Nursing Care Index

Avir At Fredericksburg

Fredericksburg, Gillespie County, Texas · CCN 675169 · For-profit (Corporation) · part of Avir Health Group (116 facilities, chain average 2.3 stars)

CMS rates Avir At Fredericksburg 3 of 5 overall as of August 2026. 90 certified beds, 49 residents a day on average. 48 citations on record from the current inspection cycles, 2 at immediate jeopardy; 1 fine totalling $23,520.

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★★★☆☆ 3 of 5
Health inspections★★☆☆☆ 2 of 5
Staffing★★☆☆☆ 2 of 5
Quality measures★★★★★ 5 of 5
Quality: long-stay / short-stay4 / 5 of 5

Staffing

Total nurse staffing2.8627 hours per resident per day
Registered nurses0.4509 hours per resident per day
Weekend total2.57024 hours per resident per day
Nursing staff turnover87.8% (registered nurses 77.8%)
Administrators who left0

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2026-06-26
complaint survey
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-07-11
2026-05-27
complaint survey
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
J Immediate jeopardy to resident health or safety; isolated Past Non-Compliance
2025-12-04
complaint survey
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-05
2025-06-20 Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0604
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-29
2025-06-20
complaint survey
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies · tag F0755
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-29
2025-06-20
complaint survey
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Nutrition and Dietary Deficiencies · tag F0801
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-29
2025-06-20 Ensure 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.
Nutrition and Dietary Deficiencies · tag F0809
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-29
2025-06-20 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-29
2025-06-20 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-29
2025-06-20 Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies · tag F0552
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-29
2025-06-20
complaint survey
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-29
2025-06-20 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-29
2025-06-20
complaint survey
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies · tag F0690
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-29
2025-06-20 Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Nursing and Physician Services Deficiencies · tag F0726
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-29
2025-06-20
complaint survey
Ensure 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.
Pharmacy Service Deficiencies · tag F0761
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-29
2025-06-20 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-29
2025-06-20 Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Environmental Deficiencies · tag F0912
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2025-06-29
2024-05-17 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Nursing and Physician Services Deficiencies · tag F0726
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Ensure 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.
Nutrition and Dietary Deficiencies · tag F0803
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Nutrition and Dietary Deficiencies · tag F0806
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Ensure 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.
Nutrition and Dietary Deficiencies · tag F0809
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Dispose of garbage and refuse properly.
Nutrition and Dietary Deficiencies · tag F0814
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Keep all essential equipment working safely.
Environmental Deficiencies · tag F0908
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-05-17 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-17
2024-05-17 Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Resident Assessment and Care Planning Deficiencies · tag F0661
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-07
2024-05-17 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-17
2024-05-17 Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies · tag F0690
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-17
2024-05-17 Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies · tag F0759
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-17
2024-05-17 Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-17
2024-05-17 Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Nutrition and Dietary Deficiencies · tag F0801
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-17
2024-05-17 Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Nutrition and Dietary Deficiencies · tag F0805
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-06-17
2024-05-17 Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Environmental Deficiencies · tag F0912
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2024-06-17
2024-03-07
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2023-03-26 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2023-04-14
2023-03-26 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-14
2023-03-26 Have 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.
Nursing and Physician Services Deficiencies · tag F0727
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-14
2023-03-26 Provide medically-related social services to help each resident achieve the highest possible quality of life.
Quality of Life and Care Deficiencies · tag F0745
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-14
2023-03-26 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-14
2023-03-26 Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Administration Deficiencies · tag F0940
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-04-14
2023-03-26 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-04-14
2023-03-26 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-04-14
2023-03-26 Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Nutrition and Dietary Deficiencies · tag F0801
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-04-14
2023-03-26 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-04-14
2023-03-26 Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Environmental Deficiencies · tag F0912
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2023-04-14

Fines and payment denials

DatePenaltyAmount
2026-05-27Fine$23,520

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Val Verde County Hospital District
Organization
5% or greater direct ownership interest100%2020-11-01
1117 S Adams Street Property Owner, LLC
Organization
adp of the snf2025-03-01
Welltower Inc.
Organization
adp of the snf2025-03-01
Welltower Nnn Group, LLC
Organization
adp of the snf2025-03-01
Welltower Op, LLC
Organization
adp of the snf2025-03-01
1117 S Adams Street Opco, LLC
Organization
operational/managerial control2025-03-01
Dennis, Wanda
Individual
adp of the snf2025-03-01
Kothmann, John
Individual
adp of the snf2025-04-16
Jurado, Jorge
Individual
corporate officer2022-06-01
Dagan, Amitai
Individual
individual is an owner, partner or trustee of any adp of the snf2025-04-16
Goldberger, Abraham
Individual
individual is an owner, partner or trustee of any adp of the snf2025-04-16
Freund, Nochum
Individual
operational/managerial control2025-03-01
Kothmann, John
Individual
operational/managerial control2025-03-01
Travitsky, Aaron
Individual
operational/managerial control2025-03-01

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Gillespie County.