Floresville, TX

Harmony Care At Floresville

2-star overall rating with 3-star inspections with $87,066 in total fines with 10 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle

1811 Sixth St, Floresville, TX

(830) 393-2561

Compare this facility

Overall

2 / 5

CMS overall stars

Health inspections

3 / 5

Survey and complaint cycles

Staffing

1 / 5

RN + nurse staffing

Quality measures

2 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

144

Certified beds

Average residents

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Harmony Care Group

Operator or chain grouping

Approved since

1995-04-01

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

6 facilities

Chain averages 2 overall / 2 health / 1 staffing / 3 quality stars

Changed ownership

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.28

Registered nurse staffing · state 0.44 · national 0.68

LPN hours / resident day

0.82

Licensed practical nurse staffing · state 0.95 · national 0.87

Aide hours / resident day

2.08

Nurse aide staffing · state 2.01 · national 2.35

Total nurse hours

3.18

All reported nurse hours · state 3.40 · national 3.89

Licensed hours

1.10

RN + LPN hours · state 1.38 · national 1.54

Weekend hours

2.87

Weekend nurse staffing · state 2.99 · national 3.43

Weekend RN hours

0.10

Weekend registered nurse coverage · state 0.34 · national 0.47

Physical therapist

0.07

Reported PT staffing · state 0.07 · national 0.07

Adjusted RN hours

0.32

CMS adjusted RN staffing hours

Adjusted total hours

3.70

CMS adjusted total nurse staffing hours

Case-mix index

1.17

Higher values indicate more complex resident acuity

RN turnover

Annual RN turnover

Total nurse turnover

Annual nurse turnover

SNF VBP

Value-based purchasing

Program rank

6,654

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

32.13

Composite VBP score used to determine payment impact.

Payment multiplier

0.9869

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

1.96

Baseline 19.87% · Performance 20.52% · Measure score 1.96 · Achievement 1.96 · Improvement 0

Healthcare-associated infections

7.68

Baseline 9.56% · Performance 5.83% · Measure score 7.68 · Achievement 6.72 · Improvement 7.68

Total nurse turnover

Not reported

This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.

Adjusted total nurse staffing

Baseline 2.79 hours · Performance 1.03 hours · Measure score 0 · Achievement 0 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	9.81%	10.72% 0.9 pts better	No Different than the National Rate · Eligible stays 77 · Observed rate 7.79% · Lower 95% interval 6.38%
Discharge to community	56.43%	50.57% 5.9 pts better	No Different than the National Rate · Eligible stays 40 · Observed rate 55% · Lower 95% interval 38.27%
Medicare spending per beneficiary	1.28	1.02 0.3 pts worse
Drug regimen review with follow-up	94.64%	95.27% 0.6 pts worse	Numerator 53 · Denominator 56
Falls with major injury	3.57%	0.77% 2.8 pts worse	Numerator 2 · Denominator 56
Discharge self-care score	56.52%	53.69% 2.8 pts better	Numerator 13 · Denominator 23
Discharge mobility score	47.83%	50.94% 3.1 pts worse	Numerator 11 · Denominator 23
Pressure ulcers or injuries, new or worsened	3.57%	2.29% 1.3 pts worse	Numerator 2 · Denominator 56 · Adjusted rate 3.15%
Healthcare-associated infections requiring hospitalization	5.83%	7.12% 1.3 pts better	No Different than the National Rate · Eligible stays 55 · Observed rate 1.82% · Lower 95% interval 2.82%
Staff COVID-19 vaccination coverage	0%	8.2% 8.2 pts worse	Numerator 0 · Denominator 107
Staff flu vaccination coverage	Not Available	42%	Numerator Not Available · Denominator Not Available · No data were submitted for this measure.
Discharge function score	65.22%	56.45% 8.8 pts better	Numerator 15 · Denominator 23
Transfer of health information to provider	95.24%	95.95% 0.7 pts worse	Numerator 20 · Denominator 21
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly.
Resident COVID-19 vaccinations up to date	Not Available	25.2%	Numerator Not Available · Denominator 16 · Too few residents or stays to report publicly.

