San Marcos Rehabilitation and Healthcare Center — nursing home in San Marcos, TX

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 129 CMS-certified beds (not state-licensed beds)
Licensed beds: State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.
Average residents per day: 103.2 CMS, MDS-derived
CMS Certification Number: 675651
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Feb 1, 1997
Ownership type: For profit - Corporation
Operator (legal business name): Guadalupe County Hospital Board
CMS chain: The Ensign Group 347 facilities
Phone: (512) 353-5026
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

10

latest Dec 30, 2025

Citations

25

17 health · 8 fire

Harm or worse

3

2 immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K2	L·
Actual harm	G1	H·	I·
Potential harm	D4	E13	F2
Minimal	A·	B·	C3

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

CMS Five-Star ratings

Federal · CMS

Overall

Health inspections

Staffing

Quality measures

Penalties · about the last 3 years

Fines

1

$33,891

Payment denials

0

Latest

Aug 1, 2025

Federal certification

Federal · CMS

Authority: Centers for Medicare & Medicaid Services (CMS), surveyed by the state survey agency
CCN: 675651
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 129
First approved: Feb 1, 1997
Located in a hospital: No
Status: Active CMS certification as of CMS release Oct 1, 2026
Evidence: Verified

State license

State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead. State coverage for Texas.

Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

Date	Domain	Survey types	Citations	Most severe	Open
Dec 30, 2025	Health	Health Complaint	1	Potential harm	—	Open →
Oct 1, 2025	Fire safety	Fire Safety Standard	2	Potential harm	—	Open →
Oct 1, 2025	Health	Health Standard	0	No citations	—	Open →
Aug 1, 2025	Health	Health Complaint	2	Immediate jeopardy	—	Open →
Nov 4, 2024	Health	Health Complaint	3	Potential harm	—	Open →
Aug 15, 2024	Fire safety	Fire Safety Standard	2	Potential harm	—	Open →
Aug 15, 2024	Health	Health Standard	8	Potential harm	—	Open →
Apr 15, 2024	Health	Health Complaint	1	Actual harm	—	Open →
Jun 16, 2023	Fire safety	Fire Safety Standard	4	Potential harm	—	Open →
Jun 16, 2023	Health	Health Standard	2	Potential harm	—	Open →

Enforcement

Penalties

Civil money penalties and denials of payment for new admissions, as published by CMS (about the last three years). Amounts may change on appeal.

Date	Type	Amount	Payment denial	Record
Aug 1, 2025	Civil money penalty (fine)	$33,891	—	675651\|Fine\|134402

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K2	L·
Actual harm	G1	H·	I·
Potential harm	D4	E13	F2
Minimal	A·	B·	C3

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Dec 30, 2025	F-0732	Post nurse staffing information every day. Nursing and Physician Services Deficiencies · Staffing & supervision	F · Potential harm Widespread	Corrected Jan 1, 2026	Complaint
Oct 1, 2025	E-0007	Address patient/client population and determine types of services needed. Emergency Preparedness Deficiencies · Emergency preparedness	F · Potential harm Widespread	Corrected Jun 26, 2026
Oct 1, 2025	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety	C · Minimal Widespread	No revisit needed
Aug 1, 2025	F-0684	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care	K · Immediate jeopardy Pattern	Corrected Aug 2, 2025	Complaint
Aug 1, 2025	F-0697	Provide safe, appropriate pain management for a resident who requires such services. Quality of Life and Care Deficiencies · Clinical care	K · Immediate jeopardy Pattern	Corrected Aug 2, 2025	Complaint
Nov 4, 2024	F-0580	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Dec 4, 2024	Complaint
Nov 4, 2024	F-0755	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Dec 4, 2024	Complaint
Nov 4, 2024	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Dec 4, 2024	Complaint
Aug 15, 2024	K-0321	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Mar 21, 2025
Aug 15, 2024	F-0583	Keep residents' personal and medical records private and confidential. Resident Rights Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Sep 14, 2024
Aug 15, 2024	F-0584	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. Resident Rights Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Sep 14, 2024
Aug 15, 2024	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Sep 14, 2024
Aug 15, 2024	F-0677	Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Sep 14, 2024
Aug 15, 2024	F-0679	Provide activities to meet all resident's needs. Quality of Life and Care Deficiencies · Clinical care	E · Potential harm Pattern	Corrected Sep 14, 2024
Aug 15, 2024	F-0790	Provide routine and 24-hour emergency dental care for each resident. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Sep 14, 2024
Aug 15, 2024	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	E · Potential harm Pattern	Corrected Sep 14, 2024
Aug 15, 2024	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	E · Potential harm Pattern	Corrected Sep 14, 2024
Aug 15, 2024	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety	C · Minimal Widespread	Waiver granted Mar 21, 2025
Apr 15, 2024	F-0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care	G · Actual harm Isolated	Corrected May 3, 2024	Complaint
Jun 16, 2023	K-0222	Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. Egress Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Nov 25, 2023
Jun 16, 2023	K-0321	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Nov 25, 2023
Jun 16, 2023	K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Nov 25, 2023
Jun 16, 2023	F-0558	Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Jul 7, 2023
Jun 16, 2023	F-0679	Provide activities to meet all resident's needs. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jul 7, 2023
Jun 16, 2023	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety	C · Minimal Widespread	Corrected Oct 26, 2023

