All states › Texas › Fredericksburg › Avir at Enchanted Rock
210 West Windcrest St Fredericksburg, TX 78624 · Gillespie County
All 4 nursing homes in Fredericksburg, TX (4 take Medicaid)
CMS certification number 455941 · See this home on Medicare Care Compare
Is Avir at Enchanted Rock a good nursing home? Reviews, ratings and inspection record
There are no official resident reviews of nursing homes: Medicare's Care Compare publishes inspections, staffing and quality data instead. Here is what that record shows for Avir at Enchanted Rock as of October 2026.
CMS rates it 1 out of 5 stars overall, below the Texas average of 2.8.
Online reviews from families and residents are on Google Maps and other sites; they reflect individual experiences and aren't checked by CMS. The full inspection reports, including what inspectors observed, are on Medicare Care Compare.
Staffing
Nursing staff spend about 3.17 hours per resident per day at Avir at Enchanted Rock, below the Texas median of 3.30 (US median: 3.72). About 0.35 of those hours are from registered nurses. On weekends it falls to 2.69 hours, 15% below its all-week average. Ask how weekends are staffed. 75% of nursing staff left within a year (Texas median 50.2%). High turnover can mean residents see unfamiliar caregivers; ask how long the nurses on the unit have worked there. 2 administrators left in the past year.
About this nursing home
Paying for care at Avir at Enchanted Rock: Medicare and Medicaid
Avir at Enchanted Rock is certified for both Medicare and Medicaid. Medicare Part A can cover a short skilled-nursing or rehab stay here after a qualifying hospital stay of at least three inpatient days (observation days don't count), for up to 100 days per benefit period. Medicaid can pay for long-term care for residents who meet Texas's income and asset rules. Being certified doesn't guarantee a Medicaid bed is open, so ask whether the home accepts residents whose Medicaid application is still pending.
In 2026 Medicare covers days 1–20 in full after the Part A deductible ($1,736 per benefit period); for days 21–100 you pay $217 a day; after day 100 you pay all costs. Medicare doesn't pay for long-term custodial care. Medicare's coverage rules.
Health inspections
The most recent standard inspection was on May 2, 2026 and found 10 deficiencies, plus 3 from complaint inspections in the same period. In total, inspectors issued 48 citations in the last three years.
Each citation has a scope and severity letter from A to L. A–C: potential for minimal harm. D–F: potential for more than minimal harm. G–I: actual harm. J–L: immediate jeopardy to resident health or safety.
What the inspections found
Over the last three years, inspectors issued 48 citations at Avir at Enchanted Rock across 9 inspection dates, 10 of them from complaint investigations. 5 were at the immediate-jeopardy level (J–L), CMS's most serious category, most recently on May 2, 2026. The most common areas cited were resident assessment and care planning (10) and freedom from abuse, neglect, and exploitation (8). The most serious was cited under the CMS rule to "ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents" (tag F0689, level K, January 19, 2025). 8 citations were under CMS's abuse, neglect and exploitation rules.
June 22, 2026 · 1 citation · includes complaint inspection
DProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
May 13, 2026 · 1 citation · includes complaint inspection
DSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
May 2, 2026 · 11 citations, includes immediate jeopardy
JEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
EDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
EProvide appropriate treatment and care according to orders, resident’s preferences and goals.
EHave a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
DRespond appropriately to all alleged violations.
DProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
DEnsure that residents are free from significant medication errors.
DProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
DSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
DProvide and implement an infection prevention and control program.
January 8, 2026 · 1 citation · includes complaint inspection
EProvide and implement an infection prevention and control program.
July 10, 2025 · 3 citations · includes complaint inspection
DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
DProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
CPost nurse staffing information every day.
February 12, 2025 · 9 citations
ECreate and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
DReasonably accommodate the needs and preferences of each resident.
DHonor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
DRespond appropriately to all alleged violations.
DEnsure each resident receives an accurate assessment.
DDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
DProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
DProvide and implement an infection prevention and control program.
