Federal inspection record · CMS data as of October 1, 2026
Town and Country Nursing and Rehabilitation Center
625 N Main St, Boerne, TX · (830) 249-3085
- Certified beds
- 126
- Residents per day
- 79
- Ownership
- Government
- Chain
- Wellsential Health
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- March 3, 1998
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
★★★★★no change
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
★★★★★+1 star
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
Town and Country Nursing and Rehabilitation Center carries 138.25 inspection points. That is fewer than 21% 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
51 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
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
-
K
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
J
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.
Everything else, by area of care
Resident Assessment and Care Planning12E
- 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.
- D
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
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
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.
Quality of Life and Care9E
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Assist a resident in gaining access to vision and hearing services.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- E
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Provide safe, appropriate pain management for a resident who requires such services.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide activities to meet all resident's needs.
- D
Provide or obtain dental services for each resident.
Pharmacy Service6E
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 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.
- E
Ensure medication error rates are not 5 percent or greater.
Resident Rights6E
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- D
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
- D
Keep residents' personal and medical records private and confidential.
- E
Prepare residents for a safe transfer or discharge from the nursing home.
- 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.
- D
Reasonably accommodate the needs and preferences of each resident.
Infection Control5E
- 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.
- E
Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
- D
Provide and implement an infection prevention and control program.
Freedom from Abuse, Neglect, and Exploitation5E
- 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.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
- E
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Nursing and Physician Services2D
- C
Post nurse staffing information every day.
- 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.
Nutrition and Dietary2F
- D
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.
Administration1E
- E
Employ staff that are licensed, certified, or registered in accordance with state laws.
Inspection history
2026-07-31
11 health deficiencies · 8 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (4 deficiencies)
2025-05-22
22 health deficiencies · 13 fire-safety deficiencies
Top issue: Quality of Life and Care (6 deficiencies)
2024-03-31
18 health deficiencies · 4 fire-safety deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 26 min of nursing staff time a day, 23 min of it from a registered nurse.
This home
3 h 26 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 68% 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
Fines and payment denials
$150,922 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2024-07-26 | Fine | $75,832 |
| 2024-03-31 | Fine | $75,090 |
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 days0.6 pts better | 1.4 | 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 injury0.2 pts worse | 3.4% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms8 pts worse | 10.3% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight1 pts worse | 3.9% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication8.8 pts worse | 26.6% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication0.7 pts better | 9.1% | 9.8% | 15.4% |
| Percentage of long-stay residents who were physically restrained1.2 pts worse | 1.2% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened2 pts better | 10.9% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased7 pts better | 8.8% | 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 infection0.5 pts better | 0.3% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence3 pts better | 9.5% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2.1 pts better | 1.6% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine11.3 pts better | 100.0% | 88.7% | 82.3% |
| 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 vaccine14.6 pts better | 100.0% | 85.4% | 80.1% |
·
Who owns and runs it
37 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 |
| 625 N Main Street LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Agha, Yasmeen | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Agha, Yasmeen | Adp Of The SNF · Individual | 0% | 1 facilities |
| Bain, William | Corporate Officer · Individual | 0% | 4 facilities |
| Baird, Daniel | Managing Control - Governing Body · Individual | 0% | 58 facilities |
| Beaumont, Jaime | Adp Of The SNF · Individual | 0% | 1 facilities |
| Bell, Billie | Corporate Officer · Individual | 0% | 7 facilities |
| Carvajal, Antonio | Managing Control - Governing Body · Individual | 0% | 28 facilities |
| Clapp, Barbara | Managing Control - Governing Body · Individual | 0% | 69 facilities |
| Cortese, Daren | Managing Control - Governing Body · Individual | 0% | 58 facilities |
| Csv Rhea Management Holdco, LLC | Adp Of The SNF · Organization | 0% | 63 facilities |
| Dekowski, Donovan | Adp Of The SNF · Individual | 0% | 69 facilities |
| Dwd Tx Holdings LLC | Adp Of The SNF · Organization | 0% | 63 facilities |
| Frosch, Kevin | Corporate Officer · Individual | 0% | 4 facilities |
| Gibson, Patricia | Managing Control - Governing Body · Individual | 0% | 57 facilities |
| Gonzales, Veronica | Managing Control - Governing Body · Individual | 0% | 27 facilities |
| Hardt, Timothy | Corporate Officer · Individual | 0% | 4 facilities |
| Jack And Nancy Dwyer Workforce Development Center Inc | Adp Of The SNF · Organization | 0% | 68 facilities |
| Johnson, Tony | Corporate Officer · Individual | 0% | 3 facilities |
| Kaufman, Nicole | Managing Control - Governing Body · Individual | 0% | 28 facilities |
| Mandelbaum, Elliot | Managing Control - Governing Body · Individual | 0% | 61 facilities |
| Mangold, Mary | Corporate Officer · Individual | 0% | 2 facilities |
| Martinez, Delia | Adp Of The SNF · Individual | 0% | 1 facilities |
| Martinez, Thelma | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Martinez, Thelma | Adp Of The SNF · Individual | 0% | 1 facilities |
| Reg Bridge Opco LLC | Adp Of The SNF · Organization | 0% | 19 facilities |
| Reg Hg Opco LLC | Adp Of The SNF · Organization | 0% | 39 facilities |
| Reg Operator Holdco LLC | Adp Of The SNF · Organization | 0% | 63 facilities |
| Regency Ihs Clinical Consulting, LLC | Adp Of The SNF · Organization | 0% | 70 facilities |
| Regency Ihs Of Boerne LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Regency Ihs Rehab LLC | Adp Of The SNF · Organization | 0% | 68 facilities |
| Regency Integrated Health Services LLC | Adp Of The SNF · Organization | 0% | 70 facilities |
| Regency Texas Holdings LLC | Adp Of The SNF · Organization | 0% | 63 facilities |
| Windrow, Zachary | Corporate Officer · Individual | 0% | 4 facilities |
| Winkler, Judy | Corporate Officer · Individual | 0% | 4 facilities |
| Young, Carlton | Corporate Officer · Individual | 0% | 4 facilities |
·
Fire safety
25 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke12F
- 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
Provide properly protected cooking facilities.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- F
Install a fire alarm system that can be heard throughout the facility.
- E
Install an approved automatic sprinkler system.
- E
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Provide properly protected cooking facilities.
- D
Properly select, install, inspect, or maintain portable fire extinguishes.
- C
Provide properly protected cooking facilities.
Egress6F
- 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.
- F
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 ramps, exits, fire escape ladders, steps, and areas of refuge that meet safety requirements.
- 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.
Services3D
- D
Have properly installed electrical wiring and gas equipment.
- D
Have properly installed electrical wiring and gas equipment.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Miscellaneous2F
- F
Have simulated fire drills held at unexpected times.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Gas, Vacuum, and Electrical Systems2E
- E
Have generator or other power source capable of supplying service within 10 seconds.
- D
Ensure proper usage of power strips and extension cords.
·
Other homes nearby
-
Carechoice Of Boerne
Boerne, TX · Charleston Healthcare Group
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 2 h 48 min
- Fines
- $33,937
-
Avir at Boerne
Boerne, TX · Avir Health Group
★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 3 h 16 min
- Fines
- $92,137
-
Cibolo Creek
Boerne, TX
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 14 min
- Fines
- $13,627