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Home / Texas / Round Rock

San Gabriel Rehabilitation and Care Center

4100 College Park Dr, Round Rock, TX 78665 · Williamson County · (512) 334-8000

142 certified beds, about 87 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 2012

CMS abuse icon: cited for abuse in a recent inspection Certified for Medicaid Certified for Medicare
Overall
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
3 of 5

CMS Care Compare ratings, data as of September 1, 2026 · CCN 676308 · See it on Medicare.gov · Compare with other homes

The record in brief

At its most recent standard inspection, on July 17, 2025, inspectors cited 8 health deficiencies (the Texas average is 9.4, the national average 9.2).

Of 31 health citations since April 2023, 3 were rated as actual harm or immediate jeopardy to residents (3 immediate jeopardy).

CMS lists 2 fines totaling $19,393 in the last three years; the largest was $11,112, and the latest is dated September 12, 2025.

Nurses and nurse aides worked 3.18 hours per resident per day, against 3.39 across Texas and 3.86 nationally. Registered nurses accounted for 0.40 of those hours.

55.1% of nursing staff left within the year CMS measured (Texas average 55.3%).

CMS links it to Fundamental Healthcare, an affiliated group of 66 nursing homes.

Health inspections

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.

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

Where its citations fall on CMS's grid

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 31 health citations on file.

