SNF

HEARTHSTONE NURSING AND REHABILITATION

CCN: 455771 · ROUND ROCK, TX 78681 · Williamson County

Overview

Address
401 OAKWOOD BLVD, ROUND ROCK, TX 78681
Phone
5123887494
Certified beds
120
Avg daily residents
89 (74% of beds filled)
Ownership
Government (hospital district)
Provider type
Medicare and Medicaid
Medicare/Medicaid since
1988-09-26
Setting
Urban
3 /5
★★★★★
CMS Overall Rating

CMS 5-Star Ratings

CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.

Overall Rating
Composite of Health Inspection, Staffing, and Quality Measures.
★★★★★ 3/5
Health Inspection
Based on the three most recent standard surveys, with more weight on recent results.
★★★★★ 3/5
Staffing
Weighted combination of RN and total nurse staffing hours per resident per day, case-mix adjusted.
★★★★★ 2/5
Quality Measures
15 resident-level quality measures split between long-stay and short-stay (post-acute) residents.
★★★★★ 3/5
Quality Measures breakdown
Long-Stay Quality Measures ★★★★★ 5/5
Short-Stay Quality Measures ★★★★★ 1/5

Staffing & Workforce

Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.

Role Reported Case-mix expected Adjusted Federal floor
Total nurse
All nursing staff combined: RN + LPN + Aide
 2.93 3.36 3.38 ≥ 3.48 Below floor
Registered Nurse (RN)
Licensed RN hours. Strongest driver of clinical outcomes.
 0.45 0.59 0.51 ≥ 0.55 Below floor
Licensed Practical Nurse (LPN)
LPN/LVN hours. Often handles medication administration.
 0.58 0.74 0.66 —
Nurse aide
CNA hours. Bulk of direct resident care — bathing, feeding, mobility.
 1.91 2.02 2.20 —
Licensed (RN + LPN)
Combined licensed nurse coverage.
 1.02 — — —
Physical therapist
Rehabilitation therapist hours — important for post-acute / rehab admissions.
 0.00 — — —

Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.

Weekend staffing

Total nurse (weekend)
2.51
hrs / resident / day
RN (weekend)
0.32
hrs / resident / day
Total nurse (adjusted, weekend)
2.89
hrs / resident / day

Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.

Staff turnover

Total nursing staff turnover
69.4%
annual
RN turnover
54.5%
annual
Administrators departed
1
last 12 months

Resident acuity

Nursing Case-Mix Index
1.19
higher acuity than avg
Case-Mix Index Ratio
0.86
facility / state ratio

Health Inspections

CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.

Cycle Date Total defs. Standard Complaint Deficiency score Revisits Total score
Cycle 1 (most recent) 2025-01-30 5 2 3 20 1 20
Cycle 2/3 (prior) 2023-12-14 17 5 12 302 1 302
Total weighted health score
90.5
lower is better
Infection-control citations
3
last cycle

Deficiencies (27)

Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).

21 D/E/F Actual harm — potential for minor
1 G/H/I Actual harm
5 J/K/L Immediate jeopardy
Tag Description Scope/Severity Survey date Corrected
0657 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. D 2026-01-14 2026-01-26
0644 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. D 2025-11-19 2025-11-26
0646 Notify the appropriate authorities when residents with MD or ID services has a significant change in condition. D 2025-11-19 2025-11-26
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2025-01-30 2025-02-17
0880 Provide and implement an infection prevention and control program. D 2025-01-30 2025-02-17
0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. G 2024-12-19 2024-12-03
0842 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. D 2024-12-19 2025-01-14
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. D 2024-04-03 2024-04-25
0552 Ensure that residents are fully informed and understand their health status, care and treatments. E 2024-02-13 2024-03-11
0553 Allow resident to participate in the development and implementation of his or her person-centered plan of care. D 2024-02-13 2024-03-11
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. D 2024-02-13 2024-03-11
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. E 2023-12-14 2024-01-20
0692 Provide enough food/fluids to maintain a resident's health. E 2023-12-14 2024-01-20
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. E 2023-12-14 2024-01-20
0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. E 2023-12-14 2024-01-20
0880 Provide and implement an infection prevention and control program. E 2023-12-14 2024-01-20
0580 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. K 2023-12-02 2023-11-16
0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. K 2023-12-02 2023-11-16
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. K 2023-12-02 2023-11-16
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. E 2023-12-02 2023-12-08
0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. J 2023-07-31 2023-08-25
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. J 2023-07-31 2023-08-25
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. D 2022-10-20 2022-11-18
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. D 2022-10-20 2022-11-18
0880 Provide and implement an infection prevention and control program. D 2022-10-20 2022-12-05
0881 Implement a program that monitors antibiotic use. F 2022-10-20 2022-12-05
0882 Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. F 2022-10-20 2022-12-05

