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HEARTHSTONE NURSING AND REHABILITATION

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HEARTHSTONE NURSING AND REHABILITATION is a government - hospital district facility in ROUND ROCK, TX with 120 certified beds and a 3-star overall CMS rating. The facility has 26 deficiency records on file. Total penalties: $153K.

401 OAKWOOD BLVD, ROUND ROCK, TX 78681

Phone: 5123887494

Overall Rating

3/5

Health Inspection

3/5

Staffing

2/5

Quality Measures

3/5

Long-Stay Quality

5/5

Facility Information

Provider Number
455771
Ownership
Government - Hospital district
Provider Type
Medicare and Medicaid
Beds
120
Residents
89
In Hospital
No
County
Williamson
Last Inspection
Jan 30, 2025

Staffing Data

RN Hours
0.45 (nat'l avg: 0.68)
LPN Hours
0.58
CNA Hours
1.91
Total Nursing Hours
2.93 (nat'l avg: 3.89)
PT Hours
0.00
Nursing Turnover
69.4%
RN Turnover
54.5%

What the CMS Record Reveals About HEARTHSTONE NURSING AND REHABILITATION

HEARTHSTONE NURSING AND REHABILITATION operates 120 certified beds in ROUND ROCK, TX with approximately 89 residents currently in care, and carries a CMS overall rating of 3 out of 5 stars. The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results (3★), staffing levels (2★), and quality measures (3★). Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone — a 3-star facility with weak inspection history reads differently from one held back by thin staffing.

The inspection file contains 26 deficiency records from recent surveys, of which 6 reached the actual-harm or immediate-jeopardy threshold on the CMS scope-and-severity grid. On the enforcement side, CMS has assessed 3 penalties totaling $153K against this provider, a tangible indicator that regulators moved beyond citation into financial consequence. Staffing is reported at 2.93 total nursing hours per resident day (national average 3.89), with RN coverage at 0.45 per resident day — the single staffing metric most strongly tied to resident outcomes in peer-reviewed literature.

Classified as "Government - Hospital district" ownership and operating as a "Medicare and Medicaid" provider, HEARTHSTONE NURSING AND REHABILITATION falls into a category where comparative context matters. National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes — ratings and fines are lagging indicators of those upstream choices. Reported nursing turnover at this facility is 69.4%, above the level where continuity of care typically begins to suffer. For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report — the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify details directly with the facility or your state survey agency before making placement decisions.

Deficiency History (26 most recent)

D — Isolated - Minimal harm Nov 19, 2025 Tag: 0646

Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Nov 26, 2025

D — Isolated - Minimal harm Nov 19, 2025 Tag: 0644

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

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Nov 26, 2025

D — Isolated - Minimal harm Jan 30, 2025 Tag: 0880

Provide and implement an infection prevention and control program.

Category: Infection Control Deficiencies

Corrected: Feb 17, 2025

D — Isolated - Minimal harm Jan 30, 2025 Tag: 0656

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Feb 17, 2025

D — Isolated - Minimal harm Dec 19, 2024 Tag: 0842

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

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Jan 14, 2025

G — Isolated - Actual harm Dec 19, 2024 Tag: 0600

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

Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected: Dec 3, 2024

D — Isolated - Minimal harm Apr 3, 2024 Tag: 0755

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

Category: Pharmacy Service Deficiencies

Corrected: Apr 25, 2024

D — Isolated - Minimal harm Feb 13, 2024 Tag: 0758

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.

Category: Pharmacy Service Deficiencies

Corrected: Mar 11, 2024

D — Isolated - Minimal harm Feb 13, 2024 Tag: 0553

Allow resident to participate in the development and implementation of his or her person-centered plan of care.

Category: Resident Rights Deficiencies

Corrected: Mar 11, 2024

E — Pattern - Minimal harm Feb 13, 2024 Tag: 0552

Ensure that residents are fully informed and understand their health status, care and treatments.

Category: Resident Rights Deficiencies

Corrected: Mar 11, 2024

E — Pattern - Minimal harm Dec 14, 2023 Tag: 0880

Provide and implement an infection prevention and control program.

Category: Infection Control Deficiencies

Corrected: Jan 20, 2024

E — Pattern - Minimal harm Dec 14, 2023 Tag: 0804

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Category: Nutrition and Dietary Deficiencies

Corrected: Jan 20, 2024

E — Pattern - Minimal harm Dec 14, 2023 Tag: 0803

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.

Category: Nutrition and Dietary Deficiencies

Corrected: Jan 20, 2024

E — Pattern - Minimal harm Dec 14, 2023 Tag: 0692

Provide enough food/fluids to maintain a resident's health.

