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Skilled nursing facility · CMS certification number 676409

The Chateau Waco

Waco, Texas · Medicare and Medicaid · 123 certified beds in Care Compare

Download The Chateau Waco’s record (CSV, each figure with its worksheet, line and column)

In Care Compare’s provider information: Penalties: 4 · Fines: 4 · Fines, total amount: $72,056.00 · Payment denials: 0. The most recent penalty on file: September 26, 2025, Fine, $16,149. Every penalty on file ↓

The Chateau Waco: its citable report, full history — $295 · an email when it changes — $99/month

What stands out

  • Its latest cost report on file is for fiscal year 2025, covering January 1, 2025 to May 31, 2025 (150 days, not a full year), and CMS processed it on January 27, 2026.
  • Net patient revenue fell from $5.5M in fiscal year 2024 to $2.5M in fiscal year 2025.
  • Its result from service to patients: −$930K (2023), −$1.0M (2024), −$482K (2025).
  • Its cost reports on file run from fiscal year 2017 to fiscal year 2025.
  • Since its cost report for fiscal year 2025 was filed on January 27, 2026, 13 changes are listed on this record: 6 owner changes and 7 owner changes.
  • Its net patient revenue of $2.5M ranks 450th of the 484 nursing facilities in Texas whose latest cost report on file is fiscal year 2025.
  • 1 of the 5 nursing facilities in Texas closest in size to it, whose latest cost report on file is fiscal year 2025, also reports a loss on service to patients.

The Chateau Waco: Medicare cost reports

Form CMS-2540-10: every report is settled.

Cost reports on form CMS-2540-10, fiscal years 2017 to 2025
Form CMS-2540-102025 · report 14470752024 · report 14360922023 · report 14385242022 · report 13977692021 · report 13074642020 · report 12739942019 · report 12457012018 · report 12165292017 · report 1182761
Period beganJanuary 1, 2025January 1, 2024January 1, 2023June 1, 2022June 1, 2020June 1, 2019June 1, 2018June 1, 2017November 2, 2016
Period endedMay 31, 2025December 31, 2024December 31, 2023December 31, 2022May 31, 2021May 31, 2020May 31, 2019May 31, 2018May 31, 2017
Days, where not a full year150——213————210
Processed by CMSJanuary 27, 2026August 28, 2025August 29, 2025October 22, 2024December 16, 2021November 18, 2020November 14, 2019December 19, 2018January 25, 2018
Total patient revenue$3,895,460$9,549,615$7,755,036$4,920,184$6,598,850$12,644,698$11,931,288$8,656,527$1,982,395
Contractual allowances and discounts$1,388,599$4,058,167$2,277,382$1,609,519$1,543,496$4,235,154$4,308,050$3,048,818$680,369
Net patient revenue$2,506,861$5,491,448$5,477,654$3,310,665$5,055,354$8,409,544$7,623,238$5,607,709$1,302,026
Total operating expenses$2,988,554$6,538,389$6,407,669$4,681,136$6,742,409$8,026,208$7,611,375$6,458,475$2,448,035
Net income from service to patients−$481,693−$1,046,941−$930,015−$1,370,471−$1,687,055$383,336$11,863−$850,766−$1,146,009
Total other income$182,297$488,501$800,880$591,475$662,308$188,034$1,243$609$35
Net income after other income−$299,396−$558,440−$129,135−$778,996−$1,024,747$571,370$13,106−$850,157−$1,145,974
Net income−$299,396−$558,440−$129,135−$778,996−$1,024,747$571,370$13,106−$850,157−$1,145,974
Total facility beds, all components123123123123123123123123123
Bed days available, all components18,573————————
Medicare (Title XVIII) patient days710————————
Medicaid (Title XIX) patient days6,801————————
Other-payer patient days1,933————————
Total patient days, all components9,44421,96821,93712,37818,80530,08628,09120,0964,210
Medicare discharges7————————
Medicaid discharges5————————
Other-payer discharges49————————
Total discharges, all components6113917112223039732024354
Average length of stay, Medicare, in days101.4359.6539.2454.827.596.3233.3335.6351.23
Average length of stay, Medicaid, in days1,360.2886.79338426.05254.49238.09916.71457.42964
Average length of stay, all patients, in days154.82158.04128.29101.4681.7675.7887.7882.777.96

Net income, fiscal years 2025, 2024, 2023, 2022, 2021, 2020, 2019, 2018, 2017. Checked against the form’s own arithmetic: what that check shows.

