Staffing
CMS publishes a 2-star staffing rating for this facility.
RN staffing was 0.52 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceAsk Trust Hub Network
Also known publicly as The Heights of Bulverde (In-House Dialysis)
SPRING BRANCH, TX
CMS overview
No proprietary TrustHub score. These ratings are published separately by CMS.
Facility information
CMS remains the primary federal record. Public website and additional contact details appear only when independently verified.
State regulatory evidence
Texas Health and Human Services Commission is the state source for this license record. It does not replace CMS federal certification, ratings, or certified-bed counts.
Texas Health and Human Services Commission
State regulatory data · checked Aug 2026
Decision guide
Factual evidence to examine before you decide. These summaries are not a score or recommendation.
CMS publishes a 2-star staffing rating for this facility.
RN staffing was 0.52 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceThe latest standard inspection on Jun 25, 2025 cited 8 deficiencies.
View inspection evidenceCMS-published records list 32 ownership or control parties.
CMS records show an ownership change effective April 2019.
View ownership evidenceCMS groups this facility with a chain covering 25 facilities across 1 states or territories.
View chain evidenceOwnership & operation
Operator, licensee, owner, manager, and chain stay separate. A connected organization is not automatically the party that runs daily operations.
SeniorTrustHub found evidence connecting this facility to:
39 currently connected nursing homes share this CMS organization identity with UVALDE COUNTY HOSPITAL AUTHORITY.
These figures summarize currently connected CMS-certified nursing homes. Some facilities have incomplete measures; missing values are omitted, not treated as zero. Ownership structures can change. State operator or licensee evidence may differ from CMS ownership disclosures.
Ownership
These are CMS-published ownership disclosures. Medicare enrollment ownership and managerial-control information is reported by enrolled providers through CMS forms; it is not an independent determination of beneficial ownership.
Organization · 5% OR GREATER SECURITY INTEREST
Association date reported to CMS: May 23, 2024
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across TX.
Individual · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2020
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across TX.
Individual · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Individual · ADP OF THE SNF
Association date reported to CMS: May 1, 2023
Individual · ADP OF THE SNF
Association date reported to CMS: Oct 1, 2025
Individual · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Individual · ADP OF THE SNF
Association date reported to CMS: Sep 1, 2025
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across TX.
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 28, 2024
Individual · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Individual · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Organization · ADP OF THE SNF
Association date reported to CMS: Jan 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Aug 26, 2025
Other facilities connected through this exact CMS organization identity: 0 across TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across TX.
Individual · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2019
Individual · CORPORATE OFFICER
Association date reported to CMS: Aug 1, 2015
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Apr 1, 2020
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Apr 1, 2019
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: May 1, 2023
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Oct 1, 2025
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Sep 1, 2025
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 28, 2024
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Apr 1, 2019
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Apr 1, 2019
Other facilities connected through this exact CMS organization identity: 0 across TX.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Apr 1, 2019
Organization · Medicare-enrolled legal organization
Other facilities connected through this exact CMS organization identity: 38 across TX.
Roles are shown as CMS publishes them. Different CMS sources can describe different enrollment, ownership, and control concepts, so TrustHub keeps each source-specific disclosure distinct.
Chain context
Chain-level values describe this CMS-defined group, not any one facility. CMS Chain ID 521 is a grouping identifier, not a legal organization.
| Month | Facilities | Overall rating | Staffing rating |
|---|---|---|---|
| Wed Jul | 25 | 2.9 | 1.7 |
| Mon Jun | 25 | 2.8 | 1.4 |
| Fri May | 25 | 2.7 | 1.4 |
| Wed Apr | 28 | 2.7 | 1.4 |
| Sun Mar | 28 | 2.8 | 1.7 |
| Sun Feb | 29 | 2.9 | 1.7 |
Nursing Home Chain Performance Measures, fixed version da2db00a-0f3d-40a9-a535-588ff1220c55. Membership comes separately from CMS Skilled Nursing Facility Enrollments.
View official CMS sourceInspections & deficiencies
Scope and severity terms below are CMS classifications. They are not a TrustHub score.
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.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 2, 2026)
Provide and implement an infection prevention and control program.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 14, 2026)
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 11, 2025)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 11, 2025)
Provide and implement an infection prevention and control program.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 11, 2025)
Ensure each resident receives an accurate assessment.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 10, 2025)
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 10, 2025)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 10, 2025)
No health-deficiency rows were deterministically linked to this inspection.
