fine | $8,226 |
What these staffing numbers mean →
All bars start at zero. Exact values and supporting details remain below.
| Measure | This facility | Texas avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.63 | 3.46 | 3.95 | top 28% in Texas; bottom 43% in the U.S. |
| Registered Nurse hours | 0.51 | 0.44 | 0.69 | top 25% in Texas; bottom 39% in the U.S. |
| Weekend total nurse staffing | 3.01 | 3.04 | 3.50 | top 40% in Texas; bottom 32% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.22 | 0.34 | 0.48 | bottom 27% in Texas; bottom 15% in the U.S. |
| Total nursing staff turnover (%) | 37.9 | 55.3 | 45.8 | top 16% in Texas; top 31% in the U.S. |
| RN turnover (%) | 22.2 | 54.6 | 42.9 | top 10% in Texas; top 17% 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 3.27, RN 0.46, weekend 2.72.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.27 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 3/5.
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: 4/5 · short-stay residents: 4/5
Price evidence · separate from quality
No verified facility-specific private-pay price is available in our data for Hays Nursing and Rehabilitation Center. CMS inspection and staffing records do not tell us what this home will charge you.
Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.
Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.
Understand who pays for care · How we handle price evidence · Report an incorrect price
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 →
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Guadalupe County Hospital Board | Organization | 5% or Greater Direct Ownership Interest | 100% | 12/01/2020 |
| Burnam, Soon | Individual | Corporate Officer | NOT APPLICABLE | 12/01/2020 |
| Chudleigh, James | Individual | Managing Control - Governing Body | NOT APPLICABLE | 02/01/2024 |
| Chudleigh, James | Individual | Operational/Managerial Control | NOT APPLICABLE | 02/01/2024 |
| Chudleigh, James | Individual | ADP of the SNF | NOT APPLICABLE | 02/01/2024 |
| Ensign Services INC | Organization | ADP of the SNF | NOT APPLICABLE | 10/13/2020 |
| Gann, Kody | Individual | Corporate Officer | NOT APPLICABLE | 04/03/2021 |
| Keetch, Chad | Individual | Corporate Officer | NOT APPLICABLE | 03/01/2011 |
| Phelps, Nelson | Individual | Managing Control - Governing Body | NOT APPLICABLE | 12/01/2020 |
| Phelps, Nelson | Individual | Operational/Managerial Control | NOT APPLICABLE | 12/01/2020 |
| Phelps, Nelson | Individual | ADP of the SNF | NOT APPLICABLE | 12/01/2020 |
| San Marcos TX Propco LLC | Organization | ADP of the SNF | NOT APPLICABLE | 12/01/2020 |
| Willow Springs Creek Healthcare, INC. | Organization | Operational/Managerial Control | NOT APPLICABLE | 12/01/2020 |
| Willow Springs Creek Healthcare, INC. | Organization | ADP of the SNF | NOT APPLICABLE | 11/25/2025 |
All 14 owning or managing parties CMS has on file are shown — none excluded.
CMS lists this facility under the chain The Ensign Group — 342 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 341 others, continuing from this facility's own place in that list.
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Cypress Healthcare and Rehabilitation Center | 0.6 mi | San Marcos, TX | ★☆☆☆☆ | 1/5 | |
| San Marcos Rehabilitation and Healthcare Center | 1.9 mi | San Marcos, TX | ★☆☆☆☆ | 1/5 | |
| Legend Oaks Healthcare and Rehabilitation - New Br | 11.6 mi | New Braunfels, TX | ★★★☆☆ | 3/5 | |
| Legend Oaks Healthcare and Rehabilitation-Kyle | 12.0 mi | Kyle, TX | ★★★☆☆ | 3/5 | |
| Sundance Inn Health Center | 12.2 mi | New Braunfels, TX | ★★☆☆☆ | 2/5 | abuse |
| Avir at New Braunfels | 12.3 mi | New Braunfels, TX | ★☆☆☆☆ | 1/5 | abuse |
| Deer Creek Nursing and Rehabilitation | 13.1 mi | Wimberley, TX | ★☆☆☆☆ | 1/5 | |
| Eden Home | 14.3 mi | New Braunfels, TX | ★★★☆☆ | 3/5 | |
| Chisolm Trail Nursing and Rehabilitation Center | 15.8 mi | Lockhart, TX | ★★★☆☆ | 3/5 | |
| Parkview Nursing and Rehabilitation Center | 16.6 mi | Lockhart, TX | ★★☆☆☆ | 2/5 | abuse |
| Kirkwood Manor | 16.8 mi | New Braunfels, TX | ★★☆☆☆ | 2/5 | |
| Avir at Walnut Springs | 18.6 mi | Seguin, TX | ★★★★☆ | 4/5 |
Compare this facility with the 3 closest →
CMS records place this facility in Hays, TX — 6 certified facilities there. These are outside the 20-mile list above, or far enough down it not to appear.
Listed by facility name — not a ranking. Homes already in the table above are not repeated here.
Facility data as of CMS processing date 2026-08-01. CCN 455960.
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