January 19, 2025 · 3 citations, includes immediate jeopardy · includes complaint inspection
KEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
EDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
June 22, 2024 · 1 citation · includes complaint inspection
DEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
January 13, 2024 · 18 citations, includes immediate jeopardy
JDevelop and implement policies and procedures to prevent abuse, neglect, and theft.
JRespond appropriately to all alleged violations.
JEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
EHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
EDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
EDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
EEnsure medication error rates are not 5 percent or greater.
EEnsure that residents are free from significant medication errors.
EEnsure 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.
EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
EMake sure that a working call system is available in each resident's bathroom and bathing area.
DImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
DHonor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
DProvide appropriate pressure ulcer care and prevent new ulcers from developing.
DProvide safe and appropriate respiratory care for a resident when needed.
DProvide and implement an infection prevention and control program.
BEnsure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Questions to ask on a tour of Avir at Enchanted Rock
- Inspectors cited the home at the immediate-jeopardy level on January 19, 2025 under the rule on quality of life and care. What changed afterwards, and can I see the plan of correction?
- CMS cited the home under its abuse and neglect rules on May 2, 2026. How are staff trained, and how are concerns reported?
- CMS rates staffing 1 out of 5. How many residents does each nurse aide care for on day, evening and night shifts?
- Weekend staffing is 15% below the all-week average. Who is on duty on Saturday nights?
- Nursing staff turnover was 75% a year. How many of the staff come from agencies?
- Several administrators left in the past year. What has changed for residents since then?
- Do you have a Medicaid bed open now, and will you admit someone whose Medicaid application is still pending?
- When is the first care-plan meeting, and can family attend?
Questions come from this home's CMS data: its inspections, staffing and ownership record.
Fines and payment denials
2 penalties in the last three years, including $63,121 in fines.
| Date | Type | Amount or length |
|---|---|---|
| Jan 19, 2025 | Fine | $49,205 |
| Jan 13, 2024 | Fine | $13,916 |
Rating history
| CMS month | Overall | Inspection | Staffing | Quality |
|---|---|---|---|---|
| October 2026 | 1/5 | 2/5 | 1/5 | 4/5 |
| August 2026 | 2/5 | 2/5 | 2/5 | 4/5 |
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Location
Hospitals near Avir at Enchanted Rock
The Medicare-certified hospitals closest to this nursing home, with their CMS data. Ask the home which hospital it usually sends residents to.
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0.1 mi
Hill Country Memorial Hospital INC FredericksburgEmergency room ★★★★☆ Medicare overall 4 of 5Median ER visit 2h 36m for patients treated and sent home
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22.2 mi
Peterson Regional Medical Center KerrvilleEmergency room ★★★★☆ Medicare overall 4 of 5Median ER visit 2h 42m for patients treated and sent home
Hospital ratings, ER visit times and more at Hospitals In Each State
Source: CMS Care Compare. Distances are approximate.
Nearby nursing homes
More nursing homes near Avir at Enchanted Rock › All nursing homes in Fredericksburg ›
Compare Avir at Enchanted Rock with the 3 closest homes side by side ›
Higher-rated nursing homes within 10 miles
- Knopp Healthcare and Rehab Center · Fredericksburg · 3 stars · 1.9 mi
- Avir at Fredericksburg · Fredericksburg · 2 stars · 0.3 mi
- Knopp Nursing & Rehab Center · Fredericksburg · 2 stars · 0.5 mi
Other Avir Health Group nursing homes in Texas
- Avir at Beeville · Beeville · 5 stars
- Avir at Temple East · Temple · 5 stars
- Avir at Courtyard · Houston · 5 stars
- Avir at Haskell · Haskell · 5 stars
- Avir at Pampa · Pampa · 5 stars
- Avir at Paris · Paris · 5 stars
Affiliation comes from CMS's affiliated-entity data, October 2026. All 118 Avir Health Group nursing homes ›
Source: CMS Provider Data Catalog (provider information, health deficiencies, penalties), October 2026. Inspection citations and penalties cover the last three years. Nursing Homes In Each State is independent and not affiliated with CMS or Medicare. About the data · Report a problem with this listing. Is this your nursing home? Feature it here.