facebook tracking Avir at Enchanted Rock, Fredericksburg TX: CMS Ratings
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Avir at Enchanted Rock

All states › Texas › Fredericksburg › Avir at Enchanted Rock

210 West Windcrest St Fredericksburg, TX 78624 · Gillespie County

(830) 637-7885

All 4 nursing homes in Fredericksburg, TX (4 take Medicaid)

Accepts Medicare Accepts Medicaid 120 certified beds Government

CMS certification number 455941 · See this home on Medicare Care Compare

Ratings come from CMS and are updated monthly; these are from October 2026. Check the latest inspection report and visit in person before you decide.

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. Inspectors issued 48 citations in the last three years. CMS imposed 2 penalties, including $63,121 in fines, in that time. For short-term rehab patients CMS rates quality 2 out of 5; for long-term residents, 5 out of 5. Those results differ a lot, so ask about the unit your family member would be on.

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.

Nursing care per resident per day 3.17 hours
Below the Texas median of 3.30 Registered nurses, licensed practical nurses and aides combined, from payroll records.
Registered nurse hours 0.35 per resident a day RNs handle assessments, medications and changes in condition.
Weekend nursing care 2.69 hours Per resident a day. A big drop from weekdays can mean thin weekend staffing.
Nursing staff turnover 75% a year Share of nursing staff who left over a year. Lower usually means steadier care.
Registered nurse turnover 71.4% a year Share of registered nurses who left over a year.
Administrators who left 2 in the past year Frequent leadership changes are worth asking about on a visit.

About this nursing home

Certified beds120
Residents per day 45 About 37% of beds filled, on average
OwnershipGovernment - Hospital district
Payment acceptedMedicare and Medicaid
Certified sinceJuly 1991
Part of a chainAvir Health Group
Legal business nameUVALDE COUNTY HOSPITAL AUTHORITY

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.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0755 · Complaint inspection · Deficient, Provider has date of correction (Jun 24, 2026)

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.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0842 · Complaint inspection · Deficient, Provider has date of correction (May 16, 2026)

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.

Immediate jeopardy · Quality of Life and Care Deficiencies · Tag F0689 · Deficient, Provider has date of correction (May 4, 2026)

EDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Deficient, Provider has date of correction (May 4, 2026)

EProvide appropriate treatment and care according to orders, resident’s preferences and goals.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0684 · Deficient, Provider has date of correction (May 4, 2026)

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.

Potential for more than minimal harm · Nursing and Physician Services Deficiencies · Tag F0727 · Deficient, Provider has date of correction (May 4, 2026)

DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 · Deficient, Provider has date of correction (May 4, 2026)

DRespond appropriately to all alleged violations.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610 · Deficient, Provider has date of correction (May 4, 2026)

DProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0690 · Deficient, Provider has date of correction (May 4, 2026)

DEnsure that residents are free from significant medication errors.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0760 · Deficient, Provider has date of correction (May 4, 2026)

DProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (May 4, 2026)

DSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0842 · Deficient, Provider has date of correction (May 4, 2026)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (May 4, 2026)

January 8, 2026 · 1 citation · includes complaint inspection

EProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Complaint inspection · Deficient, Provider has date of correction (Jan 10, 2026)

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.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0644 · Complaint inspection · Deficient, Provider has date of correction (Jul 11, 2025)

DProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0755 · Complaint inspection · Deficient, Provider has date of correction (Jul 11, 2025)

CPost nurse staffing information every day.

Potential for minimal harm · Nursing and Physician Services Deficiencies · Tag F0732 · Complaint inspection · Deficient, Provider has date of correction (Jul 11, 2025)

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

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0655 · Deficient, Provider has date of correction (Feb 13, 2025)

DReasonably accommodate the needs and preferences of each resident.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0558 · Deficient, Provider has date of correction (Feb 13, 2025)

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.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0578 · Deficient, Provider has date of correction (Feb 13, 2025)

DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 · Deficient, Provider has date of correction (Feb 13, 2025)

DRespond appropriately to all alleged violations.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610 · Deficient, Provider has date of correction (Feb 13, 2025)

DEnsure each resident receives an accurate assessment.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0641 · Deficient, Provider has date of correction (Feb 13, 2025)

DDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Deficient, Provider has date of correction (Feb 13, 2025)

DProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0755 · Deficient, Provider has date of correction (Feb 13, 2025)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (Feb 13, 2025)

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.

