About Legend Oaks Healthcare and Rehabilitation - North
Legend Oaks Healthcare And Rehabilitation - North, located in AUSTIN, TX, is a for-profit organization that accepts Medicare and Medicaid.
Why Families Choose Legend Oaks Healthcare and Rehabilitation - North
Key Performance Indicators
- CMS Overall Rating 1 Stars
- Nursing Hours N/A
- Safety Record Issues
Chain Affiliations & Network
This facility is part of the THE ENSIGN GROUP network. This chain operates 338 facilities.
Chain Performance Overview
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Nursing Staff Analysis
Staffing levels are a critical indicator of quality care. We analyze the daily hours of care provided by Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Certified Nursing Assistants (CNAs).
Registered Nurses (RN)
Licensed Practical Nurses
Certified Assistants
CMS Quality Ratings
| Category | Rating | Stars |
|---|---|---|
| Overall Rating | 1 |
|
| Health Inspection | 2 |
|
| Quality Measures | 3 |
|
| Staffing | 1 |
|
Health Inspection History
| Inspection Cycle | Score | Date |
|---|---|---|
| Cycle 1 (Most Recent) | 182 | Feb 20, 2025 |
| Weighted Average | 152 | Combined Score |
Detailed Quality Measures
Rates are from CMS quality measures (claims-based and MDS-based) for the reporting period ending May 01, 2026. Some measures may be omitted when CMS does not report a numeric rate for this facility.
Medicare claims-based measures
Typically includes short-stay outcomes, hospitalizations, and ED use from Medicare claims.
| Measure | Rate |
|---|---|
| Percentage of short-stay residents who were rehospitalized after a nursi... (QM521) | 30.7% |
| Percentage of short-stay residents who had an outpatient emergency depar... (QM522) | 8.1% |
| Number of hospitalizations per 1000 long-stay resident days (QM551) | 2.0% |
| Number of outpatient emergency department visits per 1000 long-stay resi... (QM552) | 1.5% |
MDS-based measures
Resident assessment data; often used for long-stay care quality.
| Measure | Rate |
|---|---|
| Percentage of long-stay residents whose need for help with daily activit... (QM401) | 36.8% |
| Percentage of long-stay residents who lose too much weight (QM404) | 1.5% |
| Percentage of long-stay residents with a catheter inserted and left in t... (QM406) | 0.2% |
| Percentage of long-stay residents with a urinary tract infection (QM407) | 0.8% |
| Percentage of long-stay residents who have depressive symptoms (QM408) | 0.8% |
| Percentage of long-stay residents who were physically restrained (QM409) | 0.0% |
| Percentage of long-stay residents experiencing one or more falls with ma... (QM410) | 3.1% |
| Percentage of long-stay residents assessed and appropriately given the p... (QM415) | 99.0% |
| Percentage of short-stay residents assessed and appropriately given the... (QM430) | 51.8% |
| Percentage of short-stay residents who newly received an antipsychotic m... (QM434) | 0.5% |
| Percentage of long-stay residents whose ability to walk independently wo... (QM451) | 36.3% |
| Percentage of long-stay residents who received an antianxiety or hypnoti... (QM452) | 15.1% |
| Percentage of long-stay residents assessed and appropriately given the s... (QM454) | 100.0% |
| Percentage of short-stay residents who were assessed and appropriately g... (QM472) | 65.7% |
| Percentage of long-stay residents with pressure ulcers (QM479) | 1.2% |
| Percentage of long-stay residents with new or worsened bowel or bladder... (QM480) | 23.0% |
| Percentage of long-stay residents who received an antipsychotic medicati... (QM481) | 4.9% |
Complaints & Deficiencies
Complaint History by Year
This chart shows the number of complaints filed each year.
