All states › Texas › Fredericksburg › Avir at Fredericksburg
1117 S. Adams St. Fredericksburg, TX 78624 · Gillespie County
All 4 nursing homes in Fredericksburg, TX (4 take Medicaid)
CMS certification number 675169 · See this home on Medicare Care Compare
Is Avir at Fredericksburg 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 Fredericksburg as of October 2026.
CMS rates it 2 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 2.86 hours per resident per day at Avir at Fredericksburg, below the Texas median of 3.30 (US median: 3.72). About 0.54 of those hours are from registered nurses. On weekends it falls to 2.54 hours, 11% below its all-week average. 78.6% 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.
About this nursing home
Paying for care at Avir at Fredericksburg: Medicare and Medicaid
Avir at Fredericksburg 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 June 20, 2025 and found 9 deficiencies, plus 8 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 Fredericksburg across 7 inspection dates, 9 of them from complaint investigations. 2 were at the immediate-jeopardy level (J–L), CMS's most serious category, most recently on May 27, 2026 (complaint inspection). The most common areas cited were resident assessment and care planning (12) and nutrition and dietary (11). The most serious was cited under the CMS rule to "ensure that residents are free from significant medication errors" (tag F0760, level J, May 27, 2026). 2 citations were under CMS's abuse, neglect and exploitation rules.
June 26, 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 27, 2026 · 1 citation, includes immediate jeopardy · includes complaint inspection
JEnsure that residents are free from significant medication errors.
December 4, 2025 · 1 citation · includes complaint inspection
DDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
June 20, 2025 · 14 citations · includes complaint inspection
EEnsure that each resident is free from the use of physical restraints, unless needed for medical treatment.
EProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
EEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
EEnsure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
EProvide and implement an infection prevention and control program.
DEnsure that residents are fully informed and understand their health status, care and treatments.
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 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 nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
DEnsure 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.
DSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
BProvide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
May 17, 2024 · 19 citations
EHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
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 that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
EEnsure 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.
EEnsure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
EEnsure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
EDispose of garbage and refuse properly.
EProvide and implement an infection prevention and control program.
EKeep all essential equipment working safely.
DEnsure each resident receives an accurate assessment.
DEnsure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
DProvide appropriate treatment and care according to orders, resident’s preferences and goals.
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 medication error rates are not 5 percent or greater.
DEnsure that residents are free from significant medication errors.
DEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
DEnsure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
BProvide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
March 7, 2024 · 1 citation · includes complaint inspection
DProvide and implement an infection prevention and control program.
March 26, 2023 · 11 citations, includes immediate jeopardy
JProvide appropriate treatment and care according to orders, resident’s preferences and goals.
EDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
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.
EProvide medically-related social services to help each resident achieve the highest possible quality of life.
EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
EDevelop, implement, and/or maintain an effective training program for all new and existing staff members.
DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
DEnsure each resident receives an accurate assessment.
DEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
DSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
BProvide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Questions to ask on a tour of Avir at Fredericksburg
- Inspectors cited the home at the immediate-jeopardy level on May 27, 2026 under the rule on pharmacy service. What changed afterwards, and can I see the plan of correction?
- CMS cited the home under its abuse and neglect rules on June 20, 2025. How are staff trained, and how are concerns reported?
- CMS rates staffing 2 out of 5. How many residents does each nurse aide care for on day, evening and night shifts?
- Nursing staff turnover was 78.6% a year. How many of the staff come from agencies?
- The home averages about 54% of its beds filled. Are any units closed?
- 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
1 penalty in the last three years, including $15,288 in fines.
| Date | Type | Amount or length |
|---|---|---|
| May 27, 2026 | Fine | $15,288 |
Rating history
| CMS month | Overall | Inspection | Staffing | Quality |
|---|---|---|---|---|
| October 2026 | 2/5 | 2/5 | 2/5 | 4/5 |
| August 2026 | 3/5 | 2/5 | 2/5 | 5/5 |
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Location
Hospitals near Avir at Fredericksburg
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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0.2 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 Fredericksburg › All nursing homes in Fredericksburg ›
Compare Avir at Fredericksburg 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
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.