Avir at San Angelo Inspection Report, Violations & Safety Grade (San Angelo, Texas)

5455 Knickerbocker Rd, San Angelo, Texas 76904

Phone: 3259441660

CMS Overall:1/5

Overview & Bed Count

Certified Beds

125

Avg Residents/Day

85.4

Ownership

For profit - Corporation

Provider Type

Medicare and Medicaid

County

Tom Green

Sprinkler Systems

Yes

Special Focus

None

Abuse Icon

Yes

CMS Star Ratings

Overall1/5

Health1/5

Staffing1/5

Quality2/5

Nurse Staffing Check

Metric	This Facility	Texas Avg	Difference
RN Hours per Resident per Day	0.18	0.44	-0.26
Total Nurse Hours per Resident per Day	3.14	3.42	-0.28
CMS Staffing Rating	1/5	1.9/5	-
Nursing Staff Turnover	71.3%	50.8%	-

Health Citation History

33 health citations on record

Date	Category	Description	Severity
2026-08-22	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	J – Immediate Jeopardy
2026-05-07	Resident Assessment and Care Planning Deficiencies	PASARR screening for Mental disorders or Intellectual Disabilities	E – Moderate Harm Potential
2026-05-07	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	E – Moderate Harm Potential
2026-05-07	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E – Moderate Harm Potential
2026-05-07	Nutrition and Dietary Deficiencies	Dispose of garbage and refuse properly.	E – Moderate Harm Potential
2026-05-07	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D – Moderate Harm Potential
2026-05-07	Quality of Life and Care Deficiencies	Provide care or services that was trauma informed and/or culturally competent.	D – Moderate Harm Potential
2026-05-07	Pharmacy Service Deficiencies	Ensure medication error rates are not 5 percent or greater.	D – Moderate Harm Potential
2026-05-07	Pharmacy Service Deficiencies	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 – Moderate Harm Potential
2026-05-07	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D – Moderate Harm Potential
2026-02-17	Quality of Life and Care Deficiencies	Provide appropriate pressure ulcer care and prevent new ulcers from developing.	D – Moderate Harm Potential
2025-11-19	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	E – Moderate Harm Potential
2025-06-14	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	D – Moderate Harm Potential
2025-03-06	Quality of Life and Care Deficiencies	Assist a resident in gaining access to vision and hearing services.	H – Actual Harm
2025-03-06	Quality of Life and Care Deficiencies	Provide medically-related social services to help each resident achieve the highest possible quality of life.	H – Actual Harm
2025-03-06	Environmental Deficiencies	Keep all essential equipment working safely.	F – Moderate Harm Potential
2025-03-06	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	E – Moderate Harm Potential
2024-10-03	Resident Rights Deficiencies	Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.	D – Moderate Harm Potential
2024-10-03	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	D – Moderate Harm Potential
2024-10-03	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Develop and implement policies and procedures to prevent abuse, neglect, and theft.	D – Moderate Harm Potential
2023-12-22	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	K – Immediate Jeopardy
2023-12-22	Nursing and Physician Services Deficiencies	Observe each nurse aide's job performance and give regular training.	F – Moderate Harm Potential
2023-12-22	Infection Control Deficiencies	Implement a program that monitors antibiotic use.	F – Moderate Harm Potential
2023-12-22	Resident Rights Deficiencies	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.	E – Moderate Harm Potential
2023-12-22	Resident Rights Deficiencies	Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.	E – Moderate Harm Potential
2023-12-22	Resident Assessment and Care Planning Deficiencies	Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted	E – Moderate Harm Potential
2023-12-22	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	E – Moderate Harm Potential
2023-12-22	Quality of Life and Care Deficiencies	Provide safe and appropriate respiratory care for a resident when needed.	E – Moderate Harm Potential
2023-12-22	Pharmacy Service Deficiencies	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.	E – Moderate Harm Potential
2023-12-22	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E – Moderate Harm Potential
2023-12-22	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	E – Moderate Harm Potential
2023-12-22	Resident Assessment and Care Planning Deficiencies	Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.	D – Moderate Harm Potential
2023-12-22	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D – Moderate Harm Potential

Fire Safety Citation History

12 fire safety citations on record

Date	Category	Description	Severity
2026-05-07	Smoke Deficiencies	Have approved installation, maintenance and testing program for fire alarm systems.	F – Moderate Harm Potential
2026-05-07	Smoke Deficiencies	Inspect, test, and maintain automatic sprinkler systems.	F – Moderate Harm Potential
2026-05-07	Smoke Deficiencies	Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.	F – Moderate Harm Potential
2026-05-07	Smoke Deficiencies	Properly select, install, inspect, or maintain portable fire extinguishes.	F – Moderate Harm Potential
2026-05-07	Miscellaneous Deficiencies	Have simulated fire drills held at unexpected times.	F – Moderate Harm Potential
2026-05-07	Smoke Deficiencies	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.	E – Moderate Harm Potential
2026-05-07	Smoke Deficiencies	Provide properly protected cooking facilities.	E – Moderate Harm Potential
2026-05-07	Smoke Deficiencies	Ensure smoke barriers are constructed to a 1 hour fire resistance rating.	E – Moderate Harm Potential
2025-03-06	Smoke Deficiencies	Provide properly protected cooking facilities.	F – Moderate Harm Potential
2025-03-06	Smoke Deficiencies	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.	E – Moderate Harm Potential
2025-03-06	Smoke Deficiencies	Ensure smoke barriers are constructed to a 1 hour fire resistance rating.	E – Moderate Harm Potential
2023-12-22	Smoke Deficiencies	Inspect, test, and maintain automatic sprinkler systems.	F – Moderate Harm Potential

Total Penalties & Fines

$117,827

Total Fine Amount (CMS)

Number of Fines

Total Penalties

Date	Type	Fine Amount	Payment Denial
2026-08-22	Fine	$19,352	-
2026-08-22	Fine	$19,615	-
2025-03-06	Fine	$54,919	-
2023-12-22	Fine	$23,941	-

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Need Help Finding Safe Care?

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3-Year Complete Report ($19)

Advisor service is free for families. We may receive referral compensation.