Federal inspection record · CMS data as of October 1, 2026
Bluebonnet Nursing & Rehabilitation
696 Fm 99, Karnes City, TX · (830) 780-3944
- Certified beds
- 120
- Residents per day
- 39
- Ownership
- For-Profit
- Chain
- Creative Solutions In Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- March 28, 1994
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Texas.
-
Staffing
★★★★★no change (already 1)
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Bluebonnet Nursing & Rehabilitation carries 195 inspection points. That is fewer than 11% of Texas's 1,166 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Texas: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–26 pts
- 4★ 26–51 pts
- 3★ 51–85 pts
- 2★ 85–145.75 pts
- 1★ over 145.75 pts
Bars show every rated home in Texas by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
42 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (6)
-
G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
K
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
-
K
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Everything else, by area of care
Resident Assessment and Care Planning13E
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Ensure each resident receives an accurate assessment.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Rights7E
- D
Reasonably accommodate the needs and preferences of each resident.
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- E
Keep residents' personal and medical records private and confidential.
- E
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.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
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.
Quality of Life and Care6E
- E
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Infection Control5E
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
Pharmacy Service4F
- F
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
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.
- D
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.
Environmental1E
- E
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspection history
2025-08-22
19 health deficiencies · 11 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (7 deficiencies)
2024-07-19
11 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Rights (4 deficiencies)
2023-06-14
12 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (5 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 23 min of nursing staff time a day, 26 min of it from a registered nurse.
This home
3 h 23 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 67% of nursing staff and 100% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$119,801 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-06-03 | Fine | $19,635 |
| 2026-04-09 | Fine | $10,628 |
| 2024-06-01 | Fine | $31,760 |
| 2024-04-09 | Fine | $16,801 |
| 2024-02-26 | Fine | $40,977 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3.6 pts better | 100.0% | 96.4% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine3 pts better | 100.0% | 97.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury1.9 pts better | 1.3% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms3.4 pts worse | 5.7% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight7.7 pts worse | 10.6% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication3.8 pts worse | 21.6% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication2.8 pts worse | 12.6% | 9.8% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened12.3 pts worse | 25.2% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased10.4 pts worse | 26.2% | 15.8% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.4 pts worse | 0.7% | 0.3% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.8 pts better | 0.0% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence5.9 pts worse | 18.4% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers3.6 pts worse | 7.3% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine8 pts better | 96.7% | 88.7% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.4 pts better | 0.0% | 1.4% | 1.5% |
·
Who owns and runs it
4 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Blake, Gary | Operational/Managerial Control · Individual | 0% | 139 facilities |
| Blake, Malisa | Operational/Managerial Control · Individual | 0% | 139 facilities |
| Creative Solutions In Healthcare Inc | Operational/Managerial Control · Organization | 0% | 45 facilities |
| Huggins, Linda | W-2 Managing Employee · Individual | 0% | 138 facilities |
·
Fire safety
11 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke4F
- F
Provide properly protected cooking facilities.
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Properly select, install, inspect, or maintain portable fire extinguishes.
Egress3F
- F
Install proper backup exit lighting.
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
Have properly located and lighted "Exit" signs.
Emergency Preparedness1F
- F
Conduct testing and exercise requirements.
Miscellaneous1F
- F
Have simulated fire drills held at unexpected times.
Gas, Vacuum, and Electrical Systems1F
- F
Have generator or other power source capable of supplying service within 10 seconds.
Services1E
- E
Have properly installed electrical wiring and gas equipment.
·
Other homes nearby
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-
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