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	2.9	2.1 0.8 pts worse	1.9 1 pts worse	Long Stay · 20240701-20250630 · Adjusted 2.9 · Observed 2.3 · Expected 1.5 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	3.1	2.1 1 pts worse	1.8 1.3 pts worse	Long Stay · 20240701-20250630 · Adjusted 3.1 · Observed 2.6 · Expected 1.4 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	98.7%	97.1% 1.6 pts better	93.4% 5.3 pts better	Long Stay · 2024Q4-2025Q3 · Q1 94.8% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 98.7%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	98.8%	97.9% 0.9 pts better	95.5% 3.3 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 98.8%
Percentage of long-stay residents experiencing one or more falls with major injury	3.2%	3.3% 0.1 pts better	3.3% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 3.8% · Q3 2.6% · Q4 3.8% · 4Q avg 3.2% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	2.7%	2.7% About the same	11.4% 8.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 5.3% · Q2 2.7% · Q3 1.4% · Q4 1.3% · 4Q avg 2.7%
Percentage of long-stay residents who lose too much weight	1.5%	3.3% 1.8 pts better	5.4% 3.9 pts better	Long Stay · 2024Q4-2025Q3 · Q1 1.5% · Q2 0.0% · Q3 0.0% · Q4 4.5% · 4Q avg 1.5%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	26.7%	18.9% 7.8 pts worse	19.6% 7.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 30.0% · Q2 26.8% · Q3 29.9% · Q4 20.3% · 4Q avg 26.7%
Percentage of long-stay residents who received an antipsychotic medication	18.2%	10.8% 7.4 pts worse	16.7% 1.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 15.8% · Q2 16.4% · Q3 22.8% · Q4 17.9% · 4Q avg 18.2% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.0% About the same	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	30.5%	15.4% 15.1 pts worse	16.3% 14.2 pts worse	Long Stay · 2024Q4-2025Q3 · Q2 45.6% · Q3 21.1% · Q4 30.7% · 4Q avg 30.5% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	21.2%	16.1% 5.1 pts worse	14.9% 6.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 21.0% · Q2 19.4% · Q3 11.1% · Q4 32.8% · 4Q avg 21.2% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	2.5%	0.5% 2 pts worse	1.0% 1.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 1.7% · Q2 3.4% · Q3 2.4% · Q4 2.6% · 4Q avg 2.5% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	1.0%	0.8% 0.2 pts worse	1.7% 0.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.5% · Q3 1.3% · Q4 0.0% · 4Q avg 1.0% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	29.1%	15.0% 14.1 pts worse	19.8% 9.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 41.1% · Q2 32.1% · Q3 18.6% · Q4 25.4% · 4Q avg 29.1%
Percentage of long-stay residents with pressure ulcers	3.4%	4.2% 0.8 pts better	5.1% 1.7 pts better	Long Stay · 2024Q4-2025Q3 · Q1 4.2% · Q2 5.7% · Q3 1.6% · Q4 1.9% · 4Q avg 3.4% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	81.2%	89.7% 8.5 pts worse	81.7% 0.5 pts worse	Short Stay · 2024Q4-2025Q3 · Q1 50.0% · Q2 79.2% · Q3 91.9% · Q4 98.8% · 4Q avg 81.2%
Percentage of short-stay residents who had an outpatient emergency department visit	11.0%	12.0% 1 pts better	12.0% 1 pts better	Short Stay · 20240701-20250630 · Adjusted 11.0% · Observed 11.5% · Expected 11.6% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	2.6%	1.5% 1.1 pts worse	1.6% 1 pts worse	Short Stay · 2024Q4-2025Q3 · Q1 2.3% · Q2 1.9% · Q3 4.3% · Q4 2.1% · 4Q avg 2.6% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	74.3%	88.0% 13.7 pts worse	79.7% 5.4 pts worse	Short Stay · 2024Q3-2025Q2 · 4Q avg 74.3%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	27.2%	25.9% 1.3 pts worse	23.9% 3.3 pts worse	Short Stay · 20240701-20250630 · Adjusted 27.2% · Observed 24.6% · Expected 21.5% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-03-21 · Fire 2025-03-21

10 health deficiencies

Top issue: Resident Assessment and Care Planning (3 deficiencies)

6 fire-safety deficiencies

Top issue: Miscellaneous (2 deficiencies)

Cycle 2 Health 2024-02-16 · Fire 2024-02-16

22 health deficiencies

Top issue: Resident Assessment and Care Planning (6 deficiencies)

6 fire-safety deficiencies

Top issue: Smoke (3 deficiencies)

Cycle 3 Health 2023-01-18 · Fire 2023-01-18

17 health deficiencies

Top issue: Administration (5 deficiencies)

5 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Fire safety

Fire-safety citations

L · Immediate jeopardy 2025-03-21

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have generator or other power source capable of supplying service within 10 seconds.

Corrected 2025-03-25

K · Immediate jeopardy 2025-03-21

E15 · Emergency Preparedness Deficiencies

Fire Safety

Address subsistence needs for staff and patients.

