Castroville, TX

Medina Valley Health & Rehabilitation Center

3-star overall rating with 3-star inspections with 15 recent health deficiencies with 12 fire-safety deficiencies in the latest cycle

913 Hwy 90 W, Castroville, TX

(830) 931-2900

Compare this facility

Overall

3 / 5

CMS overall stars

Health inspections

3 / 5

Survey and complaint cycles

Staffing

2 / 5

RN + nurse staffing

Quality measures

3 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

116

Certified beds

Average residents

85

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

No chain reported

Operator or chain grouping

Approved since

2003-06-20

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Changed ownership

No

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

0.34

Registered nurse staffing · state 0.44 · national 0.68

LPN hours / resident day

0.94

Licensed practical nurse staffing · state 0.95 · national 0.87

Aide hours / resident day

1.98

Nurse aide staffing · state 2.01 · national 2.35

Total nurse hours

3.26

All reported nurse hours · state 3.40 · national 3.89

Licensed hours

1.28

RN + LPN hours · state 1.38 · national 1.54

Weekend hours

2.62

Weekend nurse staffing · state 2.99 · national 3.43

Weekend RN hours

0.29

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

0.35

CMS adjusted RN staffing hours

Adjusted total hours

3.32

CMS adjusted total nurse staffing hours

Case-mix index

1.34

Higher values indicate more complex resident acuity

RN turnover

33%

Annual RN turnover · state 52% · national 45%

Total nurse turnover

33%

Annual nurse turnover · state 52% · national 46%

SNF VBP

Value-based purchasing

Program rank

12,388

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

Performance score

12.53

Composite VBP score used to determine payment impact.

Payment multiplier

0.9811

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

0

Baseline 21.64% · Performance 24.60% · Measure score 0 · Achievement 0 · Improvement 0

Healthcare-associated infections

0

Baseline 5.38% · Performance 8.34% · Measure score 0 · Achievement 0 · Improvement 0

Total nurse turnover

4.38

Baseline 43.08% · Performance 45.78% · Measure score 4.38 · Achievement 4.38 · Improvement 0

Adjusted total nurse staffing

0.63

Baseline 3.26 hours · Performance 3.26 hours · Measure score 0.63 · Achievement 0.63 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure Facility National Note
Potentially preventable 30-day readmission 9.52%
10.72%
1.2 pts better
No Different than the National Rate · Eligible stays 87 · Observed rate 6.9% · Lower 95% interval 6.47%
Discharge to community 44.87%
50.57%
5.7 pts worse
No Different than the National Rate · Eligible stays 61 · Observed rate 39.34% · Lower 95% interval 35.02%
Medicare spending per beneficiary 0.93
1.02
0.1 pts better
Drug regimen review with follow-up 96.77%
95.27%
1.5 pts better
Numerator 90 · Denominator 93
Falls with major injury 2.17%
0.77%
1.4 pts worse
Numerator 2 · Denominator 92
Discharge self-care score 63.83%
53.69%
10.1 pts better
Numerator 30 · Denominator 47
Discharge mobility score 78.72%
50.94%
27.8 pts better
Numerator 37 · Denominator 47
Pressure ulcers or injuries, new or worsened 5.43%
2.29%
3.1 pts worse
Numerator 5 · Denominator 92 · Adjusted rate 4.05%
Healthcare-associated infections requiring hospitalization 8.34%
7.12%
1.2 pts worse
No Different than the National Rate · Eligible stays 63 · Observed rate 12.7% · Lower 95% interval 5.25%
Staff COVID-19 vaccination coverage 0%
8.2%
8.2 pts worse
Numerator 0 · Denominator 129
Staff flu vaccination coverage 50%
42%
8 pts better
Numerator 66 · Denominator 132
Discharge function score 76.6%
56.45%
20.1 pts better
Numerator 36 · Denominator 47
Transfer of health information to provider 100%
95.95%
4 pts better
Numerator 39 · Denominator 39
Transfer of health information to patient 100%
96.28%
3.7 pts better
Numerator 20 · Denominator 20
Resident COVID-19 vaccinations up to date 11.63%
25.2%
13.6 pts worse
Numerator 5 · Denominator 43

