The Enclave
18803 Hardy Oak, San Antonio, TX 78258 · Bexar County · 142 certified beds · avg 120 residents/day · certified since Apr 27, 2017
Part of chain: TOUCHSTONE COMMUNITIES (25 facilities, chain avg rating 2.9★)
2/5
Health inspection rating (on-site)
1
Serious findings on record
$10,039
Fines, last 3 years
3.12
Nurse hours/resident/day (adjusted)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 1/5
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.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · May 4, 2024 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Jun 8, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (46)
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 26, 2026 | 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 |
| Feb 6, 2026 | D · Potential for harm, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Feb 6, 2026 | 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 |
| Aug 27, 2025 | 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. |
| Aug 27, 2025 | E · Potential for harm, repeated | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Aug 27, 2025 | E · Potential for harm, repeated | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Aug 27, 2025 | 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. |
| Aug 27, 2025 | 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. |
| Aug 27, 2025 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| Aug 27, 2025 | D · Potential for harm, one-off | The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. |
| Aug 27, 2025 | 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. |
| Aug 27, 2025 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Aug 27, 2025 | 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. |
| Aug 27, 2025 | 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. |
| Aug 27, 2025 | C · Minimal risk, facility-wide | The facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. |
| Aug 27, 2025 | B · Minimal risk, repeated | The facility did not enter each resident's assessment information into the required format and send it to the state within 7 days of completing the assessment, as the rules require. |
| Jul 24, 2025 | 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. · from a complaint |
| May 5, 2025 | E · Potential for harm, repeated | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint |
| Jun 28, 2024 | F · Potential for harm, facility-wide | 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. |
| Jun 28, 2024 | E · Potential for harm, repeated | 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. · from a complaint |
| Jun 28, 2024 | E · Potential for harm, repeated | The facility did not have a policy covering how food brought in by family and visitors is used and stored safely. |
| Jun 28, 2024 | D · Potential for harm, one-off | The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. |
| Jun 28, 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. |
| Jun 28, 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. |
| Jun 28, 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. |
| Jun 28, 2024 | D · Potential for harm, one-off | The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. |
| Jun 28, 2024 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Jun 28, 2024 | D · Potential for harm, one-off | The facility used bed rails without first trying safer alternatives, or without assessing the resident's safety risk, discussing the risks and benefits with the resident or family, getting consent, and installing the rails correctly. |
| Jun 28, 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. |
| Jun 28, 2024 | D · Potential for harm, one-off | The facility's menus did not meet residents' nutritional needs, or were not prepared in advance, followed as written, kept up to date, or reviewed by a dietician. |
| Jun 28, 2024 | D · Potential for harm, one-off | The facility did not provide food that accounts for each resident's allergies, intolerances, and personal preferences, or did not offer appealing alternatives. |
| Jun 28, 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. |
| Jun 7, 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 |
| May 4, 2024 | ▲ J · Immediate jeopardy, 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 |
| May 4, 2024 | E · Potential for harm, repeated | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint |
| May 4, 2024 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint |
| May 4, 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 |
| May 4, 2024 | 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. · from a complaint |
| May 4, 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. · from a complaint |
| Jan 29, 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. · from a complaint |
| Jan 29, 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. · from a complaint |
| Apr 19, 2023 | E · Potential for harm, repeated | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Apr 19, 2023 | E · Potential for harm, repeated | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. |
| Apr 19, 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. |
| Apr 19, 2023 | E · Potential for harm, repeated | The facility has more than 120 beds but did not hire a qualified full-time social worker as required. |
| Apr 19, 2023 | D · Potential for harm, one-off | The facility did not help a resident get vision and hearing services — such as eye exams, glasses, hearing tests, or hearing aids. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (14 → 13).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 5 | 0 | E |
| 2024 | 23 | 1 | J ▲ |
| 2025 | 15 | 0 | E |
| 2026 | 3 | 0 | D |
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)
1 fine totaling $10,039, plus 1 Medicare payment denial period.