Immediate jeopardy · Quality of Life and Care Deficiencies · Tag F0689 · Complaint inspection · Deficient, Provider has date of correction (Feb 9, 2025)

EDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Complaint inspection · Deficient, Provider has date of correction (Jan 20, 2025)

DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 · Complaint inspection · Deficient, Provider has date of correction (Jan 20, 2025)

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.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0689 · Complaint inspection · Deficient, Provider has date of correction (Jun 24, 2024)

January 13, 2024 · 18 citations, includes immediate jeopardy

JDevelop and implement policies and procedures to prevent abuse, neglect, and theft.

Immediate jeopardy · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0607 · Deficient, Provider has date of correction (Feb 15, 2024)

JRespond appropriately to all alleged violations.

Immediate jeopardy · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610 · Deficient, Provider has date of correction (Feb 15, 2024)

JEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Immediate jeopardy · Quality of Life and Care Deficiencies · Tag F0689 · Deficient, Provider has date of correction (Feb 15, 2024)

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.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0584 · Deficient, Provider has date of correction (Feb 15, 2024)

EDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Deficient, Provider has date of correction (Feb 15, 2024)

EDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0657 · Deficient, Provider has date of correction (Feb 15, 2024)

EEnsure medication error rates are not 5 percent or greater.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0759 · Deficient, Provider has date of correction (Feb 15, 2024)

EEnsure that residents are free from significant medication errors.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0760 · Deficient, Provider has date of correction (Feb 15, 2024)

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.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0761 · Deficient, Provider has date of correction (Feb 15, 2024)

EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (Feb 15, 2024)

EMake sure that a working call system is available in each resident's bathroom and bathing area.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0919 · Deficient, Provider has date of correction (Feb 15, 2024)

DImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0580 · Deficient, Provider has date of correction (Feb 15, 2024)

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.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0585 · Deficient, Provider has date of correction (Feb 15, 2024)

DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 · Deficient, Provider has date of correction (Feb 15, 2024)

DProvide appropriate pressure ulcer care and prevent new ulcers from developing.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0686 · Deficient, Provider has date of correction (Feb 15, 2024)

DProvide safe and appropriate respiratory care for a resident when needed.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0695 · Deficient, Provider has date of correction (Feb 15, 2024)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (Feb 15, 2024)

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.

Potential for minimal harm · Nutrition and Dietary Deficiencies · Tag F0803 · Deficient, Provider has date of correction (Feb 15, 2024)

Questions to ask on a tour of Avir at Enchanted Rock

  1. 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?
  2. CMS cited the home under its abuse and neglect rules on May 2, 2026. How are staff trained, and how are concerns reported?
  3. CMS rates staffing 1 out of 5. How many residents does each nurse aide care for on day, evening and night shifts?
  4. Weekend staffing is 15% below the all-week average. Who is on duty on Saturday nights?
  5. Nursing staff turnover was 75% a year. How many of the staff come from agencies?
  6. Several administrators left in the past year. What has changed for residents since then?
  7. Do you have a Medicaid bed open now, and will you admit someone whose Medicaid application is still pending?
  8. 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.

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

Rating history

CMS monthOverallInspectionStaffingQuality
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.

  • 0.1 mi
    Hill Country Memorial Hospital INC Fredericksburg
    Emergency room ★★★★☆ Medicare overall 4 of 5
    Median ER visit 2h 36m for patients treated and sent home
  • 22.2 mi
    Peterson Regional Medical Center Kerrville
    Emergency room ★★★★☆ Medicare overall 4 of 5
    Median 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

Avir at Fredericksburg Fredericksburg · 0.3 mi away ★★☆☆☆ Inspection 2/5 · Staffing 2/5 90 beds · Medicaid
Knopp Nursing & Rehab Center Fredericksburg · 0.5 mi away ★★☆☆☆ Inspection 2/5 · Staffing 2/5 60 beds · Medicaid
Knopp Healthcare and Rehab Center Fredericksburg · 1.9 mi away ★★★☆☆ Inspection 4/5 · Staffing 4/5 119 beds · Medicaid
Avir at Comfort Comfort · 20.2 mi away ★★★★☆ Inspection 4/5 · Staffing 3/5 76 beds · Medicaid
Hilltop Village Nursing and Rehabilitation Kerrville · 20.9 mi away ★★☆☆☆ Inspection 3/5 · Staffing 1/5 150 beds · Medicaid

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 ›

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Other Avir Health Group nursing homes in Texas

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.

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https://www.nursinghomesineachstate.com/texas/fredericksburg/avir-at-enchanted-rock/ · Data: CMS, October 2026 · Nursing Homes In Each State, not affiliated with CMS or Medicare.