Penalties (3)

Fines issued
3
last 3 years
Total fines
$152,617
Date Type Fine amount
2024-12-19 Fine $10,033
2023-12-02 Fine $15,593
2023-07-31 Fine $126,991

Source: CMS Nursing Home Penalties.

Financial Health (FY 2023)

Payer mix (share of resident days)

Medicare 11.4% Medicaid 57.4% Other 31.2%

Operating performance

Operating Margin
-25.9%
Total Margin
-12.9%
Occupancy Rate
54.3%
Cost per Resident Day
$36

Revenue & costs

Net Patient Revenue
$6.5M
Total Costs
$849K
Net Income
-$941K

Balance sheet

Total Assets
-$965K
Total Liabilities
$1.6M
Fund Balance
-$2.6M

Source: CMS SNF Cost Report (FY 2023). Cost report data lags by ~2 years.

Ownership & Corporate Structure

Chain: CARADAY HEALTHCARE

Chain ID
103
Facilities in chain
9
Legal business name
STRATFORD HOSPITAL DISTRICT
Chain-average star ratings (for peer context)
Overall
2.6
Health
2.8
Staffing
1.6
QM
3.7

Owner / manager organizations (3)

Organization Role Association
STRATFORD HOSPITAL DISTRICT 5% OR GREATER DIRECT OWNERSHIP INTEREST since 06/01/2020
CARADAY HEARTHSTONE LLC OPERATIONAL/MANAGERIAL CONTROL since 06/01/2020
GRANITE HEARTHSTONE HEALTH CENTER, LLC 5% OR GREATER MORTGAGE INTEREST since 06/01/2020

Owner / manager individuals (2)

Name Role Association
MOORE, GREGORY OPERATIONAL/MANAGERIAL CONTROL since 06/01/2020
CHUMLEY, RICHARD CORPORATE OFFICER since 06/01/2020

Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.

Facility Features

CCRC
No
Hospital-based
No
Resident / family council
Resident
Sprinkler systems
Yes
Abuse citation flag
No
Methodology & sources

Full methodology →

All Data

Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.