“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.

Five-Star ratings

Federal · CMS

Overallstate 2.8

Health inspectionsstate 2.8

Staffingstate 1.9

Quality measuresstate 3.8

Long-stay QM

Short-stay QM

CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.

Nurse staffing · hours per resident per day

Total nurse staffing2.90

State avg 3.42US avg 3.90

Registered nurse (RN)0.64

State avg 0.44US avg 0.69

Licensed practical nurse0.45

State avg 0.94US avg 0.86

Nurse aide1.81

State avg 2.03US avg 2.35

Weekend total nurse2.50

State avg 2.99US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 3.17 (case-mix index 1.28).

Staff turnover

Total nursing staff turnover46.1%

State avg 50.8%US avg 45.3%

Registered nurse turnover43.8%

State avg 49.8%US avg 42.5%

Administrators who left0

State avg 1US avg 1

Health survey score

Cycle 1 standard survey: Oct 1, 2025
Cycle 1 health score: 16
Total weighted score: 99.5

Operating entity

Guadalupe County Hospital Board

CMS legal business name of the certified provider. Operates 27 facilities.

VerifiedLinked by exact legal name

CMS chain

The Ensign Group

347 facilities in 17 states. CMS chain ID 507.

VerifiedAssigned by CMS

Chain average overall rating (CMS): 3.3

Ownership disclosures

Disclosures

17

Organizations

7

Individuals

9

Direct & indirect ownership

Owners of record

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Guadalupe County Hospital Board	Organization	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	Apr 1, 2017

CMS Ownership file

All disclosed roles

Operator, owners, managers, officers and lenders are distinct roles and are never flattened into one entity. Organizations link across facilities by exact normalized legal name; individuals are listed per facility only.

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Guadalupe County Hospital Board	Organization	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	Apr 1, 2017
Graciela Castro Pou	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Dec 27, 2024
Jerry Tochterman	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Aug 21, 2017
Wood Bayou Healthcare, Inc	Organization	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Apr 1, 2017
Graciela Castro Pou	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Dec 27, 2024
Jerry Tochterman	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Aug 21, 2017
Soon Burnam	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Apr 1, 2017
Kody Gann	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Apr 1, 2017
Chad Keetch	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Mar 1, 2011
Caretrust Gp LLC	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Apr 1, 2017
Caretrust Reit Inc	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Apr 1, 2017
Ctr Partnership LP	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Apr 1, 2017
Ensign Services Inc	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Feb 5, 2010
Ives Health Holdings LLC	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Apr 1, 2017
Wood Bayou Healthcare, Inc	Organization	Additional disclosable party	ADP OF THE SNF	not provided	Sep 30, 2025
Graciela Castro Pou	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Dec 27, 2024
Jerry Tochterman	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Aug 21, 2017

