For profit - Individual · 150 certified beds · CMS number 676114
River Hills Health and Rehabilitation Center, Kerrville, TX
CMS records 57 health deficiencies at River Hills Health and Rehabilitation Center in Kerrville, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Jun 13, 2025. The highest severity cited is J (immediate jeopardy to resident health or safety). 6 citations were at the immediate jeopardy level. CMS lists 3 fines totaling $112,133 in the last three years.
- 57deficiencies, 3 cycles (TX median 25)
- 22in the latest cycle (TX median 8)
- Jhighest severity · Immediate jeopardy
- $112,133fines, last 3 years
- 1CMS overall rating (of 5)
Inspections and deficiencies
CMS findings for River Hills Health and Rehabilitation Center as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and River Hills Health and Rehabilitation Center may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare
Most recent cycle (22 deficiencies)
Standard inspection Jun 13, 2025. CMS counts 22 health deficiencies and 4 fire safety deficiencies in this cycle.
Jun 19, 2026 · Complaint inspection
1 deficiency, highest D
F550 · Dignity and the right to exercise rights
Requirement cited (CMS): Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 7, 2026
May 7, 2026 · Complaint inspection
3 deficiencies, highest D
F761 · Drug labeling and secure storage
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 1, 2026
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 1, 2026
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 1, 2026
Feb 4, 2026 · Complaint inspection
2 deficiencies, highest D
F641 · Accurate resident assessments
Requirement cited (CMS): Ensure each resident receives an accurate assessment.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 6, 2026
F628 · Discharge paperwork, notices, and bed-hold information
Requirement cited (CMS): Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 6, 2026
Nov 26, 2025 · Complaint inspection
1 deficiency, highest F
F882 · Qualified infection preventionist
Requirement cited (CMS): Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
- Severity
- F No actual harm, potential for more than minimal harm, widespread
- Status
- Correction date Dec 19, 2025
Sep 16, 2025 · Complaint inspection
1 deficiency, highest D
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Oct 1, 2025
Jun 13, 2025 · Standard + complaint inspection
14 deficiencies, highest E
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
F813 · Food brought in by visitors
Requirement cited (CMS): Have a policy regarding use and storage of foods brought to residents by family and other visitors.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 11, 2025
F761 · Drug labeling and secure storage
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 11, 2025
F760 · No significant medication errors
Requirement cited (CMS): Ensure that residents are free from significant medication errors.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
F727 · RN coverage and director of nursing
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 11, 2025
F690 · Bladder, bowel, and catheter care
Requirement cited (CMS): Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 11, 2025
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
F685 · Vision and hearing services
Requirement cited (CMS): Assist a resident in gaining access to vision and hearing services.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
F677 · Help with daily care
Requirement cited (CMS): Provide care and assistance to perform activities of daily living for any resident who is unable.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 11, 2025
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 11, 2025
F605 · Limits on psychotropic drugs and chemical restraints
Requirement cited (CMS): Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
F584 · Safe, clean, homelike surroundings
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
F583 · Personal privacy and confidential records
Requirement cited (CMS): Keep residents' personal and medical records private and confidential.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 11, 2025
Previous cycle: 26 deficiencies (standard inspection Apr 19, 2024)
Standard inspection Apr 19, 2024. CMS counts 26 health deficiencies and 5 fire safety deficiencies in this cycle.
May 13, 2025 · Complaint inspection
2 deficiencies, highest E
F641 · Accurate resident assessments
Requirement cited (CMS): Ensure each resident receives an accurate assessment.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 3, 2025
F558 · Accommodating individual needs and preferences
Requirement cited (CMS): Reasonably accommodate the needs and preferences of each resident.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jun 3, 2025
Feb 8, 2025 · Complaint inspection
4 deficiencies, highest J
F770 · Timely laboratory services
Requirement cited (CMS): Provide timely, quality laboratory services/tests to meet the needs of residents.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Feb 9, 2025
F760 · No significant medication errors
Requirement cited (CMS): Ensure that residents are free from significant medication errors.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Feb 9, 2025
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Feb 9, 2025
F684 · Quality of care
Requirement cited (CMS): Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Feb 9, 2025
Dec 21, 2024 · Complaint inspection
5 deficiencies, highest J
F727 · RN coverage and director of nursing
Requirement cited (CMS): 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.
- Severity
- F No actual harm, potential for more than minimal harm, widespread
- Status
- Correction date Dec 22, 2024
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Dec 22, 2024
F657 · Care plan timing and team review
Requirement cited (CMS): Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Dec 22, 2024
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Dec 22, 2024
F655 · Baseline care plan within 48 hours
Requirement cited (CMS): Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Dec 22, 2024
Sep 9, 2024 · Complaint inspection
4 deficiencies, highest E
F839 · Licensed and qualified staff
Requirement cited (CMS): Employ staff that are licensed, certified, or registered in accordance with state laws.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Sep 30, 2024
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Sep 30, 2024
F609 · Reporting suspected abuse and crimes
Requirement cited (CMS): Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Sep 30, 2024
F607 · Abuse prevention policies
Requirement cited (CMS): Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Sep 30, 2024
Apr 19, 2024 · Standard inspection
11 deficiencies, highest F
F921 · Safe, functional, sanitary building
Requirement cited (CMS): Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 31, 2024
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 31, 2024
F849 · Hospice services
Requirement cited (CMS): Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 31, 2024
F813 · Food brought in by visitors
Requirement cited (CMS): Have a policy regarding use and storage of foods brought to residents by family and other visitors.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 31, 2024
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- F No actual harm, potential for more than minimal harm, widespread
- Status
- Correction date May 31, 2024
F801 · Qualified dietitian and food staff
Requirement cited (CMS): Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 31, 2024
F759 · Medication error rate under 5 percent
Requirement cited (CMS): Ensure medication error rates are not 5 percent or greater.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 31, 2024
F758 · Psychotropic drug safeguards
Requirement cited (CMS): Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 31, 2024
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 31, 2024
F641 · Accurate resident assessments
Requirement cited (CMS): Ensure each resident receives an accurate assessment.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 31, 2024
F583 · Personal privacy and confidential records
Requirement cited (CMS): Keep residents' personal and medical records private and confidential.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 31, 2024
Earlier cycle: 9 deficiencies (standard inspection Mar 4, 2023)
Standard inspection Mar 4, 2023. CMS counts 9 health deficiencies and 2 fire safety deficiencies in this cycle.
