1401 Max Copeland Dr, Marble Falls, TX 78654 · Burnet County · (830) 693-0022
124 certified beds, about 97 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 2009
CMS Care Compare ratings, data as of September 1, 2026 · CCN 676220 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on December 31, 2025, inspectors cited 7 health deficiencies (the Texas average is 9.4, the national average 9.2).
Of 25 health citations since August 2023, 2 were rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 1 fine totaling $59,345 in the last three years; the largest was $59,345, and the latest is dated January 27, 2025.
Nurses and nurse aides worked 3.16 hours per resident per day, against 3.39 across Texas and 3.86 nationally. Registered nurses accounted for 0.42 of those hours.
CMS links it to The Ensign Group, an affiliated group of 344 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 25 health citations on file.
Inspectors wroteBased on record reviews and interviews, the facility failed to ensure a resident's environment remained free of accident hazards and received adequate supervision and assistance devices to prevent accidents for 1 of 12 residents (Resident #1) reviewed for transfers in that:CNA A failed to provide adequate supervision and transfer assistance on 06/21/26 for Resident #1 in her room during a bed to chair transfer requiring x2 person assistance per the plan of care. CNA A completed a transfer alone resulting in Resident #1 having a right tibia(inner and larger of the two bones between the knee and ankle)and fibula (outer and usually smaller of the two bones between the knee and the ankle) fracture and pain requiring hospitalization. The noncompliance was identified as PNC. The noncompliance began 06/21/26 and ended 06/26/26. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that each resident has the right to secure and confidential personal and clinical records for 1 of 34 residents (Resident #1) reviewed for Privacy and Confidentiality. The facility failed to ensure Resident #1's clinical records were protected from being viewed by unauthorized persons when CMA A left Resident #1's personal information visible on the computer's screen on unattended medication cart. This failure could place residents' personal information at risk of being exposed to unauthorized individuals.
Inspectors wroteBased on observation, interview, and record review, the facility failed to be ensure they were adequately equipped to allow residents to call for staff assistance through a communication system which relays relayed the call directly to a staff member or a centralized staff work area from each resident's bedside for 5 of 10 residents (Residents # 13, # 31, # 47, # 48 and # 67) reviewed for call lights. The facility failed to ensure Residents # 13, # 31, # 47, # 48 and # 67's call lights were within reach of the residents. These failures could place residents at risk of not being able to call for staff assistance to meet care needs or at risk of injury, pain, hospitalization, and a diminished quality of life.
Inspectors wroteBased on interview and record review the facility failed to ensure assessments accurately reflected the resident's status for 3 of 3 residents (Resident #1, Resident #26 and Resident #70) reviewed for accuracy of assessments. 1. The facility failed to ensure Resident #1's admission MDS, dated [DATE], accurately reflected his smoking status.2. The facility failed to ensure Resident #26's admission MDS, dated [DATE], accurately reflected her smoking status. 3. The facility failed to ensure Resident #70's admission MDS, dated [DATE], accurately reflected her smoking status. These failures could place residents at risk of inadequate supervision due to an inaccurate assessment of smoking status.
Inspectors wroteBased on observation, interview, and record review the facility failed to provide a resident or family group with private space, and take responsible steps, with the approval of the group, to make residents and family members aware of upcoming meeting in a timely manner ensure the confidentiality offer Residents participating in Resident Council meetings in dining room [ROOM NUMBER] of 1 resident council meetings reviewed for resident rights. The facility failed to ensure that Staff members did not enter the dining room uninvited during the meeting, resident council meetings exposing residents to loss of privacy. This failure could affect place residents by placing them at risk for loss of privacy and dignity.
Inspectors wroteBased on interview and record review the facility failed to ensure all residents with newly evident or possible serious mental disorder, intellectual disability, or a related condition for level II resident review upon a significant change in status assessment were referred for 1 of 2 residents (Resident #4 and Resident #99) reviewed for PASSAR. The facility failed to ensure Resident #99's level 1 PASSAR accurately reflected her Mental Illness diagnosis. The facility failed to ensure Resident #4 received a new level 1 PASSAR screening after having a new diagnosis that would reflect a Mental Illness diagnosis. This failure could place residents at risk of loss of specialized services for their Mental Illness, Developmental Disability and Intellectual Disability.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure sufficient fluid intake is offered to maintain proper hydration and health provide hydration care and services to each resident, consistent with the resident's comprehensive assessment for 2 of 10 residents (Residents #10 and # 47) reviewed for hydration .The facility failed to follow the facility policy and did not provide adequate hydration for 2 residents. Residents #10 and #47. These failures could place residents at risk of not having hydration needs met and/or becoming dehydrated.
