Federal inspection record · CMS data as of October 1, 2026
The Chateau Waco
2430 Market Place Dr., Waco, TX · (254) 981-7900
- Certified beds
- 123
- Residents per day
- 68
- Ownership
- Government
- Chain
- The Ensign Group
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- November 2, 2016
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.
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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
★★★★★−1 star
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.
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Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
The Chateau Waco carries 145.75 inspection points. That is fewer than 19% 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
30 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.
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J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
K
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
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K
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
J
Provide safe and appropriate respiratory care for a resident when needed.
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J
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 Planning6E
- 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
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- 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.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Quality of Life and Care5E
- E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nutrition and Dietary4F
- E
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.
- E
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Resident Rights4D
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
- D
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Infection Control3E
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
Pharmacy Service2E
- 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.
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Inspection history
2026-03-19
4 health deficiencies · 0 fire-safety deficiencies
Top issue: Infection Control (1 deficiency)
2024-12-18
18 health deficiencies · 3 fire-safety deficiencies
Top issue: Quality of Life and Care (8 deficiencies)
2023-10-26
8 health deficiencies · 0 fire-safety deficiencies
Top issue: Nutrition and Dietary (3 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 42 min of nursing staff time a day, 18 min of it from a registered nurse.
This home
3 h 42 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 87% of nursing staff and 78% 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
$72,056 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2025-09-26 | Fine | $16,149 |
| 2025-08-28 | Fine | $16,149 |
| 2025-02-27 | Fine | $25,325 |
| 2024-11-24 | Fine | $14,433 |
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. |
|---|---|---|---|
| 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 injury0.6 pts better | 2.6% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms0.9 pts better | 1.4% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.4 pts better | 1.5% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication3 pts better | 14.8% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication8.5 pts better | 1.3% | 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 worsened3.2 pts worse | 16.1% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased0.4 pts worse | 16.2% | 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 infection0.8 pts better | 0.0% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence4 pts worse | 16.5% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers4.3 pts worse | 8.0% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine7.8 pts better | 96.5% | 88.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit9.9 pts worse | 22.1% | 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 vaccine10.9 pts better | 96.3% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission21.8 pts worse | 47.3% | 25.5% | 23.4% |
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Who owns and runs it
10 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 |
|---|---|---|---|
| South Limestone Hospital District | 5% Or Greater Direct Ownership Interest · Organization | 100% | 26 facilities |
| Ensign Services Inc | Adp Of The SNF · Organization | 0% | 299 facilities |
| Flowers, Adam | Adp Of The SNF · Individual | 0% | 4 facilities |
| Hicks, Heather | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Hicks, Heather | Adp Of The SNF · Individual | 0% | 1 facilities |
| Keetch, Chad | Corporate Officer · Individual | 0% | 301 facilities |
| Kendrick Healthcare LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Kendrick Healthcare LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Lake Waco Health Holdings LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Price, Larry | Corporate Officer · Individual | 0% | 27 facilities |
·
Fire safety
3 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke2D
- D
Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.
- D
Inspect, test, and maintain automatic sprinkler systems.
Gas, Vacuum, and Electrical Systems1F
- F
Have proper medical gas storage and administration areas.
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Other homes nearby
-
Greenview Nursing and Rehabilitation
Waco, TX · Eduro Healthcare
★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 2 h 46 min
- Fines
- $65,095
-
St. Anthony's Care Center
Waco, TX
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 4 h 23 min
- Fines
- $3,276
-
Avir at Jeffrey Place
Waco, TX · Avir Health Group
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 26 min
- Fines
- $22,382