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Nursing HomeMedicaid Investigative

Avir at Enchanted Rock

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

210 West Windcrest St, Fredericksburg, TX 78624120 bedsLicensed & Active
1/5
Medicare
Inspection
Quality
Staffing
Google rating
4.4/5

based on 85 Google reviews

5
4
3
2
1
Avir at Enchanted Rock Nursing Home in Fredericksburg, TX — Street View
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6/ 10
high Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (1/5 stars)
  • Low staffing rating (1/5 stars)
  • Above-median deficiencies (13 vs median 8.0)
  • High staff turnover (85%)
  • High RN turnover (100%)

Bottom 25% in Texas · Below recommended RN staffing · Very high staff turnover · $63,121 in fines

Source: Medicare data

What this means for your family

This facility is an excellent choice for patients requiring intensive physical or occupational therapy and those who value high-quality dining. However, families must remain vigilant regarding medical monitoring and should closely observe staffing levels during evening hours and weekends to ensure consistent care.

Google Reviews

Google Reviews

85 reviews analyzed
Families considering Avir Enchanted Rock (formerly Windcrest) will find a facility highly praised for its exceptional rehabilitation services and high-quality dining options. While many reviewers celebrate the compassionate nursing staff and cleanliness, there are serious, documented concerns regarding medical neglect, understaffing during evening hours, and inconsistent communication during management transitions.

Quality Themes

Tap a score for details
Food9.0Staff7.0Clean8.0ActivitiesN/AMedsN/AMemoryN/AComms4.0ValueN/A

Strengths

  • Excellent rehabilitation and physical therapy programs
  • High-quality, varied meal options
  • Compassionate and professional nursing staff
  • Clean and well-maintained facility

Concerns

  • Understaffing during evening and weekend hours (mentioned by 3 reviewers)
  • Serious medical neglect and failure to monitor worsening conditions (mentioned by 2 reviewers)
  • Inconsistent communication from administration and social workers (mentioned by 2 reviewers)

Rating Trends

Tap a year to see what changed

234'17(1)'20(7)'22(9)'24(13)'26(2)

Distribution

5
65
4
7
3
2
2
0
1
11

How They Respond to Reviews

80%response rate
Generic

The owner relies heavily on a set of repetitive, templated responses that often ignore the specific details of the review. While they attempt to personalize by adding names, the core message remains a copy-paste script.

Questions for Your Tour

  • 1We've heard great things about your rehabilitation and physical therapy programs; could you tell us more about how those are integrated into a resident's daily routine?
  • 2Since we want to ensure consistent care, how do you manage staffing levels and resident monitoring during the evening and weekend shifts?
  • 3What is the process for communicating important medical updates or changes in a resident's condition to the family members?
  • 4We noticed you are very active in responding to feedback; how does the administration use resident and family input to improve facility operations?
  • 5The meal options mentioned in recent feedback sound wonderful—could you describe what a typical daily menu looks like for the residents?
  • 6In the event of a medical emergency or a sudden change in health status during the night, what specific protocols are in place to ensure immediate response?

Personalized based on this facility's data


Key Review Excerpts

The PT/OT team is a strength here with kudos sent to Tracy and Carolyn who provide excellent therapy. We are happy with the nursing/clinical care he gets.

Short-term rehab family member · 2023★★★★★

Our dad did not receive the medical care or attention he needed and if we hadn't of pulled him out and taken him to the ER when we did, he would have died.

Long-term resident's family · 2024☆☆☆☆

I am originally from Germany and I am always happy when the food takes me 'home'. I enjoyed schnitzel German potato salad and sautéed red cabbage.

Resident · 2025★★★★★
Source: 85 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.33hrs
44%
Registered nurses for medical care
Total Nursing
3.08hrs
75%
All nurses + aides combined
Staff Turnover
83%
Lower is better (< 30% = good)
RN Turnover
90%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
4/ 5
Better Than Avg

9

measures

Worse Than Avg

3

measures

Mixed Results

5

measures

Long-Stay Residents
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility3.8%
Better than Avg
Here
3.8%
US
15.4%
TX
9.4%
Gillespie
14.0%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility15.5%
Mixed vs Avgs
Here
15.5%
US
15.3%
TX
14.9%
Gillespie
26.6%
😔