Inspectors wroteBased on observation, interview and record review the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen reviewed for Food safety and Nutrition Services. The facility failed to ensure food safety by not performing proper hand hygiene when preparing puree foods. This failure could place residents at risk for food-borne illnesses.
Inspectors wroteBased on interview and record review the facility failed to ensure, in accordance with accepted professional standards and practices, medical records were maintained on each resident that were complete and accurately documented for 1 of 4 residents (Resident #1) reviewed for complete and accurate medical records. The facility failed to ensure Resident #1's smoking assessments, dated 11/21/2025, accurately reflected his smoking status. Resident #1's smoking assessment said, resident don't smoke. This failure could place residents at risk of not having the right to smoke or not having adequate supervision while smoking.
Inspectors wroteBased on interview and record review the facility failed to ensure, in accordance with accepted professional standards and practices, medical records were maintained on each resident that were complete and accurately documented for 1 of 7 residents (Resident #1) reviewed for complete and accurate records. The facility failed to ensure Resident #1's medication and treatment was documented in PCC (electronic health records) for October 20th, November 13, November 14th, November 17th, November 18th, November 19th and November 20th. This failure could place residents at risk of not receiving care and services to meet their needs.
Inspectors wroteBased on interviews and record review, the facility failed to ensure that residents who needed respiratory care were provided with such care, consistent with professional standards of practice for one (Resident #1) of three residents reviewed for respiratory care. The facility failed to ensure RN A documented Resident #1's response to oxygen therapy after she administered a nebulizer treatment on 04/03/25. This deficient practice could place residents that receive oxygen therapy at risk for inadequate care and respiratory distress.
Inspectors wroteBased on interview and record review, the facility failed to ensure all residents were free from abuse for one (Resident #1) of four residents reviewed for abuse. The facility failed to keep Resident #1 safe from being yelled at, humiliated, and being denied care by CNA B. This failure resulted in an identification of an Immediate Jeopardy (IJ) on 01/24/2025 at 5:42 PM . While the IJ was removed on 01/25/2025 at 2:45 PM, the facility remained out of compliance at a level 2 of no actual harm at a scope of isolated that was no immediate jeopardy due to the facility's need to evaluate the effectiveness of the corrective systems. This deficient practice could place residents at risk of abuse, injury and psychosocial harm.
Inspectors wroteBased on interviews, observations, and record review, the facility failed to use the services of a registered nurse for at least 8 consecutive hours a day, 7 days a week for 19 of 94 days reviewed for RN coverage. The facility failed to ensure they had an RN scheduled on duty for 19 days (07/04/2024, 07/08/2024, 07/09/2024, 07/14/2024, 07/22/2024, 08/05/2024, 08/19/2024, 08/30/2024, 09/03/2024, 09/04/2024, 09/10/2024, 09/16/2024, 09/17/2024, 09/18/2024, 09/24/2024, 09/25/2024, 09/26/2024, 10/01/2024, and 10/02/2024) and failed to ensure the DON was not acting as the charge nurse when the facility had an average daily occupancy of more than 60 residents. This failure placed residents at risk of missed nursing assessments, interventions, care, and treatment.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident was treated with respect, dignity and cared for in a manner and in an environment that promoted maintenance or enhancement of his or her quality of life for 4 (Resident #46, Resident #56, Resident #76, and Resident #78) of 18 residents reviewed for resident rights. The facility failed to ensure Resident #46 was changed after food was spilled on her clothes after meal service. This failure placed residents at risk for diminished quality of life and at risk for decreased feelings of self-worth and dignity. 1. Review of Resident #56's Face Sheet dated 10/02/2024 revealed she was a [AGE] year-old female who was admitted to the facility on [DATE]. [...]
Inspectors wroteBased on interview and record review the facility failed to ensure the assessment accurately reflected the resident's status for 4 (Resident #33, Resident #46 and Resident #69,and Resident #433 ) of 18 residents reviewed for accuracy of assessments. 1. The facility failed to ensure Resident #33's quarterly MDS dated [DATE] accurately reflected her psychiatric/mood disorder. 2. The facility failed to ensure Resident #46's quarterly MDS date 07/21/2024 accurately reflected her psychiatric/mood disorder. 3. The facility failed to ensure Resident #69's quarterly MDS dated [DATE] accurately reflected his psychiatric/mood disorder. 4. The facility failed to ensure Resident #433's admission MDS dated [DATE] accurately reflected her psychiatric/mood disorder. This failure could result in inadequate care due to an inaccurate assessment of psychiatric and mood disorders.
