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No fines or payment denials in the published 3-year window.
913 Hwy 90 W, Castroville, TX 78009 (opens Google Maps) · Medina County · (830) 931-2900· 116 certified beds · avg 89 residents/day · certified since Jun 20, 2003 · Medicare and Medicaid certified
Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →
New to these records? How to read an inspection report →
Health inspection rating: ★★★★☆4/5 · CMS overall rating: 3/5 · how star ratings work →
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and quality measures from resident assessments and claims.
Showing the latest 3 of 36 inspection findings. Open the full record below to read every finding.
The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. F-0641
The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. F-0880
The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. F-0686
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Feb 27, 2026 | E · Potential for more than minimal harm, pattern | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641 |
| Feb 27, 2026 | E · Potential for more than minimal harm, pattern | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880 |
| Feb 27, 2026 | D · Potential for more than minimal harm, isolated | The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · F-0686 |
| Feb 27, 2026 | D · Potential for more than minimal harm, isolated | The facility did not have a registered nurse on duty at least 8 hours a day, or did not have a registered nurse serving full-time as director of nursing. · F-0727 |
| Feb 27, 2026 | D · Potential for more than minimal harm, isolated | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · F-0842 |
| Feb 27, 2026 | D · Potential for more than minimal harm, isolated | The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices. · F-0908 |
| Feb 27, 2026 | B · Potential for minimal harm, pattern | The facility did not update each resident's care assessment at least once every 3 months. These regular check-ins keep the resident's care plan matched to their current condition. · F-0638 |
| Nov 15, 2024 | E · Potential for more than minimal harm, pattern | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · F-0580 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. · F-0644 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services. · F-0645 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · F-0657 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · F-0677 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. · F-0690 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · F-0755 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · F-0761 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · F-0842 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not arrange hospice services for a resident who needed them, or help the resident move to a facility that could arrange hospice. Hospice provides comfort-focused care for people nearing the end of life. · F-0849 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880 |
| Nov 15, 2024 | D · Potential for more than minimal harm, isolated | The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices. · F-0908 |
| Nov 15, 2024 | B · Potential for minimal harm, pattern | The facility did not dispose of garbage and refuse properly. · F-0814 |
| Oct 30, 2024 | D · Potential for more than minimal harm, isolated | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609 |
| Oct 30, 2024 | D · Potential for more than minimal harm, isolated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689 |
| Oct 30, 2024 | D · Potential for more than minimal harm, isolated | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. · from a complaint · F-0690 |
| Sep 21, 2024 | D · Potential for more than minimal harm, isolated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · from a complaint · F-0761 |
| Jul 26, 2024 | D · Potential for more than minimal harm, isolated | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609 |
| Nov 15, 2023 | D · Potential for more than minimal harm, isolated | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint · F-0842 |
| Sep 22, 2023 | E · Potential for more than minimal harm, pattern | The facility used physical restraints — devices that limit a resident's movement — when they weren't needed for medical treatment. · F-0604 |
| Sep 22, 2023 | E · Potential for more than minimal harm, pattern | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812 |
| Sep 22, 2023 | E · Potential for more than minimal harm, pattern | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880 |
| Sep 22, 2023 | D · Potential for more than minimal harm, isolated | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. · F-0690 |
| Sep 22, 2023 | D · Potential for more than minimal harm, isolated | The facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident. · F-0726 |
| Sep 22, 2023 | D · Potential for more than minimal harm, isolated | The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. · F-0759 |
| Sep 22, 2023 | D · Potential for more than minimal harm, isolated | The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · F-0760 |
| Sep 22, 2023 | D · Potential for more than minimal harm, isolated | The facility did not dispose of garbage and refuse properly. · F-0814 |
Citations from standard inspections decreased between the last two inspection cycles (15 → 7).
All bars start at zero. Exact values and supporting details remain below.
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 9 | 0 | E |
| 2024 | 20 | 0 | E |
| 2026 | 7 | 0 | E |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
How to file a complaint about care →
No fines or payment denials in the published 3-year window.