Severity
Isolated
Pattern
Widespread
Immediate jeopardy
3J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
20D
8E
0F
Potential for minimal harm
0A
0B
0C
April 30, 2026Complaint inspection · 2 citations
  1. E
    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
    F600 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) May 6, 2026
    Inspectors wroteBased on observation, interview and record review, the facility failed to ensure residents were free from abuse for 3 of 8 residents (R #3, R #4 and R #5) reviewed for abuse. The facility failed to ensure R#1did not hit R# 3 on the chest 3 times at the lunch table in the dining room for an unknown reason on 04/15/2026. The facility failed to ensure on 4/26/2026 at 10:30 am, R # 4 and R#1 did not get into an altercation when R#4 accidently bumped his wheelchair into R#1s wheelchair by the nurse's station. The facility failed to ensure Resident #1 did not hit R# 5 when R# 5 was would not allow R# 1 to play dominoes on 04/26/2026 at 2:15 pm. This failure could place residents at risk of abuse, physical harm, mental anguish and/or emotional distress. [...]
  2. E
    Provide safe and appropriate respiratory care for a resident when needed.
    F695 · Quality of Life and Care · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) May 6, 2026
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that residents, who needed respiratory care, were provided such care consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents' goals and preferences for 3 of 6 residents (Resident #1, Resident#2 and Resident #3) reviewed for respiratory care. The facility failed to ensure the nebulizer masks and tubing of Resident #1, Resident #2 and Resident #3 were stored safely in protective bags. This failure placed residents at risk for respiratory infections through contamination.
December 23, 2025Complaint inspection · 1 citation
  1. D
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    F755 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) December 30, 2025
    Inspectors wroteBased on observation, interview, and record review, the facility failed to provide pharmaceutical services, including procedures that assure the accurate acquiring and administering of all drugs to meet the needs of the residents, for one resident (R#1) of three residents reviewed for pharmacy services. The facility failed to ensure physician ordered, Ingrezza 80 mg (a medication treatment of tardive dyskinesia) was provided as scheduled on [DATE], [DATE], [DATE] and [DATE]. This failure placed residents at risk for harm by not receiving the therapeutic effects of this medication prescribed.
September 12, 2025Complaint inspection · 2 citations
  1. J
    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
    F600 · Freedom from Abuse, Neglect, and Exploitation · Immediate jeopardy to resident health or safety, isolated · found on a complaint visit · Corrected (the home has a date of correction) September 13, 2025
    Inspectors wroteBased on interviews and record reviews, the facility failed to ensure residents had the right to be free from physical abuse by staff for 1 of 3 (Resident #1) residents reviewed for abuse. The facility failed to ensure Resident #1 was not physically abused by CNA A after Resident#1 suffered pain and fear after incontinent care was provided roughly by CNA A, using a dry towel and a healing labial skin tear was identified on 06/03/25. CNA A provided incontinent care to Resident #1 again with a dry towel and Resident #1 told CNA A not to come into her room. CNA A continued to provide care to Resident #1 until the day before her discharge on [DATE]. The facility failed to implement protective measures as CNA A continued to provide care to Resident #1 until the day before her discharge on [DATE]. An Immediate Jeopardy (IJ) was identified on 09/11/25 at 6:52 PM and an IJ template was provided. [...]
  2. J
    Respond appropriately to all alleged violations.
    F610 · Freedom from Abuse, Neglect, and Exploitation · Immediate jeopardy to resident health or safety, isolated · found on a complaint visit · Corrected (the home has a date of correction) September 13, 2025
    Inspectors wroteBased on observation, interview, and record review the facility failed to ensure in response to allegations of abuse, neglect, exploitation, or mistreatment the facility had evidence that all alleged violations were thoroughly investigated and prevent further abuse, neglect, exploitation, or mistreatment while the investigation was in progress for 1 of 3 residents (Residents #1) reviewed for abuse and neglect. The facility failed to investigate and report abuse when Resident #1 suffered pain and fear after incontinent care was provided roughly by CNA A, using a dry towel and a healing labial tear was identified on 06/03/25. CNA continued to provide incontinent care to Resident #1 until the day before her discharge on [DATE]. An Immediate Jeopardy (IJ) was identified on 09/11/25 at 6:52 PM and an IJ template was provided. [...]
July 17, 2025Standard inspection · 8 citations
  1. E
    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.
    F584 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) August 7, 2025
    Inspectors wroteBased on observation, interview and record review the facility failed to provide housekeeping and maintenance services necessary to maintain a sanitary and comfortable interior for 2 of 10 residents (Resident #49 and Resident #67) reviewed for environment. The facility failed to ensure Resident #49 and Resident #67's room was in good repair and free of holes in the walls. This failure could affect any resident and place them at risk for not having a sanitary homelike environment.
  2. E
    Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
    F604 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) August 7, 2025
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents were free from any physical restraints imposed for purposes of convenience and not required to treat the resident's medical symptoms for 3 (Residents #7, Residents #12, and Resident #95) of 5 residents reviewed for restraints. The facility failed to ensure that restraints were not used on Residents #7, Residents #12, and Resident #95's bed. This failure could result in residents having physical restraints used that limited their movement without being evaluated for the medical need.
