Nursing homeActive

Avir at Fredericksburg

1117 S. Adams St., Fredericksburg, TX 78624830997436490 certified beds · 49 residentsFor profit - CorporationMedicare and Medicaid
Surveys on file
7
since 2023
Deficiencies
48
3432
Penalties · 3 yrs
$23,520
1 fine
Last survey
2026-06-26
Complaint
CMS overall
3 / 5
stars as published by CMS
CMS overall 3/5
Health 2
Staffing 2
Quality 5
Star ratings as published by CMS · CMS’s caveats

Survey history

Source: CMS · Texas Health and Human Services Commission · data as of 2026-08-01
DateKindDeficienciesOfficial recordArchived PDF
2026-06-26Complaint010CMS-2567 (Care Compare)
2026-05-27Complaint001CMS-2567 (Care Compare)
2025-12-04Complaint010CMS-2567 (Care Compare)
2025-06-20Standard1130CMS-2567 (Care Compare)
2024-05-17Standard1180CMS-2567 (Care Compare)
2024-03-07Complaint010CMS-2567 (Care Compare)
2023-03-26Standard191CMS-2567 (Care Compare)

Counts by class: paperwork · standard · harm.

Deficiencies

CMS · Texas Health and Human Services Commission publishes each citation’s tag, official description and scope/severity letter. The surveyor’s written findings are in the Statement of Deficiencies (CMS-2567) for each survey, linked above.

2026-06-26Complaint survey · 1 deficiencyOfficial report
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-07-11Record 675169-20260626-F842
2026-05-27Complaint survey · 1 deficiencyOfficial report
F760Ensure that residents are free from significant medication errors.Scope/severity JHarm
Medication
Isolated; immediate jeopardy to resident health or safety.Correction not yet recordedRecord 675169-20260527-F760
2025-12-04Complaint survey · 1 deficiencyOfficial report
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-12-05Record 675169-20251204-F656
2025-06-20Standard survey · 14 deficienciesOfficial report
F552Ensure that residents are fully informed and understand their health status, care and treatments.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F552
F604Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.Scope/severity EStandard
Abuse & neglect
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F604
F641Ensure each resident receives an accurate assessment.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F641
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F656
F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F690
F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Scope/severity DStandard
Staffing
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F726
F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F755
F761Ensure 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.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F761
F801Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F801
F809Ensure 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.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F809
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F812
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F842
F880Provide and implement an infection prevention and control program.Scope/severity EStandard
Infection control
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-06-29Record 675169-20250620-F880
F912Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.Scope/severity BPaperwork
Environment
Pattern; potential for minimal harm.Corrected 2025-06-29Record 675169-20250620-F912
2024-05-17Standard survey · 19 deficienciesOfficial report
F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Scope/severity EStandard
Dignity & rights
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F550
F641Ensure each resident receives an accurate assessment.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F641
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F656
F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F657
F661Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-07Record 675169-20240517-F661
F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F684
F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F690
F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Scope/severity EStandard
Staffing
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F726
F759Ensure medication error rates are not 5 percent or greater.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F759
F760Ensure that residents are free from significant medication errors.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F760
F801Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F801
F803Ensure 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.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F803
F805Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F805
F806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F806
F809Ensure 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.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F809
F814Dispose of garbage and refuse properly.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F814
F880Provide and implement an infection prevention and control program.Scope/severity EStandard
Infection control
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F880
F908Keep all essential equipment working safely.Scope/severity EStandard
Environment
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-06-17Record 675169-20240517-F908
F912Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.Scope/severity BPaperwork
Environment
Pattern; potential for minimal harm.Corrected 2024-06-17Record 675169-20240517-F912
2024-03-07Complaint survey · 1 deficiencyOfficial report
F880Provide and implement an infection prevention and control program.Scope/severity DStandard
Infection control
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-03-08Record 675169-20240307-F880
2023-03-26Standard survey · 11 deficienciesOfficial report
F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.Scope/severity JHarm
Care planning
Isolated; immediate jeopardy to resident health or safety.Corrected 2023-04-14Record 675169-20230326-F684
F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-04-14Record 675169-20230326-F609
F641Ensure each resident receives an accurate assessment.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-04-14Record 675169-20230326-F641
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-04-14Record 675169-20230326-F656
F727Have 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.Scope/severity EStandard
Staffing
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-04-14Record 675169-20230326-F727
F745Provide medically-related social services to help each resident achieve the highest possible quality of life.Scope/severity EStandard
Care planning
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-04-14Record 675169-20230326-F745
F801Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-04-14Record 675169-20230326-F801
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-04-14Record 675169-20230326-F812
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-04-14Record 675169-20230326-F842
F940Develop, implement, and/or maintain an effective training program for all new and existing staff members.Scope/severity EStandard
Records
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-04-14Record 675169-20230326-F940
F912Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.Scope/severity BPaperwork
Environment
Pattern; potential for minimal harm.Corrected 2023-04-14Record 675169-20230326-F912

