Live Oak, TX

Advanced Rehabilitation & Healthcare Of Live Oak

4-star overall rating with 3-star inspections with $12,424 in total fines with 12 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle

8221 Palisades Drive, Live Oak, TX

(210) 600-3700

Compare this facility

Overall

4 / 5

CMS overall stars

Health inspections

3 / 5

Survey and complaint cycles

Staffing

2 / 5

RN + nurse staffing

Quality measures

5 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

123

Certified beds

Average residents

114

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Ruby Healthcare

Operator or chain grouping

Approved since

1994-07-28

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

7 facilities

Chain averages 3 overall / 2 health / 3 staffing / 5 quality stars

Changed ownership

No

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.60

Registered nurse staffing · state 0.44 · national 0.68

LPN hours / resident day

0.86

Licensed practical nurse staffing · state 0.95 · national 0.87

Aide hours / resident day

1.67

Nurse aide staffing · state 2.01 · national 2.35

Total nurse hours

3.13

All reported nurse hours · state 3.40 · national 3.89

Licensed hours

1.46

RN + LPN hours · state 1.38 · national 1.54

Weekend hours

2.83

Weekend nurse staffing · state 2.99 · national 3.43

Weekend RN hours

0.48

Weekend registered nurse coverage · state 0.34 · national 0.47

Physical therapist

0.12

Reported PT staffing · state 0.07 · national 0.07

Adjusted RN hours

0.59

CMS adjusted RN staffing hours

Adjusted total hours

3.11

CMS adjusted total nurse staffing hours

Case-mix index

1.37

Higher values indicate more complex resident acuity

RN turnover

56%

Annual RN turnover · state 52% · national 45%

Total nurse turnover

57%

Annual nurse turnover · state 52% · national 46%

SNF VBP

Value-based purchasing

Program rank

9,329

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

23.96

Composite VBP score used to determine payment impact.

Payment multiplier

0.9833

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

2.57

Baseline 23.65% · Performance 21.62% · Measure score 2.57 · Achievement 0 · Improvement 2.57

Healthcare-associated infections

0

Baseline 7.13% · Performance 7.95% · Measure score 0 · Achievement 0 · Improvement 0

Total nurse turnover

6.38

Baseline 97.96% · Performance 47.67% · Measure score 6.38 · Achievement 3.92 · Improvement 6.38

Adjusted total nurse staffing

0.63

Baseline 2.84 hours · Performance 3.17 hours · Measure score 0.63 · Achievement 0 · Improvement 0.63

SNF QRP

Medicare quality reporting measures

Measure Facility National Note
Potentially preventable 30-day readmission 11.66%
10.72%
0.9 pts worse
No Different than the National Rate · Eligible stays 108 · Observed rate 12.04% · Lower 95% interval 7.81%
Discharge to community 56.71%
50.57%
6.1 pts better
No Different than the National Rate · Eligible stays 108 · Observed rate 51.85% · Lower 95% interval 49.33%
Medicare spending per beneficiary 1.47
1.02
0.4 pts worse
Drug regimen review with follow-up 100%
95.27%
4.7 pts better
Numerator 137 · Denominator 137
Falls with major injury 0.73%
0.77%
About the same
Numerator 1 · Denominator 137
Discharge self-care score 74.24%
53.69%
20.5 pts better
Numerator 49 · Denominator 66
Discharge mobility score 77.27%
50.94%
26.3 pts better
Numerator 51 · Denominator 66
Pressure ulcers or injuries, new or worsened 1.46%
2.29%
0.8 pts better
Numerator 2 · Denominator 137 · Adjusted rate 1.14%
Healthcare-associated infections requiring hospitalization 7.95%
7.12%
0.8 pts worse
No Different than the National Rate · Eligible stays 94 · Observed rate 9.57% · Lower 95% interval 5.19%
Staff COVID-19 vaccination coverage 3.23%
8.2%
5 pts worse
Numerator 4 · Denominator 124
Staff flu vaccination coverage 31.68%
42%
10.3 pts worse
Numerator 51 · Denominator 161
Discharge function score 81.82%
56.45%
25.4 pts better
Numerator 54 · Denominator 66
Transfer of health information to provider 100%
95.95%
4 pts better
Numerator 57 · Denominator 57
Transfer of health information to patient 100%
96.28%
3.7 pts better
Numerator 57 · Denominator 57
Resident COVID-19 vaccinations up to date 26.03%
25.2%
0.8 pts better
Numerator 19 · Denominator 73