  3. E
    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
    F725 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) August 7, 2025
    Inspectors wroteBased on observations, interviews, and record review the facility failed to have sufficient nursing staff to provide nursing and related services to assure resident safety and attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident and determined by considering the number, acuity, and diagnoses of the facility's resident population with accordance with 4 (Residents #28, #33, #68, and #93) of 4 residents reviewed for sufficient staffing. The facility failed to ensure that the facility had sufficient staffing to meet the needs of Residents #28, #33, #68, and #93. [...]
  4. D
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    F550 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 7, 2025
    Inspectors wroteBased on observation, interview, and record review, the facility failed to treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his or her quality of life for 2 of 10 residents (Resident #44, and Resident #68) reviewed for rights. The facility failed to ensure LVN A and CNA B knocked on Resident #44, and Resident #68's doors when going into the residents' rooms. The deficient practice could place residents at risk of feeling like their privacy was being invaded or the facility was not their home.
  5. D
    PASARR screening for Mental disorders or Intellectual Disabilities
    F645 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 7, 2025
    Inspectors wroteBased on interview and record review, the facility failed to provide accurate PASRR screenings for individuals with a mental disorder for 1 (Resident #4) of 2 residents reviewed for PASRR. The facility failed to complete an accurate PASRR level one screening after Resident #4 was admitted with a negative PASRR Level 1 screening but had a mental illness. This failure could place residents at risk of not receiving or benefiting from specialized therapy and equipment services they may require.
  6. D
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    F677 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 7, 2025
    Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure residents who were unable to carry out activities of daily living received necessary services to maintain personal hygiene for two (Resident #53 and Resident #67) of ten residents reviewed for ADL care. The facility failed provide Resident #53 and Resident #67 with showers and brushing their teeth. This deficient practice could place residents at risk of a decline in their sense of well-being and level of satisfaction with life. [...]
  7. D
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    F755 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 7, 2025
    Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that all drugs and biologicals used in the facility were labeled in accordance with professional standards, including expiration dates for 1 of 4 medication carts reviewed. During observation of MC A, Resident #28's box of Novolin 70/30 had been opened on 05/29/25 and according to the manufacturing instructions should be disposed after 42 days of opening which would be on or before 07/10/25. This failure could lead to medication not being effective, and therefore impacting residents' health.
  8. D
    Provide and implement an infection prevention and control program.
    F880 · Infection Control · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) August 7, 2025
    Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide a safe and sanitary environment to prevent the development and transmission of communicable diseases and infections for 3 of 5 residents (Resident #2, Resident #63 and Resident #57) reviewed for infection control. 1. CNA H, CNA C, and CNA K did not sanitize their hands between glove changes during peri-care for Resident #2 and Resident #57. 2. CNA H did not sanitize their hands between glove changes during Foley catheter care for Resident #63. These failures could place the residents at risk of infection transmission, sepsis (a systemic infection), and hospitalization.
April 14, 2025Complaint inspection · 1 citation
  1. E
    Reasonably accommodate the needs and preferences of each resident.
    F558 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) April 29, 2025
    Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to ensure residents received services in the facility with reasonable accommodations of resident needs and preferences for 3 (Residents #1, #2, and #3) of 5 residents reviewed for call light placement. The facility failed to ensure Resident #1's, #2's, and #3's call light were within reach on 04/14/25. This failure could place residents at risk of needs not being met.
March 18, 2025Complaint inspection · 1 citation
  1. J
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    F689 · Quality of Life and Care · Immediate jeopardy to resident health or safety, isolated · found on a complaint visit · Corrected (the home has a date of correction) March 19, 2025
    Inspectors wroteBased on interview and record review, the facility failed to ensure each resident received adequate supervision and assistance devices to prevent accidents for 1 (Resident #1) of 5 residents reviewed for accidents and hazards. The facility failed to ensure Resident #1 did not leave the facility without supervision and/or staff knowledge as she was found in the street in front of the facility by visitors of the facility on 02/23/2025. An Immediate Jeopardy (IJ) was identified on 03/17/2025. The IJ template was provided to the facility on [DATE] at 5:04 PM. While the IJ was removed on 03/18/2025 the facility remained out of compliance at a scope of isolated and a severity level of not actual harm because all staff had not been trained on elopement. This failure could place residents at risk of unsafe elopements, falls, injuries, hospitalization and/or death.
January 22, 2025Complaint inspection · 1 citation
  1. D
    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.
    F761 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) February 10, 2025
    Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure drugs and biologicals were stored in locked compartments for 1 of 1 treatment carts reviewed for medication storage. The facility failed to ensure the treatment cart was locked while unattended by RN A on 01/22/2025. This failure could place residents at risk of harm due to unauthorized access and potential ingestion of medicated creams, ointments, and other biologicals.
September 25, 2024Complaint inspection · 2 citations
  1. D
    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
    F600 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Past noncompliance: already fixed when inspectors found it
    Inspectors wroteBased on interview and record review, the facility failed to ensure the residents had the right to be free from abuse, neglect, misappropriation of property and exploitation for one (Resident #2) out of three residents reviewed for abuse, in that: The facility failed to ensure Resident #2 was transferred by Hoyer lift from his bed to his wheelchair without being hit in the head by the Hoyer lift and without his right foot being hit against the wall causing resident pain and an abrasion. CNA B did not immediately stoop the Hoyer transfer and request an assessment of the Resident #2 when he cried out, ow. This made Resident #2 feel like, they don't give a crap about him. This failure could place residents that required Hoyer lift transfers and assistance when they express pain at risk for injuries, neglect, harm, pain, and psychosocial injury. This noncompliance was identified as PNC. [...]
  2. D
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    F689 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Past noncompliance: already fixed when inspectors found it
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure each resident received adequate supervision and assistance devices to prevent accidents for two (Resident #1 and Resident #2) of three residents reviewed, in that: The facility failed to 1. utilize a two-person transfer for Resident #1 when transferring her from her bed to her wheelchair; 2. utilize a Hoyer lift when transferring Resident #1 from her bed to her wheelchair; and 3. lock the breaks on Resident #1's wheelchair when transferring her from her bed to her wheelchair causing her wheelchair to roll backwards, resident to slide forward in front of the wheelchair and Resident #1 to fall on top of CNA A. Both Resident #1 and CNA A landed on the floor. As a result of the fall, Resident #1's left knee was bruised and minimally swollen. [...]
June 20, 2024Complaint inspection · 1 citation
  1. D
    Provide and implement an infection prevention and control program.
    F880 · Infection Control · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) June 30, 2024
    Inspectors wroteBased on observations, interviews and record review, the facility failed to maintain an Infection Control Program designed to ensure hand hygiene procedures were followed by staff in the direct care of 4 of 4 residents (Resident #1, Resident #2, Resident #3, and Resident #4) reviewed for infection control in that: CNA A did not sanitize or wash hands after touching contaminated items before feeding resident or touching residents' food, placing residents at risk of food contamination. This failure could place all residents at risk of getting sick from staff not performing proper hand hygiene. Findings Included: Record review of Resident #1's face-sheet dated 06/20/2024 revealed a [AGE] year-old male admitted to the facility on [DATE]. His diagnoses included: [...]
May 30, 2024Standard inspection · 6 citations
  1. D
    Reasonably accommodate the needs and preferences of each resident.
    F558 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) June 25, 2024
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents had the right to reside and receive services in the facility with reasonable accommodation of resident needs for 2 of 6 residents (Resident #8, and Resident #38) reviewed for accommodation of needs. The facility failed to ensure Resident #8 and Resident #38's call lights were placed within their reach. This failure could place dependent residents at risk of injuries and unmet needs.
  2. D
    Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
    F604 · Freedom from Abuse, Neglect, and Exploitation · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) June 25, 2024
    Inspectors wroteBased on observation, interview and record review the facility failed to ensure residents were free from physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms for 1 of 6 residents (Resident #8) reviewed for freedom from physical restraints. The facility failed to obtain a physician's order, code the MDS, and care plan Resident #8's bed rails in which the resident movements were restricted and there was no documentation the restraints were required to treat her medical symptoms. This failure could put residents at risk of unnecessary restriction of their freedom of movement (any change in place or position for the body or any part of the body that the person is physically able to control).
  3. D
    Ensure each resident receives an accurate assessment.
    F641 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) June 25, 2024
    Inspectors wroteBased on observation, interview, and record review the facility failed to ensure assessments accurately reflected the resident's status for two (2) (Resident #8 and Resident #77) of six (6) residents reviewed for assessments. The facility failed to ensure the MDS (Minimum Data Set) assessment accurately reflected: Resident #8 was using bed rails daily. Resident #77's diagnosis of dementia (a group of symptoms affecting memory, thinking, and social abilities) was coded as a psychotic disorder (condition of the mind) on the MDS assessment. This deficient practice could have placed the resident at risk for inadequate care due to inaccurate assessments.
  4. D
    Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
    F655 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) June 25, 2024
    Inspectors wroteBased on observation, interview and record review, the facility failed to develop a baseline care plan within 48 hours of a resident's admission for 2 (Resident's # 88 and #90) of 3 residents reviewed for baseline care plans. The facility failed to develop baseline care plans within the required 48-hour timeframe for Resident's #88 and #90. This failure could place residents at risk for not receiving necessary care and services or having important care needs identified and met.
