Advanced Rehabilitation & Healthcare Of Live Oak
8221 PALISADES DRIVE, Live Oak, TX, 78233
Federal Quality Data
Official records from CMS Care Compare — reported by the facility and audited by the Centers for Medicare & Medicaid Services. We present them unmodified. Refreshed March 2026.
CMS Star Ratings
Facility & Staffing
- Ownership
- For profit - Corporation · Chain: Ruby Healthcare
- Certified beds
- 123 · avg 114 residents/day
- Total nursing staff turnover
- 56.8% — higher than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 55.6% — higher than most Texas nursing homesTexas avg: 50.5% · National avg: 43.6% · per CMS Care Compare
- Administrators who left
- 0 departed — near the Texas averageTexas avg: 0.6 · National avg: 0.5 · per CMS Care Compare
Enforcement & Citations
- Fines (past 3 years)
- 2 fines · $12,424 total
- Infection control citations
- 1
State licensing & capacity
- License number
- 311292
- Service type
- Medicare/medicaid
- Licensed capacity
- 123 beds
- Bed type breakdown
- 15 Medicare-only · 108 Medicaid/Medicare
- Current license effective
- April 1, 2026
- Current license expires
- April 1, 2029
- Initial license date
- February 7, 1978
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Hamilton County Hospital District (HOSPITAL DISTRICT/AUTHORITY)
- Operator / manager
- Live Oak Hc Llc
- Administrator
- Traci Mcintosh
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Chain affiliation
Part of the Ruby Healthcare chain — 7 facilities. Chain-wide average overall rating 3.3 / 5.
Disclosed owners (5 on record)
- Biju Oommen
Operational/managerial Control · since 2023
- Grady Hooper
Corporate Director · since 2023
- Hamilton County Hospital District
5% or Greater Direct Ownership Interest · 100% · since 2023
- Live Oak Hc, Llc
Operational/managerial Control · 100% · since 2023
- Traci Mcintosh
Operational/managerial Control · since 2023
Recent change of ownership
April 2023 (3 years ago) · acquired from Advanced Rehabilitation & Healthcare of Live Oak
Transaction type: Change of Ownership
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Chain Performance Measures + Change of Ownership, as of April 2026.
Federal inspection record
Immediate-jeopardy citations (CMS scope/severity J–L) are the most serious category federal inspectors issue — meaning a deficiency placed residents in immediate risk of serious harm. Ask the facility for the corrective-action plan filed with CMS, and consider contacting your state long-term care ombudsman for context.
Recent health-deficiency citations (most recent 8 of 42)
- D0880·Nov 18, 2025Complaint
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
- D0726·Nov 18, 2025Complaint
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
- E0880·May 23, 2025
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
- E0812·May 23, 2025
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E0698·May 23, 2025
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
- D0690·May 23, 2025
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- E0689·May 23, 2025
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D0656·May 23, 2025
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.
Federal penalties
By year
- 20251 fine · $8,407
- 20241 fine · $4,017
Most recent events
- Jan 17, 2025Fine · $8,407
- Jun 1, 2024Fine · $4,017
Largest single fine on record: $8,407.
Fire-safety citations
9 Life-Safety-Code citations on file. Most recent: May 23, 2025. Fire-safety inspections cover building-level Life Safety Code compliance, separate from the resident-care health survey.
Source: CMS Provider Data Catalog — Health Deficiencies, Fire Safety Deficiencies, and Penalties datasets, snapshot Mar 1, 2026.
About this community
Advanced Rehabilitation & Healthcare of Live Oak is a 123-bed nursing home in Live Oak (Bexar County), licensed since 1978 and operating at roughly 93% of capacity. CMS rates it 4 stars overall, with a 5-star quality-of-care rating but a 2-star staffing rating. It is part of the Ruby Healthcare chain and managed by Live Oak HC LLC under a Hospital District license.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here at 2 stars. Each resident receives about 188 minutes of nursing care per day — roughly 53 minutes less than at a 4-star-staffing facility in Texas, which sits at about 241 minutes. Residents here also require more hands-on care than at a typical facility — more dependent or medically complex on average — so those 188 minutes stretch thinner than the number alone suggests.
Despite the staffing rating, CMS rates quality of care at 5 stars, both for residents who live here long-term and for those recovering from a hospital stay. That is the top rating on this measure.
Two CMS fines totaling $12,424 have been issued — below the Texas state median of $20,699 per facility. About 30% of Texas nursing homes have received no fines at all.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
Staffing levels on weekends
Weekend nursing hours here average 2.83 hours per resident per day — lower than the weekday figure; ask how staffing is scheduled on Saturdays and Sundays.
RN coverage each day
Reported registered-nurse hours equal about 36 minutes per resident per day; ask how many hours a registered nurse is physically on the floor each shift.
How the two fines were resolved
CMS issued two fines totaling $12,424; ask what the citations were for and what changes were made afterward.
Care plans for complex residents
Residents here require more hands-on care than at a typical facility on average; ask how care plans are reviewed and updated as a resident's needs change.
Family Council availability
The facility has a Resident Council but no Family Council; ask whether families have a formal channel to raise concerns with administration.
Management company's role day to day
The facility is licensed by a Hospital District but managed by Live Oak HC LLC; ask who makes staffing and care decisions and who to contact if a problem arises.
Where this information comes from
- License, capacity, ownership, administrator: Texas HHSC licensing registry, snapshot as of April 16, 2026.
- Star ratings, staffing, fines, deficiencies: CMS Care Compare, processed March 1, 2026.
- Summary, insights, and tour questions: Written from the state licensing and CMS records above, last updated April 19, 2026.
Read our methodology for how this information is collected and verified.