Inspectors wroteBased on observation, interview and record review, the facility failed to provide an ongoing program of activities based on the comprehensive assessment, care plan and the preferences of each resident to meet the interests of and support the physical, mental, and psychosocial well-being for 2 of 5 (Resident #46 and #71) reviewed for activities . The facility failed to develop an ongoing activity program for Resident #46 and Resident #71. This failure placed residents at risk of not having their recreational and social needs met.
Inspectors wroteBased on interview and record review, the facility failed to ensure each resident had the right to be free from misappropriation of property for 3 of 6 residents (Resident #1, Resident #2 and Resident #3) reviewed for misappropriation of property. The facility failed to prevent the misappropriation of Residents #1, #2, and #3's hydrocodone/APAP tablets (a schedule II controlled opioid medication used to treat pain). This failure placed residents at risk for not receiving prescribed medications.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure each resident had the right to be free from misappropriation of property for 3 of 6 residents (Resident #1, Resident #2 and Resident #3) reviewed for pharmacy services. The facility failed to follow their procedures that prevent drug diversions. This failure placed residents at risk for not receiving prescribed medications.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident who was unable to conduct activities of daily living received the necessary services to maintain grooming and personal hygiene were provided for 1 of 6 residents reviewed for ADLs (Resident# 6) The facility did not provide Resident #6 clean sheets or gown when blood got on this sheet and gown. These failures could place residents at risk of not receiving services/care and decreased quality of life. Findings Included: Record review of Resident #6's face sheet dated 04/16/2024 revealed resident was admitted to the facility on [DATE]. Resident #6 was an [AGE] year-old male. [...]
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents who were unable to conduct activities of daily living received necessary services to maintain personal hygiene for 2 of 6 residents reviewed for ADLs. (Resident #3, and Resident #5) The facility did not provide scheduled showers for Resident #3. The facility did not assist Resident #5 close his gown causing him to expose his butt to the female across the hall from him on at least two occasions. This failure could place all residents who were dependent on staff for ADLs at risk for embarrassment, rashes, infections, discomfort, and skin break down. Findings Include: Record review of Resident #2's face sheet dated 04/16/2024 revealed Resident #2 was admitted to the facility on [DATE]. Resident #2 was a [AGE] year-old female. [...]
Inspectors wroteBased on observation, record review and interviews, the facility failed to ensure they completed a PASRR evaluation on newly admitted residents prior to admission and after admission for one of three residents reviewed for PASRR screenings (Resident #50). The facility failed to ensure Resident #50's PASRR Level 1 screening indicated his was positive for mental illness. This failure placed residents at risk of not receiving or benefiting from specialized therapy and equipment services they may require.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents unable to conduct activities of daily living (ADLs) received the necessary services to maintain good grooming and personal hygiene for two of 15 residents (Resident #60 and #7) reviewed for quality of life. A) The facility failed to provide facial grooming and bathing assistance to Resident #60. B) The facility failed to ensure Resident#7's fingernails were trimmed and cleaned. These failures could place residents at risk for poor hygiene, dignity issues and decreased quality of life.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents who are incontinent of bladder receive appropriate treatment and services to prevent urinary tract infections for one three residents reviewed for catheters (Resident #7). The facility failed to ensure Resident #7's received care to prevent Urinary Tract Infections when they stored her catheter bag on the floor and did not ensure the catheter bag and tubing was positioned below the level of the bladder. These failures could place residents with foley catheters at risk for urinary tract infections and change of condition.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure all residents received respiratory care consistent with professional standards of practice and resident preferences for one (Resident #41) of eight residents reviewed for respiratory care. The facility failed to ensure Resident #41 had an order for oxygen which should have specified the L/m required. The facility failed to ensure a licensed nurse adjusted Resident #41's oxygen. These failures placed Resident #41 at risk of respiratory distress.
