Federal inspection record · CMS data as of October 1, 2026
Medina Valley Health & Rehabilitation Center
913 Hwy 90 W, Castroville, TX · (830) 931-2900
- Certified beds
- 116
- Residents per day
- 85
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- June 20, 2003
1
How this home got 3 stars
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.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Texas.
-
Staffing
★★★★★−1 star
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
★★★★★3 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Medina Valley Health & Rehabilitation Center carries 45 inspection points. That is fewer than 72% 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
36 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.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Resident Assessment and Care Planning9E
- E
Ensure each resident receives an accurate assessment.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- B
Assure that each resident’s assessment is updated at least once every 3 months.
- D
Ensure each resident receives an accurate assessment.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
PASARR screening for Mental disorders or Intellectual Disabilities
- 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.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Quality of Life and Care6D
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- 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
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 appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Pharmacy Service5D
- 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.
- D
Ensure medication error rates are not 5 percent or greater.
- D
Ensure that residents are free from significant medication errors.
Nutrition and Dietary4E
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- B
Dispose of garbage and refuse properly.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Dispose of garbage and refuse properly.
Infection Control3E
- 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.
Freedom from Abuse, Neglect, and Exploitation3E
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- E
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Nursing and Physician Services2D
- D
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.
- D
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.
Environmental2D
- D
Keep all essential equipment working safely.
- D
Keep all essential equipment working safely.
Resident Rights1D
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Administration1D
- D
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.
Inspection history
2026-02-27
7 health deficiencies · 4 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2024-11-15
18 health deficiencies · 12 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (5 deficiencies)
2023-09-22
11 health deficiencies · 2 fire-safety deficiencies
Top issue: Pharmacy Service (3 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h of nursing staff time a day, 28 min of it from a registered nurse.
This home
3 h
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 43% of nursing staff and 56% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.3 pts worse | 2.3 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.3 pts worse | 2.3 | 2.0 | 1.7 |
| 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 injury0.3 pts better | 2.9% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms2 pts better | 0.3% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight0.9 pts better | 2.0% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication8.1 pts better | 9.7% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication5.7 pts better | 4.1% | 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 worsened0.7 pts better | 12.2% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased5.5 pts better | 10.3% | 15.8% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.3 pts better | 0.0% | 0.3% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.2 pts worse | 1.0% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.2 pts worse | 12.7% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2.2 pts better | 1.5% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine7.2 pts better | 95.9% | 88.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit3 pts better | 9.2% | 12.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.4 pts better | 1.0% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine4.7 pts better | 90.1% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission5.4 pts worse | 30.9% | 25.5% | 23.4% |
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Who owns and runs it
18 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 |
|---|---|---|---|
| Medina County Hospital District | 5% Or Greater Direct Ownership Interest · Organization | 100% | 6 facilities |
| Bauder Family Investments, LLC | Adp Of The SNF · Organization | 0% | 25 facilities |
| Bauder, Kelly | Adp Of The SNF · Individual | 0% | 28 facilities |
| Bauder, Madison | Adp Of The SNF · Individual | 0% | 28 facilities |
| Bauder, Parker | Adp Of The SNF · Individual | 0% | 28 facilities |
| Bauder, William | Operational/Managerial Control · Individual | 0% | 42 facilities |
| Bauder, William | Adp Of The SNF · Individual | 0% | 42 facilities |
| Bell, Billie | Corporate Officer · Individual | 0% | 7 facilities |
| Boulware St James LLC | Adp Of The SNF · Organization | 0% | 25 facilities |
| Boulware, Douglas | Individual Is An Owner, Partner Or Trustee Of Any Adp Of The SNF · Individual | 0% | 46 facilities |
| Boulware, Steven | Adp Of The SNF · Individual | 0% | 48 facilities |
| Boulware, Thomas | Adp Of The SNF · Individual | 0% | 30 facilities |
| Gregory, Patrice | Adp Of The SNF · Individual | 0% | 1 facilities |
| Jaafar, Saleh | Adp Of The SNF · Individual | 0% | 2 facilities |
| Pmg Opco - Castroville LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Pmg Realco - Castroville LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Steven Boulware Family Investments LLC | Adp Of The SNF · Organization | 0% | 19 facilities |
| Walker, Katie | Adp Of The SNF · Individual | 0% | 30 facilities |
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Fire safety
18 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke9F
- E
Install an approved automatic sprinkler system.
- E
Properly select, install, inspect, or maintain portable fire extinguishes.
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Properly select, install, inspect, or maintain portable fire extinguishes.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Have approved installation, maintenance and testing program for fire alarm systems.
- C
Install an approved automatic sprinkler system.
- D
Install an approved automatic sprinkler system.
- D
Inspect, test, and maintain automatic sprinkler systems.
Egress5E
- E
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
Install proper backup exit lighting.
- D
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- D
Have properly located and lighted "Exit" signs.
Gas, Vacuum, and Electrical Systems2E
- D
Ensure proper usage of power strips and extension cords.
- E
Have proper medical gas storage and administration areas.
Miscellaneous1E
- E
Have simulated fire drills held at unexpected times.
Services1D
- D
Have properly installed electrical wiring and gas equipment.
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Other homes nearby
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Westover Hills Rehabilitation And Healthcare
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★★★★★- Worst citation, 3 yrs
- J
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-
Legend Oaks Healthcare and Rehabilitation - West S
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- Nursing / resident / day
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-
The Mission At Blue Skies Of Texas East
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