Cycle 1
Health 2025-07-11 · Fire 2025-07-11
10 health deficiencies
Top issue: Resident Assessment and Care Planning (4 deficiencies)
3 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
San Antonio, TX
The Mission At Blue Skies Of Texas East
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
4949 Ravenswood Dr, San Antonio, TX
(210) 568-5100
Overall
3 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
80
Certified beds
Average residents
47
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
2005-01-05
CMS approved date
Coverage
Medicare
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
0.89
Registered nurse staffing · state 0.44 · national 0.68
LPN hours / resident day
1.34
Licensed practical nurse staffing · state 0.95 · national 0.87
Aide hours / resident day
3.06
Nurse aide staffing · state 2.01 · national 2.35
Total nurse hours
5.29
All reported nurse hours · state 3.40 · national 3.89
Licensed hours
2.23
RN + LPN hours · state 1.38 · national 1.54
Weekend hours
4.33
Weekend nurse staffing · state 2.99 · national 3.43
Weekend RN hours
0.65
Weekend registered nurse coverage · state 0.34 · national 0.47
Physical therapist
0.11
Reported PT staffing · state 0.07 · national 0.07
Adjusted RN hours
0.99
CMS adjusted RN staffing hours
Adjusted total hours
5.89
CMS adjusted total nurse staffing hours
Case-mix index
1.23
Higher values indicate more complex resident acuity
RN turnover
77%
Annual RN turnover · state 52% · national 45%
Total nurse turnover
63%
Annual nurse turnover · state 52% · national 46%
SNF VBP
Value-based purchasing
Program rank
2,215
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
50.95
Composite VBP score used to determine payment impact.
Payment multiplier
1.0052
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.03
Baseline 22.80% · Performance 20.76% · Measure score 3.03 · Achievement 1.44 · Improvement 3.03
Healthcare-associated infections
2.09
Baseline 9.05% · Performance 8.00% · Measure score 2.09 · Achievement 0 · Improvement 2.09
Total nurse turnover
5.25
Baseline 64.55% · Performance 42.22% · Measure score 5.25 · Achievement 5.25 · Improvement 5.12
Adjusted total nurse staffing
10
Baseline 8.12 hours · Performance 7.63 hours · Measure score 10 · Achievement 10 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 8.53% |
10.72%
2.2 pts better
|
No Different than the National Rate · Eligible stays 191 · Observed rate 5.24% · Lower 95% interval 6.43% |
| Discharge to community | 64.98% |
50.57%
14.4 pts better
|
Better than the National Rate · Eligible stays 161 · Observed rate 59.63% · Lower 95% interval 56.43% |
| Medicare spending per beneficiary | 1.03 |
1.02
About the same
|
|
| Drug regimen review with follow-up | 99.28% |
95.27%
4 pts better
|
Numerator 138 · Denominator 139 |
| Falls with major injury | 0.72% |
0.77%
0.1 pts better
|
Numerator 1 · Denominator 139 |
| Discharge self-care score | 44.86% |
53.69%
8.8 pts worse
|
Numerator 48 · Denominator 107 |
| Discharge mobility score | 55.14% |
50.94%
4.2 pts better
|
Numerator 59 · Denominator 107 |
| Pressure ulcers or injuries, new or worsened | 0.72% |
2.29%
1.6 pts better
|
Numerator 1 · Denominator 139 · Adjusted rate 0.78% |
| Healthcare-associated infections requiring hospitalization | 8% |
7.12%
0.9 pts worse
|
No Different than the National Rate · Eligible stays 110 · Observed rate 8.18% · Lower 95% interval 4.55% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 177 |
| Staff flu vaccination coverage | 92.66% |
42%
50.7 pts better
|
Numerator 164 · Denominator 177 |
| Discharge function score | 67.29% |
56.45%
10.8 pts better
|
Numerator 72 · Denominator 107 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 38 · Denominator 38 |
| Transfer of health information to patient | 98.67% |
96.28%
2.4 pts better
|
Numerator 74 · Denominator 75 |
| Resident COVID-19 vaccinations up to date | 46.97% |
25.2%
21.8 pts better
|
Numerator 31 · Denominator 66 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.4 |
2.1
0.3 pts worse
