Best Nursing Homes in Fredericksburg, TX

Overview of The Villages of Windcrest

The Villages of Windcrest operates an 86-bed nursing home at 702 W Windcrest St in Fredericksburg’s Gillespie County, administered by Mr. Kraig A Turpen under Acron Windcrest Village LLC.

The two-story facility has provided nursing home, assisted living, and memory care (including 24 dedicated Alzheimer’s units) for seven years, serving a mixed payer population: 35% Medicare residents (typically short-term rehab), 22% Medicaid, and 43% private pay. Current occupancy is 59.6%, lower than the Texas average of 63.5%, with average resident stays extending to 202 days.

The facility holds a 1-star overall CMS rating, 66.8% below Texas average. This reflects a 1-star Health Inspection rating (65.4% below state average) and a 1-star Staffing rating (58.3% below state average).

Seven state inspections since 2022 resulted in 45 health citations; placing the facility at the 257th precentile among 292 Texas nursing homes, among the worst-performing in the state.

Citations average 6.43 per inspection, the second-worst rate statewide. Five deficiencies reached critical severity, 150% worse than the state average. The primary problems cluster in documentation and quality of life (8 deficiencies), resident rights (6), abuse and neglect safeguards (6), pharmacy services (5), and infection control (3).

The facility has incurred $94,000 in federal penalties across three assessments since 2024, culminating in a $49,000 civil money penalty in January 2025 and a $2,250 administrative penalty in October 2024 for failures in abuse and neglect protection.

Resident outcome measures reveal safety gaps. Falls with major injury occurred in 7.1% of long-stay residents; more than double the state average of 3.2%. Walking ability declined in 23.4% of residents, 44% worse than the state norm.

Staffing ratios exceed state average (1.82:1 vs. 1.48:1), though 47% of staff are contractors. Payroll represents 31.4% of revenue, significantly below the sustainable 51–63% range typical of well-run facilities.

The facility’s regulatory and clinical trajectory presents unresolved safety concerns and elevated risk across standard quality metrics.

Overview of Knopp Healthcare & Rehab

Located in the neighborhood of Fredericksburg, TX, Knopp Healthcare & Rehab is a dependable senior care provider, offering skilled nursing care, hospice care, and palliative care. Residents here are guaranteed a comfortable recovery environment with access to an extensive array of services and therapies to ensure they are able to maintain or regain their strength, mobility, and functionality. A dependable and compassionate care team is always available to attend to residents’ needs and emergencies, giving them utmost comfort and peace of mind.

Committed to creating a vibrant environment that fosters both healing and enrichment, the community also offers a wide array of activities that are designed to give countless opportunities for interactions, entertainment, and stimulation. The community also features an array of partnerships with third-party organizations for entertainment and access to more care services, ensuring residents are provided with the services for their ever-changing needs without moving into another community.

Overview of Knopp Retirement Center

Knopp Retirement Center is a licensed senior living community in Fredericksburg, Texas, offering assisted living services. Managed as a family-owned enterprise under Knopp Retirement Center Inc., the community has a Type B license in Gillespie County. Operating since 1965 with a 60-bed capacity, it is one of the most enduring providers for older adults in the area.

In terms of state oversight, the most recent evaluation performed on April 27, 2023, identified five Health Code deficiencies, which involved delays in creating and starting individual service plans, gaps in annual background verifications through national and state registries, inadequate tuberculosis testing for staff, the absence of a yearly fire marshal review, and questions about food procurement from approved vendors. Notably, every concern was resolved between April 28 and June 9, 2023. No Life Safety Code deficiencies were found, and the community has faced zero enforcement actions, which is a better record than the Texas average of one. With five citations against a state average of six, the total volume of findings is slightly below the regional benchmark.

The community delivers assisted living and long-term support with a focus on empathy, dignity, and personal care, which are principles rooted in its independent family legacy. Available on-site clinical services also consist of physical, occupational, and speech therapy, positioning this location as a practical choice for older adults who need consistent rehabilitative help without relocating.

Providing assisted living, memory care capabilities, and on-site therapeutic support, Knopp Retirement Center is a good option for older adults who aim to age in place in the Fredericksburg region and the wider Hill Country and prefer a more intimate, family-run atmosphere with deep local roots.