F48

WATERSIDE NURSING & REHABILITATION

Grade F 48/100 composite score

For profit - Limited Liability companySFF CandidateAbuse Citation

CMS Star Ratings

Overall
1/5
Health Insp.
1/5
Quality
3/5
Staffing
1/5
RN Staffing
Not rated

Certified Beds

179

Ownership

For profit - Limited Liability company

Total Fines

$248,481

Last Survey

N/A

1213 WATER ST, KERRVILLE, TX 78028
8308962411

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Staffing Hours & Turnover

Hours per Resident per Day (PBJ)

RN
0.26h
LPN
1.09h
CNA
2.08h
Total
3.43h
Facility
State Average

Turnover Rates

RN Turnover
N/A
Total Nurse Turnover
N/A
Admin Turnover
N/A

Ownership

GUADALUPE COUNTY HOSPITAL BOARD

Organization5% OR GREATER DIRECT OWNERSHIP INTERESTSince Nov 2022

100%

GUADALUPE COUNTY HOSPITAL BOARD

OrganizationOPERATIONAL/MANAGERIAL CONTROLSince Nov 2022

KERRVILLE NURSING OPERATIONS LLC

OrganizationOPERATIONAL/MANAGERIAL CONTROLSince Nov 2022

RIVERSIDE SNF OPERATIONS, LLC

OrganizationOPERATIONAL/MANAGERIAL CONTROLSince Oct 2024

RAMOS, BRIAN

IndividualOPERATIONAL/MANAGERIAL CONTROLSince Oct 2024

COLVIN, JIM

IndividualCORPORATE DIRECTORSince Jul 2023

HUMPHREY, RONALD

IndividualCORPORATE DIRECTORSince Mar 2022

MAJOR, DOLORES

IndividualCORPORATE DIRECTORSince Mar 2025

RAMIREZ, LOUIS

IndividualCORPORATE DIRECTORSince Mar 2021

REYES, JAMES

IndividualCORPORATE DIRECTORSince Apr 2022

SCHNURIGER, JEANNE

IndividualCORPORATE DIRECTORSince Mar 2015

VORDENBAUM, ERIC

IndividualCORPORATE DIRECTORSince Mar 2007

GANN, KODY

IndividualCORPORATE OFFICERSince Dec 2020

HAYNES, ROBERT

IndividualCORPORATE OFFICERSince Dec 2003

Penalties & Fines (7)

$248,481total fines
DateTypeDescriptionAmount
Jul 31, 2025Fine$140,450
Jul 31, 2025Payment Denial
Jun 14, 2024Fine$11,389
May 7, 2024Fine$14,814
Dec 21, 2023Fine$15,593
Dec 21, 2023Fine$21,528
Mar 19, 2023Fine$44,707

Health Inspection Deficiencies (79)

September 7, 2025Health3 deficiencies1 severe
0755EMinimal harm, Pattern

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

Pharmacy Service Deficiencies

Corrected Sep 8, 2025
0760JImmediate jeopardy, Isolated

Ensure that residents are free from significant medication errors.

Pharmacy Service Deficiencies

Corrected Sep 8, 2025
0842EMinimal harm, Pattern

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

Resident Assessment and Care Planning Deficiencies

Corrected Sep 8, 2025
July 31, 2025Health20 deficiencies2 severe
0584DMinimal harm, Isolated

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

Corrected Sep 8, 2025
0600KImmediate jeopardy, Pattern

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

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Sep 8, 2025
0605DMinimal harm, Isolated

Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Sep 8, 2025
0607EMinimal harm, Pattern

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

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Sep 8, 2025
0609EMinimal harm, Pattern

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

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Sep 8, 2025
0610DMinimal harm, Isolated

Respond appropriately to all alleged violations.

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Sep 8, 2025
0641DMinimal harm, Isolated

Ensure each resident receives an accurate assessment.

Resident Assessment and Care Planning Deficiencies

Corrected Sep 8, 2025
0656DMinimal harm, Isolated

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

Corrected Sep 8, 2025
0689KImmediate jeopardy, Pattern

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

Quality of Life and Care Deficiencies

Corrected Sep 8, 2025
0695DMinimal harm, Isolated

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

Quality of Life and Care Deficiencies

Corrected Sep 8, 2025
0727FMinimal harm, Widespread

Have 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.

Nursing and Physician Services Deficiencies

Corrected Sep 8, 2025
0729EMinimal harm, Pattern

Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.

Nursing and Physician Services Deficiencies

Corrected Sep 8, 2025
0760EMinimal harm, Pattern

Ensure that residents are free from significant medication errors.

Pharmacy Service Deficiencies

Corrected Sep 8, 2025
0761EMinimal harm, Pattern

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.

Pharmacy Service Deficiencies

Corrected Sep 8, 2025
0812FMinimal harm, Widespread

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

Nutrition and Dietary Deficiencies

Corrected Sep 8, 2025
0842DMinimal harm, Isolated

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

Resident Assessment and Care Planning Deficiencies

Corrected Sep 8, 2025
0850FMinimal harm, Widespread

Hire a qualified full-time social worker in a facility with more than 120 beds.