Quality measures

Resident outcomes and process scores

Measure Facility State National Note
Number of hospitalizations per 1000 long-stay resident days 2.5
2.1
0.4 pts worse
1.9
0.6 pts worse
Long Stay · 20240701-20250630 · Adjusted 2.5 · Observed 3.4 · Expected 2.5 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days 2.0
2.1
0.1 pts better
1.8
0.2 pts worse
Long Stay · 20240701-20250630 · Adjusted 2.0 · Observed 2.3 · Expected 2.0 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
97.1%
2.9 pts better
93.4%
6.6 pts better
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
97.9%
2.1 pts better
95.5%
4.5 pts better
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0%
Percentage of long-stay residents experiencing one or more falls with major injury 2.8%
3.3%
0.5 pts better
3.3%
0.5 pts better
Long Stay · 2024Q4-2025Q3 · Q1 1.2% · Q2 2.4% · Q3 3.8% · Q4 3.9% · 4Q avg 2.8% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms 0.7%
2.7%
2 pts better
11.4%
10.7 pts better
Long Stay · 2024Q4-2025Q3 · Q1 1.3% · Q2 1.3% · Q3 0.0% · Q4 0.0% · 4Q avg 0.7%
Percentage of long-stay residents who lose too much weight 4.2%
3.3%
0.9 pts worse
5.4%
1.2 pts better
Long Stay · 2024Q4-2025Q3 · Q1 7.5% · Q2 4.8% · Q3 2.9% · Q4 1.5% · 4Q avg 4.2%
Percentage of long-stay residents who received an antianxiety or hypnotic medication 19.6%
18.9%
0.7 pts worse
19.6%
About the same
Long Stay · 2024Q4-2025Q3 · Q1 20.8% · Q2 28.6% · Q3 22.2% · Q4 6.0% · 4Q avg 19.6%
Percentage of long-stay residents who received an antipsychotic medication 2.9%
10.8%
7.9 pts better
16.7%
13.8 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 4.3% · Q3 3.4% · Q4 4.2% · 4Q avg 2.9% · 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 21.2%
15.4%
5.8 pts worse
16.3%
4.9 pts worse
Long Stay · 2024Q4-2025Q3 · 4Q avg 21.2% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased 13.0%
16.1%
3.1 pts better
14.9%
1.9 pts better
Long Stay · 2024Q4-2025Q3 · Q1 14.3% · Q2 20.3% · Q3 10.2% · Q4 7.0% · 4Q avg 13.0% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder 0.0%
0.5%
0.5 pts better
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% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection 5.6%
0.8%
4.8 pts worse
1.7%
3.9 pts worse
Long Stay · 2024Q4-2025Q3 · Q1 16.5% · Q2 1.3% · Q3 2.6% · Q4 1.3% · 4Q avg 5.6% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence 22.7%
15.0%
7.7 pts worse
19.8%
2.9 pts worse
Long Stay · 2024Q4-2025Q3 · Q1 36.1% · Q2 16.7% · Q3 21.1% · Q4 16.0% · 4Q avg 22.7%
Percentage of long-stay residents with pressure ulcers 3.0%
4.2%
1.2 pts better
5.1%
2.1 pts better
Long Stay · 2024Q4-2025Q3 · Q1 2.8% · Q2 5.0% · Q3 2.8% · Q4 1.5% · 4Q avg 3.0% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine 92.0%
89.7%
2.3 pts better
81.7%
10.3 pts better
Short Stay · 2024Q4-2025Q3 · Q1 87.5% · Q2 89.2% · Q3 92.7% · Q4 97.9% · 4Q avg 92.0%
Percentage of short-stay residents who had an outpatient emergency department visit 18.5%
12.0%
6.5 pts worse
12.0%
6.5 pts worse
Short Stay · 20240701-20250630 · Adjusted 18.5% · Observed 21.6% · Expected 13.0% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication 0.8%
1.5%
0.7 pts better
1.6%
0.8 pts better
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 1.5% · Q4 1.8% · 4Q avg 0.8% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine 83.9%
88.0%
4.1 pts worse
79.7%
4.2 pts better
Short Stay · 2024Q3-2025Q2 · 4Q avg 83.9%
Percentage of short-stay residents who were rehospitalized after a nursing home admission 23.4%
25.9%
2.5 pts better
23.9%
0.5 pts better
Short Stay · 20240701-20250630 · Adjusted 23.4% · Observed 25.7% · Expected 26.1% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2024-11-15 · Fire 2024-11-15

