The nursing home failed to protect residents from abuse and neglect by others. Cited December 2023 — limited pattern, immediate jeopardy to residents.
View the original federal record
F-Tag 600 — 42 CFR §483.12 — S/S: K
Nursing home report
HEARTHSTONE NURSING AND REHABILITATION
ROUND ROCK, TX · Medicare-certified · 120 beds
Needs attention
Government-runChain member
Data as of July 1, 2026
2 of 5 overall
Hearthstone Nursing and Rehabilitation in Round Rock has a 2-star overall rating, with 2-star health inspection and staffing ratings, though quality measures are 4 stars. It also has a recent federal penalty, $10,033 in fines over the last 24 months, and reported nursing staffing of 2.92 hours per resident per day versus the 4.1-hour federal benchmark.
Facility ratings
Health inspections
Staffing
2.9183 hrs/resident/day
Quality measures
Last inspection: April 3, 2026Penalties, last 24 months: $10,033recent federal penalty
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 2.9183.
Staffing detail
- Registered nurses
- 0.38
- Licensed practical nurses
- 0.59
- Nurse aides
- 1.95
- Weekend nursing
- 2.53
Hours per resident per day.
Total staff turnover: 53%
Registered nurse turnover: 29%
Resident outcomes
Each measure compares a year ago with the most recent quarter. Green means the facility moved the right way; red means the wrong way.
Negative outcomes
Lower is better — fewer affected residents. A decrease is good (green); an increase is concerning (red).
Long-stay residents on antipsychotic medication
12.8%18.9%Worsening
Residents with a fall causing major injury
8.9%6.6%Improving
Residents with pressure ulcers (bedsores)
1.9%4.2%Worsening
Residents with a urinary tract infection
0%2.2%Worsening
Residents who lost too much weight
6.1%8%Worsening
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
9.5%16.9%Worsening
Residents whose ability to walk got worse
3.5%18.7%Worsening
Long-stay residents on antianxiety or sleep medication
20.4%17.1%Improving
Short-stay residents newly given an antipsychotic
2.4%3.7%Worsening
Residents with a long-term catheter
0%0%No change
Residents with new or worsening incontinence
21.9%14.2%Improving
Residents with depressive symptoms
0%0%No change
Positive outcomes
Higher is better — e.g. vaccinations. An increase is good (green); a decrease is concerning (red).
Long-stay residents given the seasonal flu vaccine
—86.9%—
Long-stay residents given the pneumonia vaccine
76.8%58.2%Worsening
Short-stay residents given the seasonal flu vaccine
—49.5%—
Short-stay residents given the pneumonia vaccine
36.6%17.5%Worsening
What the inspectors found
The home failed to promptly tell the resident, doctor, and family about changes or problems affecting the resident. Cited December 2023 — limited pattern, immediate jeopardy to residents.
View the original federal record
F-Tag 580 — 42 CFR §483.10(g)(14) — S/S: K
The nursing home failed to provide appropriate treatment and care according to residents' orders, preferences, and goals. Cited December 2023 — limited pattern, immediate jeopardy to residents.
View the original federal record
F-Tag 684 — 42 CFR §483.25 — S/S: K
The nursing home failed to keep the area free of hazards and provide enough supervision to prevent accidents. Cited July 2023 — isolated incident, immediate jeopardy to residents.
View the original federal record
F-Tag 689 — 42 CFR §483.25(d) — S/S: J
The nursing home failed to make sure each resident got an accurate assessment of their needs and condition. Cited April 2026 — limited pattern, potential for harm.
View the original federal record
F-Tag 641 — 42 CFR §483.20(g) — S/S: E
Recent history
- STAFFING
Reported nurse staffing was below the federal recommendation of 4.1 hours per resident per day.
- INSPECTION
Health inspection found 4 health deficiencies.
See what inspectors found
- STAFFING
Reported nurse staffing was below the federal recommendation of 4.1 hours per resident per day.
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
- INSPECTION
Health inspection found 2 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 2 health deficiencies.
See what inspectors found
- PENALTY
A federal fine of $10,033 was recorded.
Penalties & enforcement
On record with Medicare: 3 fines · $152,617 in total fines.
- $10,033
Federal fine
Dec 19, 2024
- $15,593
Federal fine
Dec 2, 2023
- $126,991
Federal fine
Jul 31, 2023
Operator & ownership
Recent ownership change · Jun 1, 2020
Now operated by Stratford Hospital District, previously Caraday Hearthstone LLC.
- Ownership
- Government - Hospital district
- Chain
- Part of CARADAY HEALTHCARE · 9 homes · 2.8 stars avg
- Occupancy
- 93.8 residents on an average day (78% of 120 beds)
- Resident voice
- Resident & family councils
- Medicare history
- Certified for 37 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.