Home › Texas › Bexar County › Castle Hills Rehabilitation and Care Center

Castle Hills Rehabilitation and Care Center

8020 Blanco Rd, San Antonio, TX 78216 · CMS Certification Number (CCN) 455510

Special Focus Facility candidate

CMS lists this home in its data as a candidate for the Special Focus Facility (SFF) program, which CMS describes as for homes with a history of serious quality issues. CMS Technical Users’ Guide

At a glance

CMS overall rating: ★☆☆☆☆ 1 of 5
Health inspection citations: 67 in the last 3 inspection cycles (8 immediate jeopardy, 0 actual harm, 36 from complaints)
Fire safety citations: 32
Fines (last 3 years): 4 fines, total $112,386
Payment denials: 0
Most recent standard inspection: September 12, 2025
Official record: Medicare Care Compare page for this facility

Source: CMS Nursing Home Provider Information: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

CMS star ratings

CMS rates every Medicare- and Medicaid-certified nursing home from 1 to 5 stars. Health inspection stars are relative to other homes in the same state: the top 10% get 5 stars and the bottom 20% get 1 star. CMS says to use the ratings together with other information, including a visit. Technical Users’ Guide

Rating	This facility	Texas average	U.S. average
Overall	★☆☆☆☆ 1 of 5	2.7	3
Health inspections	★☆☆☆☆ 1 of 5	2.8	2.8
Staffing	★☆☆☆☆ 1 of 5	1.9	2.9
Quality measures	★☆☆☆☆ 1 of 5	3.7	3.6
Long-stay quality	★★☆☆☆ 2 of 5	Not published	Not published
Short-stay quality	★☆☆☆☆ 1 of 5	Not published	Not published

Averages: CMS State and US Averages: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Health inspections

Inspection cycle	Standard survey date	Health citations	From standard survey	From complaints
Cycle 1 (most recent)	September 12, 2025	31	10	21
Cycle 2	August 23, 2024	25	10	15

CMS weighted health inspection score: 327.25 (lower is better; it counts citation severity, complaints and repeat revisits). Citations from infection control inspections: 0. How to read these citations

67 health citations across 21 inspection dates, newest first. The letter is CMS’s scope/severity code: A–C means potential for minimal harm, D–F potential for more than minimal harm, G–I actual harm, and J–L immediate jeopardy.

May 20, 2026: 3 citations (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0755	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/21/2026
F	F-0727	Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. Nursing and Physician Services Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/21/2026
D	F-0580	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/21/2026

May 15, 2026: 4 citations (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/16/2026
D	F-0842	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/16/2026
D	F-0761	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Pharmacy Service Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/16/2026
D	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/16/2026

April 24, 2026: 2 citations (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/31/2026
E	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/31/2026

March 6, 2026: 1 citation (Complaint)

Severity	Tag	What was cited	Type	Status
E	F-0761	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Pharmacy Service Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 03/20/2026

February 22, 2026: 3 citations (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0842	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 03/15/2026
D	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 03/15/2026
D	F-0641	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 03/15/2026

January 16, 2026: 2 citations (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 02/20/2026
D	F-0755	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 02/20/2026

December 10, 2025: 2 citations (Complaint)

Severity	Tag	What was cited	Type	Status
E	F-0908	Keep all essential equipment working safely. Environmental Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 12/12/2025
E	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 01/10/2026

November 25, 2025: 1 citation (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0726	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. Nursing and Physician Services Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 11/26/2025

November 14, 2025: 2 citations (Complaint)

Severity	Tag	What was cited	Type	Status
E	F-0925	Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Environmental Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 11/30/2025
E	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 01/10/2026

September 12, 2025: 11 citations (Standard + Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0926	Have policies on smoking. Environmental Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025
D	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025
E	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025
E	F-0803	Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. Nutrition and Dietary Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025
D	F-0761	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Pharmacy Service Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025
J	F-0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 09/13/2025
D	F-0677	Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025
D	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025
D	F-0641	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025
C	F-0577	Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. Resident Rights Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025
D	F-0558	Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/13/2025

August 15, 2025: 1 citation (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0644	Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Resident Assessment and Care Planning Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 09/14/2025

June 26, 2025: 1 citation (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0609	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 06/30/2025

May 2, 2025: 2 citations (Complaint)

Severity	Tag	What was cited	Type	Status
J	F-0690	Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/03/2025
J	F-0655	Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 05/03/2025

September 13, 2024: 1 citation (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0755	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 09/30/2024

September 10, 2024: 1 citation (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 09/30/2024

August 23, 2024: 10 citations (Standard)