15 health deficiencies

Top issue: Resident Assessment and Care Planning (5 deficiencies)

12 fire-safety deficiencies

Top issue: Smoke (5 deficiencies)

Cycle 2 Health 2023-09-22 · Fire 2023-09-22

13 health deficiencies

Top issue: Freedom from Abuse and Neglect and Exploitation (3 deficiencies)

2 fire-safety deficiencies

Top issue: Smoke (2 deficiencies)

Cycle 3 Health 2022-07-29 · Fire 2022-07-29

7 health deficiencies

Top issue: Quality of Life and Care (3 deficiencies)

4 fire-safety deficiencies

Top issue: Gas and Vacuum and Electrical Systems (3 deficiencies)

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2024-11-15

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2024-12-18

E · Potential for more than minimal harm 2024-11-15

K211 · Egress Deficiencies

Fire Safety

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

Corrected 2024-12-18

E · Potential for more than minimal harm 2024-11-15

K281 · Egress Deficiencies

Fire Safety

Install proper backup exit lighting.

Corrected 2024-12-18

E · Potential for more than minimal harm 2024-11-15

K355 · Smoke Deficiencies

Fire Safety

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

Corrected 2024-12-18

E · Potential for more than minimal harm 2024-11-15

K372 · Smoke Deficiencies

Fire Safety

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Corrected 2024-12-18

E · Potential for more than minimal harm 2024-11-15

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2024-12-18

E · Potential for more than minimal harm 2024-11-15

K923 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have proper medical gas storage and administration areas.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

K222 · Egress Deficiencies

Fire Safety

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.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

K293 · Egress Deficiencies

Fire Safety

Have properly located and lighted "Exit" signs.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

K345 · Smoke Deficiencies

Fire Safety

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

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

K511 · Services Deficiencies

Fire Safety

Have properly installed electrical wiring and gas equipment.

Corrected 2024-12-18

C · Minimal harm 2024-11-15

K351 · Smoke Deficiencies

Fire Safety

Install an approved automatic sprinkler system.

Corrected 2024-12-18

D · Potential for more than minimal harm 2023-09-22

K351 · Smoke Deficiencies

Fire Safety

Install an approved automatic sprinkler system.

Corrected 2023-10-25

D · Potential for more than minimal harm 2023-09-22

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2023-10-25

F · Potential for more than minimal harm 2022-07-29

K916 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have a battery powered remote alarm panel in a location accessible by operating personnel.

Corrected 2022-08-31

E · Potential for more than minimal harm 2022-07-29

K929 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure precautions for handling oxygen cylinders and equipment are correctly followed.

Corrected 2022-08-31

D · Potential for more than minimal harm 2022-07-29

K511 · Services Deficiencies

Fire Safety

Have properly installed electrical wiring and gas equipment.