Ensure that residents are fully informed and understand their health status, care and treatments.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 26, 2025)
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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 26, 2025)
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 26, 2025)
Ensure medication error rates are not 5 percent or greater.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 26, 2025)
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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 26, 2025)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 26, 2025)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 26, 2025)
Provide and implement an infection prevention and control program.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 26, 2025)
Ensure each resident receives an accurate assessment.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 25, 2025)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 25, 2025)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 20, 2025)
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 22, 2025)
Respond appropriately to all alleged violations.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 22, 2025)
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Past Non-Compliance (Dec 24, 2024)
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
CMS scope/severity J: Isolated; Immediate jeopardy to resident health or safety.
Correction status: Deficient, Provider has date of correction (Mar 22, 2025)
Provide and implement an infection prevention and control program.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 22, 2025)
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jul 23, 2024)
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jul 23, 2024)
No health-deficiency rows were deterministically linked to this inspection.
No health-deficiency rows were deterministically linked to this inspection.
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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
Provide care and assistance to perform activities of daily living for any resident who is unable.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
Ensure medication error rates are not 5 percent or greater.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
Ensure that residents are free from significant medication errors.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 6, 2024)
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 22, 2024)
No health-deficiency rows were deterministically linked to this inspection.
No health-deficiency rows were deterministically linked to this inspection.
No health-deficiency rows were deterministically linked to this inspection.
Ensure each resident receives an accurate assessment.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 25, 2023)
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 25, 2023)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 25, 2023)
Provide and implement an infection prevention and control program.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 25, 2023)
Penalties & enforcement
No penalty records were found for this provider in the currently loaded CMS Penalties dataset.
Questions to ask
Facility history
17 historical events available. Dates and values come from published CMS and official state regulator evidence, not a score.
1 deficiency was recorded.
CMS · Recorded event date · View related evidence
1 deficiency was recorded.
CMS · Recorded event date · View related evidence
3 deficiencies were recorded.
CMS · Recorded event date · View related evidence
3 deficiencies were recorded.
CMS · Recorded event date · View related evidence
RN staffing decreased from 0.53 to 0.41 hours per resident day between 2025Q2 and 2025Q3. Staffing declined across those reported periods.
0.53 → 0.41
CMS · Reported in a source release · View related evidence
8 deficiencies were recorded.
CMS · Recorded event date · View related evidence
2 deficiencies were recorded.
CMS · Recorded event date · View related evidence
1 deficiency was recorded.
CMS · Recorded event date · View related evidence
5 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
2 deficiencies were recorded.
CMS · Recorded event date · View related evidence
10 deficiencies were recorded.
CMS · Recorded event date · View related evidence
No linked health-deficiency findings were recorded for this survey.
CMS · Recorded event date · View related evidence
Staffing
CMS staffing rating: 2 of 5 stars. CMS calculates that rating separately using its published methodology. The values below are calculations from daily PBJ records for 2026Q1 (current source quarter).
| Measure | Monday–Friday | Saturday–Sunday |
|---|---|---|
| Total nursing | 3.338 | 2.608 |
| RN categories | 0.568 | 0.405 |
Contract staff accounted for 5.4% of reported nursing hours included in this quarter calculation.
Reported RN-category hours per resident day were 0.083 higher than the prior loaded quarter.
Solid bar: Total nursing · Outlined bar: RN categories
| Quarter | Total nursing | RN categories | LPN/LVN | CNA | Contract share | Days |
|---|---|---|---|---|---|---|
| 2025Q2 | 3.092 | 0.534 | 0.782 | 1.283 | 3.9% | 91 |
| 2025Q3 | 3.033 | 0.413 | 0.778 | 1.341 | 2% | 92 |
| 2025Q4 | 2.996 | 0.438 | 0.758 | 1.58 | 1.9% | 92 |
| 2026Q1 | 3.127 | 0.521 | 0.863 | 1.571 | 5.4% | 90 |
Hours-per-resident-day values are calculated by this platform from CMS-published daily PBJ hours and MDS census. For each displayed period, included hours are summed and divided by the summed census for days with a positive census. They are not CMS case-mix-adjusted staffing measures or a staffing rating.
View official CMS PBJ sourceWhat we can verify today
These measures come from the current successfully ingested CMS Nursing Home Provider Information release.
Planned evidence layers
These areas require separate authoritative CMS datasets. No findings are shown until those sources are ingested and reviewed.
Trust participation
Claims, corrections, and factual context are free. Submissions never replace CMS evidence or affect ranking.
Source register
No paid placements. Facilities cannot pay to rank higher. We cite. You decide.