Hearthstone Nursing and Rehabilitation
401 Oakwood Blvd, Round Rock, TX 78681 · Williamson County · 120 certified beds · avg 94 residents/day · certified since Sep 26, 1988
Part of chain: CARADAY HEALTHCARE (8 facilities, chain avg rating 2.8★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★☆☆3/5 · 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, repeated · Dec 2, 2023 · F-0580 · triggered by a complaint
The 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.
Why it matters: A family could learn about a serious injury or decline days later, after the chance to act has passed.
Severity (K): A life-threatening or extremely dangerous situation affected several residents. Among the most serious findings an inspection can produce.
Corrected: Nov 16, 2023 (Past Non-Compliance)
▲ Immediate jeopardy, repeated · Dec 2, 2023 · 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 (K): A life-threatening or extremely dangerous situation affected several residents. Among the most serious findings an inspection can produce.
Corrected: Nov 16, 2023 (Past Non-Compliance)
▲ Immediate jeopardy, repeated · Dec 2, 2023 · F-0684 · triggered by a complaint
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 (K): A life-threatening or extremely dangerous situation affected several residents. Among the most serious findings an inspection can produce.
Corrected: Nov 16, 2023 (Past Non-Compliance)
▲ Actual harm, one-off · Dec 19, 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 (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Dec 3, 2024 (Past Non-Compliance)
All citations in the current public record (24)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Apr 3, 2026 | E · Potential for harm, repeated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Apr 3, 2026 | E · Potential for harm, repeated | 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. |
| Apr 3, 2026 | E · Potential for harm, repeated | 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. |
| Apr 3, 2026 | D · Potential for harm, one-off | The facility did not maintain an effective pest control program to prevent or deal with mice, insects, or other pests. |
| Jan 14, 2026 | D · Potential for harm, one-off | The 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. · from a complaint |
| Nov 19, 2025 | D · Potential for harm, one-off | The 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 |
| Nov 19, 2025 | D · Potential for harm, one-off | The facility did not notify the appropriate authorities when a resident with a mental disorder or intellectual disability had a significant change in condition. · from a complaint |
| Jan 30, 2025 | D · Potential for harm, one-off | 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. |
| Jan 30, 2025 | D · Potential for harm, one-off | 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. |
| Dec 19, 2024 | ▲ G · Actual harm, one-off | 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 |
| Dec 19, 2024 | D · Potential for harm, one-off | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint |
| Apr 3, 2024 | D · Potential for harm, one-off | 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 |
| Feb 13, 2024 | E · Potential for harm, repeated | The facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand. · from a complaint |
| Feb 13, 2024 | D · Potential for harm, one-off | The facility did not let a resident help develop and carry out their own plan of care — the written roadmap of the services and support they'll receive, built around their personal goals and preferences. · from a complaint |
| Feb 13, 2024 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. · from a complaint |
| Dec 14, 2023 | E · Potential for harm, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Dec 14, 2023 | E · Potential for harm, repeated | The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. |
| Dec 14, 2023 | E · Potential for harm, repeated | The 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. |
| Dec 14, 2023 | E · Potential for harm, repeated | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. |
| Dec 14, 2023 | E · Potential for harm, repeated | 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. |
| Dec 2, 2023 | ▲ K · Immediate jeopardy, repeated | The 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. · from a complaint |
| Dec 2, 2023 | ▲ K · Immediate jeopardy, repeated | 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 |
| Dec 2, 2023 | ▲ K · Immediate jeopardy, repeated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Dec 2, 2023 | E · Potential for harm, repeated | 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 |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (2 → 4).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 9 | 3 | K ▲ |
| 2024 | 6 | 1 | G ▲ |
| 2025 | 4 | 0 | D |
| 2026 | 5 | 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.
Fines and enforcement (last 3 years)
2 fines totaling $25,626.
| Date | Type | Amount / length |
|---|---|---|
| Dec 19, 2024 | Fine | $10,033 |
| Dec 2, 2023 | Fine | $15,593 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Texas avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.28 | 3.46 | 3.95 | bottom 47% in Texas; bottom 25% in the U.S. |
| Registered Nurse hours | 0.43 | 0.44 | 0.69 | top 39% in Texas; bottom 27% in the U.S. |
| Weekend total nurse staffing | 2.84 | 3.04 | 3.50 | bottom 42% in Texas; bottom 23% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.19 | 0.34 | 0.48 | bottom 20% in Texas; bottom 11% in the U.S. |
| Total nursing staff turnover (%) | 53.3 | 55.3 | 45.8 | bottom 47% in Texas; bottom 29% in the U.S. |
| RN turnover (%) | 28.6 | 54.6 | 42.9 | top 15% in Texas; top 26% 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 2.92, RN 0.38, weekend 2.53. 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: 4/5 · long-stay residents: 4/5 · short-stay residents: —/5
Who owns this facility
Government - Hospital district
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Stratford Hospital District | Organization | 5% or Greater Direct Ownership Interest | 100% | 06/01/2020 |
| Caraday Hearthstone LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 06/01/2020 |
| Choi, Maryann | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/04/2025 |
| Choi, Robert | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/04/2025 |
| Chumley, Richard | Individual | Corporate Officer | NOT APPLICABLE | 06/01/2020 |
| Cunningham, Ernest | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/04/2025 |
| Granite Hearthstone Health Center, LLC | Organization | 5% or Greater Mortgage Interest | NOT APPLICABLE | 06/01/2020 |
| Granite Hearthstone Health Center, LLC | Organization | ADP of the SNF | NOT APPLICABLE | 06/01/2020 |
| Javadi, Jasmine | Individual | ADP of the SNF | NOT APPLICABLE | 06/01/2020 |
| Moore, Gregory | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/01/2020 |
| O'Donoghue-Stallard, Maire | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/04/2025 |
| Stallard, Thomas | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/04/2025 |
| Wages, Adriana | Individual | ADP of the SNF | NOT APPLICABLE | 03/24/2025 |
| Wood, Stephen | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/04/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "If my family member falls or their condition changes, exactly when and how will I be notified?"
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "How is pest control handled here, and when was the last treatment or inspection?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Park Valley Inn Health Center | 0.5 mi | Round Rock, TX | ★★☆☆☆ | 1/5 | abuse |
| Ignite Medical Resort Round Rock, LLC | 1.8 mi | Austin, TX | ★★☆☆☆ | 1/5 | |
| The Center at Parmer | 1.9 mi | Austin, TX | ★★★★★ | 4/5 | |
| Trinity Care Center | 2.6 mi | Round Rock, TX | ★★★☆☆ | 2/5 | |
| San Gabriel Rehabilitation and Care Center | 3.8 mi | Round Rock, TX | ★☆☆☆☆ | 1/5 | abuse |
| Bel Air at Teravista | 4.6 mi | Round Rock, TX | ★★★☆☆ | 2/5 | |
| Cedar Pointe Health and Wellness Center | 5.9 mi | Cedar Park, TX | ★★★★☆ | 4/5 | |
| Five Points of Pflugerville | 5.9 mi | Pflugerville, TX | ★☆☆☆☆ | 1/5 | |
| The Springs Healthcare and Rehabilitation | 6.0 mi | Cedar Park, TX | ★★★★☆ | 3/5 | |
| Sagebrook Nursing and Rehabilitation | 6.5 mi | Cedar Park, TX | ★★★★☆ | 4/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 455771.