For profit - Limited Liability company · 143 certified beds · CMS number 455510

Castle Hills Rehabilitation and Care Center, San Antonio, TX

CMS records 67 health deficiencies at Castle Hills Rehabilitation and Care Center in San Antonio, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Sep 12, 2025. The highest severity cited is K (immediate jeopardy to resident health or safety). 8 citations were at the immediate jeopardy level, 1 of them recorded as past non-compliance (fixed before the inspection). CMS lists 4 fines totaling $112,386 in the last three years.

Inspections and deficiencies

CMS findings for Castle Hills Rehabilitation and Care Center as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and Castle Hills Rehabilitation and Care Center may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare

Most recent cycle (31 deficiencies)

Standard inspection Sep 12, 2025. CMS counts 31 health deficiencies and 10 fire safety deficiencies in this cycle.

May 20, 2026 · Complaint inspection

3 deficiencies, highest F

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 May 21, 2026

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 May 21, 2026

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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date May 21, 2026

May 15, 2026 · Complaint inspection

4 deficiencies, highest D

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 May 16, 2026

F842 · Complete, confidential medical records

Requirement cited (CMS): Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date May 16, 2026

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 May 16, 2026

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 16, 2026

Apr 24, 2026 · Complaint inspection

2 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 May 31, 2026

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 May 31, 2026

Mar 6, 2026 · Complaint inspection

1 deficiency, highest E

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 20, 2026

Feb 22, 2026 · Complaint inspection

3 deficiencies, highest D

F842 · Complete, confidential medical records

Requirement cited (CMS): Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Mar 15, 2026

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 Mar 15, 2026

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 Mar 15, 2026

Jan 16, 2026 · Complaint inspection

2 deficiencies, highest D

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 Feb 20, 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 Feb 20, 2026

Dec 10, 2025 · Complaint inspection

2 deficiencies, highest E

F908 · Equipment kept in safe working order

Requirement cited (CMS): Keep all essential equipment working safely.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Dec 12, 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 Jan 10, 2026

Nov 25, 2025 · Complaint inspection

1 deficiency, highest D

F726 · Competent nurses and nurse aides

Requirement cited (CMS): 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.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Nov 26, 2025

Nov 14, 2025 · Complaint inspection

2 deficiencies, highest E

F925 · Pest control

Requirement cited (CMS): Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Nov 30, 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 Jan 10, 2026

Sep 12, 2025 · Standard + complaint inspection

11 deficiencies, highest J

F926 · Smoking policies

Requirement cited (CMS): Have policies on smoking.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 13, 2025

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 Sep 13, 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 Sep 13, 2025

F803 · Menus that meet nutritional needs

Requirement cited (CMS): 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.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Sep 13, 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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 13, 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
J Immediate jeopardy to resident health or safety, isolated
Status
Correction date Sep 13, 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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 13, 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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 13, 2025

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 Sep 13, 2025

F577 · Seeing inspection results

Requirement cited (CMS): Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.

Severity
C No actual harm, potential for minimal harm, widespread
Status
Correction date Sep 13, 2025

F558 · Accommodating individual needs and preferences

Requirement cited (CMS): Reasonably accommodate the needs and preferences of each resident.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 13, 2025
Previous cycle: 16 deficiencies (standard inspection Aug 23, 2024)

Standard inspection Aug 23, 2024. CMS counts 16 health deficiencies and 8 fire safety deficiencies in this cycle.

Aug 15, 2025 · Complaint inspection

1 deficiency, highest D

F644 · Coordinating with PASARR screening

Requirement cited (CMS): Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 14, 2025

Jun 26, 2025 · Complaint inspection

1 deficiency, highest D

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 30, 2025

May 2, 2025 · Complaint inspection

2 deficiencies, highest J

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
J Immediate jeopardy to resident health or safety, isolated
Status
Correction date May 3, 2025

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
J Immediate jeopardy to resident health or safety, isolated
Status
Correction date May 3, 2025

Sep 13, 2024 · Complaint inspection

1 deficiency, highest D

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

Sep 10, 2024 · Complaint inspection

1 deficiency, highest D

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 Sep 30, 2024

Aug 23, 2024 · Standard inspection

10 deficiencies, highest E

F908 · Equipment kept in safe working order

Requirement cited (CMS): Keep all essential equipment working safely.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 23, 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
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Sep 23, 2024

F810 · Adaptive eating equipment and help

Requirement cited (CMS): Provide special eating equipment and utensils for residents who need them and appropriate assistance.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 23, 2024

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 Sep 23, 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 23, 2024

F726 · Competent nurses and nurse aides

Requirement cited (CMS): 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.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 23, 2024

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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 23, 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
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 23, 2024

F641 · Accurate resident assessments

Requirement cited (CMS): Ensure each resident receives an accurate assessment.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Sep 23, 2024

F558 · Accommodating individual needs and preferences

Requirement cited (CMS): Reasonably accommodate the needs and preferences of each resident.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Sep 23, 2024
Earlier cycle: 20 deficiencies (standard inspection Jul 14, 2023)

Standard inspection Jul 14, 2023. CMS counts 20 health deficiencies and 14 fire safety deficiencies in this cycle.