  5. D
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    F656 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) June 25, 2024
    Inspectors wroteBased on observation, interview and record review, the facility failed to develop a comprehensive care plan, as well as implement a comprehensive care plan, to meet the medical and nursing needs and the services to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being of 2 (Resident #8 and Resident #60) of 15 residents reviewed for care plans. 1)The facility failed to complete an accurate comprehensive care plan for Resident #8 by not including side rails. 2) a. The facility failed to provide Resident #60 with a functioning communication system to call for nursing assistance. b. The facility failed to provide Resident #60 with a comprehensive care plan having addressed her functional limitations to utilize the facility's call light system and having developed alternative approaches and interventions for care. [...]
  6. D
    Make sure that a working call system is available in each resident's bathroom and bathing area.
    F919 · Environmental · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) June 25, 2024
    Inspectors wroteBased on observation, interview, and record review, the facility failed to adequately equip residents who have disabilities, and were unable to utilize the facility's communication system, with alternative services to meet the resident's needs as identified in the resident's plan or care for 1 of 8 residents (Resident #60) who was reviewed for functioning communication systems. 1. The facility failed to provide Resident #60 with a functioning communication system to call for nursing assistance. 2. The facility failed to provide Resident #60 with a call light system that accounted for Resident #60's functional limitations. This failure placed residents at risk of their needs having gone unmet.
March 21, 2024Complaint inspection · 1 citation
  1. D
    Make sure that a working call system is available in each resident's bathroom and bathing area.
    F919 · Environmental · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) April 10, 2024
    Inspectors wroteBased on observation, interview, and record review, the facility failed to be adequately equipped to allow residents to call for staff assistance through a communication system which relays the call directly to a centralized staff work area, for 2 of 5 residents (Resident #1 and Resident #2) reviewed for physical environment. The facility failed to ensure Resident #1, and Resident #2 had a working call light in the room. This failure could place residents at risk of not being able to get assistance when needed.
April 5, 2023Standard inspection · 5 citations
  1. E
    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.
    F803 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) April 15, 2023
    Inspectors wroteBased on observation, interview and record review, the facility failed to follow the menu for six (Resident #40, Resident #21, Resident #69, Resident #48, Resident #9 and Resident #63) of 18 residents reviewed for portion size accuracy. CK I failed to use the proper scoop size when serving residents on a pureed diet. This failure placed Resident #40, Resident #21, Resident #69, Resident #48, Resident #9 and Resident #63 at risk of reduced intake, weight loss, and malnutrition.
  2. E
    Provide and implement an infection prevention and control program.
    F880 · Infection Control · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) April 15, 2023
    Inspectors wroteBased on observation, interview and record review, the facility failed to maintain an infection and prevention control program that included, at a minimum, a system for preventing and controlling infections for 9 of 15 residents reviewed for wound care and usage of blood glucose meter and blood pressure monitors (Resident #31, Resident #3, Resident #53, Resident #27, Resident #43, Resident #7, Resident #6, Resident #64, Resident #31) as indicated by: Facility failed to ensure MA D, MA E and LVN B disinfected the blood glucose meter or blood pressure monitors between the residents. These failures could place the residents at risk for cross contamination and infection.
  3. D
    Keep residents' personal and medical records private and confidential.
    F583 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2023
    Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the residents' right to privacy during personal care for 1 of 3 residents (Residents #64) reviewed for privacy in that: The facility failed to ensure RN A provided privacy by closing the door and privacy curtain during wound care on Residents #64. This failure could place residents at risk of having their bodies and wounds exposed to the public, resulting in low self-esteem and a diminished quality of life.
  4. D
    Provide safe and appropriate respiratory care for a resident when needed.
    F695 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2023
    Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that a resident who needed respiratory care was provided such care, consistent with professional standards of practice and the comprehensive person-centered care plan for one of three residents (Resident #7) reviewed for supplemental oxygen therapy. Resident #7 was receiving oxygen at a rate not ordered (five liters/minute) by a physician and her humidifier bottle was empty. This failure placed residents at risk of irritated nasal passages and infection.
  5. D
    Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
    F806 · Nutrition and Dietary · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) April 15, 2023
    Inspectors wroteBased on observation, interviews, and record reviews, the facility failed to ensure that residents were served food that accommodated their allergies, intolerances, or preferences for one of ten residents (Resident #28) reviewed for food preferences. Resident #28 chose not to eat wheat, beef, or pork but was served wheat, beef, and/or pork on 04/03/23 and 04/04/23. This failure placed residents at risk of weight loss, indignity, and diminished quality of life.