Quality measures

Resident outcomes and process scores

Measure Facility State National Note
Number of hospitalizations per 1000 long-stay resident days 2.3
2.1
0.2 pts worse
1.9
0.4 pts worse
Long Stay · 20240701-20250630 · Adjusted 2.3 · Observed 3.3 · Expected 2.8 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days 1.4
2.1
0.7 pts better
1.8
0.4 pts better
Long Stay · 20240701-20250630 · Adjusted 1.4 · Observed 1.6 · Expected 2.0 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
97.1%
2.9 pts better
93.4%
6.6 pts better
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
97.9%
2.1 pts better
95.5%
4.5 pts better
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0%
Percentage of long-stay residents experiencing one or more falls with major injury 2.1%
3.3%
1.2 pts better
3.3%
1.2 pts better
Long Stay · 2024Q4-2025Q3 · Q1 3.5% · Q2 2.5% · Q3 1.2% · Q4 1.2% · 4Q avg 2.1% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms 3.2%
2.7%
0.5 pts worse
11.4%
8.2 pts better
Long Stay · 2024Q4-2025Q3 · Q1 1.3% · Q2 2.6% · Q3 3.6% · Q4 5.3% · 4Q avg 3.2%
Percentage of long-stay residents who lose too much weight 5.2%
3.3%
1.9 pts worse
5.4%
0.2 pts better
Long Stay · 2024Q4-2025Q3 · Q1 9.1% · Q2 4.7% · Q3 1.6% · Q4 5.4% · 4Q avg 5.2%
Percentage of long-stay residents who received an antianxiety or hypnotic medication 16.7%
18.9%
2.2 pts better
19.6%
2.9 pts better
Long Stay · 2024Q4-2025Q3 · Q1 16.4% · Q2 16.9% · Q3 16.7% · Q4 16.7% · 4Q avg 16.7%
Percentage of long-stay residents who received an antipsychotic medication 9.9%
10.8%
0.9 pts better
16.7%
6.8 pts better
Long Stay · 2024Q4-2025Q3 · Q1 12.0% · Q2 10.6% · Q3 11.4% · Q4 4.9% · 4Q avg 9.9% · Used in QM five-star
Percentage of long-stay residents who were physically restrained 0.0%
0.0%
About the same
0.1%
0.1 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened 4.5%
15.4%
10.9 pts better
16.3%
11.8 pts better
Long Stay · 2024Q4-2025Q3 · Q1 9.1% · Q2 0.0% · Q3 0.0% · Q4 8.8% · 4Q avg 4.5% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased 9.0%
16.1%
7.1 pts better
14.9%
5.9 pts better
Long Stay · 2024Q4-2025Q3 · Q1 11.5% · Q2 5.2% · Q3 6.7% · Q4 12.7% · 4Q avg 9.0% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder 0.0%
0.5%
0.5 pts better
1.0%
1 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection 0.3%
0.8%
0.5 pts better
1.7%
1.4 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 1.3% · 4Q avg 0.3% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence 15.2%
15.0%
0.2 pts worse
19.8%
4.6 pts better
Long Stay · 2024Q4-2025Q3 · Q1 18.1% · Q2 16.8% · Q3 12.0% · Q4 13.8% · 4Q avg 15.2%
Percentage of long-stay residents with pressure ulcers 3.3%
4.2%
0.9 pts better
5.1%
1.8 pts better
Long Stay · 2024Q4-2025Q3 · Q1 2.3% · Q2 3.1% · Q3 2.9% · Q4 5.2% · 4Q avg 3.3% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine 99.4%
89.7%
9.7 pts better
81.7%
17.7 pts better
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 99.4% · Q3 99.4% · Q4 99.0% · 4Q avg 99.4%
Percentage of short-stay residents who had an outpatient emergency department visit 4.8%
12.0%
7.2 pts better
12.0%
7.2 pts better
Short Stay · 20240701-20250630 · Adjusted 4.8% · Observed 5.5% · Expected 12.8% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication 0.0%
1.5%
1.5 pts better
1.6%
1.6 pts better
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine 99.4%
88.0%
11.4 pts better
79.7%
19.7 pts better
Short Stay · 2024Q3-2025Q2 · 4Q avg 99.4%
Percentage of short-stay residents who were rehospitalized after a nursing home admission 30.9%
25.9%
5 pts worse
23.9%
7 pts worse
Short Stay · 20240701-20250630 · Adjusted 30.9% · Observed 33.6% · Expected 26.0% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-05-23 · Fire 2025-05-23

