Fredericksburg, TX

Knopp Healthcare And Rehab Center Inc

4-star overall rating with 4-star inspections with 6 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle

1208 N Llano, Fredericksburg, TX

(830) 997-3704

Compare this facility

Overall

4 / 5

CMS overall stars

Health inspections

4 / 5

Survey and complaint cycles

Staffing

3 / 5

RN + nurse staffing

Quality measures

2 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

119

Certified beds

Average residents

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

No chain reported

Operator or chain grouping

Approved since

1976-03-01

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Changed ownership

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

0.50

Registered nurse staffing · state 0.44 · national 0.68

LPN hours / resident day

0.76

Licensed practical nurse staffing · state 0.95 · national 0.87

Aide hours / resident day

1.85

Nurse aide staffing · state 2.01 · national 2.35

Total nurse hours

3.11

All reported nurse hours · state 3.40 · national 3.89

Licensed hours

1.26

RN + LPN hours · state 1.38 · national 1.54

Weekend hours

2.92

Weekend nurse staffing · state 2.99 · national 3.43

Weekend RN hours

0.37

Weekend registered nurse coverage · state 0.34 · national 0.47

Physical therapist

0.11

Reported PT staffing · state 0.07 · national 0.07

Adjusted RN hours

0.56

CMS adjusted RN staffing hours

Adjusted total hours

3.48

CMS adjusted total nurse staffing hours

Case-mix index

1.22

Higher values indicate more complex resident acuity

RN turnover

Annual RN turnover

Total nurse turnover

49%

Annual nurse turnover · state 52% · national 46%

SNF VBP

Value-based purchasing

Program rank

3,785

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

Performance score

42.69

Composite VBP score used to determine payment impact.

Payment multiplier

0.9956

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

7.47

Performance 17.97% · Measure score 7.47 · Achievement 7.47 · This facility did not have sufficient data to calculate a baseline period measure result.

Healthcare-associated infections

5.14

Performance 6.30% · Measure score 5.14 · Achievement 5.14 · This facility did not have sufficient data to calculate a baseline period measure result.

Total nurse turnover

3.35

Baseline 63.64% · Performance 50.00% · Measure score 3.35 · Achievement 3.35 · Improvement 3.02

Adjusted total nurse staffing

1.12

Baseline 3.59 hours · Performance 3.40 hours · Measure score 1.12 · Achievement 1.12 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	10.41%	10.72% 0.3 pts better	No Different than the National Rate · Eligible stays 85 · Observed rate 7.06% · Lower 95% interval 7.68%
Discharge to community	54.89%	50.57% 4.3 pts better	No Different than the National Rate · Eligible stays 65 · Observed rate 56.92% · Lower 95% interval 46.26%
Medicare spending per beneficiary	0.75	1.02 0.3 pts better
Drug regimen review with follow-up	100%	95.27% 4.7 pts better	Numerator 44 · Denominator 44
Falls with major injury	2.27%	0.77% 1.5 pts worse	Numerator 1 · Denominator 44
Discharge self-care score	58.54%	53.69% 4.9 pts better	Numerator 24 · Denominator 41
Discharge mobility score	34.15%	50.94% 16.8 pts worse	Numerator 14 · Denominator 41
Pressure ulcers or injuries, new or worsened	2.27%	2.29% About the same	Numerator 1 · Denominator 44 · Adjusted rate 2.38%
Healthcare-associated infections requiring hospitalization	6.3%	7.12% 0.8 pts better	No Different than the National Rate · Eligible stays 50 · Observed rate 2% · Lower 95% interval 3.69%
Staff COVID-19 vaccination coverage	0%	8.2% 8.2 pts worse	Numerator 0 · Denominator 62
Staff flu vaccination coverage	30.77%	42% 11.2 pts worse	Numerator 20 · Denominator 65
Discharge function score	53.66%	56.45% 2.8 pts worse	Numerator 22 · Denominator 41
Transfer of health information to provider	Not Available	95.95%	Numerator Not Available · Denominator 2 · Too few residents or stays to report publicly.
Transfer of health information to patient	100%	96.28% 3.7 pts better	Numerator 28 · Denominator 28
Resident COVID-19 vaccinations up to date	3.7%	25.2% 21.5 pts worse	Numerator 1 · Denominator 27