Download CSV

Show 112 rows
Source Metric Value Raw key
Cost Report Cost per Resident Day ($) $36 metrics.cost_per_resident_day
Cost Report fiscal_year 2,023 fiscal_year
Cost Report Medicaid Day Share (%) 57.4% metrics.medicaid_day_share
Cost Report Medicare Day Share (%) 11.4% metrics.medicare_day_share
Cost Report Net Income ($) $-940,948 metrics.net_income
Cost Report Net Patient Revenue ($) $6,529,487 metrics.net_patient_revenue
Cost Report Occupancy Rate (%) 54.3% metrics.occupancy_rate
Cost Report Operating Margin (%) -25.9% metrics.operating_margin
Cost Report Total Assets ($) $-965,013 metrics.total_assets
Cost Report Total Costs ($) $849,354 metrics.total_costs
Cost Report Total Fund Balances ($) $-2,580,730 metrics.fund_balance
Cost Report Total Liabilities ($) $1,615,717 metrics.total_liabilities
Cost Report Total Margin (%) -12.9% metrics.total_margin
Provider Information Abuse Icon N Abuse Icon
Provider Information Adjusted LPN Staffing Hours per Resident per Day 0.66206 Adjusted LPN Staffing Hours per Resident per Day
Provider Information Adjusted Nurse Aide Staffing Hours per Resident per Day 2.20085 Adjusted Nurse Aide Staffing Hours per Resident per Day
Provider Information Adjusted RN Staffing Hours per Resident per Day 0.51226 Adjusted RN Staffing Hours per Resident per Day
Provider Information Adjusted Total Nurse Staffing Hours per Resident per Day 3.37517 Adjusted Total Nurse Staffing Hours per Resident per Day
Provider Information Adjusted Weekend Total Nurse Staffing Hours per Resident per Day 2.88671 Adjusted Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Administrator turnover footnote — Administrator turnover footnote
Provider Information Automatic Sprinkler Systems in All Required Areas Yes Automatic Sprinkler Systems in All Required Areas
Provider Information Average Number of Residents per Day 88.9 Average Number of Residents per Day
Provider Information Average Number of Residents per Day Footnote — Average Number of Residents per Day Footnote
Provider Information Case-Mix LPN Staffing Hours per Resident per Day 0.74458 Case-Mix LPN Staffing Hours per Resident per Day
Provider Information Case-Mix Nurse Aide Staffing Hours per Resident per Day 2.02359 Case-Mix Nurse Aide Staffing Hours per Resident per Day
Provider Information Case-Mix RN Staffing Hours per Resident per Day 0.58689 Case-Mix RN Staffing Hours per Resident per Day
Provider Information Case-Mix Total Nurse Staffing Hours per Resident per Day 3.35506 Case-Mix Total Nurse Staffing Hours per Resident per Day
Provider Information Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day 2.95713 Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Chain Average Health Inspection Rating 2.8 Chain Average Health Inspection Rating
Provider Information Chain Average Overall 5-star Rating 2.6 Chain Average Overall 5-star Rating
Provider Information Chain Average QM Rating 3.7 Chain Average QM Rating
Provider Information Chain Average Staffing Rating 1.6 Chain Average Staffing Rating
Provider Information Chain ID 103 Chain ID
Provider Information Chain Name CARADAY HEALTHCARE Chain Name
Provider Information City/Town ROUND ROCK City/Town
Provider Information CMS Certification Number (CCN) 455771 CMS Certification Number (CCN)
Provider Information Continuing Care Retirement Community N Continuing Care Retirement Community
Provider Information County/Parish Williamson County/Parish
Provider Information Date First Approved to Provide Medicare and Medicaid Services 1988-09-26 Date First Approved to Provide Medicare and Medicaid Services
Provider Information Geocoding Footnote — Geocoding Footnote
Provider Information Health Inspection Rating 3 Health Inspection Rating
Provider Information Health Inspection Rating Footnote — Health Inspection Rating Footnote
Provider Information Latitude 30.5116 Latitude
Provider Information Legal Business Name STRATFORD HOSPITAL DISTRICT Legal Business Name
Provider Information Location 401 OAKWOOD BLVD,ROUND ROCK,TX,78681 Location
Provider Information Long-Stay QM Rating 5 Long-Stay QM Rating
Provider Information Long-Stay QM Rating Footnote — Long-Stay QM Rating Footnote
Provider Information Longitude -97.711 Longitude
Provider Information Most Recent Health Inspection More Than 2 Years Ago N Most Recent Health Inspection More Than 2 Years Ago
Provider Information Number of administrators who have left the nursing home 1 Number of administrators who have left the nursing home
Provider Information Number of Certified Beds 120 Number of Certified Beds
Provider Information Number of Citations from Infection Control Inspections 3 Number of Citations from Infection Control Inspections
Provider Information Number of Facilities in Chain 9 Number of Facilities in Chain
Provider Information Number of Fines 3 Number of Fines
Provider Information Number of Payment Denials 0 Number of Payment Denials
Provider Information Nursing Case-Mix Index 1.18855 Nursing Case-Mix Index
Provider Information Nursing Case-Mix Index Ratio 0.86274 Nursing Case-Mix Index Ratio
Provider Information Overall Rating 3 Overall Rating