Severity	Tag	What was cited	Type	Status
D	F-0908	Keep all essential equipment working safely. Environmental Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024
E	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024
D	F-0810	Provide special eating equipment and utensils for residents who need them and appropriate assistance. Nutrition and Dietary Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024
D	F-0761	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Pharmacy Service Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024
D	F-0755	Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024
D	F-0726	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. Nursing and Physician Services Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024
D	F-0690	Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024
D	F-0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024
E	F-0641	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024
D	F-0558	Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies	Standard	Deficient, Provider has date of correction Corrected 09/23/2024

August 2, 2024: 1 citation (Complaint)

Severity	Tag	What was cited	Type	Status
J	F-0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies	Complaint	Past Non-Compliance Corrected 06/20/2024

March 23, 2024: 2 citations (Complaint)

Severity	Tag	What was cited	Type	Status
J	F-0689	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 03/24/2024
J	F-0600	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 03/24/2024

March 16, 2024: 4 citations (Complaint)

Severity	Tag	What was cited	Type	Status
E	F-0842	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 03/17/2024
K	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 03/17/2024
D	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 04/15/2024
K	F-0580	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 03/17/2024

December 21, 2023: 2 citations (Complaint)

Severity	Tag	What was cited	Type	Status
D	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 01/20/2024
D	F-0551	Give the resident's representative the ability to exercise the resident's rights. Resident Rights Deficiencies	Complaint	Deficient, Provider has date of correction Corrected 01/20/2024

July 14, 2023: 11 citations (Standard)

Severity	Tag	What was cited	Type	Status
E	F-0944	Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program. Administration Deficiencies	Standard	Deficient, Provider has date of correction Corrected 07/28/2023
E	F-0921	Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Environmental Deficiencies	Standard	Deficient, Provider has date of correction Corrected 08/14/2023
D	F-0814	Dispose of garbage and refuse properly. Nutrition and Dietary Deficiencies	Standard	Deficient, Provider has date of correction Corrected 08/14/2023
E	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies	Standard	Deficient, Provider has date of correction Corrected 07/15/2023
E	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies	Standard	Deficient, Provider has date of correction Corrected 07/15/2023
D	F-0695	Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies	Standard	Deficient, Provider has date of correction Corrected 07/15/2023
D	F-0661	Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. Resident Assessment and Care Planning Deficiencies	Standard	Deficient, Provider has date of correction Corrected 08/14/2023
D	F-0656	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies	Standard	Deficient, Provider has date of correction Corrected 08/14/2023
D	F-0645	PASARR screening for Mental disorders or Intellectual Disabilities Resident Assessment and Care Planning Deficiencies	Standard	Deficient, Provider has date of correction Corrected 08/14/2023
E	F-0584	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Resident Rights Deficiencies	Standard	Deficient, Provider has date of correction Corrected 08/14/2023
E	F-0582	Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Resident Rights Deficiencies	Standard	Deficient, Provider has date of correction Corrected 08/14/2023

Source: CMS Health Deficiencies: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Fire safety inspections

32 fire safety citations across 3 inspection dates

Date	Severity	Tag	What was cited	Status
09/12/2025	E	K-0920	Ensure proper usage of power strips and extension cords. Gas, Vacuum, and Electrical Systems Deficiencies	Deficient, Provider has date of correction Corrected 09/11/2025
09/12/2025	E	K-0741	Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies	Deficient, Provider has date of correction Corrected 09/11/2025
09/12/2025	C	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies	No revisit needed
09/12/2025	E	K-0374	Install smoke barrier doors that can resist smoke for at least 20 minutes. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 09/11/2025
09/12/2025	E	K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 09/11/2025
09/12/2025	E	K-0355	Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 09/11/2025
09/12/2025	E	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 09/11/2025
09/12/2025	E	K-0321	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 09/11/2025
09/12/2025	C	K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies	No revisit needed
09/12/2025	F	E-0032	Provide primary/alternate means for communication. Emergency Preparedness Deficiencies	Deficient, Provider has date of correction Corrected 09/11/2025
08/23/2024	E	K-0923	Have proper medical gas storage and administration areas. Gas, Vacuum, and Electrical Systems Deficiencies	Deficient, Provider has date of correction Corrected 10/07/2024
08/23/2024	E	K-0741	Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies	Deficient, Provider has date of correction Corrected 10/07/2024
08/23/2024	C	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies	Waiver has been granted Corrected 08/23/2024
08/23/2024	E	K-0511	Have properly installed electrical wiring and gas equipment. Services Deficiencies	Deficient, Provider has date of correction Corrected 10/07/2024
08/23/2024	F	K-0374	Install smoke barrier doors that can resist smoke for at least 20 minutes. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 10/07/2024
08/23/2024	F	K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 10/07/2024
08/23/2024	F	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 10/07/2024
08/23/2024	C	K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies	Waiver has been granted Corrected 08/23/2024
07/14/2023	E	K-0920	Ensure proper usage of power strips and extension cords. Gas, Vacuum, and Electrical Systems Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	E	K-0918	Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	D	K-0741	Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	F	K-0712	Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	C	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies	Waiver has been granted Corrected 07/13/2023
07/14/2023	D	K-0511	Have properly installed electrical wiring and gas equipment. Services Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	F	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	F	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	F	K-0324	Provide properly protected cooking facilities. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	E	K-0321	Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	C	K-0211	Keep aisles, corridors, and exits free of obstruction in case of emergency. Egress Deficiencies	Waiver has been granted Corrected 07/13/2023
07/14/2023	D	K-0200	Meet other general requirements. Egress Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	D	E-0006	Conduct risk assessment and an All-Hazards approach. Emergency Preparedness Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023
07/14/2023	D	E-0004	Develop and maintain an Emergency Preparedness Program (EP). Emergency Preparedness Deficiencies	Deficient, Provider has date of correction Corrected 08/25/2023

