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Silver Tree Nursing and Rehabilitation Center

All states › Texas › Schertz › Silver Tree Nursing and Rehabilitation Center

930 Roy Richard Dr Schertz, TX 78154 · Guadalupe County

(210) 566-9100

All 2 nursing homes in Schertz, TX (2 take Medicaid)

Accepts Medicare Accepts Medicaid 120 certified beds Government

CMS certification number 676121 · 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 Silver Tree Nursing and Rehabilitation Center 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 Silver Tree Nursing and Rehabilitation Center as of October 2026.

CMS rates it 1 out of 5 stars overall, below the Texas average of 2.8. Inspectors issued 61 citations in the last three years. CMS imposed 3 penalties, including $114,303 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.

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Compare with the 3 closest homes

Staffing

Nursing staff spend about 3.23 hours per resident per day at Silver Tree Nursing and Rehabilitation Center, about the same as the Texas median of 3.30 (US median: 3.72). About 0.55 of those hours are from registered nurses. On weekends it falls to 2.72 hours, 16% below its all-week average. Ask how weekends are staffed. 45.5% of nursing staff left within a year (Texas median 50.2%).

Nursing care per resident per day 3.23 hours
Below the Texas median of 3.30 Registered nurses, licensed practical nurses and aides combined, from payroll records.
Registered nurse hours 0.55 per resident a day RNs handle assessments, medications and changes in condition.
Weekend nursing care 2.72 hours Per resident a day. A big drop from weekdays can mean thin weekend staffing.
Nursing staff turnover 45.5% a year Share of nursing staff who left over a year. Lower usually means steadier care.
Registered nurse turnover 35.7% a year Share of registered nurses who left over a year.
Administrators who left 1 in the past year Frequent leadership changes are worth asking about on a visit.

About this nursing home

Certified beds120
Residents per day 93 About 77% of beds filled, on average
OwnershipGovernment - Hospital district
Payment acceptedMedicare and Medicaid
Certified sinceNovember 2006
Part of a chainCreative Solutions In Healthcare
Legal business nameWEST WHARTON COUNTY HOSPITAL DISTRICT

Paying for care at Silver Tree Nursing and Rehabilitation Center: Medicare and Medicaid

Silver Tree Nursing and Rehabilitation Center 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 12, 2026 and found 10 deficiencies, plus 8 from complaint inspections in the same period. In total, inspectors issued 61 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 61 citations at Silver Tree Nursing and Rehabilitation Center across 12 inspection dates, 31 of them from complaint investigations. 4 were at the immediate-jeopardy level (J–L), CMS's most serious category, most recently on October 10, 2025 (complaint inspection). The most common areas cited were resident assessment and care planning (23) and quality of life and care (11). 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 J, October 10, 2025). 2 citations were under CMS's abuse, neglect and exploitation rules.

August 6, 2026 · 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.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Complaint inspection · Deficient, Provider has date of correction (Aug 31, 2026)

June 12, 2026 · 10 citations

EEnsure 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 (Jun 13, 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 (Jun 13, 2026)

EProvide 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 (Jun 13, 2026)

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 (Jun 13, 2026)

ESafeguard 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 (Jun 13, 2026)

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 (Jun 13, 2026)

DEncode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0640 · Deficient, Provider has date of correction (Jun 13, 2026)

DPASARR screening for Mental disorders or Intellectual Disabilities

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0645 · Deficient, Provider has date of correction (Jun 13, 2026)

DDevelop 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 (Jun 13, 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 (Jun 13, 2026)

January 28, 2026 · 3 citations · includes complaint inspection

DEnsure each resident receives an accurate assessment.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0641 · Complaint inspection · Deficient, Provider has date of correction (Jan 29, 2026)

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 · Complaint inspection · Deficient, Provider has date of correction (Jan 29, 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 · Complaint inspection · Deficient, Provider has date of correction (Jan 29, 2026)

December 1, 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.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Complaint inspection · Deficient, Provider has date of correction (Dec 2, 2025)

October 10, 2025 · 3 citations, includes immediate jeopardy · includes complaint inspection

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 · Complaint inspection · Past Non-Compliance (Aug 29, 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 · Complaint inspection · Deficient, Provider has date of correction (Oct 11, 2025)

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 (Oct 11, 2025)

April 27, 2025 · 2 citations, includes immediate jeopardy · includes complaint inspection

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

Immediate jeopardy · Resident Rights Deficiencies · Tag F0580 · Complaint inspection · Past Non-Compliance (Apr 25, 2025)

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

Immediate jeopardy · Quality of Life and Care Deficiencies · Tag F0684 · Complaint inspection · Past Non-Compliance (Apr 25, 2025)

April 18, 2025 · 19 citations

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 (Apr 19, 2025)

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 (Apr 19, 2025)

EProvide 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 (Apr 19, 2025)

EDevelop, implement, and/or maintain an effective training program for all new and existing staff members.

Potential for more than minimal harm · Administration Deficiencies · Tag F0940 · Deficient, Provider has date of correction (Apr 19, 2025)

EProvide training in compliance and ethics.

Potential for more than minimal harm · Administration Deficiencies · Tag F0946 · Deficient, Provider has date of correction (Apr 19, 2025)

DKeep residents' personal and medical records private and confidential.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0583 · Deficient, Provider has date of correction (Apr 19, 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 (Apr 19, 2025)

DCreate 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 (Apr 19, 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 (Apr 19, 2025)

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 · Deficient, Provider has date of correction (Apr 19, 2025)

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 (Apr 19, 2025)

DEnsure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0693 · Deficient, Provider has date of correction (Apr 19, 2025)

DProvide for the safe, appropriate administration of IV fluids for a resident when needed.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0694 · Deficient, Provider has date of correction (Apr 19, 2025)

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 (Apr 19, 2025)

DDevelop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.