Summary:
- 2024: 4 complaints
- 2025: 9 complaints
- Total: 13 complaints on record
Recent Complaints (Since Jan 2023)
| Date | Description |
|---|---|
| Sep 18, 2025 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. |
| Sep 18, 2025 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. |
| Sep 18, 2025 | Provide appropriate treatment and care according to orders, resident?s preferences and goals. |
| Sep 18, 2025 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. |
| Sep 18, 2025 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. |
| Apr 28, 2025 | Let each resident or the resident's legal representative access or purchase copies of all the resident's records. |
| Feb 06, 2025 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. |
| Feb 06, 2025 | Provide and implement an infection prevention and control program. |
| Jan 20, 2025 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. |
| Nov 11, 2024 | Provide and implement an infection prevention and control program. |
| Sep 14, 2024 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. |
| Sep 14, 2024 | Reasonably accommodate the needs and preferences of each resident. |
| Jan 07, 2024 | Provide and implement an infection prevention and control program. |
Nearby Hospitals
NORTH AUSTIN MEDICAL CENTER
AUSTIN, TX
ROUND ROCK MEDICAL CENTER
ROUND ROCK, TX
ST DAVID'S SOUTH AUSTIN MEDICAL CENTER
AUSTIN, TX
ASCENSION SETON MEDICAL CENTER AUSTIN
AUSTIN, TX
ASCENSION SETON CEDAR PARK
CEDAR PARK, TX
ASCENSION SETON NORTHWEST
AUSTIN, TX
BAYLOR SCOTT & WHITE MEDICAL CENTER - ROUND ROCK
ROUND ROCK, TX
ASCENSION SETON WILLIAMSON
ROUND ROCK, TX
BAYLOR SCOTT & WHITE MEDICAL CENTER - MARBLE FALLS
MARBLE FALLS, TX
BAYLOR SCOTT & WHITE MEDICAL CENTER PFLUGERVILLE
PFLUGERVILLE, TX
ST DAVID'S MEDICAL CENTER
AUSTIN, TX
GEORGETOWN BEHAVIORAL HEALTH INSTITUTE
GEORGETOWN, TX
ASCENSION SETON SOUTHWEST
AUSTIN, TX
CROSS CREEK HOSPITAL
AUSTIN, TX
THE HOSPITAL AT WESTLAKE MEDICAL CENTER
AUSTIN, TX
BAYLOR SCOTT & WHITE MEDICAL CENTER -TAYLOR
TAYLOR, TX
DELL CHILDREN'S MEDICAL CENTER
AUSTIN, TX
TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS
AUSTIN, TX
NORTHWEST HILLS SURGICAL HOSPITAL
AUSTIN, TX
Owner & Operator Information
Business Entity
GUADALUPE COUNTY HOSPITAL BOARD
Ownership Structure
- GUADALUPE COUNTY HOSPITAL BOARD Direct: 100%
Management & Direction
- SOON BURNAM CORPORATE OFFICER
- DESSAU HEALTHCARE INC OPERATIONAL/MANAGERIAL CONTROL
- DESSAU HEALTHCARE INC ADP OF THE SNF
- ENSIGN SERVICES INC ADP OF THE SNF
- KODY GANN CORPORATE OFFICER
- CHAD KEETCH CORPORATE OFFICER
- NATIONAL HEALTH INVESTORS INC. ADP OF THE SNF
- JOSELYN QUINTERO MANAGING CONTROL - GOVERNING BODY
- JOSELYN QUINTERO OPERATIONAL/MANAGERIAL CONTROL
- JOSELYN QUINTERO ADP OF THE SNF
- ANIL RATHI MANAGING CONTROL - GOVERNING BODY
- ANIL RATHI OPERATIONAL/MANAGERIAL CONTROL
- ANIL RATHI ADP OF THE SNF
- TEXAS NHI INVESTORS LLC ADP OF THE SNF
Associated Doctors
Local Comparison
| Facility | Distance | Rating |
|---|---|---|
| Longhorn Village | N/A | 5 |
| Marbridge Villa | N/A | 5 |
| Gracy Woods Ii Living Center | N/A | 5 |
| Sedona Trace Health and Wellness Center | N/A | 4 |
| Cedar Pointe Health and Wellness Center | N/A | 4 |
| The Arbour at Westminster Manor | N/A | 5 |
| Sagebrook Nursing and Rehabilitation | N/A | 4 |
| Barton Valley Rehabilitation and Healthcare Center | N/A | 4 |
| The Center at Parmer | N/A | 5 |
| Silver Pines Nursing and Rehabilitation Center | N/A | 4 |
Related Analysis
Best Nursing Homes in AUSTIN, TX
Compare Legend Oaks Healthcare and Rehabilitation - North to the top-rated facilities in the area.
Ownership Details
Complete list of registered owners, including direct and indirect ownership.
Noted Deficiencies
Detailed history of deficiencies with descriptions and correction dates.
Nursing Hours Analysis
Detailed breakdown of staffing hours per resident by role.
Frequently Asked Questions
- Skilled Nursing Care: 24/7 medical supervision and complex medical treatments
- Long-term Residential Care: Assistance with daily living activities for extended stays
- Short-term Rehabilitation: Recovery services after hospital stays or surgeries
- Memory Care: Specialized programs for residents with dementia and Alzheimer's disease
- Level of care needed (skilled nursing vs. long-term care)
- Room type (private vs. semi-private)
- Insurance coverage (Medicare, Medicaid, private insurance)
- Length of stay and specific services required
For current rates and to discuss payment options, contact Legend Oaks Healthcare and Rehabilitation - North directly at 5128732244. Their admissions team can help determine coverage and out-of-pocket expenses.
Environment & Cleanliness
- Overall cleanliness and odors
- Resident room conditions
- Common area maintenance
- Safety features and accessibility
Staff & Care Quality
- Staff-to-resident ratios
- How staff interact with residents
- Response time to resident needs
- Staff knowledge and professionalism
Ask to speak with current residents and their families, tour at different times of day, and review the facility's most recent inspection reports.