| Date | Type | Amount / length |
|---|---|---|
| May 4, 2024 | Fine | $10,039 |
| May 4, 2024 | Payment Denial | 28 days from Jun 1, 2024 |
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) | 3.12 | 3.46 | 3.95 | bottom 32% in Texas; bottom 18% in the U.S. |
| Registered Nurse hours | 0.28 | 0.44 | 0.69 | bottom 25% in Texas; bottom 8% in the U.S. |
| Weekend total nurse staffing | 2.66 | 3.04 | 3.50 | bottom 27% in Texas; bottom 15% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.29 | 0.34 | 0.48 | bottom 48% in Texas; bottom 29% in the U.S. |
| Total nursing staff turnover (%) | 60.9 | 55.3 | 45.8 | bottom 32% in Texas; bottom 15% in the U.S. |
| RN turnover (%) | 45.5 | 54.6 | 42.9 | top 39% in Texas; bottom 43% 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 3.63, RN 0.33, weekend 3.09. 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: 3/5 · long-stay residents: 4/5 · short-stay residents: 2/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Aegis Therapies, INC. | Organization | ADP of the SNF | NOT APPLICABLE | 03/01/2023 |
| Campbell, Leslie | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/01/2023 |
| Campbell, Leslie | Individual | ADP of the SNF | NOT APPLICABLE | 03/01/2023 |
| Carvajal Pharmacy LTC | Organization | ADP of the SNF | NOT APPLICABLE | 03/01/2023 |
| Castillo, Lynnea | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/01/2023 |
| Castillo, Lynnea | Individual | ADP of the SNF | NOT APPLICABLE | 03/01/2023 |
| Clayton, Jonathon | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2023 |
| Clayton, Jonathon | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2023 |
| Collingwood, Ying | Individual | Operational/Managerial Control | NOT APPLICABLE | 08/11/2025 |
| Collingwood, Ying | Individual | ADP of the SNF | NOT APPLICABLE | 08/11/2025 |
| Cruz, Elizabeth | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2025 |
| Cruz, Elizabeth | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| Fellbaum, Ernest | Individual | ADP of the SNF | NOT APPLICABLE | 03/01/2023 |
| International Bank of Commerce | Organization | 5% or Greater Security Interest | NOT APPLICABLE | 04/28/2021 |
| Nutritious Lifestyles, INC. | Organization | ADP of the SNF | NOT APPLICABLE | 03/01/2023 |
| Plante & Moran PLLC | Organization | ADP of the SNF | NOT APPLICABLE | 03/01/2023 |
| Sehlke, Bryon | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/01/2023 |
| Sehlke, Bryon | Individual | ADP of the SNF | NOT APPLICABLE | 03/01/2023 |
| Studer, Stanley | Individual | ADP of the SNF | NOT APPLICABLE | 03/01/2023 |
| Thompson, Johnny | Individual | Corporate Officer | NOT APPLICABLE | 11/01/2023 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
- "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 |
|---|---|---|---|---|---|
| Stone Oak Care Center | 1.1 mi | San Antonio, TX | ★★☆☆☆ | 3/5 | |
| Sonterra Health Center | 1.2 mi | San Antonio, TX | ★☆☆☆☆ | 2/5 | |
| Coronado at Stone Oak | 1.6 mi | San Antonio, TX | ★★★★★ | 4/5 | |
| Castle Hills Rehabilitation and Care Center | 5.9 mi | San Antonio, TX | ★☆☆☆☆ | 1/5 | |
| Estates at Shavano Park | 6.0 mi | Shavano Park, TX | ★★★☆☆ | 3/5 | |
| San Antonio Wellness & Rehabilitation | 6.2 mi | San Antonio, TX | ★★☆☆☆ | 2/5 | |
| Broadway Nursing & Rehabilitation | 7.3 mi | San Antonio, TX | ★☆☆☆☆ | 2/5 | |
| Sage Park San Antonio | 8.2 mi | San Antonio, TX | ★★★☆☆ | 2/5 | |
| Windcrest Nursing and Rehabilitation | 8.4 mi | Windcrest, TX | ★☆☆☆☆ | 2/5 | |
| The Heights at Medical Center | 8.4 mi | San Antonio, TX | ★☆☆☆☆ | 2/5 | |
| The Heights on Huebner | 8.6 mi | San Antonio, TX | ★★★★☆ | 4/5 | |
| The Lev at San Antonio | 8.7 mi | San Antonio, TX | ★☆☆☆☆ | 2/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 676425.