|
1.9
0.5 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.4 · Observed 1.9 · Expected 1.5 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.1 |
2.1
1 pts better
|
1.8
0.7 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.1 · Observed 0.9 · Expected 1.3 · 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 | 6.0% |
3.3%
2.7 pts worse
|
3.3%
2.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 10.3% · Q2 7.9% · Q3 2.6% · Q4 2.9% · 4Q avg 6.0% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 2.2% |
2.7%
0.5 pts better
|
11.4%
9.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.8% · Q3 0.0% · Q4 7.1% · 4Q avg 2.2% |
| Percentage of long-stay residents who lose too much weight | 9.7% |
3.3%
6.4 pts worse
|
5.4%
4.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 10.0% · Q2 3.7% · Q3 17.9% · Q4 7.1% · 4Q avg 9.7% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 28.9% |
18.9%
10 pts worse
|
19.6%
9.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 38.7% · Q2 26.7% · Q3 30.0% · Q4 20.0% · 4Q avg 28.9% |
| Percentage of long-stay residents who received an antipsychotic medication | 0.0% |
10.8%
10.8 pts better
|
16.7%
16.7 pts better
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 0.0% · 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 | 12.1% |
15.4%
3.3 pts better
|
16.3%
4.2 pts better
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 12.1% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 15.8% |
16.1%
0.3 pts better
|
14.9%
0.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 22.6% · Q2 16.7% · Q3 16.7% · Q4 6.9% · 4Q avg 15.8% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.1% |
0.5%
0.6 pts worse
|
1.0%
0.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.1% · Q2 0.0% · Q3 0.0% · Q4 2.5% · 4Q avg 1.1% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.7% |
0.8%
0.1 pts better
|
1.7%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 3.1% · 4Q avg 0.7% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 15.0% |
15.0%
About the same
|
19.8%
4.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 19.3% · Q2 17.3% · Q3 13.1% · Q4 9.3% · 4Q avg 15.0% |
| Percentage of long-stay residents with pressure ulcers | 5.8% |
4.2%
1.6 pts worse
|
5.1%
0.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.4% · Q2 5.1% · Q3 9.7% · Q4 6.3% · 4Q avg 5.8% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
89.7%
10.3 pts better
|
81.7%
18.3 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 9.7% |
12.0%
2.3 pts better
|
12.0%
2.3 pts better
|
Short Stay · 20240701-20250630 · Adjusted 9.7% · Observed 8.9% · Expected 10.2% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 3.2% |
1.5%
1.7 pts worse
|
1.6%
1.6 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 2.8% · Q2 3.7% · Q3 4.1% · Q4 2.2% · 4Q avg 3.2% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 97.5% |
88.0%
9.5 pts better
|
79.7%
17.8 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 97.5% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 24.1% |
25.9%
1.8 pts better
|
23.9%
0.2 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 24.1% · Observed 21.1% · Expected 20.8% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-05-10 · Fire 2024-05-10
12 health deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2023-04-07 · Fire 2023-04-07
5 health deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (2 deficiencies)
1 fire-safety deficiencies
Top issue: Miscellaneous (1 deficiency)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-07-11
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2025-06-27
D · Potential for more than minimal harm
2025-07-11
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-06-27
D · Potential for more than minimal harm
2025-07-11
K511 · Services Deficiencies
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2025-06-27
E · Potential for more than minimal harm
2023-04-07
K700 · Miscellaneous Deficiencies
Fire Safety
Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors.