12 health deficiencies

Top issue: Quality of Life and Care (3 deficiencies)

3 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Cycle 2 Health 2024-04-05 · Fire 2024-04-05

19 health deficiencies

Top issue: Resident Rights (6 deficiencies)

2 fire-safety deficiencies

Top issue: Miscellaneous (1 deficiency)

Cycle 3 Health 2023-02-17 · Fire 2023-02-17

11 health deficiencies

Top issue: Nutrition and Dietary (2 deficiencies)

4 fire-safety deficiencies

Top issue: Miscellaneous (2 deficiencies)

Fire safety

Fire-safety citations

D · Potential for more than minimal harm 2025-05-23

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2025-05-29

D · Potential for more than minimal harm 2025-05-23

K355 · Smoke Deficiencies

Fire Safety

Properly select, install, inspect, or maintain portable fire extinguishes.

Corrected 2025-05-29

D · Potential for more than minimal harm 2025-05-23

K741 · Miscellaneous Deficiencies

Fire Safety

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

Corrected 2025-05-29

E · Potential for more than minimal harm 2024-04-05

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2024-05-06

E · Potential for more than minimal harm 2024-04-05

K741 · Miscellaneous Deficiencies

Fire Safety

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

Corrected 2024-04-06

E · Potential for more than minimal harm 2023-02-17

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2023-03-15

E · Potential for more than minimal harm 2023-02-17

K700 · Miscellaneous Deficiencies

Fire Safety

Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors.

Corrected 2023-03-15

E · Potential for more than minimal harm 2023-02-17

K741 · Miscellaneous Deficiencies

Fire Safety

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

Corrected 2023-03-15

D · Potential for more than minimal harm 2023-02-17

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have generator or other power source capable of supplying service within 10 seconds.

Corrected 2023-03-15

Inspection history

Recent health citations

D · Potential for more than minimal harm 2025-11-18

F726 · Nursing and Physician Services Deficiencies

Health

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.

Corrected 2025-11-19

D · Potential for more than minimal harm 2025-11-18

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-11-19

E · Potential for more than minimal harm 2025-05-23

F576 · Resident Rights Deficiencies

Health

Ensure residents have reasonable access to and privacy in their use of communication methods.

Corrected 2025-05-24

E · Potential for more than minimal harm 2025-05-23

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2025-05-24

E · Potential for more than minimal harm 2025-05-23

F698 · Quality of Life and Care Deficiencies

Health

Provide safe, appropriate dialysis care/services for a resident who requires such services.

Corrected 2025-05-24

E · Potential for more than minimal harm 2025-05-23

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2025-05-24

E · Potential for more than minimal harm 2025-05-23

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-05-24

D · Potential for more than minimal harm 2025-05-23

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2025-05-24

D · Potential for more than minimal harm 2025-05-23

F690 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Corrected 2025-05-24

E · Potential for more than minimal harm 2025-04-17

F842 · Resident Assessment and Care Planning Deficiencies

Health

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Corrected 2025-04-18

D · Potential for more than minimal harm 2025-04-17

F585 · Resident Rights Deficiencies

Health

Honor 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.

Corrected 2025-04-18

D · Potential for more than minimal harm 2025-04-17

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2025-04-18

E · Potential for more than minimal harm 2025-02-12

F807 · Nutrition and Dietary Deficiencies

Health

Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.

Corrected 2025-02-13

D · Potential for more than minimal harm 2025-02-12

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2025-02-13

D · Potential for more than minimal harm 2025-02-12

F805 · Nutrition and Dietary Deficiencies

Health

Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

Corrected 2025-02-13

J · Immediate jeopardy 2025-01-17

F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Corrected 2024-11-13

D · Potential for more than minimal harm 2024-09-12

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2024-09-13

D · Potential for more than minimal harm 2024-06-01

F622 · Resident Rights Deficiencies

Health

Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.