Administration Deficiencies

Corrected Sep 8, 2025
0880DMinimal harm, Isolated

Provide and implement an infection prevention and control program.

Infection Control Deficiencies

Corrected Sep 8, 2025
0925FMinimal harm, Widespread

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Environmental Deficiencies

Corrected Sep 8, 2025
0677DMinimal harm, Isolated

Provide care and assistance to perform activities of daily living for any resident who is unable.

Quality of Life and Care Deficiencies

Corrected Sep 8, 2025
June 12, 2025Health6 deficiencies
0550DMinimal harm, Isolated

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Resident Rights Deficiencies

Corrected Jul 8, 2025
0689DMinimal harm, Isolated

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

Quality of Life and Care Deficiencies

Corrected Jul 8, 2025
0801DMinimal harm, Isolated

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

Nutrition and Dietary Deficiencies

Corrected Jul 8, 2025
0802DMinimal harm, Isolated

Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.

Nutrition and Dietary Deficiencies

Corrected Jul 8, 2025
0809EMinimal harm, Pattern

Ensure 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.

Nutrition and Dietary Deficiencies

Corrected Jul 8, 2025
0842EMinimal harm, Pattern

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

Resident Assessment and Care Planning Deficiencies

Corrected Jul 8, 2025
February 28, 2025Health1 deficiency
0842DMinimal harm, Isolated

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

Resident Assessment and Care Planning Deficiencies

Corrected Apr 1, 2025
October 12, 2024Health2 deficiencies
0550DMinimal harm, Isolated

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Resident Rights Deficiencies

Corrected Oct 13, 2024
0583EMinimal harm, Pattern

Keep residents' personal and medical records private and confidential.

Resident Rights Deficiencies

Corrected Oct 13, 2024
May 7, 2024Health1 deficiency1 severe
0689GActual harm, Isolated

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

Quality of Life and Care Deficiencies

Corrected May 8, 2024
March 14, 2024Health3 deficiencies
0812FMinimal harm, Widespread

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

Nutrition and Dietary Deficiencies

Corrected Mar 15, 2024
0814EMinimal harm, Pattern

Dispose of garbage and refuse properly.

Nutrition and Dietary Deficiencies

Corrected Mar 15, 2024
0925EMinimal harm, Pattern

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Environmental Deficiencies

Corrected Mar 12, 2024
March 7, 2024Health1 deficiency
0644DMinimal harm, Isolated

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

Resident Assessment and Care Planning Deficiencies

Corrected Mar 8, 2024
January 22, 2024Health3 deficiencies1 severe
0584KImmediate jeopardy, Pattern

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

Corrected Jan 23, 2024
0609EMinimal harm, Pattern

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

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Jan 23, 2024
0908EMinimal harm, Pattern

Keep all essential equipment working safely.

Environmental Deficiencies

Corrected Jan 23, 2024
December 21, 2023Health7 deficiencies1 severe
0600DMinimal harm, Isolated

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

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Dec 22, 2023
0689KImmediate jeopardy, Pattern

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

Quality of Life and Care Deficiencies

Corrected Oct 26, 2023
0726EMinimal harm, Pattern

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

Nursing and Physician Services Deficiencies

Corrected Dec 22, 2023
0727FMinimal harm, Widespread

Have 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.

Nursing and Physician Services Deficiencies

Corrected Dec 22, 2023
0755EMinimal harm, Pattern

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

Pharmacy Service Deficiencies

Corrected Dec 22, 2023
0761EMinimal harm, Pattern

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.

Pharmacy Service Deficiencies

Corrected Dec 22, 2023
0943EMinimal harm, Pattern

Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Dec 22, 2023
May 18, 2023Health1 deficiency
0921DMinimal harm, Isolated

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

Environmental Deficiencies

Corrected Jun 8, 2023
April 27, 2023Health17 deficiencies
0550DMinimal harm, Isolated

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Resident Rights Deficiencies

Corrected May 22, 2023
0558DMinimal harm, Isolated

Reasonably accommodate the needs and preferences of each resident.

Resident Rights Deficiencies

Corrected May 22, 2023
0582EMinimal harm, Pattern

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Resident Rights Deficiencies

Corrected May 22, 2023
0641DMinimal harm, Isolated

Ensure each resident receives an accurate assessment.

Resident Assessment and Care Planning Deficiencies

Corrected May 22, 2023
0656DMinimal harm, Isolated

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

Corrected May 22, 2023
0684DMinimal harm, Isolated

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Quality of Life and Care Deficiencies

Corrected May 22, 2023
0685DMinimal harm, Isolated

Assist a resident in gaining access to vision and hearing services.

Quality of Life and Care Deficiencies

Corrected May 22, 2023
0690DMinimal harm, Isolated

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Quality of Life and Care Deficiencies

Corrected May 22, 2023
0758DMinimal harm, Isolated

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.