Corrected 2023-05-08
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-08-08
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 2025-09-01
D · Potential for more than minimal harm
2025-08-08
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 2025-09-05
D · Potential for more than minimal harm
2025-07-11
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 2025-07-12
D · Potential for more than minimal harm
2025-07-11
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 2025-07-12
D · Potential for more than minimal harm
2025-07-11
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 2025-07-15
D · Potential for more than minimal harm
2025-07-11
F760 · Pharmacy Service Deficiencies
Health
Ensure that residents are free from significant medication errors.
Corrected 2025-07-12
D · Potential for more than minimal harm
2025-07-11
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 2025-07-12
E · Potential for more than minimal harm
2025-03-17
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 2025-03-20
E · Potential for more than minimal harm
2025-03-17
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 2025-04-01
D · Potential for more than minimal harm
2025-03-17
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 2025-04-10
K · Immediate jeopardy
2025-01-03
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2024-10-18
D · Potential for more than minimal harm
2025-01-03
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2024-10-18
E · Potential for more than minimal harm
2024-05-10
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 2024-05-16
E · Potential for more than minimal harm
2024-05-10
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 2024-05-15
E · Potential for more than minimal harm
2024-05-10
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 2024-05-15
D · Potential for more than minimal harm
2024-05-10
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 2024-05-15
D · Potential for more than minimal harm
2024-05-10
F583 · Resident Rights Deficiencies
Health
Keep residents' personal and medical records private and confidential.
Corrected 2024-05-15
D · Potential for more than minimal harm
2024-05-10
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2024-05-15
D · Potential for more than minimal harm
2024-05-10
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 2024-05-15
D · Potential for more than minimal harm
2024-05-10
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 2024-05-15
D · Potential for more than minimal harm
2024-05-10
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-05-15
G · Actual harm
2024-03-04
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2024-04-01
E · Potential for more than minimal harm
2023-04-07
F759 · Pharmacy Service Deficiencies
Health
Ensure medication error rates are not 5 percent or greater.
Corrected 2023-05-08
D · Potential for more than minimal harm
2023-04-07
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2023-05-08
D · Potential for more than minimal harm
2023-04-07
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-05-08
E · Potential for more than minimal harm
2023-03-27
F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2023-04-14
E · Potential for more than minimal harm
2023-03-27
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 2023-04-14
Penalties and ownership
What sits behind the stars
$17,345
2025-01-03
Fine
Fine · fine $17,345
Fine
Ownership
Air Force Village Inc
Operational/Managerial Control · Organization
Biery, Diane
Corporate Director · Individual
Bryan, Helen
Corporate Director · Individual
Bst Health Services Corp
Operational/Managerial Control · Organization
Dubensky, Michael
Corporate Director · Individual
Flowers, Alfred
Corporate Director · Individual
Goswami, Sushanta
Operational/Managerial Control · Individual
Hansen, Roger
Corporate Director · Individual
Hepburn, Deborah
Corporate Director · Individual
Hostage, Katherine
Corporate Director · Individual
Jones, Darrell
Operational/Managerial Control · Individual
Jones, Darrell
Corporate Officer · Individual
Kardys, Richard
Corporate Director · Individual
Kelly-Rank, Sally
Operational/Managerial Control · Individual
Kruger, Robert
Corporate Director · Individual
Lyons, Amy
Operational/Managerial Control · Individual
Lyons, Amy
Corporate Officer · Individual
Manzke, Sarah
Operational/Managerial Control · Individual
Manzke, Sarah
Corporate Officer · Individual
Meigs, Stephen
Corporate Director · Individual
Moran, Joseph
Corporate Director · Individual
Olsen, Janice
Corporate Director · Individual
Potter, Charles
Corporate Director · Individual
Profenna, Leonardo
Corporate Director · Individual
Ransom, Heather
Operational/Managerial Control · Individual
Ransom, Heather
Corporate Officer · Individual
Schnelzer, Gary
Corporate Director · Individual
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#3
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