Your report for Avir at San Angelo
Overall Score
CMS Five-Star Quality RatingMuch below averageCMS Five-Star overall rating
- Much below average
- Below average
- Average
- Above average
- Much above average
Where it ranks
- TexasLowest tier among peers1,167 rated homes · average 2.8★
- Tom Green CountyLowest tier among peers7 rated homes · average 2.7★
- United StatesLowest tier among peers14,574 rated homes · average 3.0★
How the rating is built
- Health inspectionsStarting point1★−1.8 vs TX avg
- StaffingCan add or remove a star1★−1.1 vs TX avg
- Quality measuresCan add or remove a star1★−2.8 vs TX avg
CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.
Ratings & measures
Tap a row to see what it meansHealth inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersTX avg2.8★U.S. avg2.8★
What is health inspection rating?
Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.
Why it matters
It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.
Staffing ratingCMS stars from payroll-reported hours and turnover1★Lowest tier among peersTX avg2.1★U.S. avg2.9★
What is staffing rating?
Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.
Why it matters
More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.
Quality measures ratingCMS stars from clinical outcomes and resident assessments1★Lowest tier among peersTX avg3.8★U.S. avg3.6★
What is quality measures rating?
Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.
Why it matters
It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.
Total nurse hoursPer resident per day, all nursing staff3.15hrsAbove only 34% of peersTX avg3.40Benchmark4.10
What is total nurse hours?
All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.
Why it matters
Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.
RN hoursPer resident per day, registered nurses only0.25hrsAbove only 17% of peersTX avg0.44Benchmark0.75
What is rn hours?
Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.
Why it matters
RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.
Nursing staff turnoverShare of nursing staff who left within a year · lower is better—No dataTX avg51%RN turnover—
What is nursing staff turnover?
The share of nursing staff who left within the past year, from the same payroll data.
Why it matters
High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.
Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$241,795Above only 5% of peersTX avg$55,368Fines · denials6 · 0
What is fines in the last three years?
Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.
Why it matters
Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.
Inspection history
Last three inspection cycles37citations
10inspection dates
4actual harm (G–I)
5immediate jeopardy (J–L)
Nov 19, 2025most recent
Citations by monthOct 2022 – Nov 2025
- No actual harm (D–F)
- Actual harm (G–I)
- Immediate jeopardy (J–L)
- $Fine or payment denial
Click to filter the findings below
Showing
Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.
Nov 19, 2025Cycle 1worst E · no actual harm
- F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningE · patternCorrected Nov 20, 2025
Jun 14, 2025Cycle 1worst D · no actual harm
- F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Jul 8, 2025
Mar 6, 2025Cycle 1worst H · actual harm$54,919
- F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Mar 7, 2025
- F908Keep all essential equipment working safely.EnvironmentalF · widespreadCorrected Mar 7, 2025
- F685Assist a resident in gaining access to vision and hearing services.Quality of Life and CareH · patternCorrected Mar 7, 2025
- F745Provide medically-related social services to help each resident achieve the highest possible quality of life.Quality of Life and CareH · patternCorrected Mar 7, 2025
Oct 3, 2024Cycle 2worst D · no actual harm
- F559Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.Resident RightsD · isolatedCorrected Oct 16, 2024
- F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Oct 16, 2024
- F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Oct 16, 2024
Dec 22, 2023Cycle 2worst K · immediate jeopardy$23,941
- F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryE · patternCorrected Dec 23, 2023
- F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Dec 23, 2023
- F881Implement a program that monitors antibiotic use.Infection ControlF · widespreadCorrected Dec 23, 2023
- F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareK · patternCorrected Dec 23, 2023
- F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareE · patternCorrected Dec 23, 2023
- F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareE · patternCorrected Dec 23, 2023