Other facilities operated by Guadalupe County Hospital Board

All 26 →

Facility	Beds	Last inspection	Citations (window)	Fines
Morningside Manor 602 Babcock Rd, San Antonio, TX 78201 CCN 455523	147	Apr 11, 2026	37	$5,000
Eden Home 631 Lakeview Blvd, New Braunfels, TX 78130 CCN 455618	122	May 1, 2026	432 IJ	$45k
Avir at Bay City 700 12th St, Bay City, TX 77414 CCN 455643	120	Feb 26, 2026	341 IJ	$14k
Avir at Longview 301 Hollybrook Dr., Longview, TX 75605 CCN 455678	115	Aug 13, 2026	654 IJ3 harm	$263k
Arbor View Nursing & Rehabilitation 1213 Water St, Kerrville, TX 78028 CCN 455724	179	Sep 4, 2026	1095 IJ1 harm22 open	$155k
Northeast Rehabilitation and Healthcare Center 603 Corinne Drive, San Antonio, TX 78218 CCN 455754	120	Jul 9, 2026	651 IJ1 harm	$16k
Hays Nursing and Rehabilitation Center 1900 Medical Parkway, San Marcos, TX 78666 CCN 455960	116	Mar 5, 2026	312 IJ	$8,226
Parklane West Healthcare Center 2 Towers Park Lane, San Antonio, TX 78209 CCN 675509	124	Jul 17, 2026	91	—

Same chain in Texas

All 346 in chain →

Facility	Beds	Last inspection	Citations (window)	Fines
Richland Hills Rehabilitation and Healthcare Cente 3109 Kings Ct, Fort Worth, TX 76118 CCN 455576	92	May 28, 2026	401 harm	$8,190
Grand Terrace Rehabilitation and Healthcare 812 W. Houston Ave., Mcallen, TX 78501 CCN 455586	93	Jun 17, 2026	16	—
Alta Vista Rehabilitation and Healthcare 510 Paredes Line Rd, Brownsville, TX 78521 CCN 455625	100	May 1, 2026	281 IJ	—
Wellington Rehabilitation and Healthcare 1802 S 31st, Temple, TX 76504 CCN 455637	124	Aug 6, 2026	404 IJ	$32k
Golden Palms Rehabilitation and Retirement 2101 Treasure Hills Boulevard, Harlingen, TX 78550 CCN 455672	60	May 13, 2026	271 IJ1 harm	$16k
Park Village Healthcare and Rehabilitation 207 E Parkerville Rd, Desoto, TX 75115 CCN 455727Abuse icon	150	Aug 25, 2026	636 IJ2 harm2 open	$221k
Kirkwood Manor 2590 Loop 337 N, New Braunfels, TX 78130 CCN 455732	162	Jun 17, 2026	691 IJ	$29k
Timberwood Nursing and Rehabilitation Center 4001 Hwy 59 North, Livingston, TX 77351 CCN 455745	120	Jan 14, 2026	181 IJ	$8,021

No building or property record is linked to this facility yet. Parcel, assessor and building-permit joins will be added only where a valid site match exists.

Coordinates as published by CMS (geocoding footnote 22).

Address: 1600 N I H 35, San Marcos, TX 78666
ZIP: 78666
County: Hays County FIPS 48209
State: Texas
Urban / rural (CMS): Urban

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	Last inspection	Citations (window)	Fines
Hays Nursing and Rehabilitation Center 1900 Medical Parkway, San Marcos, TX 78666 CCN 455960	3.1 km	116	Mar 5, 2026	312 IJ	$8,226
Cypress Healthcare and Rehabilitation Center 1351 Sadler, San Marcos, TX 78666 CCN 676226	3.9 km	174	Jun 25, 2026	474 IJ1 harm	$192k
Deer Creek Nursing and Rehabilitation 555 Ranch Rd 3237, Wimberley, TX 78676 CCN 455917	19 km	122	Aug 20, 2026	544 IJ1 harm	$50k
Legend Oaks Healthcare and Rehabilitation - New Br 2468 Fm 1101, New Braunfels, TX 78130 CCN 676392	21.2 km	126	May 20, 2026	42	—
Sundance Inn Health Center 2034 Sundance Parkway, New Braunfels, TX 78130 CCN 676472	22 km	128	Aug 21, 2026	422 IJ	$6,364
Avir at New Braunfels 821 US Hwy 81 W, New Braunfels, TX 78130 CCN 455020Abuse icon	22.4 km	154	Jul 10, 2026	755 IJ	$158k
Eden Home 631 Lakeview Blvd, New Braunfels, TX 78130 CCN 455618	25.1 km	122	May 1, 2026	432 IJ	$45k

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	675651	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	675651	ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only.	Verified	Oct 1, 2026	Nov 7, 2026

Record-level source links for CCN 675651

First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction