Federal inspection record · CMS data as of October 1, 2026
Arbor View Nursing & Rehabilitation
1213 Water St, Kerrville, TX · (830) 896-2411
- Certified beds
- 179
- Residents per day
- 76
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- December 3, 1987
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Texas.
-
Staffing
★★★★★no change (already 1)
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Arbor View Nursing & Rehabilitation carries 269.5 inspection points. That is fewer than 4% of Texas's 1,166 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Texas: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–26 pts
- 4★ 26–51 pts
- 3★ 51–85 pts
- 2★ 85–145.75 pts
- 1★ over 145.75 pts
Bars show every rated home in Texas by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
81 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (6)
-
J
Ensure that residents are free from significant medication errors.
-
K
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
K
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
K
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.
-
K
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Resident Assessment and Care Planning15E
- D
Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Ensure each resident receives an accurate assessment.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Ensure each resident receives an accurate assessment.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Quality of Life and Care10E
- E
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Assist a resident in gaining access to vision and hearing services.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide or obtain dental services for each resident.
Nutrition and Dietary9F
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
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.
- D
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.
- D
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Dispose of garbage and refuse properly.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Dispose of garbage and refuse properly.
Resident Rights9E
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- D
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- D
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.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- E
Keep residents' personal and medical records private and confidential.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- E
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Reasonably accommodate the needs and preferences of each resident.
Freedom from Abuse, Neglect, and Exploitation9E
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- E
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- D
Respond appropriately to all alleged violations.
- E
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- E
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Pharmacy Service7E
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E
Ensure that residents are free from significant medication errors.
- E
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.
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E
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.
- D
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
- D
Ensure that residents are free from significant medication errors.
Environmental6F
- E
Keep all essential equipment working safely.
- D
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
- F
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- E
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- E
Keep all essential equipment working safely.
- D
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Nursing and Physician Services5F
- D
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.
- F
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.
- E
Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.
- F
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.
- E
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.
Infection Control4E
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Implement a program that monitors antibiotic use.
Administration1F
- F
Hire a qualified full-time social worker in a facility with more than 120 beds.
Inspection history
2026-09-04
17 health deficiencies · 11 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (5 deficiencies)
2025-07-31
32 health deficiencies · 11 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (6 deficiencies)
2023-04-27
32 health deficiencies · 6 fire-safety deficiencies
Top issue: Quality of Life and Care (6 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 16 min of nursing staff time a day, 22 min of it from a registered nurse.
This home
3 h 16 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 73% of nursing staff and 77% of registered nurses left in the past year, along with 2 administrators.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$154,617 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-07-31 | Fine | $91,293 |
| 2025-07-31 | Payment Denial · 6 day denial | $0 |
| 2024-06-14 | Fine | $11,389 |
| 2024-05-07 | Fine | $14,814 |
| 2023-12-21 | Fine | $15,593 |
| 2023-12-21 | Fine | $21,528 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.3 pts worse | 2.3 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days1.8 pts worse | 3.8 | 2.0 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3.6 pts better | 100.0% | 96.4% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine3 pts better | 100.0% | 97.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury4.3 pts worse | 7.5% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms1.7 pts worse | 4.0% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.5 pts worse | 3.4% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication9 pts worse | 26.8% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication1.2 pts better | 8.6% | 9.8% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened6.8 pts better | 6.1% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased3 pts worse | 18.8% | 15.8% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.3 pts better | 0.0% | 0.3% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.4 pts better | 0.4% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence1.6 pts better | 10.9% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2.2 pts better | 1.5% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine10.5 pts better | 99.2% | 88.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit0.8 pts worse | 13.0% | 12.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication4.2 pts worse | 5.6% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine14.6 pts better | 100.0% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission4.9 pts better | 20.6% | 25.5% | 23.4% |
·
Who owns and runs it
19 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Guadalupe County Hospital Board | 5% Or Greater Direct Ownership Interest · Organization | 100% | 27 facilities |
| Chamberlain, Jeff | Adp Of The SNF · Individual | 0% | 1 facilities |
| Colvin, Jim | Corporate Director · Individual | 0% | 4 facilities |
| Gann, Kody | Corporate Officer · Individual | 0% | 27 facilities |
| Givens, Laura | Adp Of The SNF · Individual | 0% | 12 facilities |
| Guadalupe County Hospital Board | Operational/Managerial Control · Organization | 0% | 27 facilities |
| Guadalupe County Hospital Board | Adp Of The SNF · Organization | 0% | 27 facilities |
| Haynes, Robert | Corporate Officer · Individual | 0% | 1 facilities |
| Humphrey, Ronald | Corporate Director · Individual | 0% | 3 facilities |
| Kerrville Nursing Operations LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Major, Dolores | Corporate Director · Individual | 0% | 4 facilities |
| Ramirez, Louis | Corporate Director · Individual | 0% | 4 facilities |
| Ramos, Brian | Operational/Managerial Control · Individual | 0% | 9 facilities |
| Ramos, Brian | Adp Of The SNF · Individual | 0% | 9 facilities |
| Reyes, James | Corporate Director · Individual | 0% | 4 facilities |
| Riverside SNF Operations, LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Riverside SNF Operations, LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Schnuriger, Jeanne | Corporate Director · Individual | 0% | 1 facilities |
| Vordenbaum, Eric | Corporate Director · Individual | 0% | 2 facilities |
·
Fire safety
28 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Emergency Preparedness6F
- F
Conduct testing and exercise requirements.
- F
Conduct risk assessment and an All-Hazards approach.
- F
Provide primary/alternate means for communication.
- F
Establish staff and initial training requirements.
- F
Conduct testing and exercise requirements.
- F
Develop and maintain an Emergency Preparedness Program (EP).
Smoke6F
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- E
Properly select, install, inspect, or maintain portable fire extinguishes.
- E
Have approved installation, maintenance and testing program for fire alarm systems.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Have an alternate power supply for its alarm system.
- E
Inspect, test, and maintain automatic sprinkler systems.
Miscellaneous6F
- F
Have simulated fire drills held at unexpected times.
- F
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- F
Have simulated fire drills held at unexpected times.
- F
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- E
Have restrictions on the use of portable space heaters.
- E
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Egress4F
- F
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- F
Have properly located and lighted "Exit" signs.
- F
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Services4E
- E
Have properly installed electrical wiring and gas equipment.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Gas, Vacuum, and Electrical Systems2F
- F
Have generator or other power source capable of supplying service within 10 seconds.
- E
Have generator or other power source capable of supplying service within 10 seconds.
·
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-
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-
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