Automatic sprinklers in all required areas: Yes. CMS does not count fire safety citations in the health inspection star rating.

Source: CMS Fire Safety Deficiencies: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Penalties

Date	Type	Fine amount	Payment denial
September 12, 2025	Fine	$19,418	—
May 2, 2025	Fine	$27,094	—
August 2, 2024	Fine	$10,226	—
March 16, 2024	Fine	$55,648	—

Source: CMS Penalties: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Staffing

Measure	This facility	Texas average	U.S. average
Total nurse staff hours per resident per day	2.96	3.39	3.86
Registered nurse (RN) hours per resident per day	0.59	0.43	0.69
LPN/LVN hours per resident per day	0.66	Not published	Not published
Nurse aide hours per resident per day	1.71	Not published	Not published
Total nurse staff hours per resident per day, weekends	2.52	Not published	Not published
RN hours per resident per day, weekends	0.19	Not published	Not published
Total nursing staff turnover (%)	Staffing data not submitted or invalid for calculating turnover.	55.3	45.8
Registered nurse turnover (%)	Staffing data not submitted or invalid for calculating turnover.	Not published	Not published
Administrators who have left	2	Not published	Not published

Reported hours come from the Payroll-Based Journal (PBJ) staffing data that facilities submit to CMS each quarter.

Source: CMS Provider Information; State and US Averages: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Facility details

Legal business name: Frio Hospital District
Ownership type: For profit - Limited Liability company
Chain: Optima Care (8 facilities)
Ownership changed in last 12 months: No
Certified beds: 143
Average residents per day: 61.8
Participates in: Medicare and Medicaid
Located inside a hospital: No
Continuing care retirement community: No
Resident and family council: Resident
First approved for Medicare/Medicaid: July 1, 1985
County/parish: Bexar

Source: CMS Provider Information: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Owners and managers reported to CMS

9 ownership and management records

Name	Role	Type	Ownership %	Since
FRIO HOSPITAL DISTRICT	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	100%	undefined undefined, NaN
RUFF, MICHAEL	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	undefined undefined, NaN
RUFF, MICHAEL	CORPORATE OFFICER	Individual	NOT APPLICABLE	undefined undefined, NaN
CASTLE HILLS NURSING AND REHAB CENTER LLC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	undefined undefined, NaN
BEWSEY, MICHAEL	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	undefined undefined, NaN
PORRAS, PETER	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	undefined undefined, NaN
CASTLE HILLS NURSING AND REHAB CENTER LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	undefined undefined, NaN
AZIZ, WESAM	ADP OF THE SNF	Individual	NOT APPLICABLE	undefined undefined, NaN
PORRAS, PETER	ADP OF THE SNF	Individual	NOT APPLICABLE	undefined undefined, NaN

Source: CMS Ownership: data.cms.gov · data as of September 1, 2026 · last checked October 26, 2026

Check it yourself

Medicare Care Compare: Castle Hills Rehabilitation and Care Center. Full inspection reports, quality measures and staffing.
HHSC long-term care complaint portal (TULIP). The state agency also takes nursing home complaints.
Ask the facility to show you its most recent inspection report and plan of correction.

Page built from CMS data files processed September 1, 2026 (CMS refreshes monthly). Last checked October 26, 2026. Not a ranking or endorsement.