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	2.2	2.1 0.1 pts worse	1.9 0.3 pts worse	Long Stay · 20240701-20250630 · Adjusted 2.2 · Observed 1.9 · Expected 1.6 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	2.7	2.1 0.6 pts worse	1.8 0.9 pts worse	Long Stay · 20240701-20250630 · Adjusted 2.7 · Observed 2.4 · Expected 1.4 · 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	95.6%	97.9% 2.3 pts worse	95.5% 0.1 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 95.6%
Percentage of long-stay residents experiencing one or more falls with major injury	1.2%	3.3% 2.1 pts better	3.3% 2.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 2.5% · Q4 2.1% · 4Q avg 1.2% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	4.6%	2.7% 1.9 pts worse	11.4% 6.8 pts better	Long Stay · 2024Q4-2025Q3 · Q1 8.1% · Q2 5.6% · Q3 0.0% · Q4 4.4% · 4Q avg 4.6%
Percentage of long-stay residents who lose too much weight	10.1%	3.3% 6.8 pts worse	5.4% 4.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 17.9% · Q2 12.0% · Q3 0.0% · Q4 10.7% · 4Q avg 10.1%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	14.7%	18.9% 4.2 pts better	19.6% 4.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 20.7% · Q2 10.3% · Q3 10.7% · Q4 16.7% · 4Q avg 14.7%
Percentage of long-stay residents who received an antipsychotic medication	5.0%	10.8% 5.8 pts better	16.7% 11.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 3.8% · Q2 4.2% · Q3 0.0% · Q4 11.1% · 4Q avg 5.0% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	1.2%	0.0% 1.2 pts worse	0.1% 1.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 2.5% · Q2 2.5% · Q3 0.0% · Q4 0.0% · 4Q avg 1.2%
Percentage of long-stay residents whose ability to walk independently worsened	36.3%	15.4% 20.9 pts worse	16.3% 20 pts worse	Long Stay · 2024Q4-2025Q3 · 4Q avg 36.3% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	26.0%	16.1% 9.9 pts worse	14.9% 11.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 19.2% · Q2 16.0% · Q3 23.1% · Q4 44.4% · 4Q avg 26.0% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	4.2%	0.5% 3.7 pts worse	1.0% 3.2 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 6.8% · Q2 2.6% · Q3 2.8% · Q4 4.5% · 4Q avg 4.2% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	4.3%	0.8% 3.5 pts worse	1.7% 2.6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 5.1% · Q2 2.8% · Q3 7.5% · Q4 2.2% · 4Q avg 4.3% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	24.0%	15.0% 9 pts worse	19.8% 4.2 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 25.8% · Q2 21.9% · Q3 25.2% · Q4 23.2% · 4Q avg 24.0%
Percentage of long-stay residents with pressure ulcers	9.7%	4.2% 5.5 pts worse	5.1% 4.6 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 14.2% · Q2 9.5% · Q3 9.7% · Q4 6.2% · 4Q avg 9.7% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	98.7%	89.7% 9 pts better	81.7% 17 pts better	Short Stay · 2024Q4-2025Q3 · Q1 98.0% · Q2 98.6% · Q3 97.7% · Q4 100.0% · 4Q avg 98.7%
Percentage of short-stay residents who had an outpatient emergency department visit	24.5%	12.0% 12.5 pts worse	12.0% 12.5 pts worse	Short Stay · 20240701-20250630 · Adjusted 24.5% · Observed 22.0% · Expected 10.0% · 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	47.3%	88.0% 40.7 pts worse	79.7% 32.4 pts worse	Short Stay · 2024Q3-2025Q2 · 4Q avg 47.3%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	31.1%	25.9% 5.2 pts worse	23.9% 7.2 pts worse	Short Stay · 20240701-20250630 · Adjusted 31.1% · Observed 25.4% · Expected 19.5% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2024-10-04 · Fire 2024-10-04

6 health deficiencies

Top issue: Environmental (2 deficiencies)

7 fire-safety deficiencies

Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)

Cycle 2 Health 2023-08-24 · Fire 2023-08-24

13 health deficiencies

Top issue: Resident Assessment and Care Planning (3 deficiencies)

4 fire-safety deficiencies

Top issue: Egress (1 deficiency)

Cycle 3 Health 2022-07-08 · Fire 2022-07-08

9 health deficiencies

Top issue: Resident Assessment and Care Planning (4 deficiencies)

4 fire-safety deficiencies

Top issue: Emergency Preparedness (2 deficiencies)

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2024-10-04

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2024-11-29

F · Potential for more than minimal harm 2024-10-04

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

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

Corrected 2024-10-30

E · Potential for more than minimal harm 2024-10-04

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2024-11-29

E · Potential for more than minimal harm 2024-10-04

K511 · Services Deficiencies

Fire Safety

Have properly installed electrical wiring and gas equipment.