Pharmacy Service Deficiencies

Corrected May 22, 2023
0760DMinimal harm, Isolated

Ensure that residents are free from significant medication errors.

Pharmacy Service Deficiencies

Corrected May 22, 2023
0791DMinimal harm, Isolated

Provide or obtain dental services for each resident.

Quality of Life and Care Deficiencies

Corrected May 22, 2023
0812EMinimal harm, Pattern

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

Nutrition and Dietary Deficiencies

Corrected May 22, 2023
0814EMinimal harm, Pattern

Dispose of garbage and refuse properly.

Nutrition and Dietary Deficiencies

Corrected May 22, 2023
0842DMinimal harm, Isolated

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

Resident Assessment and Care Planning Deficiencies

Corrected May 22, 2023
0881DMinimal harm, Isolated

Implement a program that monitors antibiotic use.

Infection Control Deficiencies

Corrected May 22, 2023
0925DMinimal harm, Isolated

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Environmental Deficiencies

Corrected May 22, 2023
0880DMinimal harm, Isolated

Provide and implement an infection prevention and control program.

Infection Control Deficiencies

Corrected May 22, 2023
March 19, 2023Health2 deficiencies1 severe
0600KImmediate jeopardy, Pattern

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

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Apr 14, 2023
0880DMinimal harm, Isolated

Provide and implement an infection prevention and control program.

Infection Control Deficiencies

Corrected Apr 14, 2023
February 10, 2022Health12 deficiencies
0609DMinimal harm, Isolated

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

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected Mar 5, 2022
0644DMinimal harm, Isolated

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

Resident Assessment and Care Planning Deficiencies

Corrected Mar 5, 2022
0689DMinimal harm, Isolated

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

Quality of Life and Care Deficiencies

Corrected Mar 5, 2022
0732CNo harm, Widespread

Post nurse staffing information every day.

Nursing and Physician Services Deficiencies

Corrected Mar 5, 2022
0761EMinimal harm, Pattern

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.

Pharmacy Service Deficiencies

Corrected Mar 5, 2022
0770DMinimal harm, Isolated

Provide timely, quality laboratory services/tests to meet the needs of residents.

Administration Deficiencies

Corrected Mar 5, 2022
0801DMinimal harm, Isolated

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

Nutrition and Dietary Deficiencies

Corrected Mar 5, 2022
0803EMinimal harm, Pattern

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.

Nutrition and Dietary Deficiencies

Corrected Mar 5, 2022
0812EMinimal harm, Pattern

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

Nutrition and Dietary Deficiencies

Corrected Mar 5, 2022
0814CNo harm, Widespread

Dispose of garbage and refuse properly.

Nutrition and Dietary Deficiencies

Corrected Mar 5, 2022
0880EMinimal harm, Pattern

Provide and implement an infection prevention and control program.

Infection Control Deficiencies

Corrected Mar 5, 2022
0947DMinimal harm, Isolated

Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.

Nursing and Physician Services Deficiencies

Corrected Mar 5, 2022

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Frequently Asked Questions

What is the CareGrader rating for WATERSIDE NURSING & REHABILITATION?

WATERSIDE NURSING & REHABILITATION in KERRVILLE, Texas has a CareGrader grade of F (Poor), with a composite score of 48.3 out of 100. This grade is based on health inspections, staffing levels, quality measures, and penalty history from official CMS government data.

What is the CMS star rating for WATERSIDE NURSING & REHABILITATION?

WATERSIDE NURSING & REHABILITATION has an overall CMS star rating of 1 out of 5, a health inspection rating of 1/5, and a staffing rating of 1/5. CareGrader combines this with additional data to calculate an A-F grade.

How many health deficiencies does WATERSIDE NURSING & REHABILITATION have?

WATERSIDE NURSING & REHABILITATION has 79 health deficiencies on record from CMS health inspection surveys. Deficiencies are rated from A (minimal harm potential) to L (immediate jeopardy, widespread). This facility has abuse citations on record. View the full inspection timeline above for details on each deficiency.

Has WATERSIDE NURSING & REHABILITATION been fined?

Yes. WATERSIDE NURSING & REHABILITATION has $248,481 in total fines from CMS enforcement actions across 7 penalties.

How many beds does WATERSIDE NURSING & REHABILITATION have?

WATERSIDE NURSING & REHABILITATION has 179 certified beds with approximately 70 current residents (39% occupancy). The facility is located at 1213 WATER ST, KERRVILLE, Texas 78028. It is a for profit - limited liability company facility.

Data Disclaimer

Inspection data, staffing levels, and star ratings are sourced from CMS Medicare Nursing Home Compare and are largely self-reported by facilities. A 2019 GAO study found that 43% of facilities under-reported falls. CareGrader provides this data for informational purposes only and is not affiliated with CMS or Medicare. Always visit facilities in person before making a decision.