Corrected 2022-08-31

D · Potential for more than minimal harm 2022-07-29

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2022-08-31

Inspection history

Recent health citations

E · Potential for more than minimal harm 2024-11-15

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 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F580 · Resident Rights Deficiencies

Health

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F644 · Resident Assessment and Care Planning Deficiencies

Health

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F645 · Resident Assessment and Care Planning Deficiencies

Health

PASARR screening for Mental disorders or Intellectual Disabilities

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F657 · Resident Assessment and Care Planning Deficiencies

Health

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F677 · Quality of Life and Care Deficiencies

Health

Provide care and assistance to perform activities of daily living for any resident who is unable.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F690 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F755 · Pharmacy Service Deficiencies

Health

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

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 2024-12-18

D · Potential for more than minimal harm 2024-11-15

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 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F849 · Administration Deficiencies

Health

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.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-11-15

F908 · Environmental Deficiencies

Health

Keep all essential equipment working safely.

Corrected 2024-12-17

B · Minimal harm 2024-11-15

F814 · Nutrition and Dietary Deficiencies

Health

Dispose of garbage and refuse properly.

Corrected 2024-12-18

D · Potential for more than minimal harm 2024-10-30

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 2024-11-14

D · Potential for more than minimal harm 2024-10-30

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 2023-12-11

D · Potential for more than minimal harm 2024-10-30

F690 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Corrected 2024-11-14

D · Potential for more than minimal harm 2024-09-21

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 2024-10-01

D · Potential for more than minimal harm 2024-07-26

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 2024-09-02

D · Potential for more than minimal harm 2023-11-15

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 2023-12-11

E · Potential for more than minimal harm 2023-09-22

F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.

Corrected 2023-10-25

E · Potential for more than minimal harm 2023-09-22

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 2023-10-25

E · Potential for more than minimal harm 2023-09-22

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2023-10-25

D · Potential for more than minimal harm 2023-09-22

F690 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Corrected 2023-10-25

D · Potential for more than minimal harm 2023-09-22

F726 · Nursing and Physician Services Deficiencies

Health

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.

Corrected 2023-10-25

D · Potential for more than minimal harm 2023-09-22

F759 · Pharmacy Service Deficiencies

Health

Ensure medication error rates are not 5 percent or greater.

Corrected 2023-10-25

D · Potential for more than minimal harm 2023-09-22

F760 · Pharmacy Service Deficiencies

Health

Ensure that residents are free from significant medication errors.

Corrected 2023-10-25

D · Potential for more than minimal harm 2023-09-22

F814 · Nutrition and Dietary Deficiencies

Health

Dispose of garbage and refuse properly.

Corrected 2023-10-25

F · Potential for more than minimal harm 2022-07-29

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 2022-08-31

E · Potential for more than minimal harm 2022-07-29

F755 · Pharmacy Service Deficiencies

Health

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Corrected 2022-08-31

D · Potential for more than minimal harm 2022-07-29

F686 · Quality of Life and Care Deficiencies

Health

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2022-08-31

D · Potential for more than minimal harm 2022-07-29

F690 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Corrected 2022-08-31

D · Potential for more than minimal harm 2022-07-29

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 2022-08-31

D · Potential for more than minimal harm 2022-07-29

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2022-08-31

Penalties and ownership

What sits behind the stars

Ownership

Medina County Hospital District

5% Or Greater Direct Ownership Interest · Organization

100% 5 facilities 2014-08-01
Bell, Billie

Corporate Officer · Individual

0% 6 facilities 2023-06-03
Cascade Health Services, LLC

Operational/Managerial Control · Organization

0% 1 facilities 2014-08-01
Cascade Medina Health Services, Ltd

Operational/Managerial Control · Organization

0% 1 facilities 2014-08-01
Haney, Ronald

Operational/Managerial Control · Individual

0% 2 facilities 2014-08-01

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Staffing
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Fines
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#2

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5-star overall rating with 4-star inspections with $8,632 in total fines with 3 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle

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Fines
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#3

The Mission At Blue Skies Of Texas East

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3-star overall rating with 3-star inspections with $17,345 in total fines with 10 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle

Overall
3 / 5
Health
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Staffing
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Fines
$17,345

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