What these staffing numbers mean →
All bars start at zero. Exact values and supporting details remain below.
| Measure | This facility | Texas avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 2.87 | 3.46 | 3.95 | bottom 15% in Texas; bottom 10% in the U.S. |
| Registered Nurse hours | 0.27 | 0.44 | 0.69 | bottom 22% in Texas; bottom 7% in the U.S. |
| Weekend total nurse staffing | 2.34 | 3.04 | 3.50 | bottom 8% in Texas; bottom 6% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.31 | 0.34 | 0.48 | top 44% in Texas; bottom 35% in the U.S. |
| Total nursing staff turnover (%) | 37.5 | 55.3 | 45.8 | top 15% in Texas; top 30% in the U.S. |
| RN turnover (%) | 44.4 | 54.6 | 42.9 | top 37% in Texas; bottom 45% in the U.S. |
Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 2.95, RN 0.28, weekend 2.41.Comparing with Medicare Care Compare? Care Compare shows the raw figure (2.95 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 1/5.
Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.
Quality measures rating: 4/5 · long-stay residents: 5/5 · short-stay residents: 3/5
Price evidence · separate from quality
No verified facility-specific private-pay price is available in our data for Medina Valley Health & Rehabilitation Center. CMS inspection and staffing records do not tell us what this home will charge you.
Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.
Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.
Understand who pays for care · How we handle price evidence · Report an incorrect price
How to read ownership records →
Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →
For profit - Partnership
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Medina County Hospital District | Organization | 5% or Greater Direct Ownership Interest | 100% | 08/01/2014 |
| Bell, Billie | Individual | Corporate Officer | NOT APPLICABLE | 06/03/2023 |
| Cascade Health Services, LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 08/01/2014 |
| Cascade Medina Health Services, LTD | Organization | Operational/Managerial Control | NOT APPLICABLE | 08/01/2014 |
| Castroville Care Center, LTD | Organization | ADP of the SNF | NOT APPLICABLE | 08/01/2014 |
| Dorrow, Marjorie | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 05/08/2025 |
| Gregory, Patrice | Individual | ADP of the SNF | NOT APPLICABLE | 11/30/2020 |
| Haney, Max | Individual | ADP of the SNF | NOT APPLICABLE | 08/01/2014 |
| Haney, Ronald | Individual | Operational/Managerial Control | NOT APPLICABLE | 08/01/2014 |
| Haney, Ronald | Individual | ADP of the SNF | NOT APPLICABLE | 08/01/2014 |
| Jaafar, Saleh | Individual | ADP of the SNF | NOT APPLICABLE | 08/01/2024 |
| Kubik, Darlene | Individual | ADP of the SNF | NOT APPLICABLE | 08/01/2014 |
All 12 owning or managing parties CMS has on file are shown — none excluded.
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Westover Hills Rehabilitation and Healthcare | 8.6 mi | San Antonio, TX | ★★★★☆ | 3/5 | |
| Legend Oaks Healthcare and Rehabilitation - West S | 8.6 mi | San Antonio, TX | ★★★☆☆ | 3/5 | |
| The Mission at Blue Skies of Texas East | 8.8 mi | San Antonio, TX | ★★★★★ | 4/5 | |
| Lakeside Nursing and Rehabilitation Center | 9.2 mi | San Antonio, TX | ★★★★★ | 4/5 | |
| Las Colinas of Westover | 9.4 mi | San Antonio, TX | ★★☆☆☆ | 2/5 | |
| Lytle Nursing Home | 9.6 mi | Lytle, TX | ★☆☆☆☆ | 2/5 | |
| Windemere at Westover Hills | 9.6 mi | San Antonio, TX | ★★☆☆☆ | 3/5 | |
| Harbor Valley Health and Rehabilitation | 10.6 mi | San Antonio, TX | ★★☆☆☆ | 2/5 | abuse |
| Silver Creek Nursing and Rehabilitation | 11.3 mi | San Antonio, TX | ★★★☆☆ | 4/5 | |
| Mystic Park Nursing and Rehabilitation Center | 13.8 mi | San Antonio, TX | ★★★☆☆ | 2/5 | |
| Avir at San Antonio | 14.7 mi | San Antonio, TX | ★☆☆☆☆ | 2/5 | |
| Inspiration Hills Rehabilitation Center | 14.8 mi | San Antonio, TX | ★★★☆☆ | 3/5 |
Compare this facility with the 3 closest →
CMS records place this facility in Medina, TX — 3 certified facilities there. These are outside the 20-mile list above, or far enough down it not to appear.
Listed by facility name — not a ranking. Homes already in the table above are not repeated here.
Facility data as of CMS processing date 2026-08-01. CCN 675974.
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