Inspectors wroteBased on interview and record reviews the facility failed to ensure PRN orders for psychotropic drugs were limited to 14 days, except if the attending physician or prescribing practitioner believes that it is appropriate for the PRN order to be extended beyond 14 days, for two of five residents reviewed for unnecessary medications. (Residents #38 and #181) A) The facility failed to ensure a PRN order for Lorazepam (anti-anxiety) dated 07/07/2023 had a stop date to ensure the medication did not extend beyond 14 days for Resident #38. B) The facility failed to ensure a PRN order for Lorazepam (anti-anxiety) dated 07/27/2023 had a stop date to ensure the medication did not extend beyond 14 days for Resident #181. [...]
1 fire safety citation on file: 1 on August 2, 2023.
| Date | Penalty | Amount or length |
|---|---|---|
| January 27, 2025 | Fine | $59,345 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Texas | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.16 | 3.39 | 3.86 |
| Registered nurses | 0.42 | 0.43 | 0.69 |
| All nursing staff on weekends | 2.54 | 2.98 | 3.42 |
| Nurse aides | 1.93 | ||
| Licensed practical nurses | 0.82 | ||
| Nursing staff turnover (share who left in a year) | not reported | 55.3% | 45.8% |
| Registered nurse turnover | not reported | 54.6% | 42.9% |
| Administrators who left | not reported |
CMS expects 3.67 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.42 on weekdays and 2.54 on weekends, 26% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 8.1% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.06 in April to June 2025 to 3.16 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.16 | 0.42 | 3.42 | 2.54 | 8.1% | 0 of 90 | 97 |
| Jul to Sep 2025 | 3.10 | 0.29 | 3.29 | 2.64 | 7.6% | 0 of 92 | 93 |
| Apr to Jun 2025 | 3.06 | 0.33 | 3.28 | 2.51 | 3.4% | 2 of 91 | 89 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Texas, Jan to Mar 2026 | 3.33 | 0.40 | 3.50 | 2.93 | 2.2% | 0.7% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Texas, all employers | |||
| CNAs (nursing assistants) | $18.03 | $16.97 to $20.71 | 88,680 |
| LPNs and LVNs | $29.92 | $27.46 to $32.89 | 57,560 |
| Registered nurses | $46.14 | $38.06 to $50.53 | 271,380 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Texas | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 30.8 | 15.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 0.3 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.3 | 0.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 10.4 | 3.3 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.6 | 1.5 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 17.4 | 14.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 1.7 | 3.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 8.7 | 9.6 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 22.3 | 25.7 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 26.6 | 12.3 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.2 | 2.2 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.1 | 2.1 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Granite Mesa Health Center's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (58.2% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
58.2% this home
No different from the national rate
US median of homes 51.5% · Texas: 116 better, 50 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 138 eligible stays.
11.1% this home
No different from the national rate
US median of homes 10.7% · Texas: 0 better, 9 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 166 eligible stays.
8.1% this home
No different from the national rate
US median of homes 7.1% · Texas: 4 better, 11 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 91 eligible stays.
71.8% this home
Median of homes: Texas57.3% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 71 residents counted.
1.1% this home
Median of homes: Texas0.0% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 94 residents counted.
1.2% this home
Median of homes: Texas1.3% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 94 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: Texas98.5% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 9 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: GUADALUPE COUNTY HOSPITAL BOARD. CMS links this home to The Ensign Group, a group of 344 nursing homes averaging 3.2 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Guadalupe County Hospital Board | 5% or greater direct ownership interest | Organization | 100% | 04/01/2017 |
| Syed, Asif | Managing control - governing body | Individual | 02/11/2019 | |
| Thompson, Amber | Managing control - governing body | Individual | 05/27/2021 | |
| Burnam, Soon | Corporate officer | Individual | 04/01/2017 | |
| Gann, Kody | Corporate officer | Individual | 02/01/2021 | |
| Keetch, Chad | Corporate officer | Individual | 03/01/2011 | |
| Copeland Healthcare, Inc | Operational/managerial control | Organization | 04/01/2017 | |
| Syed, Asif | Operational/managerial control | Individual | 02/11/2019 | |
| Thompson, Amber | Operational/managerial control | Individual | 05/27/2021 | |
| Copeland Healthcare, Inc | Adp of the SNF | Organization | 10/06/2025 | |
| Ensign Services Inc | Adp of the SNF | Organization | 05/01/2016 | |
| National Health Investors, Inc. | Adp of the SNF | Organization | 04/01/2017 | |
| Texas Nhi Investors, LLC | Adp of the SNF | Organization | 04/01/2017 | |
| Syed, Asif | Adp of the SNF | Individual | 02/11/2019 | |
| Thompson, Amber | Adp of the SNF | Individual | 05/27/2021 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
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