Nursing HomeMedicaid

Hearthstone Nursing and Rehabilitation

Meets baseline Medicare standards with room for improvement. A tour and talking to current residents' families is the best next step.

401 Oakwood Blvd, The Oaklands · Round Rock, TX 78681|120 beds|Licensed & Active

3/5

Medicare

Inspection

Quality

Staffing

Google rating

3.4/5

based on 91 Google reviews

(512) 388-7494 Directions Website

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What this means for your family

This facility offers excellent rehabilitation therapy and many families find the nursing staff to be incredibly compassionate. However, you must be vigilant regarding hygiene and responsiveness, as several reviewers have reported issues with unpleasant odors and delayed responses to call lights. We recommend visiting during off-hours to personally verify staffing levels and room cleanliness.

Google Reviews

91 reviews on Google

“Hearthstone Nursing and Rehabilitation receives high praise from many families for its compassionate nursing staff and effective physical and occupational therapy teams. However, there are serious, recurring allegations regarding neglect, poor hygiene, and inadequate staffing levels. While many recent reviews highlight a professional and warm environment, families should be extremely cautious of reports involving unresponsiveness to call lights and poor sanitation.”

Quality Themes

Tap a score for details

Strengths

Compassionate and professional therapy teams
Friendly and attentive nursing staff
Welcoming and helpful admissions process
Engaging activity programs and events

Concerns

Inadequate response to call lights and resident needs (mentioned by 3 reviewers)
Poor sanitation and unpleasant odors in facility (mentioned by 3 reviewers)
Communication gaps between staff and families (mentioned by 3 reviewers)
Inconsistent food quality and temperature (mentioned by 3 reviewers)

Rating Trends

Tap a year to see what changed

Distribution · 93 analyzed

How They Respond to Reviews

97%response rate

Good

The owner provides highly personalized responses to positive reviews, often addressing specific staff members or events mentioned. For negative reviews, they use a consistent, professional template that avoids confrontation and directs the reviewer to a phone number for resolution.

Questions for Your Tour

1It is wonderful to see how much care you put into responding to feedback from families; how does your team use that feedback to improve the daily dining experience and food temperature?
2We are really looking forward to the activity programs mentioned in your reviews; could you tell us more about what a typical week of events looks like for residents?
3With the therapy team being such a strength here, how do you coordinate their schedules with the nursing staff to ensure a smooth recovery plan?
4What specific protocols do you have in place to ensure that call lights are answered promptly and that resident needs are met even during busy shifts?
5How does the facility manage cleaning schedules and air quality to ensure a fresh and sanitary environment for all residents?
6How do you ensure that communication remains consistent and clear between the nursing staff and family members regarding a resident's daily care?

Personalized based on this facility's data

Key Review Excerpts

“All of the staff goes above & beyond. They are friendly, cheerful & make meaningful relationships with patients.”

Long-term resident's family · 2026★★★★★

“The nurses and aides are always helpful and pleasant no matter the time of day or night, and the therapists are excellent and innovative during each session.”

Rehab patient's family · 2024★★★★★

“I heard her screaming “Help!”, and NO ONE was around to hear, nor came to check on her. We ran in and after helping her she said the nurses there hid the red “Help” button from her so she wouldn’t ask for help anymore”

Neighbor of resident · 2025★☆☆☆☆

Source: 91 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026

RN Hours

0.48hrs

63%

Registered nurses for medical care

Total Nursing

2.88hrs

70%

All nurses + aides combined

Staff Turnover

56%

Lower is better (< 30% = good)

RN Turnover

38%

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

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

Medicare Rating

2/ 5

Better Than Avg

measures

Worse Than Avg

measures

Mixed Results

measures

Long-Stay Residents

💉

Residents vaccinated for pneumonia

↑ Higher is better

This Facility65.9%

Worse than Avg

Here

65.9%

93.4%

96.9%

Williamson

92.7%

😔

Residents with depression symptoms

↓ Lower is better

This Facility0.4%

Better than Avg

Here

0.4%

12.1%

2.5%

Williamson

4.4%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

💉

Residents vaccinated for the flu

↑ Higher is better

This Facility86.9%

Worse than Avg

Here

86.9%

95.5%

98.0%

Williamson

94.6%

🚿

Residents whose bladder or bowel control got worse

↓ Lower is better

This Facility20.4%

Worse than Avg

Here

20.4%

19.4%

14.2%

Williamson

15.5%

⚠️

Residents who fell and were seriously hurt

↓ Lower is better

This Facility8.6%

Worse than Avg

Here

8.6%

3.2%

3.3%

Williamson

4.0%

🛏️

Residents needing more daily help over time

↓ Lower is better

This Facility12.8%

Better than Avg

Here

12.8%

14.4%

16.1%

Williamson

17.4%

Short-Stay Residents (Rehab / Post-Acute)

💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better

This Facility33.9%

Worse than Avg

Here

33.9%

81.8%

89.2%

Williamson

80.2%

💉

Short-stay residents vaccinated for the flu

↑ Higher is better

This Facility49.5%

Worse than Avg

Here

49.5%

79.7%

88.0%

Williamson

81.3%

💊

Short-stay residents newly given antipsychotics

↓ Lower is better

This Facility5.6%

Worse than Avg

Here

5.6%

1.6%

1.5%

Williamson

1.4%

Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

5deficiencies

3penalties

Near state avg (9.1)

16 complaint-triggered

$152,617 in fines

This facility has faced recurring serious problems with frequent family complaints triggering federal investigations. The most persistent issues involve protection from abuse and neglect (cited multiple times including as recently as December 2024), medication management problems, and care planning failures. With 15 of 31 deficiencies stemming from family-filed complaints, this pattern of ongoing concerns about resident safety and care quality warrants careful consideration during any visit.

Jan 14, 2026Complaint1 finding

0657Potential for harm · IsolatedCorrected

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.

Nov 19, 2025Complaint2 findings

0644Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

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

0646Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.

Jan 30, 2025Routine4 findings

0656Potential for harm · IsolatedCorrected

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.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0321Potential for harm · IsolatedCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0363Potential for harm · IsolatedCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

Dec 19, 2024Complaint2 findings

0600Actual harm · IsolatedResolved (past non-compliance)

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

0842Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Apr 3, 2024Complaint2 findings

0755Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

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

0755Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

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

Feb 13, 2024Complaint3 findings

0552Potential for harm · PatternCorrected

Resident Rights Deficiencies

Ensure that residents are fully informed and understand their health status, care and treatments.

0553Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Allow resident to participate in the development and implementation of his or her person-centered plan of care.

0758Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

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.

Federal Penalties

Fine

Dec 19, 2024

$10,033

Fine

Dec 2, 2023

$15,593

Fine

Jul 31, 2023

$126,991

Ownership & Operations

Who Operates This Facility

Owner / Operator

Stratford Hospital District

Organization Type

for profit

Management Company

CARADAY HEARTHSTONE LLC

Administrator

ADRIANA MARIE BEAVERS

Chain Affiliation

Chain Name

Caraday Healthcare

Chain Size

9 facilities nationwide

Chain avg rating: 2.6/5 · Rank 5 of 9

Ownership & Management

Owners

Stratford Hospital District

Owner · Organization

100%

Choi, Maryann