Category: Quality of Life and Care Deficiencies

Corrected: Jan 20, 2024

E — Pattern - Minimal harm Dec 14, 2023 Tag: 0689

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

Category: Quality of Life and Care Deficiencies

Corrected: Jan 20, 2024

E — Pattern - Minimal harm Dec 2, 2023 Tag: 0755

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

Category: Pharmacy Service Deficiencies

Corrected: Dec 8, 2023

K — Pattern - Jeopardy Dec 2, 2023 Tag: 0684

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

Category: Quality of Life and Care Deficiencies

Corrected: Nov 16, 2023

K — Pattern - Jeopardy Dec 2, 2023 Tag: 0600

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

Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected: Nov 16, 2023

K — Pattern - Jeopardy Dec 2, 2023 Tag: 0580

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Category: Resident Rights Deficiencies

Corrected: Nov 16, 2023

J — Isolated - Jeopardy Jul 31, 2023 Tag: 0689

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

Category: Quality of Life and Care Deficiencies

Corrected: Aug 25, 2023

J — Isolated - Jeopardy Jul 31, 2023 Tag: 0600

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

Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected: Aug 25, 2023

F — Widespread - Minimal harm Oct 20, 2022 Tag: 0882

Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.

Category: Infection Control Deficiencies

Corrected: Dec 5, 2022

F — Widespread - Minimal harm Oct 20, 2022 Tag: 0881

Implement a program that monitors antibiotic use.

Category: Infection Control Deficiencies

Corrected: Dec 5, 2022

D — Isolated - Minimal harm Oct 20, 2022 Tag: 0880

Provide and implement an infection prevention and control program.

Category: Infection Control Deficiencies

Corrected: Dec 5, 2022

D — Isolated - Minimal harm Oct 20, 2022 Tag: 0761

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.

Category: Pharmacy Service Deficiencies

Corrected: Nov 18, 2022

D — Isolated - Minimal harm Oct 20, 2022 Tag: 0755

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

Category: Pharmacy Service Deficiencies

Corrected: Nov 18, 2022

Quality Measures

Measure Type Score Used in Rating
Percentage of long-stay residents whose need for help with daily activities has increased Long Stay 10.2% Yes
Percentage of long-stay residents who lose too much weight Long Stay 7.2% No
Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay 0.0% Yes
Percentage of long-stay residents with a urinary tract infection Long Stay 0.0% Yes
Percentage of long-stay residents who have depressive symptoms Long Stay 0.4% No
Percentage of long-stay residents who were physically restrained Long Stay 0.0% No
Percentage of long-stay residents experiencing one or more falls with major injury Long Stay 6.9% Yes
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Long Stay 75.0% No
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine Short Stay 35.7% No
Percentage of short-stay residents who newly received an antipsychotic medication Short Stay 7.0% Yes
Percentage of long-stay residents whose ability to walk independently worsened Long Stay 9.0% Yes
Percentage of long-stay residents who received an antianxiety or hypnotic medication Long Stay 20.7% No
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Long Stay 86.9% No
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine Short Stay 49.5% No
Percentage of long-stay residents with pressure ulcers Long Stay 2.2% Yes
Percentage of long-stay residents with new or worsened bowel or bladder incontinence Long Stay 23.7% No
Percentage of long-stay residents who received an antipsychotic medication Long Stay 13.3% Yes

Penalty History 3 penalties totaling $153K

Date Type Amount
Dec 19, 2024 Fine $10K
Dec 2, 2023 Fine $16K
Jul 31, 2023 Fine $127K

Frequently Asked Questions

What is the overall CMS rating for HEARTHSTONE NURSING AND REHABILITATION?
HEARTHSTONE NURSING AND REHABILITATION has an overall CMS rating of 3 out of 5 stars. This rating combines health inspection results (3★), staffing levels (2★), and quality measures (3★).
What are the staffing levels at HEARTHSTONE NURSING AND REHABILITATION?
HEARTHSTONE NURSING AND REHABILITATION reports 2.93 total nursing hours per resident day (national average: 3.89). RN hours are 0.45 per resident day (national average: 0.68). Nursing staff turnover is 69.4%.
How many beds does HEARTHSTONE NURSING AND REHABILITATION have?
HEARTHSTONE NURSING AND REHABILITATION has 120 certified beds with approximately 89 residents. The facility is located at 401 OAKWOOD BLVD, ROUND ROCK, TX 78681.
Does HEARTHSTONE NURSING AND REHABILITATION have any deficiencies on record?
Yes, HEARTHSTONE NURSING AND REHABILITATION has 26 deficiencies on record from recent inspections. Of these, 6 are classified as causing actual harm or jeopardy.
Has HEARTHSTONE NURSING AND REHABILITATION received any fines or penalties?
Yes, HEARTHSTONE NURSING AND REHABILITATION has received 3 penalties totaling $153K.
Who owns HEARTHSTONE NURSING AND REHABILITATION?
HEARTHSTONE NURSING AND REHABILITATION is classified as "Government - Hospital district" ownership. The facility type is "Medicare and Medicaid".
When was HEARTHSTONE NURSING AND REHABILITATION last inspected?
The most recent health inspection for HEARTHSTONE NURSING AND REHABILITATION was on Jan 30, 2025. The facility received a health inspection rating of 3 out of 5 stars.
What quality measures are tracked for HEARTHSTONE NURSING AND REHABILITATION?
HEARTHSTONE NURSING AND REHABILITATION is evaluated on 17 quality measures, of which 8 are used in the CMS star rating calculation. These include measures for both long-stay and short-stay residents covering areas like infections, falls, pressure ulcers, and medication use.

Data Sources

Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Always verify information directly with the facility or your state health department.

Related

Data sourced from official U.S. government datasets. See our methodology for details. Retrieved and formatted by PlainNursing Editorial