The Chateau Waco: nurse staffing hours by quarter →

Who owns The Chateau Waco, as filed with CMS

Care Compare

  • 5% OR GREATER DIRECT OWNERSHIP INTEREST: SOUTH LIMESTONE HOSPITAL DISTRICT (organization), 100%%, since 06/01/2025
  • ADP OF THE SNF: ENSIGN SERVICES INC (organization), NOT APPLICABLE, since 02/01/2026; FLOWERS, ADAM (individual), NOT APPLICABLE, since 07/05/2022; HICKS, HEATHER (individual), NOT APPLICABLE, since 02/01/2026; KENDRICK HEALTHCARE LLC (organization), NOT APPLICABLE, since 02/12/2026; LAKE WACO HEALTH HOLDINGS LLC (organization), NOT APPLICABLE, since 02/01/2026
  • CORPORATE OFFICER: KEETCH, CHAD (individual), NOT APPLICABLE, since 03/01/2011; PRICE, LARRY (individual), NOT APPLICABLE, since 06/01/2025
  • OPERATIONAL/MANAGERIAL CONTROL: HICKS, HEATHER (individual), NOT APPLICABLE, since 02/01/2026; KENDRICK HEALTHCARE LLC (organization), NOT APPLICABLE, since 02/01/2026

Medicare enrollment

As filed in the CMS file dated October 1, 2026 (Medicare enrollment ownership), under the enrollment of SOUTH LIMESTONE HOSPITAL DISTRICT (enrollment ID O20250901000023).

  • 5% OR GREATER DIRECT OWNERSHIP INTEREST: SOUTH LIMESTONE HOSPITAL DISTRICT (organization), 100.00%, since 06/01/2025
  • ADP OF THE SNF: ADAM DAVID FLOWERS (individual), since 07/05/2022; ENSIGN SERVICES INC (organization), since 02/01/2026; HEATHER HICKS (individual), since 02/01/2026; KENDRICK HEALTHCARE LLC (organization), since 02/12/2026; LAKE WACO HEALTH HOLDINGS LLC (organization), since 02/01/2026
  • CORPORATE OFFICER: CHAD KEETCH (individual), 0.00%, since 03/01/2011; LARRY N PRICE (individual), since 06/01/2025
  • OPERATIONAL/MANAGERIAL CONTROL: HEATHER HICKS (individual), since 02/01/2026; KENDRICK HEALTHCARE LLC (organization), since 02/01/2026

Paused by CMS: Form CMS-855A, December 11, 2025.

Private equity company, real estate investment trust and holding company: No: SOUTH LIMESTONE HOSPITAL DISTRICT; ENSIGN SERVICES INC; KENDRICK HEALTHCARE LLC; LAKE WACO HEALTH HOLDINGS LLC; KENDRICK HEALTHCARE LLC.

Private equity company, real estate investment trust and holding company: Paused by CMS: ADAM DAVID FLOWERS; HEATHER HICKS; CHAD KEETCH; LARRY N PRICE; HEATHER HICKS.