Corrected 2025-03-25

F · Potential for more than minimal harm 2025-03-21

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2025-03-25

E · Potential for more than minimal harm 2025-03-21

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2025-04-11

D · Potential for more than minimal harm 2025-03-21

K741 · Miscellaneous Deficiencies

Fire Safety

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

Corrected 2025-04-11

C · Minimal harm 2025-03-21

K521 · Services Deficiencies

Fire Safety

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Corrected 2025-03-25

E · Potential for more than minimal harm 2024-02-16

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2024-03-18

E · Potential for more than minimal harm 2024-02-16

K345 · Smoke Deficiencies

Fire Safety

Have approved installation, maintenance and testing program for fire alarm systems.

Corrected 2024-03-18

E · Potential for more than minimal harm 2024-02-16

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2024-03-18

E · Potential for more than minimal harm 2024-02-16

K741 · Miscellaneous Deficiencies

Fire Safety

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

Corrected 2024-03-18

E · Potential for more than minimal harm 2024-02-16

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2024-03-18

C · Minimal harm 2024-02-16

K521 · Services Deficiencies

Fire Safety

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Corrected 2024-03-18

F · Potential for more than minimal harm 2023-01-18

K211 · Egress Deficiencies

Fire Safety

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Corrected 2023-01-20

F · Potential for more than minimal harm 2023-01-18

K355 · Smoke Deficiencies

Fire Safety

Properly select, install, inspect, or maintain portable fire extinguishes.

Corrected 2023-01-20

F · Potential for more than minimal harm 2023-01-18

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have generator or other power source capable of supplying service within 10 seconds.

Corrected 2023-01-20

E · Potential for more than minimal harm 2023-01-18

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2023-01-20

C · Minimal harm 2023-01-18

K521 · Services Deficiencies

Fire Safety

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Corrected 2023-01-20

Inspection history

Recent health citations

D · Potential for more than minimal harm 2025-09-12

F802 · Nutrition and Dietary Deficiencies

Health

Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.

Corrected 2025-09-27

E · Potential for more than minimal harm 2025-03-21

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-04-12

D · Potential for more than minimal harm 2025-03-21

F578 · Resident Rights Deficiencies

Health

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.

Corrected 2025-04-01

D · Potential for more than minimal harm 2025-03-21

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2025-04-12

D · Potential for more than minimal harm 2025-03-21

F655 · Resident Assessment and Care Planning Deficiencies

Health

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Corrected 2025-04-12

D · Potential for more than minimal harm 2025-03-21

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2025-04-12

D · Potential for more than minimal harm 2025-03-21

F695 · Quality of Life and Care Deficiencies

Health

Provide safe and appropriate respiratory care for a resident when needed.

Corrected 2025-04-12

D · Potential for more than minimal harm 2025-03-21

F761 · Pharmacy Service Deficiencies

Health

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.

Corrected 2025-04-12

D · Potential for more than minimal harm 2025-03-21

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2025-04-12

B · Minimal harm 2025-03-21

F921 · Environmental Deficiencies

Health

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

Corrected 2025-04-12

J · Immediate jeopardy 2025-01-31

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2025-01-13

E · Potential for more than minimal harm 2025-01-31

F727 · Nursing and Physician Services Deficiencies

Health

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.

Corrected 2025-02-28

D · Potential for more than minimal harm 2025-01-31

F558 · Resident Rights Deficiencies

Health

Reasonably accommodate the needs and preferences of each resident.

Corrected 2025-02-28

D · Potential for more than minimal harm 2025-01-31

F583 · Resident Rights Deficiencies

Health

Keep residents' personal and medical records private and confidential.

Corrected 2025-02-28

D · Potential for more than minimal harm 2025-01-31

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2025-02-28

E · Potential for more than minimal harm 2024-08-08

F693 · Quality of Life and Care Deficiencies

Health

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.

Corrected 2024-09-06

D · Potential for more than minimal harm 2024-08-08

F583 · Resident Rights Deficiencies

Health

Keep residents' personal and medical records private and confidential.

Corrected 2024-09-06

D · Potential for more than minimal harm 2024-08-08

F761 · Pharmacy Service Deficiencies

Health

Corrected 2024-09-06

J · Immediate jeopardy 2024-05-15

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2024-06-07

D · Potential for more than minimal harm 2024-05-15

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2024-06-07

E · Potential for more than minimal harm 2024-02-16

F842 · Resident Assessment and Care Planning Deficiencies

Health

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Corrected 2024-03-18