Fredericksburg, Texas's Gillespie County seat, has 4 Medicare-certified nursing homes with approximately 389 beds. Families have solid options to choose from.

Fredericksburg vs. Texas: Near State Average

Fredericksburg nursing homes perform near the state average on key quality metrics. The city's average CMS rating of 2.50 stars is close to Texas's statewide average of 2.79 stars.

0 of 4 facilities earn a B grade or better. Families should still research carefully, as 2 facilities have significant concerns.

Understanding Our Trust Score System

The Trust Score is a 0-100 rating calculated from CMS's official nursing home database. The score combines five data categories:

• Health Inspection Results — Recent deficiencies, their severity, and patterns over time
• Staffing Levels — RN hours, total nursing hours, and weekend staffing
• Quality Measures — Clinical outcomes like falls, pressure ulcers, and rehospitalizations
• Penalties — Fines, payment denials, and enforcement actions
• Complaints — Substantiated complaints and their severity

In Fredericksburg, 0 facilities score a B grade or better, indicating they meet quality benchmarks across these categories. We recommend families prioritize these facilities and carefully research any facility rated C or below before visiting.

Staffing: A Significant Concern in Fredericksburg

Staffing levels are among the most important predictors of nursing home quality. Research consistently shows that facilities with more nursing staff—especially registered nurses—have better outcomes for residents.

Fredericksburg facilities average 0.52 RN hours per resident day, which falls below the CMS-recommended threshold of 0.75 hours. The typical Fredericksburg resident receives approximately 31 minutes of RN attention daily—compared to the 45 minutes experts recommend.

0 Fredericksburg facilities exceed CMS staffing recommendations. Families prioritizing staffing should look for facilities with the "Top Staffing" badge and ask specifically about RN hours during facility visits.

Ownership: An All For-Profit Market

Fredericksburg has no non-profit nursing homes—all 4 facilities with reported ownership data are for-profit operations. 1 of 4 facility is chain-owned, meaning these facilities are part of larger corporate systems rather than independently operated.

Research suggests non-profit facilities often have higher staffing levels and fewer deficiencies on average. The absence of non-profit options in Fredericksburg may be worth noting. Families seeking non-profit care should consider facilities in surrounding areas.

Ownership type alone does not guarantee quality. Several for-profit facilities in Fredericksburg perform well. Families should evaluate each facility individually using inspection data, staffing levels, and recent deficiency reports rather than ownership type alone.

Nearby Alternatives Worth Considering

Families may also want to consider nearby Texas cities for additional options. The following Texas cities offer multiple nursing home options:

• Houston — 61 facilities
• San Antonio — 59 facilities
• Dallas — 35 facilities
• Fort Worth — 30 facilities
• Austin — 25 facilities
• El Paso — 21 facilities