Fire safety inspections

1 fire safety citation on file: 1 on May 30, 2024.

Every fire safety citation1 citation
  1. E
    Inspect, test, and maintain automatic sprinkler systems.
    K 353 · May 30, 2024 · Corrected (the home has a date of correction)

Fines and payment denials

DatePenaltyAmount or length
September 12, 2025Fine $11,112
March 18, 2025Fine $8,281

A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.

Staffing

Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.

MeasureThis homeTexasUnited States
All nursing staff (RN, LPN and aides)3.183.393.86
Registered nurses0.400.430.69
All nursing staff on weekends2.952.983.42
Nurse aides1.87
Licensed practical nurses0.91
Nursing staff turnover (share who left in a year)55.1%55.3%45.8%
Registered nurse turnover50.0%54.6%42.9%
Administrators who left0

CMS expects 4.28 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.

Staffing by quarter, from daily payroll records

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 3.28 on weekdays and 2.95 on weekends, 10% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.2% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.16 in April to June 2025 to 3.18 in January to March 2026.

QuarterAll nursing staffRegistered nursesWeekdaysWeekendsContract staff shareDays with no RN hoursResidents a day
Jan to Mar 20263.180.403.282.95 0.2%0 of 9087
Oct to Dec 20252.880.432.972.65 0.0%0 of 9293
Jul to Sep 20252.970.383.072.71 0.1%0 of 9296
Apr to Jun 20253.160.383.322.74 0.4%2 of 9192
United States, Jan to Mar 20263.750.623.923.335.3%0.5% of days
Texas, Jan to Mar 20263.330.403.502.932.2%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

Staff pay at this home

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. If you work here, your report helps start one.

Official wage estimates for Texas

JobMedianMiddle halfEmployed
Texas, all employers
CNAs (nursing assistants)$18.03$16.97 to $20.7188,680
LPNs and LVNs$29.92$27.46 to $32.8957,560
Registered nurses$46.14$38.06 to $50.53271,380
United States, nursing care facilities
CNAs (nursing assistants)$20.67$17.91 to $22.55534,270
LPNs and LVNs$33.86$30.05 to $37.40188,210
Registered nurses$41.11$37.85 to $47.68142,270

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.

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For San Gabriel Rehabilitation and Care Center. No name, email or phone, and nothing you could type about a resident: every answer is a number or a choice.

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Every report is reviewed before it counts; what it says about the home never decides whether it counts. How pay reports are handled.

How staff pay reports work · CNA pay by state

Quality measures

The measures CMS uses for the quality star. Lower is better for every one of them.