Penalties & enforcement

DateActionAmountSource
2026-05-27Civil money penalty$23,520CMS · Penalties

Staffing

CMS Payroll-Based Journal · PBJ, as published Aug 2026 · explainer
RN hours per resident day0.45
Facility
Texas
National
Texas 0.43 · National 0.69
Total nurse hours per resident day2.86
Facility
Texas
National
Texas 3.39 · National 3.86
Weekend total nurse hours2.57
Facility
Texas
National
Texas 2.98 · National 3.42
Total nursing staff turnover88%
Facility
Texas
National
Texas 55% · National 46%
Registered nurse turnover78%
Facility
Texas
National
Texas 55% · National 43%

Quality measures

CMS MDS quality measures · 2025Q2-2026Q1 · definitions
MeasureFacilityTexasNational
Percentage of long-stay residents with pressure ulcers
lower is better
0.8%3.8%4.6%
Percentage of long-stay residents experiencing one or more falls with major injury
lower is better
1.6%3.3%3.2%
Percentage of long-stay residents who received an antipsychotic medication
lower is better
17.9%9.6%15.4%
Percentage of long-stay residents with a urinary tract infection
lower is better
0.8%0.8%1.6%
Percentage of long-stay residents who were physically restrained
lower is better
0.0%0.0%0.1%
Percentage of long-stay residents whose need for help with daily activities has increased
lower is better
12.1%15.8%13.9%
Percentage of long-stay residents who lose too much weight
lower is better
2.9%3.0%5.2%
Percentage of long-stay residents who received an antianxiety or hypnotic medication
lower is better
24.8%18.0%19.5%

Figures verbatim from CMS, with the state and national figures from the same release. The direction that counts as better is CMS’s own and is stated on every row.

Ownership

As reported to CMS (Provider Enrollment)
EntityRoleInterestSinceRegistry
Val Verde County Hospital District
Organization
5% OR GREATER DIRECT OWNERSHIP INTEREST100%
1117 S Adams Street Opco, LLC
Organization
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Freund, Nochum
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Kothmann, John
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Travitsky, Aaron
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
1117 S Adams Street Property Owner, LLC
Organization
ADP OF THE SNFNOT APPLICABLE
Dagan, Amitai
Individual
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFNOT APPLICABLE
Dennis, Wanda
Individual
ADP OF THE SNFNOT APPLICABLE
Goldberger, Abraham
Individual
INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFNOT APPLICABLE
Jurado, Jorge
Individual
CORPORATE OFFICERNOT APPLICABLE
Kothmann, John
Individual
ADP OF THE SNFNOT APPLICABLE
Welltower Inc
Organization
ADP OF THE SNFNOT APPLICABLE
Welltower Nnn Group, LLC
Organization
ADP OF THE SNFNOT APPLICABLE
Welltower Op, LLC
Organization
ADP OF THE SNFNOT APPLICABLE
Part of a chain
Avir Health Group116 facilities
View chain record

Ownership as reported to CMS/state. CMS ownership data has known gaps; merges between entities are published only after human review.

Cost context

County figures from public surveys. Not this facility’s price. Nursing-home rates are not published by CMS or Texas.

No county cost figures on file for Gillespie.

Nearby nursing homes

FacilityDistanceLast surveyDeficiencies · 3 yrs
Avir at Enchanted Rock
Fredericksburg
0.3 mi2026-06-222415
Knopp Nursing & Rehab Center Inc
Fredericksburg
0.4 mi2026-01-210322
Knopp Healthcare And Rehab Center Inc
Fredericksburg
1.9 mi2026-01-090160
Avir at Comfort
Comfort
20.0 mi2026-05-272110
Hilltop Village Nursing And Rehabilitation
Kerrville
21.0 mi2025-08-272310
Watch this facility

One email when a new survey, harm-class deficiency, penalty, Special Focus change or ownership change is recorded. Nothing else, ever.

Sources & provenance

SectionAgency · datasetRetrieved
Facility, ratingsCMS Provider Data · Nursing Home Provider Information2026-08-01
SurveysCMS · Survey Summary2026-08-01
DeficienciesCMS · Health Deficiencies (CMS-2567 findings via Care Compare)2026-08-01
PenaltiesCMS · Penalties2026-08-01
StaffingCMS · Payroll-Based Journal (PBJ, as published Aug 2026)2026-08-01
Quality measuresCMS · MDS Quality Measures2026-08-01
OwnershipCMS · Ownership2026-08-01