Provider Information Overall Rating Footnote — Overall Rating Footnote
Provider Information Ownership Type Government - Hospital district Ownership Type
Provider Information Physical Therapist Staffing Footnote — Physical Therapist Staffing Footnote
Provider Information Processing Date 2026-03-01 Processing Date
Provider Information Provider Address 401 OAKWOOD BLVD Provider Address
Provider Information Provider Changed Ownership in Last 12 Months N Provider Changed Ownership in Last 12 Months
Provider Information Provider Name HEARTHSTONE NURSING AND REHABILITATION Provider Name
Provider Information Provider Resides in Hospital N Provider Resides in Hospital
Provider Information Provider SSA County Code 970 Provider SSA County Code
Provider Information Provider Type Medicare and Medicaid Provider Type
Provider Information QM Rating 3 QM Rating
Provider Information QM Rating Footnote — QM Rating Footnote
Provider Information Rating Cycle 1 Health Deficiency Score 20 Rating Cycle 1 Health Deficiency Score
Provider Information Rating Cycle 1 Health Revisit Score 0 Rating Cycle 1 Health Revisit Score
Provider Information Rating Cycle 1 Number of Complaint Health Deficiencies 3 Rating Cycle 1 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 1 Number of Health Revisits 1 Rating Cycle 1 Number of Health Revisits
Provider Information Rating Cycle 1 Number of Standard Health Deficiencies 2 Rating Cycle 1 Number of Standard Health Deficiencies
Provider Information Rating Cycle 1 Standard Survey Health Date 2025-01-30 Rating Cycle 1 Standard Survey Health Date
Provider Information Rating Cycle 1 Total Health Score 20 Rating Cycle 1 Total Health Score
Provider Information Rating Cycle 1 Total Number of Health Deficiencies 5 Rating Cycle 1 Total Number of Health Deficiencies
Provider Information Rating Cycle 2 Number of Standard Health Deficiencies 5 Rating Cycle 2 Number of Standard Health Deficiencies
Provider Information Rating Cycle 2 Standard Health Survey Date 2023-12-14 Rating Cycle 2 Standard Health Survey Date
Provider Information Rating Cycle 2/3 Health Deficiency Score 302 Rating Cycle 2/3 Health Deficiency Score
Provider Information Rating Cycle 2/3 Health Revisit Score 0 Rating Cycle 2/3 Health Revisit Score
Provider Information Rating Cycle 2/3 Number of Complaint Health Deficiencies 12 Rating Cycle 2/3 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 2/3 Number of Health Revisits 1 Rating Cycle 2/3 Number of Health Revisits
Provider Information Rating Cycle 2/3 Total Health Score 302 Rating Cycle 2/3 Total Health Score
Provider Information Rating Cycle 2/3 Total Number of Health Deficiencies 17 Rating Cycle 2/3 Total Number of Health Deficiencies
Provider Information Registered Nurse hours per resident per day on the weekend 0.32058 Registered Nurse hours per resident per day on the weekend
Provider Information Registered Nurse turnover 54.5 Registered Nurse turnover
Provider Information Registered Nurse turnover footnote — Registered Nurse turnover footnote
Provider Information Reported Licensed Staffing Hours per Resident per Day 1.02046 Reported Licensed Staffing Hours per Resident per Day
Provider Information Reported LPN Staffing Hours per Resident per Day 0.57532 Reported LPN Staffing Hours per Resident per Day
Provider Information Reported Nurse Aide Staffing Hours per Resident per Day 1.91248 Reported Nurse Aide Staffing Hours per Resident per Day
Provider Information Reported Physical Therapist Staffing Hours per Resident Per Day 0.00000 Reported Physical Therapist Staffing Hours per Resident Per Day
Provider Information Reported RN Staffing Hours per Resident per Day 0.44514 Reported RN Staffing Hours per Resident per Day
Provider Information Reported Staffing Footnote — Reported Staffing Footnote
Provider Information Reported Total Nurse Staffing Hours per Resident per Day 2.93294 Reported Total Nurse Staffing Hours per Resident per Day
Provider Information Short-Stay QM Rating 1 Short-Stay QM Rating
Provider Information Short-Stay QM Rating Footnote — Short-Stay QM Rating Footnote
Provider Information Special Focus Status — Special Focus Status
Provider Information Staffing Rating 2 Staffing Rating
Provider Information Staffing Rating Footnote — Staffing Rating Footnote
Provider Information State TX State
Provider Information Telephone Number 5123887494 Telephone Number
Provider Information Total Amount of Fines in Dollars 152617.00 Total Amount of Fines in Dollars
Provider Information Total number of nurse staff hours per resident per day on the weekend 2.50848 Total number of nurse staff hours per resident per day on the weekend
Provider Information Total Number of Penalties 3 Total Number of Penalties
Provider Information Total nursing staff turnover 69.4 Total nursing staff turnover
Provider Information Total nursing staff turnover footnote — Total nursing staff turnover footnote
Provider Information Total Weighted Health Survey Score 90.500 Total Weighted Health Survey Score
Provider Information Urban Y Urban
Provider Information With a Resident and Family Council Resident With a Resident and Family Council
Provider Information ZIP Code 78681 ZIP Code