Aug 2, 2024 · Complaint inspection

1 deficiency, highest J

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
Past non-compliance (fixed before the inspection), Jun 20, 2024

Mar 23, 2024 · Complaint inspection

2 deficiencies, highest J

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 Mar 24, 2024

F600 · Freedom from abuse and neglect

Requirement cited (CMS): Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Severity
J Immediate jeopardy to resident health or safety, isolated
Status
Correction date Mar 24, 2024

Mar 16, 2024 · Complaint inspection

4 deficiencies, highest K

F842 · Complete, confidential medical records

Requirement cited (CMS): Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Mar 17, 2024

F760 · No significant medication errors

Requirement cited (CMS): Ensure that residents are free from significant medication errors.

Severity
K Immediate jeopardy to resident health or safety, pattern
Status
Correction date Mar 17, 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 Apr 15, 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
K Immediate jeopardy to resident health or safety, pattern
Status
Correction date Mar 17, 2024

Dec 21, 2023 · Complaint inspection

2 deficiencies, highest D

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 Jan 20, 2024

F551 · Role of the resident's representative

Requirement cited (CMS): Give the resident's representative the ability to exercise the resident's rights.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Jan 20, 2024

Jul 14, 2023 · Standard inspection

11 deficiencies, highest E

F944 · Quality program training

Requirement cited (CMS): Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Jul 28, 2023

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 Aug 14, 2023

F814 · Garbage disposal

Requirement cited (CMS): Dispose of garbage and refuse properly.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Aug 14, 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 Jul 15, 2023

F760 · No significant medication errors

Requirement cited (CMS): Ensure that residents are free from significant medication errors.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Jul 15, 2023

F695 · Respiratory and oxygen care

Requirement cited (CMS): Provide safe and appropriate respiratory care for a resident when needed.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Jul 15, 2023

F661 · Discharge summary

Requirement cited (CMS): Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Aug 14, 2023

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 Aug 14, 2023

F645 · Pre-admission screening for mental disorder or intellectual disability

Requirement cited (CMS): PASARR screening for Mental disorders or Intellectual Disabilities

Severity
D No actual harm, potential for more than minimal harm, isolated
Status
Correction date Aug 14, 2023

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
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Aug 14, 2023

F582 · Notice of covered and extra charges

Requirement cited (CMS): Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Severity
E No actual harm, potential for more than minimal harm, pattern
Status
Correction date Aug 14, 2023

Tags cited in more than one inspection

14 tags cited on more than one inspection date at Castle Hills Rehabilitation and Care Center; each date counts once and does not mean the same incident. PNC = past non-compliance.

TagInspectionsDates
F812 Food safety and sanitation6Apr 24, 2026; Dec 10, 2025; Nov 14, 2025; Sep 12, 2025; Aug 23, 2024; Jul 14, 2023
F880 Infection prevention and control program6May 15, 2026; Apr 24, 2026; Jan 16, 2026; Sep 12, 2025; Sep 10, 2024; Dec 21, 2023
F656 Comprehensive person-centered care plan5May 15, 2026; Feb 22, 2026; Sep 12, 2025; Mar 16, 2024; Jul 14, 2023
F689 Accident prevention and supervision4Sep 12, 2025; Aug 23, 2024; Aug 2, 2024 (PNC); Mar 23, 2024
F755 Pharmacy services and a consultant pharmacist4May 20, 2026; Jan 16, 2026; Sep 13, 2024; Aug 23, 2024
F761 Drug labeling and secure storage4May 15, 2026; Mar 6, 2026; Sep 12, 2025; Aug 23, 2024
F641 Accurate resident assessments3Feb 22, 2026; Sep 12, 2025; Aug 23, 2024
F842 Complete, confidential medical records3May 15, 2026; Feb 22, 2026; Mar 16, 2024
F558 Accommodating individual needs and preferences2Sep 12, 2025; Aug 23, 2024
F580 Telling residents and families about changes2May 20, 2026; Mar 16, 2024
F690 Bladder, bowel, and catheter care2May 2, 2025; Aug 23, 2024
F726 Competent nurses and nurse aides2Nov 25, 2025; Aug 23, 2024
F760 No significant medication errors2Mar 16, 2024; Jul 14, 2023
F908 Equipment kept in safe working order2Dec 10, 2025; Aug 23, 2024

Fines and payment denials

DateTypeAmount / length
Sep 12, 2025Fine$19,418
May 2, 2025Fine$27,094
Aug 2, 2024Fine$10,226
Mar 16, 2024Fine$55,648

Staffing and CMS ratings

Total nurse staff hours per resident per day
2.96 h (below the Texas median of 3.27 h)
RN hours per resident per day
0.59 h (above the Texas median of 0.38 h)
Weekend nurse staff hours per resident per day
2.52 h
Nursing staff turnover
not reported
Administrators who left
2
CMS overall rating
1 of 5
Health inspection rating
1 of 5
Staffing rating
1 of 5
Quality measure rating
1 of 5

CMS figures for Castle Hills Rehabilitation and Care Center, copied as published; Texas medians are ours.

Facility details

Address
8020 Blanco Rd, San Antonio, TX 78216
Phone
(210) 344-4553
County
Bexar
Accepts
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Chain (CMS)
Optima Care
Certified beds
143
Average residents per day
61.8
In Medicare/Medicaid since
Jul 1, 1985
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.

  • When was the kitchen last inspected, and how are food temperatures checked? (F812, cited 6 times)
  • How do staff track and report infections among residents? (F880, cited 6 times)
  • How are a resident's goals and preferences written into the care plan? (F656, cited 5 times)
  • How does the home assess each resident's fall risk and plan to prevent falls? (F689, cited 4 times)

Other nursing homes in San Antonio

Source

CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.

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