Nursing Care Index

Silver Tree Nursing And Rehabilitation Center

Schertz, Guadalupe County, Texas · CCN 676121 · Government (Hospital district) · part of Creative Solutions In Healthcare (149 facilities, chain average 2.1 stars)

CMS rates Silver Tree Nursing And Rehabilitation Center 2 of 5 overall as of August 2026. 120 certified beds, 97 residents a day on average. 60 citations on record from the current inspection cycles, 4 at immediate jeopardy; 3 fines totalling $114,303.

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

Staffing

Total nurse staffing3.25924 hours per resident per day
Registered nurses0.52925 hours per resident per day
Weekend total3.02333 hours per resident per day
Nursing staff turnover93.3% (registered nurses 80%)
Administrators who left1

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
2026-06-12 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-06-13
2026-06-12 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
2026-06-13
2026-06-12 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
2026-06-13
2026-06-12 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
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-06-13
2026-06-12 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
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-06-13
2026-06-12 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
2026-06-13
2026-06-12 Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Resident Assessment and Care Planning Deficiencies · tag F0640
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-06-13
2026-06-12 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies · tag F0645
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-06-13
2026-06-12 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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-06-13
2026-06-12 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
2026-06-13
2026-01-28
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
2026-01-29
2026-01-28
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
2026-01-29
2026-01-28
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
2026-01-29
2025-12-01
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
2025-12-02
2025-10-10
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
J Immediate jeopardy to resident health or safety; isolated Past Non-Compliance
2025-08-29
2025-10-10
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
2025-10-11
2025-10-10
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
2025-10-11
2025-04-27
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
J Immediate jeopardy to resident health or safety; isolated Past Non-Compliance
2025-04-25
2025-04-27
complaint survey
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 Past Non-Compliance
2025-04-25
2025-04-18 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
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-19
2025-04-18 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
2025-04-19
2025-04-18 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
2025-04-19
2025-04-18 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
2025-04-19
2025-04-18 Provide training in compliance and ethics.
Administration Deficiencies · tag F0946
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-19
2025-04-18 Keep residents' personal and medical records private and confidential.
Resident Rights Deficiencies · tag F0583
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 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
2025-04-19
2025-04-18 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning Deficiencies · tag F0655
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 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
2025-04-19
2025-04-18 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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 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
2025-04-19
2025-04-18 Ensure 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.
Quality of Life and Care Deficiencies · tag F0693
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Quality of Life and Care Deficiencies · tag F0694
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.
Administration Deficiencies · tag F0941
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
Resident Rights Deficiencies · tag F0942
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Nursing and Physician Services Deficiencies · tag F0947
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Administration Deficiencies · tag F0949
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-19
2025-04-18 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
B No actual harm, with potential for minimal harm; pattern Deficient, Provider has date of correction
2025-04-19
2025-01-17
complaint survey
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-01-18
2025-01-17
complaint survey
Protect each resident from the wrongful use of the resident's belongings or money.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0602
D No actual harm, with potential for more than minimal harm; isolated Past Non-Compliance
2024-08-01
2025-01-17
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
2025-01-18
2025-01-17
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
2025-01-18
2024-06-14
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
2024-06-15
2024-03-07
complaint survey
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
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-03-08
2024-03-07
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
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-08
2024-03-07 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
2024-03-08
2024-03-07
complaint survey
Assure that each resident’s assessment is updated at least once every 3 months.
Resident Assessment and Care Planning Deficiencies · tag F0638
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-03-07
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
2024-03-08
2024-03-07
complaint survey
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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-03-07
complaint survey
Ensure 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.
Quality of Life and Care Deficiencies · tag F0693
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-03-07
complaint survey
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-08
2024-03-07
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
2024-03-08
2024-03-07
complaint survey
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
2024-03-08
2024-03-07
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
2024-03-08
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
2024-02-01
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
2024-02-02
2023-12-22
complaint survey
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2024-01-31
2023-12-22
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
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-12-23
2023-12-22
complaint survey
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-12-23
2023-12-22
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
2023-12-23

Fines and payment denials

DatePenaltyAmount
2025-10-10Fine$16,471
2025-04-27Fine$15,156
2023-12-22Fine$82,676

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
Schertz I Enterprises, LLC
Organization
adp of the snf2025-05-20
Schertz I Enterprises, LLC
Organization
operational/managerial control2022-09-01
Blake, Gary
Individual
adp of the snf2022-09-01
Kasperkhan, Jibrail
Individual
adp of the snf2025-01-01
Linahan, Kori
Individual
adp of the snf2025-05-20
Huggins, Linda
Individual
corporate director2022-06-01
Willig, Zachary
Individual
corporate director2025-01-01
Thompson, Johnny
Individual
corporate officer2024-01-01
Bowers, Sean
Individual
managing control - governing body2024-07-01
Cisneros, Alfred
Individual
managing control - governing body2008-02-18
Cobb, Travis
Individual
managing control - governing body2022-10-05
Cooper, Stephen
Individual
managing control - governing body2022-11-11
Hardin, Sherrie
Individual
managing control - governing body2024-09-04
Kerzee, Richard
Individual
managing control - governing body2007-09-24
Korenek, Patricia
Individual
managing control - governing body2018-05-05
Soechting, Paul
Individual
managing control - governing body2024-11-22
Strack, Joe
Individual
managing control - governing body2022-02-11
Blake, Gary
Individual
operational/managerial control2022-09-01
Blake, Malisa
Individual
operational/managerial control2022-09-01

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 Guadalupe County.