MeasureThis homeTexasUS
Percentage of long-stay residents whose need for help with daily activities has increased
Long Stay residents, 2025Q2-2026Q1
13.015.813.9
Percentage of long-stay residents with a catheter inserted and left in their bladder
Long Stay residents, 2025Q2-2026Q1
0.00.30.8
Percentage of long-stay residents with a urinary tract infection
Long Stay residents, 2025Q2-2026Q1
0.00.81.6
Percentage of long-stay residents experiencing one or more falls with major injury
Long Stay residents, 2025Q2-2026Q1
4.13.33.2
Percentage of short-stay residents who newly received an antipsychotic medication
Short Stay residents, 2025Q2-2026Q1
2.41.51.6
Percentage of long-stay residents whose ability to walk independently worsened
Long Stay residents, 2025Q2-2026Q1
11.114.014.1
Percentage of long-stay residents with pressure ulcers
Long Stay residents, 2025Q2-2026Q1
4.73.84.6
Percentage of long-stay residents who received an antipsychotic medication
Long Stay residents, 2025Q2-2026Q1
16.89.615.4
Percentage of short-stay residents who were rehospitalized after a nursing home admission
Short Stay residents, 20250101-20251231
29.825.723.8
Percentage of short-stay residents who had an outpatient emergency department visit
Short Stay residents, 20250101-20251231
14.812.312.0
Number of hospitalizations per 1000 long-stay resident days
Long Stay residents, 20250101-20251231
1.62.21.9
Number of outpatient emergency department visits per 1000 long-stay resident days
Long Stay residents, 20250101-20251231
1.12.11.8

Short-term rehab results

For a stay to recover after a hospital visit, these are the results CMS publishes for San Gabriel Rehabilitation and Care Center's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (60.1% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.

Went home or back to the community

60.1% 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. 83 eligible stays.

Potentially preventable readmissions

10.3% 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. 118 eligible stays.

Infections that led to a hospital stay

6.9% 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. 82 eligible stays.

Self-care and mobility at discharge

40.4% 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. 57 residents counted.

Falls with major injury

0.0% 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. 76 residents counted.

New or worsened pressure ulcers

0.0% 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. 76 residents counted.

Medication list given at discharge

93.8% this home

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. 32 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.

Owners and operators

Legal business name: SOUTH LIMESTONE HOSPITAL DISTRICT. CMS links this home to Fundamental Healthcare, a group of 66 nursing homes averaging 2.5 stars overall.

NameRoleTypeShareSince
South Limestone Hospital District5% or greater direct ownership interestOrganization100%04/01/2017
Price, LarryCorporate directorIndividual04/01/2017
Care Inn of Seguin LLCOperational/managerial controlOrganization04/01/2017
Garcia, MaryOperational/managerial controlIndividual12/04/2024
Krol, MichaelOperational/managerial controlIndividual12/01/2025
Forman, MurrayIndividual is an owner, partner or trustee of any ADP of the SNFIndividual11/30/2025
Garcia, MaryAdp of the SNFIndividual12/04/2024
Krol, MichaelAdp of the SNFIndividual12/01/2025

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.

Questions to ask on a visit

Chosen from this home's own inspection record.

  1. How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 6 problems in this area, most recently on April 30, 2026: "Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody."
  2. How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 5 problems in this area, most recently on April 30, 2026: "Provide safe and appropriate respiratory care for a resident when needed."
  3. How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 5 problems in this area, most recently on July 17, 2025: "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."
  4. When is the care plan meeting, and can family attend it?Inspectors cited 4 problems in this area, most recently on July 17, 2025: "PASARR screening for Mental disorders or Intellectual Disabilities"
  5. Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.95 hours per resident per day, below the Texas average of 2.98.

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Common questions

What is San Gabriel Rehabilitation and Care Center's Medicare star rating?
CMS rates San Gabriel Rehabilitation and Care Center 1 out of 5 stars overall, with 1 for health inspections, 1 for staffing and 3 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did San Gabriel Rehabilitation and Care Center get at its last inspection?
8 health deficiencies at the standard inspection on July 17, 2025. The Texas average is 9.4.
Has San Gabriel Rehabilitation and Care Center been fined?
Yes. CMS lists 2 fines totaling $19,393 in the last three years.
Does San Gabriel Rehabilitation and Care Center accept Medicaid?
It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
Who owns San Gabriel Rehabilitation and Care Center?
CMS lists 8 owners and managers, and links the home to Fundamental Healthcare. Legal business name: SOUTH LIMESTONE HOSPITAL DISTRICT.

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