Corrected 2024-11-29

D · Potential for more than minimal harm 2024-10-04

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2024-11-29

C · Minimal harm 2024-10-04

K211 · Egress Deficiencies

Fire Safety

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Corrected 2024-10-17

C · Minimal harm 2024-10-04

K521 · Services Deficiencies

Fire Safety

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Corrected 2024-10-17

F · Potential for more than minimal harm 2023-08-24

K345 · Smoke Deficiencies

Fire Safety

Have approved installation, maintenance and testing program for fire alarm systems.

Corrected 2023-09-25

D · Potential for more than minimal harm 2023-08-24

K923 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have proper medical gas storage and administration areas.

Corrected 2023-10-06

C · Minimal harm 2023-08-24

K211 · Egress Deficiencies

Fire Safety

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Corrected 2023-09-23

C · Minimal harm 2023-08-24

K521 · Services Deficiencies

Fire Safety

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Corrected 2023-09-20

F · Potential for more than minimal harm 2022-07-08

E4 · Emergency Preparedness Deficiencies

Fire Safety

Develop and maintain an Emergency Preparedness Program (EP).

Corrected 2022-08-18

F · Potential for more than minimal harm 2022-07-08

E6 · Emergency Preparedness Deficiencies

Fire Safety

Conduct risk assessment and an All-Hazards approach.

Corrected 2022-08-18

C · Minimal harm 2022-07-08

K211 · Egress Deficiencies

Fire Safety

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Corrected 2022-07-07

C · Minimal harm 2022-07-08

K521 · Services Deficiencies

Fire Safety

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Corrected 2022-07-07

Inspection history

Recent health citations

D · Potential for more than minimal harm 2024-10-16

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 2024-11-29

D · Potential for more than minimal harm 2024-10-16

F925 · Environmental Deficiencies

Health

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Corrected 2024-11-29

E · Potential for more than minimal harm 2024-10-04

F759 · Pharmacy Service Deficiencies

Health

Ensure medication error rates are not 5 percent or greater.

Corrected 2024-11-18

E · Potential for more than minimal harm 2024-10-04

F908 · Environmental Deficiencies

Health

Keep all essential equipment working safely.

Corrected 2024-11-18

D · Potential for more than minimal harm 2024-10-04

F640 · Resident Assessment and Care Planning Deficiencies

Health

Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Corrected 2024-11-18

D · Potential for more than minimal harm 2024-10-04

F695 · Quality of Life and Care Deficiencies

Health

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

Corrected 2024-11-18

D · Potential for more than minimal harm 2024-10-04

F758 · Pharmacy Service Deficiencies

Health

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.

Corrected 2024-11-18

D · Potential for more than minimal harm 2024-10-04

F919 · Environmental Deficiencies

Health

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

Corrected 2024-11-18

D · Potential for more than minimal harm 2024-09-20

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 2024-10-23

D · Potential for more than minimal harm 2024-09-20

F657 · Resident Assessment and Care Planning Deficiencies

Health

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Corrected 2024-10-23

F · Potential for more than minimal harm 2023-08-24

F727 · Nursing and Physician Services Deficiencies

Health

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.

Corrected 2023-09-20

F · Potential for more than minimal harm 2023-08-24

F944 · Administration Deficiencies

Health

Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.

Corrected 2023-10-09

E · Potential for more than minimal harm 2023-08-24

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 2023-10-09

E · Potential for more than minimal harm 2023-08-24

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 2023-10-09

E · Potential for more than minimal harm 2023-08-24

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 2023-09-20

D · Potential for more than minimal harm 2023-08-24

F657 · Resident Assessment and Care Planning Deficiencies

Health

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Corrected 2023-10-09

D · Potential for more than minimal harm 2023-08-24

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 2023-10-09

D · Potential for more than minimal harm 2023-08-24

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 2023-10-09

D · Potential for more than minimal harm 2023-08-24

F849 · Administration Deficiencies

Health

Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.

Corrected 2023-09-20

F · Potential for more than minimal harm 2022-07-08

F727 · Nursing and Physician Services Deficiencies

Health

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.

Corrected 2022-08-18

E · Potential for more than minimal harm 2022-07-08

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 2022-08-18

E · Potential for more than minimal harm 2022-07-08

F921 · Environmental Deficiencies

Health

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

Corrected 2022-08-18