Federal inspection record · CMS data as of October 1, 2026
The Heights at Medical Center
3935 Medical Drive, San Antonio, TX · (210) 614-4888
- Certified beds
- 134
- Residents per day
- 84
- Ownership
- For-Profit
- Chain
- Touchstone Communities
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- October 4, 2001
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
★★★★★−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
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
The Heights at Medical Center carries 99 inspection points. That is fewer than 36% 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
44 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 (3)
-
J
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
-
J
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.
Everything else, by area of care
Resident Rights11E
- D
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
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
- E
Reasonably accommodate the needs and preferences of each resident.
- 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
Keep residents' personal and medical records private and confidential.
- D
Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.
- D
Let each resident or the resident's legal representative access or purchase copies of all the resident's records.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- 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
Keep residents' personal and medical records private and confidential.
Quality of Life and Care9D
- 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
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 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 safe and appropriate respiratory care for a resident when needed.
- D
Provide or obtain dental services for each resident.
- 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.
Resident Assessment and Care Planning8D
- D
Ensure each resident receives an accurate assessment.
- B
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
- 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
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure each resident receives an accurate assessment.
- 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.
Nutrition and Dietary4F
- D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control4D
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Pharmacy Service3D
- 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 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.
Nursing and Physician Services1D
- 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.
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
2025-08-15
7 health deficiencies · 6 fire-safety deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
2024-07-18
15 health deficiencies · 11 fire-safety deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
2023-05-05
22 health deficiencies · 2 fire-safety deficiencies
Top issue: Resident Rights (7 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 8 min of nursing staff time a day, 17 min of it from a registered nurse.
This home
3 h 8 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 51% of nursing staff and 63% 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
Fines and payment denials
$22,052 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2024-05-28 | Fine | $8,171 |
| 2024-05-28 | Fine | $13,881 |
| 2024-05-28 | Payment Denial · 57 day denial | $0 |
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. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.3 pts better | 1.7 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.3 pts better | 1.7 | 2.0 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine2.1 pts better | 98.5% | 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 injury0.4 pts worse | 3.6% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms2.3 pts better | 0.0% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.6 pts better | 1.3% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication0.1 pts worse | 17.9% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication8.7 pts better | 1.1% | 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 worsened6.6 pts better | 6.3% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased9.3 pts better | 6.5% | 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 infection0.8 pts better | 0.0% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence6.3 pts better | 6.2% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.8 pts better | 2.9% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine8.2 pts better | 96.9% | 88.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit6.7 pts worse | 18.9% | 12.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.4 pts better | 0.0% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine10.7 pts better | 96.1% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission8.7 pts worse | 34.2% | 25.5% | 23.4% |
·
Who owns and runs it
7 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 |
|---|---|---|---|
| Apolinar, Adam | Corporate Director · Individual | 0% | 38 facilities |
| Oommen, Biju | Operational/Managerial Control · Individual | 0% | 7 facilities |
| Oommen, Biju | Adp Of The SNF · Individual | 0% | 7 facilities |
| Robinson, Larry | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Robinson, Larry | Adp Of The SNF · Individual | 0% | 1 facilities |
| Touchstone Strategies - Med Center LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Touchstone Strategies - Med Center LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
·
Fire safety
19 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke7F
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- F
Provide properly protected cooking facilities.
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Install corridor and hallway doors that block smoke.
- E
Inspect, test, and maintain automatic sprinkler systems.
Emergency Preparedness4F
- F
Conduct testing and exercise requirements.
- F
Establish policies and procedures for volunteers.
- F
Provide primary/alternate means for communication.
- F
Address patient/client population and determine types of services needed.
Egress3F
- F
Have properly located and lighted "Exit" signs.
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
- E
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Gas, Vacuum, and Electrical Systems3F
- F
Have generator or other power source capable of supplying service within 10 seconds.
- F
Have generator or other power source capable of supplying service within 10 seconds.
- E
Ensure precautions for handling oxygen cylinders and equipment are correctly followed.
Services1F
- F
Have properly installed electrical wiring and gas equipment.
Miscellaneous1F
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
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-
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