The Waterford At Round Rock
State licensed7230 Wyoming Springs Dr, Round Rock, TX 78681
Assisted LivingMemory Care
Assisted livingState-licensed (Texas HHSC)24-hour personal care
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Medicare-certifiedSkilled Nursing
Hearthstone Nursing and Rehabilitation
Round Rock, TexasMedicare inspection record
About Hearthstone Nursing and Rehabilitation
HEARTHSTONE NURSING AND REHABILITATION is a government - hospital district nursing home in ROUND ROCK, TX with 120 certified beds.
Community at a glance
Capacity
120 residents
Location
Round Rock, TX
Status
Listed in a public registry
Care & services offered
Skilled Nursing
Contact & location
401 OAKWOOD BLVD, Round Rock, Texas 78681
Medicare inspection record
From CMS Care Compare, the federal record every Medicare-certified nursing home is held to. Data as of September 1, 2026. Check it on Medicare.gov
At its most recent standard inspection, on April 3, 2026, state inspectors cited 7 health deficiencies (the Texas average is 9.4).
Nurses and nurse aides spend 2 hours 55 minutes with each resident a day, below the Texas average of 3 hours 23 minutes.
Medicare fined Hearthstone Nursing and Rehabilitation 2 times in the last three years, $25,626 in total.
Staffing
| Measure | This home |
|---|---|
| Nurse and aide time per resident, per day | 2 hours 55 minutesBelow the Texas average |
| Registered nurse time per resident, per day | 23 minutesBelow the Texas average |
| Nursing staff who left in the past year | 53% |
2 administrators have left the home in the past year.
Inspections
24 health citations in the last three years. Each one is a federal standard inspectors found the home was not meeting.
April 3, 2026 · Standard inspection · 4 citations
Ensure each resident receives an accurate assessment.
Risk of harm, no one hurt, a pattern (level E)Resident Assessment and Care PlanningCorrected Apr 17, 2026Provide and implement an infection prevention and control program.
Risk of harm, no one hurt, a pattern (level E)Infection ControlCorrected Apr 17, 2026Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Risk of harm, no one hurt, a pattern (level E)Nutrition and DietaryCorrected Apr 17, 2026Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Risk of harm, no one hurt, a few residents (level D)EnvironmentalCorrected Apr 17, 2026
January 14, 2026 · Complaint investigation · 1 citation
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningFrom a complaintCorrected Jan 26, 2026
November 19, 2025 · Complaint investigation · 2 citations+
Notify the appropriate authorities when residents with MD or ID services has a significant change in condition.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningFrom a complaintCorrected Nov 26, 2025Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningFrom a complaintCorrected Nov 26, 2025
January 30, 2025 · Standard inspection · 2 citations+
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningCorrected Feb 17, 2025Provide and implement an infection prevention and control program.
Risk of harm, no one hurt, a few residents (level D)Infection ControlCorrected Feb 17, 2025
December 19, 2024 · Complaint investigation · 2 citations+
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Residents were harmed, a few residents (level G)Freedom from Abuse, Neglect, and ExploitationFrom a complaintAlready fixed by Dec 3, 2024Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningFrom a complaintCorrected Jan 14, 2025
April 3, 2024 · Complaint investigation · 1 citation+
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Risk of harm, no one hurt, a few residents (level D)Pharmacy ServiceFrom a complaintCorrected Apr 25, 2024
February 13, 2024 · Complaint investigation · 3 citations+
Ensure that residents are fully informed and understand their health status, care and treatments.
Risk of harm, no one hurt, a pattern (level E)Resident RightsFrom a complaintCorrected Mar 11, 2024Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Risk of harm, no one hurt, a few residents (level D)Resident RightsFrom a complaintCorrected Mar 11, 2024Implement 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.
Risk of harm, no one hurt, a few residents (level D)Pharmacy ServiceFrom a complaintCorrected Mar 11, 2024
December 14, 2023 · Standard inspection · 5 citations+
Provide enough food/fluids to maintain a resident's health.
Risk of harm, no one hurt, a pattern (level E)Quality of Life and CareCorrected Jan 20, 2024Ensure 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.
Risk of harm, no one hurt, a pattern (level E)Nutrition and DietaryCorrected Jan 20, 2024Provide and implement an infection prevention and control program.
Risk of harm, no one hurt, a pattern (level E)Infection ControlCorrected Jan 20, 2024Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Risk of harm, no one hurt, a pattern (level E)Quality of Life and CareCorrected Jan 20, 2024Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Risk of harm, no one hurt, a pattern (level E)Nutrition and DietaryCorrected Jan 20, 2024
December 2, 2023 · Complaint investigation · 4 citations+
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Immediate danger to residents, a pattern (level K)Quality of Life and CareFrom a complaintAlready fixed by Nov 16, 2023Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Immediate danger to residents, a pattern (level K)Resident RightsFrom a complaintAlready fixed by Nov 16, 2023Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Immediate danger to residents, a pattern (level K)Freedom from Abuse, Neglect, and ExploitationFrom a complaintAlready fixed by Nov 16, 2023Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Risk of harm, no one hurt, a pattern (level E)Pharmacy ServiceFrom a complaintCorrected Dec 8, 2023
Fines and payment denials
2 fines totaling $25,626 in the last three years.
- December 19, 2024Fine: $10,033
- December 2, 2023Fine: $15,593
About the home, per Medicare
- Ownership
- Government - Hospital district
- Legal business name
- Stratford Hospital District
- Medicare-certified beds
- 120
- Average residents per day
- 94
- Accepts
- Medicare and Medicaid
- First certified
- September 26, 1988
- Part of a chain
- Caraday Healthcare, 8 homes
- Inside a hospital
- No
- Continuing care retirement community
- No
- Resident or family council
- Both
- Sprinklers in all required areas
- Yes
- CMS Certification Number
- 455771
Location
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401 OAKWOOD BLVDRound Rock, TX 78681
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Questions about Hearthstone Nursing and Rehabilitation
How did Hearthstone Nursing and Rehabilitation do on its last inspection?+
State inspectors visited on April 3, 2026 and cited 7 health deficiencies, 3 of them from complaint investigations. The Texas average is 9.4.
How much nursing care does each resident get at Hearthstone Nursing and Rehabilitation?+
Nurses and aides spend 2 hours 55 minutes with each resident per day, including 23 minutes from registered nurses. 53% of nursing staff left over the past year.
Has Hearthstone Nursing and Rehabilitation been fined by Medicare?+
Yes. Medicare fined Hearthstone Nursing and Rehabilitation 2 times in the last three years, totaling $25,626.
Does Medicare cover skilled nursing?+
Medicare covers up to 100 days of skilled nursing per benefit period after a qualifying 3-day hospital stay — fully for the first 20 days, then with a daily copay. Long-term custodial stays are generally not covered.
How much does a nursing home cost?+
A semi-private room averages about $7,900 per month nationally; private rooms cost more. Medicaid is the largest payer for long-term nursing home care.
What is the CMS star rating?+
Medicare rates nursing homes 1 to 5 stars on its Care Compare site. We don't repeat those stars here. Each nursing home page shows Medicare's underlying record instead: inspections, staffing and fines, with a link to check it on Medicare.gov.