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.
| Form CMS-2540-10 | 2025 · report 1447075 | 2024 · report 1436092 | 2023 · report 1438524 | 2022 · report 1397769 | 2021 · report 1307464 | 2020 · report 1273994 | 2019 · report 1245701 | 2018 · report 1216529 | 2017 · report 1182761 |
|---|---|---|---|---|---|---|---|---|---|
| Period began | January 1, 2025 | January 1, 2024 | January 1, 2023 | June 1, 2022 | June 1, 2020 | June 1, 2019 | June 1, 2018 | June 1, 2017 | November 2, 2016 |
| Period ended | May 31, 2025 | December 31, 2024 | December 31, 2023 | December 31, 2022 | May 31, 2021 | May 31, 2020 | May 31, 2019 | May 31, 2018 | May 31, 2017 |
| Days, where not a full year | 150 | — | — | 213 | — | — | — | — | 210 |
| Processed by CMS | January 27, 2026 | August 28, 2025 | August 29, 2025 | October 22, 2024 | December 16, 2021 | November 18, 2020 | November 14, 2019 | December 19, 2018 | January 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 components | 123 | 123 | 123 | 123 | 123 | 123 | 123 | 123 | 123 |
| Bed days available, all components | 18,573 | — | — | — | — | — | — | — | — |
| Medicare (Title XVIII) patient days | 710 | — | — | — | — | — | — | — | — |
| Medicaid (Title XIX) patient days | 6,801 | — | — | — | — | — | — | — | — |
| Other-payer patient days | 1,933 | — | — | — | — | — | — | — | — |
| Total patient days, all components | 9,444 | 21,968 | 21,937 | 12,378 | 18,805 | 30,086 | 28,091 | 20,096 | 4,210 |
| Medicare discharges | 7 | — | — | — | — | — | — | — | — |
| Medicaid discharges | 5 | — | — | — | — | — | — | — | — |
| Other-payer discharges | 49 | — | — | — | — | — | — | — | — |
| Total discharges, all components | 61 | 139 | 171 | 122 | 230 | 397 | 320 | 243 | 54 |
| Average length of stay, Medicare, in days | 101.43 | 59.65 | 39.24 | 54.8 | 27.5 | 96.32 | 33.33 | 35.63 | 51.23 |
| Average length of stay, Medicaid, in days | 1,360.2 | 886.79 | 338 | 426.05 | 254.49 | 238.09 | 916.71 | 457.42 | 964 |
| Average length of stay, all patients, in days | 154.82 | 158.04 | 128.29 | 101.46 | 81.76 | 75.78 | 87.78 | 82.7 | 77.96 |
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
- January 1, 2026: enrollment_id: O20220609000120 → O20250901000023. Skilled_Nursing_Facility_Enrollments_:_2026-01-01.csv
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 date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| September 26, 2025 | Fine | $16,149 | 135718 | ||
| August 28, 2025 | Fine | $16,149 | 134922 | ||
| February 27, 2025 | Fine | $25,325 | 113637 | ||
| November 24, 2024 | Fine | $14,433 | 113391 |
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.