Changes in ownership

  • April 1, 2026, enrollment ownership file; no longer listed: JAMES BOSWELL (ADP OF THE SNF); JAMES BOSWELL (OPERATIONAL/MANAGERIAL CONTROL); BROADMORE HEALTH REALTY LTD (ADP OF THE SNF); MARKET PLACE HEALTHCARE LLC (OPERATIONAL/MANAGERIAL CONTROL); FREDERICK EHRSAM (ADP OF THE SNF); WACO HEALTH REALTY, LLC (ADP OF THE SNF); first listed: KENDRICK HEALTHCARE LLC (ADP OF THE SNF), associated since February 12, 2026; KENDRICK HEALTHCARE LLC (OPERATIONAL/MANAGERIAL CONTROL), associated since February 1, 2026; CHAD A KEETCH (CORPORATE OFFICER), associated since March 1, 2011; HEATHER HICKS (ADP OF THE SNF), associated since February 1, 2026; HEATHER HICKS (OPERATIONAL/MANAGERIAL CONTROL), associated since February 1, 2026; ENSIGN SERVICES INC (ADP OF THE SNF), associated since February 1, 2026; LAKE WACO HEALTH HOLDINGS LLC (ADP OF THE SNF), associated since February 1, 2026. Skilled_Nursing_Facility_All_Owners_:_2026-04-01.csv
  • January 1, 2026, enrollment ownership file; no longer listed: CITY OF ENNIS (5% OR GREATER DIRECT OWNERSHIP INTEREST); MARTY W NELSON (CORPORATE OFFICER); JUSTIN FALLEY (W-2 MANAGING EMPLOYEE); first listed: SOUTH LIMESTONE HOSPITAL DISTRICT (5% OR GREATER DIRECT OWNERSHIP INTEREST), associated since June 1, 2025; JAMES BOSWELL (ADP OF THE SNF), associated since May 1, 2025; JAMES BOSWELL (OPERATIONAL/MANAGERIAL CONTROL), associated since May 1, 2025; BROADMORE HEALTH REALTY LTD (ADP OF THE SNF), associated since June 1, 2025; ADAM D FLOWERS (ADP OF THE SNF), associated since July 5, 2022; MARKET PLACE HEALTHCARE LLC (OPERATIONAL/MANAGERIAL CONTROL), associated since June 1, 2025; FREDERICK EHRSAM (ADP OF THE SNF), associated since June 1, 2025; LARRY N PRICE (CORPORATE OFFICER), associated since June 1, 2025; WACO HEALTH REALTY, LLC (ADP OF THE SNF), associated since June 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-01-01.csv

Recent changes on this record

Inspections of The Chateau Waco

  • Cycle 1: health March 19, 2026 (4 deficiencies), fire safety March 19, 2026 (0)
  • Cycle 2: health December 18, 2024 (18 deficiencies), fire safety December 18, 2024 (3)
  • Cycle 3: health October 26, 2023 (8 deficiencies), fire safety October 26, 2023 (0)

Deficiencies cited at The Chateau Waco

31 deficiencies on file, by tag, newest citation first

every one from a health inspection; 20 cited from a complaint, marked below. Letter after a date: scope and severity grade.

