Hearthstone Nursing and Rehabilitation
401 Oakwood Blvd · Round Rock, TX · 78681 · 5123887494
120 certified beds Government - Hospital district Chain: Caraday Healthcare
Why this verdict
- Federal penalties on record: $10,033 in fines in the last 24 months.
- Inspection results have improved across recent cycles.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
5 immediate-jeopardy citations in prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
3 abuse-related citations at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
Total nurse staffing below 3.0 hours per resident-day
2.88 reported hours vs the 3.48 minimum CMS's own staffing study recommends.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 3 of 5 Inspections: 3 of 5 Staffing: 2 of 5 Quality measures: 2 of 5
| Total nurse hours / resident-day | 2.88 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.48 | 0.55–0.75 |
| Weekend hours / resident-day | 2.57 | ≈ weekday level |
| Nursing turnover / year | 56% | median 45% |
| Fines (3-yr window) | 3 · $152,617 |
Inspection citations (27 in the current record)
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Potential for harm · D January 14, 2026 · found via complaint
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected January 26, 2026 · Resident Assessment and Care Planning
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Potential for harm · D November 19, 2025 · found via complaint
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected November 26, 2025 · Resident Assessment and Care Planning
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Potential for harm · D November 19, 2025 · found via complaint
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
Corrected November 26, 2025 · Resident Assessment and Care Planning
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Potential for harm · D January 30, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected February 17, 2025 · Resident Assessment and Care Planning
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Potential for harm · D January 30, 2025
Provide and implement an infection prevention and control program.
Corrected February 17, 2025 · Infection Control
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Actual harm · G December 19, 2024 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected December 3, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D December 19, 2024 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected January 14, 2025 · Resident Assessment and Care Planning
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Potential for harm · D April 3, 2024 · found via complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected April 25, 2024 · Pharmacy Service
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Potential for harm · E February 13, 2024 · found via complaint
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected March 11, 2024 · Resident Rights
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Potential for harm · D February 13, 2024 · found via complaint
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Corrected March 11, 2024 · Resident Rights
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Potential for harm · D February 13, 2024 · found via complaint
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.
Corrected March 11, 2024 · Pharmacy Service
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Potential for harm · E December 14, 2023
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected January 20, 2024 · Quality of Life and Care
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Potential for harm · E December 14, 2023
Provide enough food/fluids to maintain a resident's health.
Corrected January 20, 2024 · Quality of Life and Care
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Potential for harm · E December 14, 2023
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.
Corrected January 20, 2024 · Nutrition and Dietary
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Potential for harm · E December 14, 2023
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected January 20, 2024 · Nutrition and Dietary
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Potential for harm · E December 14, 2023
Provide and implement an infection prevention and control program.
Corrected January 20, 2024 · Infection Control
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Immediate jeopardy · K December 2, 2023 · found via complaint
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected November 16, 2023 · Resident Rights
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Immediate jeopardy · K December 2, 2023 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected November 16, 2023 · Freedom from Abuse, Neglect, and Exploitation
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Immediate jeopardy · K December 2, 2023 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected November 16, 2023 · Quality of Life and Care
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Potential for harm · E December 2, 2023 · found via complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected December 8, 2023 · Pharmacy Service
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Immediate jeopardy · J July 31, 2023 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected August 25, 2023 · Freedom from Abuse, Neglect, and Exploitation
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Immediate jeopardy · J July 31, 2023 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected August 25, 2023 · Quality of Life and Care
-
Potential for harm · D October 20, 2022
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected November 18, 2022 · Pharmacy Service
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Potential for harm · D October 20, 2022
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.
Corrected November 18, 2022 · Pharmacy Service
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Potential for harm · D October 20, 2022
Provide and implement an infection prevention and control program.
Corrected December 5, 2022 · Infection Control
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| December 19, 2024 | Fine | $10,033 |
| December 2, 2023 | Fine | $15,593 |
| July 31, 2023 | Fine | $126,991 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 455771 · certified since September 26, 1988. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.