Federal inspection record · CMS data as of October 1, 2026
Avir at Fredericksburg
1117 S. Adams St., Fredericksburg, TX · (830) 997-4364
- Certified beds
- 90
- Residents per day
- 48
- Ownership
- For-Profit
- Chain
- Avir Health Group
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- August 12, 1993
1
How this home got 2 stars
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
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
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Avir at Fredericksburg carries 107 inspection points. That is fewer than 31% 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
48 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 (2)
-
J
Ensure that residents are free from significant medication errors.
-
J
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Everything else, by area of care
Resident Assessment and Care Planning12E
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- 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
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure each resident receives an accurate assessment.
- D
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure each resident receives an accurate assessment.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Nutrition and Dietary11E
- E
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.
- 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.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
- E
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
- 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.
- E
Dispose of garbage and refuse properly.
- 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
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- 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.
Pharmacy Service4E
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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
Ensure medication error rates are not 5 percent or greater.
- D
Ensure that residents are free from significant medication errors.
Quality of Life and Care4E
- 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 appropriate treatment and care according to orders, resident’s preferences and goals.
- 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.
- E
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Environmental4E
- B
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
- E
Keep all essential equipment working safely.
- B
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
- B
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Infection Control3E
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Nursing and Physician Services3E
- D
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.
- 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.
- E
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.
Freedom from Abuse, Neglect, and Exploitation2E
- E
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Resident Rights2E
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Administration1E
- E
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Inspection history
2025-06-20
17 health deficiencies · 4 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (5 deficiencies)
2024-05-17
19 health deficiencies · 7 fire-safety deficiencies
Top issue: Nutrition and Dietary (6 deficiencies)
2023-03-26
12 health deficiencies · 5 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 2 h 52 min of nursing staff time a day, 32 min of it from a registered nurse.
This home
2 h 52 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 79% of nursing staff and 56% of registered nurses left in the past year.
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
$15,288 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-05-27 | Fine | $15,288 |
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 days0.4 pts better | 1.6 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.2 pts better | 1.8 | 2.0 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine32.8 pts worse | 63.6% | 96.4% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine1.7 pts worse | 95.3% | 97.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.8 pts better | 1.4% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms1.6 pts better | 0.7% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.2 pts better | 2.7% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication6.3 pts worse | 24.1% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication10.2 pts worse | 20.0% | 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 worsened3.6 pts worse | 16.5% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased0.3 pts better | 15.5% | 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 infection0.1 pts better | 0.7% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence1.7 pts better | 10.8% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2.3 pts better | 1.4% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine12.5 pts worse | 76.2% | 88.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit10.5 pts worse | 22.7% | 12.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.4 pts better | 0.0% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine15.1 pts worse | 70.3% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission12.8 pts better | 12.7% | 25.5% | 23.4% |
·
Who owns and runs it
14 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 |
|---|---|---|---|
| Val Verde County Hospital District | 5% Or Greater Direct Ownership Interest · Organization | 100% | 19 facilities |
| 1117 S Adams Street Opco, LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| 1117 S Adams Street Property Owner, LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Dagan, Amitai | Individual Is An Owner, Partner Or Trustee Of Any Adp Of The SNF · Individual | 0% | 156 facilities |
| Dennis, Wanda | Adp Of The SNF · Individual | 0% | 1 facilities |
| Freund, Nochum | Operational/Managerial Control · Individual | 0% | 164 facilities |
| Goldberger, Abraham | Individual Is An Owner, Partner Or Trustee Of Any Adp Of The SNF · Individual | 0% | 154 facilities |
| Jurado, Jorge | Corporate Officer · Individual | 0% | 19 facilities |
| Kothmann, John | Operational/Managerial Control · Individual | 0% | 3 facilities |
| Kothmann, John | Adp Of The SNF · Individual | 0% | 3 facilities |
| Travitsky, Aaron | Operational/Managerial Control · Individual | 0% | 162 facilities |
| Welltower Inc | Adp Of The SNF · Organization | 0% | 139 facilities |
| Welltower Nnn Group, LLC | Adp Of The SNF · Organization | 0% | 121 facilities |
| Welltower Op LLC | Adp Of The SNF · Organization | 0% | 158 facilities |
·
Fire safety
16 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke4F
- E
Provide properly protected cooking facilities.
- E
Install an approved automatic sprinkler system.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Provide properly protected cooking facilities.
Services4F
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- F
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.
Egress2E
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- D
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Gas, Vacuum, and Electrical Systems2F
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Have proper medical gas storage and administration areas.
Miscellaneous2E
- E
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Emergency Preparedness1F
- F
Establish policies and procedures including evacuation.
Construction1D
- D
Satisfy building requirements after a repair, renovation, modification, or change of user/occupancy.
·
Other homes nearby
-
Avir at Enchanted Rock
Fredericksburg, TX · Avir Health Group
★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 3 h 10 min
- Fines
- $63,121
-
Knopp Nursing & Rehab Center Inc
Fredericksburg, TX
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 26 min
- Fines
- $32,094
-
Knopp Healthcare And Rehab Center Inc
Fredericksburg, TX
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 37 min
- Fines
- $0