  • F 0550, resident rights: March 19, 2026 (D, Deficient, Provider has date of correction, corrected April 19, 2026).
  • F 0812, nutrition and dietary: March 19, 2026 (E, Deficient, Provider has date of correction, corrected April 19, 2026); October 26, 2023 (F, Deficient, Provider has date of correction, corrected November 16, 2023).
  • F 0880, infection control: March 19, 2026 (D, Deficient, Provider has date of correction, corrected April 19, 2026); January 8, 2025 (E, from a complaint, Deficient, Provider has date of correction, corrected January 28, 2025); February 28, 2024 (E, from a complaint, Deficient, Provider has date of correction, corrected March 19, 2024).
  • F 0842, resident assessment and care planning: January 23, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected February 23, 2026).
  • F 0760, pharmacy service: September 26, 2025 (J, from a complaint, Past Non-Compliance, corrected September 20, 2025).
  • F 0580, resident rights: August 28, 2025 (D, from a complaint, Deficient, Provider has date of correction, corrected August 29, 2025); March 20, 2025 (K, from a complaint, Deficient, Provider has date of correction, corrected March 21, 2025).
  • F 0689, quality of life and care: August 28, 2025 (J, from a complaint, Deficient, Provider has date of correction, corrected August 29, 2025); November 24, 2024 (J, from a complaint, Past Non-Compliance, corrected November 23, 2024); October 26, 2023 (D, Deficient, Provider has date of correction, corrected November 16, 2023).
  • F 0627, resident rights: July 30, 2025 (D, from a complaint, Deficient, Provider has date of correction, corrected July 31, 2025).
  • F 0644, resident assessment and care planning: July 1, 2025 (D, from a complaint, Deficient, Provider has date of correction, corrected July 9, 2025).
  • F 0684, quality of life and care: March 20, 2025 (K, from a complaint, Deficient, Provider has date of correction, corrected March 21, 2025); January 8, 2025 (E, from a complaint, Deficient, Provider has date of correction, corrected January 28, 2025).
  • F 0656, resident assessment and care planning: February 27, 2025 (D, from a complaint, Deficient, Provider has date of correction, corrected March 19, 2025); December 18, 2024 (E, Deficient, Provider has date of correction, corrected January 10, 2025); October 26, 2023 (E, Deficient, Provider has date of correction, corrected November 16, 2023); September 1, 2023 (E, from a complaint, Deficient, Provider has date of correction, corrected September 21, 2023).
  • F 0695, quality of life and care: February 27, 2025 (J, from a complaint, Deficient, Provider has date of correction, corrected March 19, 2025); January 8, 2025 (E, from a complaint, Deficient, Provider has date of correction, corrected January 28, 2025).
  • F 0641, resident assessment and care planning: December 18, 2024 (D, Deficient, Provider has date of correction, corrected January 10, 2025).
  • F 0677, quality of life and care: December 18, 2024 (E, Deficient, Provider has date of correction, corrected January 10, 2025).
  • F 0686, quality of life and care: December 18, 2024 (E, Deficient, Provider has date of correction, corrected January 10, 2025).
  • F 0761, pharmacy service: December 18, 2024 (D, Deficient, Provider has date of correction, corrected January 10, 2025).
  • F 0623, resident rights: February 28, 2024 (D, from a complaint, Deficient, Provider has date of correction, corrected March 19, 2024).
  • F 0809, nutrition and dietary: February 28, 2024 (E, from a complaint, Deficient, Provider has date of correction, corrected March 19, 2024).
  • F 0810, nutrition and dietary: February 28, 2024 (E, from a complaint, Deficient, Provider has date of correction, corrected March 19, 2024).
  • F 0755, pharmacy service: January 16, 2024 (E, from a complaint, Deficient, Provider has date of correction, corrected February 13, 2024).

Penalties

Penalty dateTypeFine amountPayment denial beganPayment denial, daysFine ID
September 26, 2025Fine$16,149135718
August 28, 2025Fine$16,149134922
February 27, 2025Fine$25,325113637
November 24, 2024Fine$14,433113391

From the Care Compare penalties file NH_Penalties_Oct2026.csv, processed on October 1, 2026.

The Chateau Waco in Care Compare

  • Ownership Type: Government - Hospital district
  • Legal Business Name: SOUTH LIMESTONE HOSPITAL DISTRICT
  • Date First Approved to Provide Medicare and Medicaid Services: 2016-11-02
  • Provider Resides in Hospital: N
  • Continuing Care Retirement Community: N
  • Urban: Y
  • County/Parish: Mc Lennan
  • Telephone Number: 2549817900
  • Chain Name: THE ENSIGN GROUP
  • Chain ID: 507
  • Provider Changed Ownership in Last 12 Months: N
  • With a Resident and Family Council: Resident
  • Automatic Sprinkler Systems in All Required Areas: Yes
  • Average Number of Residents per Day: 68.1
  • Overall Rating: 1
  • Health Inspection Rating: 2
  • QM Rating: 3
  • Long-Stay QM Rating: 5
  • Short-Stay QM Rating: 2

Care Compare, October 1, 2026: provider information NH_ProviderInfo_Oct2026.csv · inspections NH_SurveySummary_Oct2026.csv · citations NH_HealthCitations_Oct2026.csv · penalties NH_Penalties_Oct2026.csv · ownership NH_Ownership_Oct2026.csv.

Other nursing facilities in Waco and Texas

Report a figure on The Chateau Waco’s record that differs from its CMS file, quoting 676409.