Nursing Care Index

The Chateau Waco

Waco, Mc Lennan County, Texas · CCN 676409 · Government (Hospital district) · part of The Ensign Group (342 facilities, chain average 3.2 stars)

CMS rates The Chateau Waco 1 of 5 overall as of August 2026. 123 certified beds, 68 residents a day on average. 31 citations on record from the current inspection cycles, 6 at immediate jeopardy; 4 fines totalling $72,056.

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

Staffing

Total nurse staffing3.48098 hours per resident per day
Registered nurses0.38392 hours per resident per day
Weekend total2.95302 hours per resident per day
Nursing staff turnover73.6% (registered nurses 70%)
Administrators who left2

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
2026-03-19 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
2026-04-19
2026-03-19 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-19
2026-03-19 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
2026-04-19
2026-01-23
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
2026-02-23
2025-09-26
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
2025-09-20
2025-08-28
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 Deficient, Provider has date of correction
2025-08-29
2025-08-28
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
2025-08-29
2025-07-30
complaint survey
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Resident Rights Deficiencies · tag F0627
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-07-31
2025-07-01
complaint survey
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies · tag F0644
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-07-09
2025-03-20
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
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2025-03-21
2025-03-20
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
2025-03-21
2025-02-27
complaint survey
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2025-03-19
2025-02-27
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
2025-03-19
2025-01-08
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-01-28
2025-01-08
complaint survey
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-01-28
2025-01-08
complaint survey
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
2025-01-28
2024-12-18 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
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-01-10
2024-12-18 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
2025-01-10
2024-12-18 Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-01-10
2024-12-18 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
2025-01-10
2024-12-18 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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-01-10
2024-11-24
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
2024-11-23
2024-02-28
complaint survey
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
2024-03-19
2024-02-28
complaint survey
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
Nutrition and Dietary Deficiencies · tag F0810
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-19
2024-02-28
complaint survey
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
2024-03-19
2024-02-28
complaint survey
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-19
2024-01-16
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
2024-02-13
2023-10-26 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
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2023-11-16
2023-10-26 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
2023-11-16
2023-10-26 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
2023-11-16
2023-09-01
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
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-09-21

Fines and payment denials

DatePenaltyAmount
2025-09-26Fine$16,149
2025-08-28Fine$16,149
2025-02-27Fine$25,325
2024-11-24Fine$14,433

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
South Limestone Hospital District
Organization
5% or greater direct ownership interest100%2025-06-01
Ensign Services Inc.
Organization
adp of the snf2026-02-01
Kendrick Healthcare LLC
Organization
adp of the snf2026-02-12
Lake Waco Health Holdings LLC
Organization
adp of the snf2026-02-01
Kendrick Healthcare LLC
Organization
operational/managerial control2026-02-01
Flowers, Adam
Individual
adp of the snf2022-07-05
Hicks, Heather
Individual
adp of the snf2026-02-01
Keetch, Chad
Individual
corporate officer2011-03-01
Price, Larry
Individual
corporate officer2025-06-01
Hicks, Heather
Individual
operational/managerial control2026-02-01

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 Mc Lennan County.