Starfile / Texas

Avir at Enchanted Rock

210 WEST WINDCREST ST, FREDERICKSBURG, TX 78624 · CCN 455941

Inspection history vs Texas & national averages

Cycle 1 is the most recent standard health inspection. Lower total deficiency counts are better.

Cycle 1 deficiencies by category

Staffing (hours per resident per day)

Fines & penalties

Total fines

$63,121

Number of fines

2

Number of penalties

2

Payment denials

0

Inspection citations (44)4 immediate jeopardy

1. EF0880Provide and implement an infection prevention and control program.2026-01-08 · Health · corrected 2026-01-10

   Potential for more than minimal harm

2. DF0644Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.2025-07-10 · Health · corrected 2025-07-11

   Potential for more than minimal harm

3. CF0732Post nurse staffing information every day.2025-07-10 · Health · corrected 2025-07-11

   Potential for minimal harm

4. DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2025-07-10 · Health · corrected 2025-07-11

   Potential for more than minimal harm

5. DF0558Reasonably accommodate the needs and preferences of each resident.2025-02-12 · Health · corrected 2025-02-13

   Potential for more than minimal harm

6. DF0578Honor 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.2025-02-12 · Health · corrected 2025-02-13

   Potential for more than minimal harm

7. DF0609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.2025-02-12 · Health · corrected 2025-02-13

   Potential for more than minimal harm

8. DF0610Respond appropriately to all alleged violations.2025-02-12 · Health · corrected 2025-02-13

   Potential for more than minimal harm

9. DF0641Ensure each resident receives an accurate assessment.2025-02-12 · Health · corrected 2025-02-13

   Potential for more than minimal harm

10. EF0655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted2025-02-12 · Health · corrected 2025-02-13

    Potential for more than minimal harm

11. DF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.2025-02-12 · Health · corrected 2025-02-13

    Potential for more than minimal harm

12. DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2025-02-12 · Health · corrected 2025-02-13

    Potential for more than minimal harm

13. DF0880Provide and implement an infection prevention and control program.2025-02-12 · Health · corrected 2025-02-13

    Potential for more than minimal harm

14. DF0609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.2025-01-19 · Health · corrected 2025-01-20

    Potential for more than minimal harm

15. EF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.2025-01-19 · Health · corrected 2025-01-20

    Potential for more than minimal harm

16. KF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2025-01-19 · Health · corrected 2025-02-09

    Immediate jeopardy

17. DF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2024-06-22 · Health · corrected 2024-06-24

    Potential for more than minimal harm

18. DF0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

19. EF0584Honor 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.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

20. DF0585Honor 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.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

21. JF0607Develop and implement policies and procedures to prevent abuse, neglect, and theft.2024-01-13 · Health · corrected 2024-02-15

    Immediate jeopardy

22. DF0609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

23. JF0610Respond appropriately to all alleged violations.2024-01-13 · Health · corrected 2024-02-15

    Immediate jeopardy

24. EF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

25. EF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

26. DF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

27. JF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2024-01-13 · Health · corrected 2024-02-15

    Immediate jeopardy

28. DF0695Provide safe and appropriate respiratory care for a resident when needed.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

29. EF0759Ensure medication error rates are not 5 percent or greater.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

30. EF0760Ensure that residents are free from significant medication errors.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

31. EF0761Ensure 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.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

32. BF0803Ensure 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.2024-01-13 · Health · corrected 2024-02-15

    Potential for minimal harm

33. EF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

34. DF0880Provide and implement an infection prevention and control program.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

35. EF0919Make sure that a working call system is available in each resident's bathroom and bathing area.2024-01-13 · Health · corrected 2024-02-15

    Potential for more than minimal harm

36. EF0578Honor 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.2022-11-18 · Health · corrected 2022-12-22

    Potential for more than minimal harm

37. DF0645PASARR screening for Mental disorders or Intellectual Disabilities2022-11-18 · Health · corrected 2022-12-22

    Potential for more than minimal harm

38. DF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.2022-11-18 · Health · corrected 2022-12-22

    Potential for more than minimal harm

39. EF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.2022-11-18 · Health · corrected 2022-12-22

    Potential for more than minimal harm

40. DF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2022-11-18 · Health · corrected 2022-12-22

    Potential for more than minimal harm

41. DF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2022-11-18 · Health · corrected 2022-12-22

    Potential for more than minimal harm

42. DF0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.2022-11-18 · Health · corrected 2022-12-22

    Potential for more than minimal harm

43. DF0880Provide and implement an infection prevention and control program.2022-11-18 · Health · corrected 2022-12-22

    Potential for more than minimal harm

44. EF0921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.2022-11-18 · Health · corrected 2022-12-22

    Potential for more than minimal harm

Ownership

Other facilities in FREDERICKSBURG

Source: CMS Provider Data Catalog, Nursing Home Care Compare files (processed 2026-03-01). Citations show the 3 most recent inspection cycles.