Federal inspection record · CMS data as of October 1, 2026
San Marcos Rehabilitation and Healthcare Center
1600 N I H 35, San Marcos, TX · (512) 353-5026
- Certified beds
- 129
- Residents per day
- 103
- Ownership
- For-Profit
- Chain
- The Ensign Group
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- February 1, 1997
1
How this home got 3 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.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Texas.
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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.
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Quality measures
★★★★★+1 star
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★3 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
San Marcos Rehabilitation and Healthcare Center carries 99.5 inspection points. That is fewer than 36% 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
17 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 (3)
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K
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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K
Provide safe, appropriate pain management for a resident who requires such services.
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G
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 Rights4E
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- E
Keep residents' personal and medical records private and confidential.
- E
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
Reasonably accommodate the needs and preferences of each resident.
Quality of Life and Care4E
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide activities to meet all resident's needs.
- D
Provide routine and 24-hour emergency dental care for each resident.
- D
Provide activities to meet all resident's needs.
Pharmacy Service2E
- 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.
Nursing and Physician Services1F
- F
Post nurse staffing information every day.
Resident Assessment and Care Planning1E
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Nutrition and Dietary1E
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control1E
- E
Provide and implement an infection prevention and control program.
Inspection history
2025-10-01
1 health deficiencies · 2 fire-safety deficiencies
Top issue: Nursing and Physician Services (1 deficiency)
2024-08-15
13 health deficiencies · 2 fire-safety deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
2023-06-16
3 health deficiencies · 4 fire-safety deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 2 h 54 min of nursing staff time a day, 38 min of it from a registered nurse.
This home
2 h 54 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 46% of nursing staff and 44% 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
$33,891 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-08-01 | Fine | $33,891 |
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 days0.9 pts better | 1.1 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days1.4 pts better | 0.6 | 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 vaccine1.9 pts better | 98.9% | 97.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.5 pts better | 1.7% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms0.3 pts worse | 2.6% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.8 pts better | 1.1% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication8.7 pts better | 9.1% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication5.1 pts better | 4.7% | 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 worsened5.5 pts worse | 18.4% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased3.7 pts better | 12.1% | 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 infection0.5 pts better | 0.3% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinenceAbout the same | 12.5% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.5 pts better | 2.2% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine11.1 pts better | 99.8% | 88.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit7.8 pts worse | 20.0% | 12.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.8 pts worse | 2.2% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine12.2 pts better | 97.6% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission9.8 pts better | 15.7% | 25.5% | 23.4% |
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Who owns and runs it
17 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 |
| Burnam, Soon | Corporate Officer · Individual | 0% | 353 facilities |
| Caretrust Gp LLC | Adp Of The SNF · Organization | 0% | 95 facilities |
| Caretrust Reit Inc | Adp Of The SNF · Organization | 0% | 102 facilities |
| Castro Pou, Graciela | Managing Control - Governing Body · Individual | 0% | 3 facilities |
| Castro Pou, Graciela | Operational/Managerial Control · Individual | 0% | 3 facilities |
| Castro Pou, Graciela | Adp Of The SNF · Individual | 0% | 3 facilities |
| Ctr Partnership LP | Adp Of The SNF · Organization | 0% | 104 facilities |
| Ensign Services Inc | Adp Of The SNF · Organization | 0% | 299 facilities |
| Gann, Kody | Corporate Officer · Individual | 0% | 27 facilities |
| Ives Health Holdings LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Keetch, Chad | Corporate Officer · Individual | 0% | 301 facilities |
| Tochterman, Jerry | Managing Control - Governing Body · Individual | 0% | 1 facilities |
| Tochterman, Jerry | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Tochterman, Jerry | Adp Of The SNF · Individual | 0% | 1 facilities |
| Wood Bayou Healthcare, Inc. | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Wood Bayou Healthcare, Inc. | Adp Of The SNF · Organization | 0% | 1 facilities |
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Fire safety
8 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Services3C
- 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.
Smoke3E
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Emergency Preparedness1F
- F
Address patient/client population and determine types of services needed.
Egress1E
- E
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.
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Other homes nearby
-
Hays Nursing and Rehabilitation Center
San Marcos, TX · The Ensign Group
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 16 min
- Fines
- $8,226
-
Cypress Healthcare and Rehabilitation Center
San Marcos, TX
★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 3 h 21 min
- Fines
- $191,611
-
Legend Oaks Healthcare and Rehabilitation-Kyle
Kyle, TX · The Ensign Group
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 23 min
- Fines
- $8,407