For profit - Corporation · 124 certified beds · CMS number 676418
The Heights of Bulverde, Spring Branch, TX
CMS records 47 health deficiencies at The Heights of Bulverde in Spring Branch, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Jun 25, 2025. The highest severity cited is J (immediate jeopardy to resident health or safety). 1 citation was at the immediate jeopardy level. CMS lists no fines or payment denials in the last three years.
- 47deficiencies, 3 cycles (TX median 25)
- 16in the latest cycle (TX median 8)
- Jhighest severity · Immediate jeopardy
- $0fines, last 3 years
- 2CMS overall rating (of 5)
Inspections and deficiencies
CMS findings for The Heights of Bulverde as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and The Heights of Bulverde may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare
Most recent cycle (16 deficiencies)
Standard inspection Jun 25, 2025. CMS counts 16 health deficiencies and 1 fire safety deficiency in this cycle.
Apr 1, 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 Apr 2, 2026
Jan 13, 2026 · 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 Jan 14, 2026
Dec 10, 2025 · Complaint inspection
3 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 Dec 11, 2025
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 Dec 11, 2025
F603 · Freedom from involuntary seclusion
Requirement cited (CMS): Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Dec 11, 2025
Dec 9, 2025 · Complaint inspection
3 deficiencies, highest E
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 Dec 10, 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
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Dec 10, 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 Dec 10, 2025
Jun 25, 2025 · Standard inspection
8 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 Jun 26, 2025
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 Jun 26, 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 Jun 26, 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 Jun 26, 2025
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 Jun 26, 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 Jun 26, 2025
F578 · Refusing treatment and advance directives
Requirement cited (CMS): Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 26, 2025
F552 · Being informed about health and treatment
Requirement cited (CMS): Ensure that residents are fully informed and understand their health status, care and treatments.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 26, 2025
Previous cycle: 24 deficiencies (standard inspection May 5, 2024)
Standard inspection May 5, 2024. CMS counts 24 health deficiencies and 4 fire safety deficiencies in this cycle.
Apr 24, 2025 · Complaint inspection
2 deficiencies, highest E
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 Apr 25, 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 Apr 25, 2025
Apr 19, 2025 · Complaint inspection
1 deficiency, highest E
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 Apr 20, 2025
Mar 21, 2025 · Complaint inspection
5 deficiencies, highest J
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 Mar 22, 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 Mar 22, 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
- Past non-compliance (fixed before the inspection), Dec 24, 2024
F610 · Investigating and responding to allegations
Requirement cited (CMS): Respond appropriately to all alleged violations.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 22, 2025
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 Mar 22, 2025
May 5, 2024 · Standard + complaint inspection
16 deficiencies, highest F
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 May 6, 2024
F814 · Garbage disposal
Requirement cited (CMS): Dispose of garbage and refuse properly.
- Severity
- F No actual harm, potential for more than minimal harm, widespread
- Status
- Correction date May 6, 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 6, 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 6, 2024
F806 · Allergies, preferences, and meal substitutes
Requirement cited (CMS): Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 6, 2024
F773 · Ordering labs and reporting results
Requirement cited (CMS): Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 6, 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 May 6, 2024
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 May 6, 2024
F759 · Medication error rate under 5 percent
Requirement cited (CMS): Ensure medication error rates are not 5 percent or greater.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 6, 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 May 6, 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
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date May 6, 2024
F686 · Pressure ulcer prevention and care
Requirement cited (CMS): Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 6, 2024
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 May 6, 2024
F635 · Doctor's orders at admission
Requirement cited (CMS): Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date May 6, 2024
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 May 6, 2024
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 May 6, 2024
Earlier cycle: 7 deficiencies (standard inspection Mar 24, 2023)
Standard inspection Mar 24, 2023. CMS counts 7 health deficiencies and 3 fire safety deficiencies in this cycle.
Jul 22, 2024 · Complaint inspection
2 deficiencies, 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 Jul 23, 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 Jul 23, 2024
Mar 21, 2024 · 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 Mar 22, 2024
Mar 24, 2023 · Standard inspection
4 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 Mar 25, 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 25, 2023
F808 · Physician-ordered therapeutic diets
Requirement cited (CMS): Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Mar 25, 2023
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 25, 2023
Tags cited in more than one inspection
10 tags cited on more than one inspection date at The Heights of Bulverde; each date counts once and does not mean the same incident. PNC = past non-compliance.
| Tag | Inspections | Dates |
|---|---|---|
| F842 Complete, confidential medical records | 5 | Dec 10, 2025; Dec 9, 2025; Jun 25, 2025; Apr 24, 2025; Apr 19, 2025 |
| F880 Infection prevention and control program | 5 | Jan 13, 2026; Dec 10, 2025; Jun 25, 2025; Mar 21, 2025; Mar 24, 2023 |
| F641 Accurate resident assessments | 3 | Dec 9, 2025; Apr 24, 2025; Mar 24, 2023 |
| F656 Comprehensive person-centered care plan | 3 | Jun 25, 2025; Mar 21, 2025 (PNC); Jul 22, 2024 |
| F761 Drug labeling and secure storage | 3 | Apr 1, 2026; Jun 25, 2025; May 5, 2024 |
| F812 Food safety and sanitation | 3 | Jun 25, 2025; May 5, 2024; Mar 24, 2023 |
| F609 Reporting suspected abuse and crimes | 2 | Mar 21, 2025; Mar 21, 2024 |
| F689 Accident prevention and supervision | 2 | Mar 21, 2025; May 5, 2024 |
| F690 Bladder, bowel, and catheter care | 2 | Dec 9, 2025; May 5, 2024 |
| F759 Medication error rate under 5 percent | 2 | Jun 25, 2025; May 5, 2024 |
Fines and payment denials
CMS lists no fines or payment denials for this nursing home in the last three years.
Staffing and CMS ratings
- Total nurse staff hours per resident per day
- 3.13 h (about the same as the Texas median of 3.27 h)
- RN hours per resident per day
- 0.52 h (above the Texas median of 0.38 h)
- Weekend nurse staff hours per resident per day
- 2.61 h
- Nursing staff turnover
- 55.9% (Texas median 52.1%)
- Administrators who left
- 0
- CMS overall rating
- 2 of 5
- Health inspection rating
- 2 of 5
- Staffing rating
- 2 of 5
- Quality measure rating
- 4 of 5
CMS figures for The Heights of Bulverde, copied as published; Texas medians are ours.
Facility details
- Address
- 384 Harmony Hills, Spring Branch, TX 78070
- Phone
- (830) 438-1276
- County
- Comal
- Accepts
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Chain (CMS)
- Touchstone Communities
- Certified beds
- 124
- Average residents per day
- 97.3
- In Medicare/Medicaid since
- Mar 15, 2017
- Inside a hospital
- Yes
- 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.
- Does the home use electronic health records, and can families get access through a portal? (F842, cited 5 times)
- How do staff track and report infections among residents? (F880, cited 5 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)
Other nursing homes in Spring Branch and the same chain
- Harker Heights Nursing & Rehabilitation
Harker Heights · 51 deficiencies - The Enclave
San Antonio · 46 deficiencies - The Heights at Medical Center
San Antonio · 44 deficiencies - Stone Oak Care Center
San Antonio · 40 deficiencies
Source
CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.