Hearthstone Nursing and Rehabilitation
Round Rock, Texas · CCN 455771
23 surveys since 2011, 8 of them producing a finding at harm level or worse.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
- Citations on record
- 76
- Surveys
- 23
- Harm or worse
- 8
- Immediate jeopardy
- 6
Findings at the most serious level CMS records. 3 of these were recorded as past non-compliance — corrected before the survey.
Older surveys no longer in CMS’s monthly file or on Care Compare. They are shown here.
The facility
- Certified beds
- 120
- Ownership
- Government - Hospital district
- Chain
- CARADAY HEALTHCARE
- County
- Williamson
- Medicare-certified since
- 1988
CMS ratings
- Overall
- 3
- Health inspection
- 3
- Staffing
- 2
- Quality measures
- 4
CMS’s own Five-Star ratings.
Compared with similar facilities
Since 2021, this facility recorded more weighted findings than most of its peer group.
Weighted by harm level, against 104 government-run facilities of 100–127 beds in Texas.
Last survey on record
Apr 3, 2026
220 days ago.
Counts surveys with at least one finding. A clean survey leaves no record here, so the real gap may be shorter.
Staffing
| Measure | This facility | Peer median |
|---|---|---|
| Nurse hours per resident day | 2.92 | 3.25 |
| Registered-nurse hours per resident day | 0.38 | — |
| Annual nurse turnover | 53.3% | 48.1% |
As reported by the facility to CMS, beside the peer-group median.
Enforcement
- Fines
- $25,626 across 2 penalties
Federal civil money penalties and remedies as CMS currently publishes them. Amounts may still be under appeal.
Severity of recent findings
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J27.7% | K311.5% | L— |
| Actual harm | G13.8% | H— | I— |
| No harm, potential for more than minimal | D1038.5% | E1038.5% | F— |
| No harm, potential for minimal | A— | B— | C— |
Most frequently cited here
In CMS’s current monthly file.
- F6003×
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- F8803×
Provide and implement an infection prevention and control program.
- F6892×
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- F7552×
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- F5521×
Ensure that residents are fully informed and understand their health status, care and treatments.
In the surveyor’s words
From the most serious findings on record at Hearthstone Nursing and Rehabilitation, in the surveyor’s own words.
- Immediate jeopardy, patternF580Dec 2, 2023
Based on interview and record review, the facility failed to immediately consult with the resident's physician when there was a significant change for one (Resident #1) of three residents reviewed for notification of changes, in that: The facility failed to ensure Resident #1 was properly assessed after being found on the floor of her room on 11/10/23. Resident #1 was picked up by CNA B, there was no assessment documented by the nurse, the on-coming nurse nor NP were notified of the fall. On 11/15/23 she was sent to the ER and diagnosed with a left hip fracture requiring surgery. An Immediate Jeopardy (IJ) existed on 11/16/23. […]
- Immediate jeopardy, patternF600Dec 2, 2023
Based on interview and record review, the facility failed to ensure the residents had the right to be free from neglect for one (Resident #1) out of three residents reviewed for neglect. The facility failed to ensure Resident #1 was properly assessed after being found on the floor of her room on 11/10/23. Resident #1 was picked up by CNA B, there was no assessment documented by the nurse, the on-coming nurse nor NP were notified of the fall. On 11/15/23 she was sent to the ER and diagnosed with a left hip fracture requiring surgery. An Immediate Jeopardy (IJ) existed on 11/16/23. […]
- Immediate jeopardy, patternF684Dec 2, 2023
Based on observation, interview, and record review, the facility failed to ensure that residents received treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices for one (Resident #1) of three residents reviewed for quality of care, in that: The facility failed to ensure Resident #1 was properly assessed after being found on the floor of her room on 11/10/23. Resident #1 was picked up by CNA B, there was no assessment documented by the nurse, the on-coming nurse nor NP were notified of the fall. On 11/15/23 she was sent to the ER and diagnosed with a left hip fracture requiring surgery. An Immediate Jeopardy (IJ) existed on 11/16/23. […]
- Immediate jeopardy, isolatedF600Jul 31, 2023
Based on observation, interview and record review the facility failed to ensure residents were free from abuse, neglect, misappropriation of resident property, and exploitation for 1 (Resident #1) of 7 residents reviewed for abuse and neglect. On 7/5/2023 at 9:00pm, CNA A attempted to transfer Resident # 1 from her wheelchair to her bed using a mechanical lift. CNA A attempted the transfer with one person, although Resident # 1 required two-person assistance. As a result, the mechanical lift fell on top of Resident # 1 and the cross bar struck Resident # 1 in head causing a bump, soreness, headache causing injury to her head in which she had to take medication. An (IJ) Immediate Jeopardy was identified on 7/28/2023 at 6:45pm. […]
- Immediate jeopardy, isolatedF689Jul 31, 2023
Based on observation, interview, and record review the facility failed to provide adequate supervision and devices to prevent accidents for 1(Resident # 1) of 7 residents reviewed for accidents and supervision. Staff attempted to use the mechanical lift to transfer Resident # 1 from her wheelchair to her bed with one person. As a result, the mechanical lift fell on top of Resident # 1, causing injury and pain to her head in which she was prescribed medication for the pain. This failure placed all residents who require the use of a mechanical lift at risk for accidents, harm, and injuries. An (IJ) Immediate Jeopardy was identified on 7/31/2023 at 1:35pm. […]
Read 27 findings in full →The most serious and the most recent: 27 of 76 on record.
Every survey on record
FindingsAt actual harm or above
- Apr 3, 2026Standard4 findings
- Jan 14, 2026Complaint1 finding
- Nov 19, 2025Complaint2 findings
- Jan 30, 2025Standard2 findings
- Dec 19, 2024Complaint2 findings · 1 harm
- Apr 3, 2024Complaint1 finding
- Feb 13, 2024Complaint3 findings
- Dec 14, 2023Standard5 findings
Show the 15 earlier surveys
- Dec 2, 2023Complaint4 findings · 3 harm
- Jul 31, 2023Complaint2 findings · 2 harm
- Dec 27, 2022Complaint1 finding
- Oct 20, 2022Standard5 findings
- May 27, 2021Complaint3 findings · 1 harm
- Jul 29, 2019Complaint1 finding
- May 30, 2019Standard4 findings
- Jun 6, 2018Standard6 findings
- Jul 13, 2017Standard4 findings
- Jul 15, 2016Standard4 findings
- Jun 3, 2015Standard2 findings
- Jul 17, 2014Standard3 findings
- Jul 17, 2013—3 findings · 1 harm
- Jun 28, 2012—5 findings
- Jun 24, 2011—9 findings
Surveys that found no deficiencies are not in CMS’s files and do not appear here.
Comparable facilities
The nearest facilities to this one in the same peer group, by weighted findings.
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