Potential for more than minimal harm · Administration Deficiencies · Tag F0941 · Deficient, Provider has date of correction (Apr 19, 2025)

DEnsure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0942 · Deficient, Provider has date of correction (Apr 19, 2025)

DEnsure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.

Potential for more than minimal harm · Nursing and Physician Services Deficiencies · Tag F0947 · Deficient, Provider has date of correction (Apr 19, 2025)

DProvide behavior health training consistent with the requirements and as determined by a facility assessment.

Potential for more than minimal harm · Administration Deficiencies · Tag F0949 · Deficient, Provider has date of correction (Apr 19, 2025)

BGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Potential for minimal harm · Resident Rights Deficiencies · Tag F0582 · Deficient, Provider has date of correction (Apr 19, 2025)

January 17, 2025 · 4 citations · includes complaint inspection

DProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0600 · Complaint inspection · Deficient, Provider has date of correction (Jan 18, 2025)

DProtect each resident from the wrongful use of the resident's belongings or money.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0602 · Complaint inspection · Past Non-Compliance (Aug 1, 2024)

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.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0761 · Complaint inspection · Deficient, Provider has date of correction (Jan 18, 2025)

DProvide 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 18, 2025)

June 14, 2024 · 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 (Jun 15, 2024)

March 7, 2024 · 12 citations · includes complaint inspection

FProcure 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 · Complaint inspection · Deficient, Provider has date of correction (Mar 8, 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 · Complaint inspection · Deficient, Provider has date of correction (Mar 8, 2024)

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 (Mar 8, 2024)

DAssure that each resident’s assessment is updated at least once every 3 months.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0638 · Complaint inspection · Deficient, Provider has date of correction (Mar 8, 2024)

DEnsure each resident receives an accurate assessment.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0641 · Complaint inspection · Deficient, Provider has date of correction (Mar 8, 2024)

DDevelop 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 · Complaint inspection · Deficient, Provider has date of correction (Mar 8, 2024)

DEnsure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0693 · Complaint inspection · Deficient, Provider has date of correction (Mar 8, 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 · Complaint inspection · Deficient, Provider has date of correction (Mar 8, 2024)

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.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0761 · Complaint inspection · Deficient, Provider has date of correction (Mar 8, 2024)

DEnsure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0805 · Complaint inspection · Deficient, Provider has date of correction (Mar 8, 2024)

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 (Mar 8, 2024)

DProvide 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 (Mar 8, 2024)

February 1, 2024 · 1 citation · includes complaint inspection

DProvide 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 (Feb 2, 2024)

December 22, 2023 · 4 citations, includes immediate jeopardy · includes complaint inspection

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

Immediate jeopardy · Quality of Life and Care Deficiencies · Tag F0686 · Complaint inspection · Infection control · Deficient, Provider has date of correction (Jan 31, 2024)

ESafeguard 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 · Infection control · Deficient, Provider has date of correction (Dec 23, 2023)

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 · Complaint inspection · Infection control · Deficient, Provider has date of correction (Dec 23, 2023)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Complaint inspection · Infection control · Deficient, Provider has date of correction (Dec 23, 2023)

Questions to ask on a tour of Silver Tree Nursing and Rehabilitation Center

  1. Inspectors cited the home at the immediate-jeopardy level on October 10, 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 January 17, 2025. How are staff trained, and how are concerns reported?
  3. There were 4 infection-control citations. Who leads infection prevention, and what is the current outbreak policy?
  4. CMS rates staffing 2 out of 5. How many residents does each nurse aide care for on day, evening and night shifts?
  5. Weekend staffing is 16% below the all-week average. Who is on duty on Saturday nights?
  6. CMS rates short-stay quality 2 out of 5. How often do rehab patients go back to the hospital, and how many therapy sessions a week are typical?
  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

3 penalties in the last three years, including $114,303 in fines.

DateTypeAmount or length
Oct 10, 2025 Fine $16,471
Apr 27, 2025 Fine $15,156
Dec 22, 2023 Fine $82,676

Rating history

CMS monthOverallInspectionStaffingQuality
October 2026 1/5 1/5 2/5 4/5
August 2026 2/5 2/5 2/5 4/5
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Location

Hospitals near Silver Tree Nursing and Rehabilitation Center

The Medicare-certified hospitals closest to this nursing home, with their CMS data. Ask the home which hospital it usually sends residents to.

Hospital ratings, ER visit times and more at Hospitals In Each State
Source: CMS Care Compare. Distances are approximate.

Nearby nursing homes

Avir at Schertz Schertz · 3.1 mi away ★★☆☆☆ Inspection 1/5 · Staffing 1/5 96 beds · Medicaid
Advanced Rehabilitation & Healthcare of Live Oak Live Oak · 4.2 mi away ★★★☆☆ Inspection 2/5 · Staffing 2/5 123 beds · Medicaid
Trucare Living Centers - Selma Selma · 4.4 mi away ★★☆☆☆ Inspection 3/5 · Staffing 1/5 128 beds · Medicaid
Avir at Converse Converse · 5.3 mi away ★☆☆☆☆ Inspection 2/5 · Staffing 1/5 100 beds · Medicaid
Army Residence Community San Antonio · 6.1 mi away ★★★★★ Inspection 4/5 · Staffing 5/5 91 beds

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Affiliation comes from CMS's affiliated-entity data, October 2026. All 150 Creative Solutions In Healthcare 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/schertz/silver-tree-nursing-and-rehabilitation-center/ · Data: CMS, October 2026 · Nursing Homes In Each State, not affiliated with CMS or Medicare.