Jan 10, 2024 · Complaint inspection
2 deficiencies, highest J
F684 · Quality of care
Requirement cited (CMS): Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Jan 29, 2024
F580 · Telling residents and families about changes
Requirement cited (CMS): Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- Severity
- J Immediate jeopardy to resident health or safety, isolated
- Status
- Correction date Jan 29, 2024
Mar 4, 2023 · Standard inspection
7 deficiencies, highest E
F814 · Garbage disposal
Requirement cited (CMS): Dispose of garbage and refuse properly.
- Severity
- C No actual harm, potential for minimal harm, widespread
- Status
- Correction date Mar 5, 2023
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Mar 5, 2023
F761 · Drug labeling and secure storage
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Mar 5, 2023
F755 · Pharmacy services and a consultant pharmacist
Requirement cited (CMS): Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Mar 5, 2023
F727 · RN coverage and director of nursing
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Mar 5, 2023
F684 · Quality of care
Requirement cited (CMS): Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 5, 2023
F657 · Care plan timing and team review
Requirement cited (CMS): Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Mar 5, 2023
Tags cited in more than one inspection
14 tags cited on more than one inspection date at River Hills Health and Rehabilitation Center; each date counts once and does not mean the same incident. PNC = past non-compliance.
| Tag | Inspections | Dates |
|---|---|---|
| F755 Pharmacy services and a consultant pharmacist | 4 | May 7, 2026; Feb 8, 2025; Sep 9, 2024; Mar 4, 2023 |
| F641 Accurate resident assessments | 3 | Feb 4, 2026; May 13, 2025; Apr 19, 2024 |
| F656 Comprehensive person-centered care plan | 3 | Jun 13, 2025; Dec 21, 2024; Apr 19, 2024 |
| F684 Quality of care | 3 | Feb 8, 2025; Jan 10, 2024; Mar 4, 2023 |
| F689 Accident prevention and supervision | 3 | Sep 16, 2025; Jun 13, 2025; Dec 21, 2024 |
| F727 RN coverage and director of nursing | 3 | Jun 13, 2025; Dec 21, 2024; Mar 4, 2023 |
| F761 Drug labeling and secure storage | 3 | May 7, 2026; Jun 13, 2025; Mar 4, 2023 |
| F812 Food safety and sanitation | 3 | Jun 13, 2025; Apr 19, 2024; Mar 4, 2023 |
| F583 Personal privacy and confidential records | 2 | Jun 13, 2025; Apr 19, 2024 |
| F609 Reporting suspected abuse and crimes | 2 | May 7, 2026; Sep 9, 2024 |
| F657 Care plan timing and team review | 2 | Dec 21, 2024; Mar 4, 2023 |
| F760 No significant medication errors | 2 | Jun 13, 2025; Feb 8, 2025 |
| F813 Food brought in by visitors | 2 | Jun 13, 2025; Apr 19, 2024 |
| F880 Infection prevention and control program | 2 | Jun 13, 2025; Apr 19, 2024 |
Fines and payment denials
| Date | Type | Amount / length |
|---|---|---|
| Feb 8, 2025 | Fine | $49,392 |
| Dec 21, 2024 | Fine | $47,467 |
| Jan 10, 2024 | Fine | $15,274 |
Staffing and CMS ratings
- Total nurse staff hours per resident per day
- 3.11 h (about the same as the Texas median of 3.27 h)
- RN hours per resident per day
- 0.23 h (below the Texas median of 0.38 h)
- Weekend nurse staff hours per resident per day
- 2.73 h
- Nursing staff turnover
- 75.9% (Texas median 52.1%)
- Administrators who left
- not reported
- CMS overall rating
- 1 of 5
- Health inspection rating
- 1 of 5
- Staffing rating
- 1 of 5
- Quality measure rating
- 4 of 5
CMS figures for River Hills Health and Rehabilitation Center, copied as published; Texas medians are ours.
Facility details
- Address
- 2091 Bandera Hwy, Kerrville, TX 78028
- Phone
- (830) 257-9900
- County
- Kerr
- Accepts
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Chain (CMS)
- Not part of a chain in CMS data
- Certified beds
- 150
- Average residents per day
- 99.2
- In Medicare/Medicaid since
- Oct 1, 2006
- Inside a hospital
- No
- Continuing care retirement community
- No
- Resident and family council
- Resident
- Sprinklers in all required areas
- Yes
Questions to ask on a visit
Based on the tags cited most often here.
- How are new medication orders filled, and how quickly can urgent medications arrive? (F755, cited 4 times)
- How does the home check that resident assessments match what staff actually observe? (F641, cited 3 times)
- How are a resident's goals and preferences written into the care plan? (F656, cited 3 times)
- How does the home make sure doctor's orders are followed consistently across shifts? (F684, cited 3 times)
Other nursing homes in Kerrville
- Arbor View Nursing & Rehabilitation
Kerrville · 82 deficiencies - Avir at Kerrville
Kerrville · 67 deficiencies - Hilltop Village Nursing and Rehabilitation
Kerrville · 51 deficiencies
Source
CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.