Federal inspection record · CMS data as of October 1, 2026
The Heights Of Bulverde
384 Harmony Hills, Spring Branch, TX · (830) 438-1276
- Certified beds
- 124
- Residents per day
- 100
- Ownership
- Government
- Chain
- Touchstone Communities
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- March 15, 2017
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 Of Bulverde carries 104.75 inspection points. That is fewer than 33% 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
47 health citations on record since 2024. 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 (1)
-
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 Assessment and Care Planning12E
- D
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.
- 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.
- 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.
- E
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 and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
Pharmacy Service10E
- E
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E
Ensure medication error rates are not 5 percent or greater.
- 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.
- E
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 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
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- E
Ensure medication error rates are not 5 percent or greater.
- E
Ensure that residents are free from significant medication errors.
- 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.
Quality of Life and Care5E
- 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.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- 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.
Nutrition and Dietary5F
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Dispose of garbage and refuse properly.
- D
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
- D
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
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.
Freedom from Abuse, Neglect, and Exploitation4D
- D
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Resident Rights4E
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- 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.
- E
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- 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.
Environmental1E
- E
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Administration1D
- D
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
Inspection history
2026-08-14
12 health deficiencies · 6 fire-safety deficiencies
Top issue: Pharmacy Service (4 deficiencies)
2025-06-25
16 health deficiencies · 1 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (6 deficiencies)
2024-05-05
19 health deficiencies · 4 fire-safety deficiencies
Top issue: Nutrition and Dietary (4 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 13 min of nursing staff time a day, 28 min of it from a registered nurse.
This home
3 h 13 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 64% of nursing staff and 50% 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 days0.2 pts better | 1.8 | 2.0 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.5 pts worse | 2.5 | 2.0 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine20.3 pts worse | 76.1% | 96.4% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine5.7 pts worse | 91.3% | 97.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2.6 pts worse | 5.8% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms2.9 pts worse | 5.2% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight2.5 pts better | 0.4% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication3.8 pts better | 14.0% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication3.1 pts better | 6.7% | 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 worsened8.4 pts better | 4.5% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased1.5 pts better | 14.3% | 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 infection0.8 pts better | 0.0% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence1.1 pts better | 11.4% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.9 pts better | 1.8% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine21 pts worse | 67.7% | 88.7% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit11.6 pts worse | 23.8% | 12.2% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.2 pts worse | 1.6% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine10.4 pts worse | 75.0% | 85.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission14.3 pts worse | 39.8% | 25.5% | 23.4% |
·
Who owns and runs it
31 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 |
|---|---|---|---|
| Aegis Therapies, Inc. | Adp Of The SNF · Organization | 0% | 35 facilities |
| Alamo Advisors LP | Adp Of The SNF · Organization | 0% | 8 facilities |
| Apolinar, Adam | Corporate Officer · Individual | 0% | 38 facilities |
| Campbell, Leslie | Operational/Managerial Control · Individual | 0% | 22 facilities |
| Campbell, Leslie | Adp Of The SNF · Individual | 0% | 22 facilities |
| Carvajal Pharmacy Ltc | Adp Of The SNF · Organization | 0% | 22 facilities |
| Castillo, Lynnea | Operational/Managerial Control · Individual | 0% | 23 facilities |
| Castillo, Lynnea | Adp Of The SNF · Individual | 0% | 23 facilities |
| Clayton, Jonathon | Operational/Managerial Control · Individual | 0% | 6 facilities |
| Clayton, Jonathon | Adp Of The SNF · Individual | 0% | 6 facilities |
| Dentino, Andrew | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Dentino, Andrew | Adp Of The SNF · Individual | 0% | 1 facilities |
| Fellbaum, Ernest | Adp Of The SNF · Individual | 0% | 27 facilities |
| Frost Bank | 5% Or Greater Security Interest · Organization | 0% | 4 facilities |
| Hackett, Edward | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Hackett, Edward | Adp Of The SNF · Individual | 0% | 1 facilities |
| Nutritious Lifestyles, Inc. | Adp Of The SNF · Organization | 0% | 19 facilities |
| Plante & Moran Pllc | Adp Of The SNF · Organization | 0% | 65 facilities |
| Prado, Aaron | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Prado, Aaron | Adp Of The SNF · Individual | 0% | 1 facilities |
| Sehlke, Bryon | Operational/Managerial Control · Individual | 0% | 22 facilities |
| Sehlke, Bryon | Adp Of The SNF · Individual | 0% | 22 facilities |
| Studer, Stanley | Adp Of The SNF · Individual | 0% | 26 facilities |
| The Bryon And Rena Sehlke Living Trust | Adp Of The SNF · Organization | 0% | 12 facilities |
| Touchstone Communities Inc | Adp Of The SNF · Organization | 0% | 23 facilities |
| Touchstone Realty - Bulverde LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Touchstone Strategies - Bulverde LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Touchstone Strategies - Bulverde LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Trident Health Services Inc | Adp Of The SNF · Organization | 0% | 22 facilities |
| Zurovec, Darrell | Operational/Managerial Control · Individual | 0% | 23 facilities |
| Zurovec, Darrell | Adp Of The SNF · Individual | 0% | 23 facilities |
·
Fire safety
11 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke4E
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Inspect, test, and maintain automatic sprinkler systems.
Gas, Vacuum, and Electrical Systems3E
- E
Have generator or other power source capable of supplying service within 10 seconds.
- E
Ensure proper usage of power strips and extension cords.
- E
Have proper medical gas storage and administration areas.
Egress2E
- E
Meet other general requirements.
- E
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Miscellaneous2E
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- E
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
·
Other homes nearby
-
Coronado At Stone Oak
San Antonio, TX · Cantex Continuing Care
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 40 min
- Fines
- $0
-
The Enclave
San Antonio, TX · Touchstone Communities
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 31 min
- Fines
- $10,039
-
Stone Oak Care Center
San Antonio, TX · Touchstone Communities
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 2 h 55 min
- Fines
- $9,087