Silver Tree Nursing and Rehabilitation Center

930 Roy Richard Dr · Schertz, TX · 78154 · 2105669100

120 certified beds For profit - Corporation Chain: Creative Solutions in Healthcare

Why this verdict

  • Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
  • Inspection record is far worse than the national median (deficiency count and severity).
  • Federal penalties on record: $31,305 in fines in the last 24 months.

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.

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Red flags

1 immediate-jeopardy citation in the most recent inspection cycle

Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.

Cited under the freedom-from-abuse rule

Cited 1 time under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.

98% of nursing staff left within a year

High turnover disrupts continuity of care; the national median is 45%.

Score breakdown

Inspection record 30% of score 32
Serious harm & abuse 20% 52
Staffing 20% 56
Federal penalties 15% 35
Trend 10% 73
Context 5% 75

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 3 of 5 Inspections: 2 of 5 Staffing: 2 of 5 Quality measures: 5 of 5

Total nurse hours / resident-day3.383.48 min · 4.1 strong
RN hours / resident-day0.590.55–0.75
Weekend hours / resident-day3.08≈ weekday level
Nursing turnover / year98%median 45%
Fines (3-yr window)3 · $113,981

Inspection citations (52 in the current record)

  • Potential for harm · D January 28, 2026 · found via complaint

    Ensure each resident receives an accurate assessment.

    Corrected January 29, 2026 · Resident Assessment and Care Planning

  • Potential for harm · D January 28, 2026 · found via complaint

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Corrected January 29, 2026 · Resident Assessment and Care Planning

  • Potential for harm · D January 28, 2026 · 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 29, 2026 · Resident Assessment and Care Planning

  • Potential for harm · D December 1, 2025 · found via complaint

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Corrected December 2, 2025 · Resident Assessment and Care Planning

  • Immediate jeopardy · J October 10, 2025 · found via complaint

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Corrected August 29, 2025 · Quality of Life and Care

  • Potential for harm · D October 10, 2025 · found via complaint

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Corrected October 11, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D October 10, 2025 · found via complaint

    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Corrected October 11, 2025 · Resident Assessment and Care Planning

  • Immediate jeopardy · J April 27, 2025 · 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 April 25, 2025 · Resident Rights

  • Immediate jeopardy · J April 27, 2025 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected April 25, 2025 · Quality of Life and Care

  • Potential for harm · D April 18, 2025

    Keep residents' personal and medical records private and confidential.

    Corrected April 19, 2025 · Resident Rights

  • Potential for harm · D April 18, 2025

    Ensure each resident receives an accurate assessment.

    Corrected April 19, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D April 18, 2025

    Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

    Corrected April 19, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D April 18, 2025

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Corrected April 19, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D April 18, 2025

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Corrected April 19, 2025 · Quality of Life and Care

  • Potential for harm · D April 18, 2025

    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

    Corrected April 19, 2025 · Quality of Life and Care

  • Potential for harm · D April 18, 2025

    Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

    Corrected April 19, 2025 · Quality of Life and Care

  • Potential for harm · D April 18, 2025

    Provide for the safe, appropriate administration of IV fluids for a resident when needed.

    Corrected April 19, 2025 · Quality of Life and Care

  • Potential for harm · D April 18, 2025

    Provide safe and appropriate respiratory care for a resident when needed.

    Corrected April 19, 2025 · Quality of Life and Care

  • Potential for harm · E April 18, 2025

    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 April 19, 2025 · Pharmacy Service

  • Potential for harm · E April 18, 2025

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Corrected April 19, 2025 · Nutrition and Dietary

  • Potential for harm · E April 18, 2025

    Provide and implement an infection prevention and control program.

    Corrected April 19, 2025 · Infection Control

  • Potential for harm · E April 18, 2025

    Develop, implement, and/or maintain an effective training program for all new and existing staff members.

    Corrected April 19, 2025 · Administration

  • Potential for harm · D April 18, 2025

    Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.

    Corrected April 19, 2025 · Administration

  • Potential for harm · D April 18, 2025

    Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.

    Corrected April 19, 2025 · Resident Rights

  • Potential for harm · E April 18, 2025

    Provide training in compliance and ethics.

    Corrected April 19, 2025 · Administration

Showing the 25 most recent. The Safety Report includes every citation with full findings.

Federal penalties

DateTypeAmount / length
October 10, 2025Fine$16,149
April 27, 2025Fine$15,156
December 22, 2023Fine$82,676

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 676121 · certified since November 21, 2006. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.