Corrected 2024-06-02

F · Potential for more than minimal harm 2024-04-05

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2024-04-12

E · Potential for more than minimal harm 2024-04-05

F550 · Resident Rights Deficiencies

Health

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Corrected 2024-04-12

E · Potential for more than minimal harm 2024-04-05

F565 · Resident Rights Deficiencies

Health

Honor the resident's right to organize and participate in resident/family groups in the facility.

Corrected 2024-04-12

E · Potential for more than minimal harm 2024-04-05

F576 · Resident Rights Deficiencies

Health

Ensure residents have reasonable access to and privacy in their use of communication methods.

Corrected 2024-04-12

E · Potential for more than minimal harm 2024-04-05

F584 · Resident Rights Deficiencies

Health

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.

Corrected 2024-04-06

E · Potential for more than minimal harm 2024-04-05

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2024-04-12

E · Potential for more than minimal harm 2024-04-05

F684 · Quality of Life and Care Deficiencies

Health

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Corrected 2024-04-12

E · Potential for more than minimal harm 2024-04-05

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2024-04-12

E · Potential for more than minimal harm 2024-04-05

F698 · Quality of Life and Care Deficiencies

Health

Provide safe, appropriate dialysis care/services for a resident who requires such services.

Corrected 2024-04-12

E · Potential for more than minimal harm 2024-04-05

F759 · Pharmacy Service Deficiencies

Health

Ensure medication error rates are not 5 percent or greater.

Corrected 2024-04-12

D · Potential for more than minimal harm 2024-04-05

F582 · Resident Rights Deficiencies

Health

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Corrected 2024-04-12

D · Potential for more than minimal harm 2024-04-05

F761 · Pharmacy Service Deficiencies

Health

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.

Corrected 2024-04-12

D · Potential for more than minimal harm 2024-04-05

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2024-04-06

D · Potential for more than minimal harm 2023-08-17

F919 · Environmental Deficiencies

Health

Make sure that a working call system is available in each resident's bathroom and bathing area.

Corrected 2023-08-18

C · Minimal harm 2023-03-28

F732 · Nursing and Physician Services Deficiencies

Health

Post nurse staffing information every day.

Corrected 2023-04-11

F · Potential for more than minimal harm 2023-02-17

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2023-03-15

E · Potential for more than minimal harm 2023-02-17

F755 · Pharmacy Service Deficiencies

Health

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Corrected 2023-03-15

D · Potential for more than minimal harm 2023-02-17

F578 · Resident Rights Deficiencies

Health

Honor 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.

Corrected 2023-03-15

D · Potential for more than minimal harm 2023-02-17

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2023-03-15

D · Potential for more than minimal harm 2023-02-17

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2023-03-15

D · Potential for more than minimal harm 2023-02-17

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2023-03-15

D · Potential for more than minimal harm 2023-02-17

F695 · Quality of Life and Care Deficiencies

Health

Provide safe and appropriate respiratory care for a resident when needed.

Corrected 2023-03-15

D · Potential for more than minimal harm 2023-02-17

F800 · Nutrition and Dietary Deficiencies

Health

Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.

Corrected 2023-03-15

D · Potential for more than minimal harm 2023-02-17

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2023-03-15

Penalties and ownership

What sits behind the stars

$8,407 2025-01-17

Fine

Fine · fine $8,407

Fine

$4,017 2024-06-01

Fine

Fine · fine $4,017

Fine

Ownership

Hamilton County Hospital District

5% Or Greater Direct Ownership Interest · Organization

100% 55 facilities 2023-04-01
Hooper, Grady

Corporate Director · Individual

0% 61 facilities 2023-04-01
Live Oak Hc, LLC

Operational/Managerial Control · Organization

0% 1 facilities 2023-04-01
Mcintosh, Traci

Operational/Managerial Control · Individual

0% 1 facilities 2023-04-01
Oommen, Biju

Operational/Managerial Control · Individual

0% 2 facilities 2023-04-01

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#3

Crestway Nursing & Rehabilitation

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1-star overall rating with 1-star inspections with $73,977 in total fines with 28 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle

Overall
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Health
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Staffing
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Fines
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