- F730Observe each nurse aide's job performance and give regular training.Nursing and Physician ServicesF · widespreadCorrected Dec 23, 2023
- F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsE · patternCorrected Dec 23, 2023
- F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident RightsE · patternCorrected Dec 23, 2023
- F644Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.Resident Assessment and Care PlanningD · isolatedCorrected Dec 23, 2023
- F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningE · patternCorrected Dec 23, 2023
- F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected Dec 23, 2023
- F761Ensure 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.Pharmacy ServiceE · patternCorrected Dec 23, 2023
Sep 13, 2023Cycle 3worst H · actual harm$12,220
- F760Ensure that residents are free from significant medication errors.Pharmacy ServiceH · patternCorrected Aug 14, 2023
- F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Oct 12, 2023
Jul 28, 2023Cycle 3worst K · immediate jeopardy$126,135
- F583Keep residents' personal and medical records private and confidential.Resident RightsD · isolatedCorrected Jul 30, 2023
- F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationK · patternCorrected Jul 30, 2023
- F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationK · patternCorrected Jul 30, 2023
- F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationK · patternCorrected Jul 30, 2023
May 16, 2023Cycle 3worst G · actual harm$10,059
- F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareG · isolatedCorrected May 17, 2023
- F711Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.Nursing and Physician ServicesE · patternCorrected May 17, 2023
Apr 1, 2023Cycle 3worst J · immediate jeopardy$14,521
- F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareJ · isolatedCorrected Apr 3, 2023
Oct 19, 2022Cycle 3worst E · no actual harm
- F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected Nov 8, 2022
- F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningD · isolatedCorrected Nov 8, 2022
- F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningE · patternCorrected Nov 8, 2022
- F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryE · patternCorrected Nov 8, 2022
- F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care PlanningE · patternCorrected Nov 8, 2022
- F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Nov 8, 2022
Staffing
From quarterly payroll reportsHours per resident per day
- All nursing staffRNs, LPNs and aides combined3.15hrs
- Registered nursesRN hours only0.25hrs
- Licensed practical nursesLPN hours0.77hrs
- Nurse aidesCNA hours2.14hrs
- Weekend nursingAll staff on Saturdays and Sundays2.94hrs
- Texas average
- Research benchmark (4.10 total, 0.75 RN)
Turnover & capacity
- Nursing staff turnoverShare who left within a year · lower is better—TX avg 51%
- RN turnoverRegistered nurses only—Not ranked by CMS
- Administrators who leftIn the past year—
- Occupancy125 certified beds · ~86 residents a day69%Above 52% of peersTX avg 67%
Fines & penalties
Roughly the past three yearsEnforcement summary
- $241,795In fines
- 6Fines
- 0Payment denials
- $55,368TX avg in fines
Above only 5% of peersFewer fines than 5% of rated homes in Texas
Actions on record
- Mar 6, 2025Civil money penalty$54,919
- Dec 22, 2023Civil money penalty$23,941
- Sep 13, 2023Civil money penalty$12,220
- Jul 28, 2023Civil money penalty$126,135
- May 16, 2023Civil money penalty$10,059
- Apr 1, 2023Civil money penalty$14,521
Ownership
As filed with CMSStructure
- Ownership type
- For profit - Individual
- Chain
- Avir Health Group79 facilities in the chain2.2★ chain average
- Certification
- Medicare and Medicaid
- Location type
- Urban
- Ownership change
- None in the last 12 months
People and entities on file
Direct owners (5%+)
- Uvalde County Hospital Authority
Operational or managerial control
- 5455 Knickerbocker Road Opco, LLC
- Peter Chang
- Nochum Freund
- Aaron Travitsky
Corporate directors
- Adam Apolinar
5% Or Greater Security Interest
- 5455 Knickerbocker Road Property Owner, LLC
- Welltower Nnn Group, LLC
- Welltower Op LLC
Mortgage or security interest (5%+)
- 5455 Knickerbocker Rd LLC
Person Organization
Sources & notes
Public data, updated quarterlyData sources
- CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
- CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
- CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.
Notes
- CMS Certification Number 676100 · 5455 KNICKERBOCKER RD, SAN ANGELO, TX, 76904.
- Percentiles compare this facility with every rated nursing home in Texas and Tom Green County. Turnover and fines are inverted so a high percentile is always good.
- This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.