Residents with depression symptoms

↓ Lower is better
This Facility1.2%
Better than Avg
Here
1.2%
US
12.1%
TX
2.5%
Gillespie
2.4%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility26.3%
Worse than Avg
Here
26.3%
US
19.5%
TX
18.4%
Gillespie
24.0%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility16.4%
Mixed vs Avgs
Here
16.4%
US
19.4%
TX
14.2%
Gillespie
22.3%
💉

Residents vaccinated for the flu

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
95.5%
TX
98.0%
Gillespie
98.5%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility48.7%
Worse than Avg
Here
48.7%
US
81.8%
TX
89.2%
Gillespie
97.9%
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility71.1%
Mixed vs Avgs
Here
71.1%
US
79.7%
TX
88.0%
Gillespie
54.8%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility1.3%
Mixed vs Avgs
Here
1.3%
US
1.6%
TX
1.5%
Gillespie
0.6%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

13deficiencies
2penalties
Above state avg (9.1)
8 complaint-triggered
$63,121 in fines

This facility has ongoing safety concerns with families filing multiple complaints, particularly regarding accident prevention which has been cited repeatedly across recent surveys. The most frequent issues involve care planning problems, infection control failures, and medication management errors. While all deficiencies show correction dates, the pattern of recurring violations in critical areas like safety supervision and the recent complaint-triggered citations for accident hazards suggest persistent quality challenges that families should carefully consider.

Jan 8, 2026Complaint
1
0880ModerateCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Jul 10, 2025Complaint
3
0644MinorCorrected

Resident Assessment and Care Planning Deficiencies

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

0755MinorCorrected

Pharmacy Service Deficiencies

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

0732MinorCorrected

Nursing and Physician Services Deficiencies

Post nurse staffing information every day.

Feb 12, 2025Routine
11
0655ModerateCorrected

Resident Assessment and Care Planning Deficiencies

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

0281ModerateCorrected

Egress Deficiencies

Install proper backup exit lighting.

0558MinorCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0578MinorCorrected

Resident Rights Deficiencies

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

0609MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0610MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

0641MinorCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0656MinorCorrected

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

0755MinorCorrected

Pharmacy Service Deficiencies

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

0880MinorCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0511MinorCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

Jan 19, 2025Complaint
3
0689SevereCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0656ModerateCorrected

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

0609MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Jun 22, 2024Complaint
1
0689MinorCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Jan 13, 2024Routine
21
0607SevereCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

0610SevereCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

0689SevereCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0584ModerateCorrected

Resident Rights Deficiencies

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.

0656ModerateCorrected

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

0657ModerateCorrected

Resident Assessment and Care Planning Deficiencies

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

0759ModerateCorrected

Pharmacy Service Deficiencies

Ensure medication error rates are not 5 percent or greater.

0760ModerateCorrected

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

0761ModerateCorrected

Pharmacy Service Deficiencies

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.

0812ModerateCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0919ModerateCorrected

Environmental Deficiencies

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

0580MinorCorrected

Resident Rights Deficiencies

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

0585MinorCorrected

Resident Rights Deficiencies

Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.

0609MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0686MinorCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0695MinorCorrected

Quality of Life and Care Deficiencies

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

0880MinorCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0211MinorCorrected

Egress Deficiencies

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

0293MinorCorrected

Egress Deficiencies

Have properly located and lighted "Exit" signs.

0511MinorCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0803MinorCorrected

Nutrition and Dietary Deficiencies

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.

Federal Penalties

Fine

Jan 19, 2025

$49,205

Fine

Jan 13, 2024

$13,916

Ownership & Operations

Who Operates This Facility

Owner / Operator

Uvalde County Hospital Authority

Organization Type

for profit

Management Company

210 WEST WINDCREST STREET OPCO LLC

Administrator

RICHARD P HERREN

Chain Affiliation

Chain Name

Avir Health Group

Chain Size

117 facilities nationwide

Ownership & Management

Owners

Uvalde County Hospital District

Owner · Organization

100%

Dagan, Amitai

Individual is an Owner, Partner or Trustee of Any Adp of the Snf

Goldberger, Abraham

Individual is an Owner, Partner or Trustee of Any Adp of the Snf

Key personnel

Hccf Management Group Xi LLC5% or Greater Security InterestWelltower INC5% or Greater Security InterestWelltower Nnn Group, LLC5% or Greater Security InterestApolinar, AdamOfficer / Director210 West Windcrest Street Opco, LLCManager
Source: Medicare provider data

Contact

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Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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