Nursing Care Index

San Marcos Rehabilitation And Healthcare Center

San Marcos, Hays County, Texas · CCN 675651 · For-profit (Corporation) · part of The Ensign Group (342 facilities, chain average 3.2 stars)

CMS rates San Marcos Rehabilitation And Healthcare Center 1 of 5 overall as of August 2026. 129 certified beds, 105 residents a day on average. 17 citations on record from the current inspection cycles, 2 at immediate jeopardy; 1 fine totalling $33,891.

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★☆☆☆☆ 1 of 5
Health inspections★☆☆☆☆ 1 of 5
Staffing★★☆☆☆ 2 of 5
Quality measures★★★★☆ 4 of 5
Quality: long-stay / short-stay5 / 3 of 5

Staffing

Total nurse staffing2.98379 hours per resident per day
Registered nurses0.64247 hours per resident per day
Weekend total2.54451 hours per resident per day
Nursing staff turnover48.8% (registered nurses 53.3%)
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
2025-12-30
complaint survey
Post nurse staffing information every day.
Nursing and Physician Services Deficiencies · tag F0732
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2026-01-01
2025-08-01
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2025-08-02
2025-08-01
complaint survey
Provide safe, appropriate pain management for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0697
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2025-08-02
2024-11-04
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
2024-12-04
2024-11-04
complaint survey
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-12-04
2024-11-04
complaint survey
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies · tag F0580
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-12-04
2024-08-15 Keep residents' personal and medical records private and confidential.
Resident Rights Deficiencies · tag F0583
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-14
2024-08-15 Honor 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.
Resident Rights Deficiencies · tag F0584
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-14
2024-08-15 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
2024-09-14
2024-08-15 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-14
2024-08-15 Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies · tag F0679
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-14
2024-08-15 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
2024-09-14
2024-08-15 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
2024-09-14
2024-08-15 Provide routine and 24-hour emergency dental care for each resident.
Quality of Life and Care Deficiencies · tag F0790
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-14
2024-04-15
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2024-05-03
2023-06-16 Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies · tag F0558
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-07
2023-06-16 Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies · tag F0679
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-07

Fines and payment denials

DatePenaltyAmount
2025-08-01Fine$33,891

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
Guadalupe County Hospital Board
Organization
5% or greater direct ownership interest100%2017-04-01
Caretrust Gp LLC
Organization
adp of the snf2017-04-01
Caretrust Reit Inc.
Organization
adp of the snf2017-04-01
Ctr Partnership Lp
Organization
adp of the snf2017-04-01
Ensign Services Inc.
Organization
adp of the snf2010-02-05
Ives Health Holdings LLC
Organization
adp of the snf2017-04-01
Wood Bayou Healthcare, Inc.
Organization
adp of the snf2025-09-30
Wood Bayou Healthcare, Inc.
Organization
operational/managerial control2017-04-01
Castro Pou, Graciela
Individual
adp of the snf2024-12-27
Tochterman, Jerry
Individual
adp of the snf2017-08-21
Burnam, Soon
Individual
corporate officer2017-04-01
Gann, Kody
Individual
corporate officer2017-04-01
Keetch, Chad
Individual
corporate officer2011-03-01
Castro Pou, Graciela
Individual
managing control - governing body2024-12-27
Tochterman, Jerry
Individual
managing control - governing body2017-08-21
Castro Pou, Graciela
Individual
operational/managerial control2024-12-27
Tochterman, Jerry
Individual
operational/managerial control2017-08-21

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 Hays County.