Medina Valley Health & Rehabilitation Center

Name: Medina Valley Health & Rehabilitation Center
Address: 913 Hwy 90 W, Castroville, TX, 78009, US
Telephone: 8309312900

913 Hwy 90 W, Castroville, TX 78009 · Medina County · 116 certified beds · avg 89 residents/day · certified since Jun 20, 2003

4/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

2.87

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★★★☆4/5 · CMS overall rating: 3/5

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 self-reported quality measures.

All citations in the current public record (36)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Feb 27, 2026	E · Potential for harm, repeated	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
Feb 27, 2026	E · Potential for harm, repeated	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.
Feb 27, 2026	D · Potential for harm, one-off	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.
Feb 27, 2026	D · Potential for harm, one-off	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.
Feb 27, 2026	D · Potential for harm, one-off	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Feb 27, 2026	D · Potential for harm, one-off	The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices.
Feb 27, 2026	B · Minimal risk, repeated	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.
Nov 15, 2024	E · Potential for harm, repeated	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.
Nov 15, 2024	D · Potential for harm, one-off	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.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
Nov 15, 2024	D · Potential for harm, one-off	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.
Nov 15, 2024	D · Potential for harm, one-off	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.
Nov 15, 2024	D · Potential for harm, one-off	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.
Nov 15, 2024	D · Potential for harm, one-off	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.
Nov 15, 2024	D · Potential for harm, one-off	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.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist.
Nov 15, 2024	D · Potential for harm, one-off	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.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Nov 15, 2024	D · Potential for harm, one-off	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.
Nov 15, 2024	D · Potential for harm, one-off	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.
Nov 15, 2024	D · Potential for harm, one-off	The facility did not keep all essential equipment working safely — things like heating and cooling systems, kitchen equipment, and medical devices.
Nov 15, 2024	B · Minimal risk, repeated	The facility did not dispose of garbage and refuse properly.
Oct 30, 2024	D · Potential for harm, one-off	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
Oct 30, 2024	D · Potential for harm, one-off	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
Oct 30, 2024	D · Potential for harm, one-off	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
Sep 21, 2024	D · Potential for harm, one-off	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
Jul 26, 2024	D · Potential for harm, one-off	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
Nov 15, 2023	D · Potential for harm, one-off	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint
Sep 22, 2023	E · Potential for harm, repeated	The facility used physical restraints — devices that limit a resident's movement — when they weren't needed for medical treatment.
Sep 22, 2023	E · Potential for harm, repeated	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.
Sep 22, 2023	E · Potential for harm, repeated	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.
Sep 22, 2023	D · Potential for harm, one-off	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.
Sep 22, 2023	D · Potential for harm, one-off	The facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident.
Sep 22, 2023	D · Potential for harm, one-off	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.
Sep 22, 2023	D · Potential for harm, one-off	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.
Sep 22, 2023	D · Potential for harm, one-off	The facility did not dispose of garbage and refuse properly.

Inspection trend by year

Citations from standard inspections decreased between the last two inspection cycles (15 → 7).

Year	Citations	Worst severity that year
2023	9	E
2024	20	E
2026	7	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.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

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, 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. Staffing rating: 1/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 4/5 · long-stay residents: 5/5 · short-stay residents: 3/5

Who owns this facility

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

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"Who completes resident assessments here, and how do you check them for accuracy?"
"Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
"How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
"How many hours a day is a registered nurse physically in the building, including weekends?"
"How do you keep residents' medical records accurate, complete, and secure?"
"How do you inspect and maintain essential equipment, and how quickly are repairs made?"
"How do you track that every resident's quarterly assessment happens on time?"
"What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

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
Windemere at Westover Hills	9.6 mi	San Antonio, TX	★★☆☆☆	3/5
Lytle Nursing Home	9.6 mi	Lytle, TX	★☆☆☆☆	2/5
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

Compare this facility with the 3 closest →

All facilities in Castroville →

Facility data as of CMS processing date 2026-08-01. CCN 675974.

The Care File

Visit checklist — Medina Valley Health & Rehabilitation Center

913 Hwy 90 W, Castroville, TX 78009 · 8309312900

Health inspection rating 4/5 · CMS overall 3/5· Fines (3y): $0

Questions for the administrator:

☐ "Who completes resident assessments here, and how do you check them for accuracy?"
☐ "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
☐ "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
☐ "How many hours a day is a registered nurse physically in the building, including weekends?"
☐ "How do you keep residents' medical records accurate, complete, and secure?"
☐ "How do you inspect and maintain essential equipment, and how quickly are repairs made?"
☐ "How do you track that every resident's quarterly assessment happens on time?"
☐ "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 675974 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)