The Heights of Bulverde
384 Harmony Hills, Spring Branch, TX 78070 · Comal County · 124 certified beds · avg 97 residents/day · certified since Mar 15, 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
$0
Fines, last 3 years
2.73
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: 2/5
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 · Mar 21, 2025 · 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: Mar 22, 2025 (Deficient, Provider has date of correction)
All citations in the current public record (47)
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 |
|---|---|---|
| Apr 1, 2026 | E · Potential for harm, repeated | 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 |
| Jan 13, 2026 | 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 |
| Dec 10, 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 |
| Dec 10, 2025 | D · Potential for harm, one-off | The facility did not protect residents from being involuntarily separated — kept apart from other residents, kept out of their own room, or confined to their room. Isolating a resident this way is a form of mistreatment. · from a complaint |
| Dec 10, 2025 | 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 |
| Dec 9, 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 |
| Dec 9, 2025 | 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. · from a complaint |
| Dec 9, 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. · from a complaint |
| Jun 25, 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. |
| Jun 25, 2025 | D · Potential for harm, one-off | The facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand. |
| Jun 25, 2025 | D · Potential for harm, one-off | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. |
| Jun 25, 2025 | D · Potential for harm, one-off | 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. |
| Jun 25, 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. |
| Jun 25, 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. |
| Jun 25, 2025 | 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. |
| Jun 25, 2025 | 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. |
| Apr 24, 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 |
| Apr 24, 2025 | 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. · from a complaint |
| Apr 19, 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 |
| Mar 21, 2025 | ▲ 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 |
| Mar 21, 2025 | 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 |
| Mar 21, 2025 | D · Potential for harm, one-off | The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint |
| Mar 21, 2025 | D · Potential for harm, one-off | 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. · from a complaint |
| Mar 21, 2025 | 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 |
| Jul 22, 2024 | D · Potential for harm, one-off | 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. · from a complaint |
| Jul 22, 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 |
| May 5, 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. · from a complaint |
| May 5, 2024 | F · Potential for harm, facility-wide | The facility did not dispose of garbage and refuse properly. · from a complaint |
| May 5, 2024 | E · Potential for harm, repeated | The facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. · from a complaint |
| May 5, 2024 | E · Potential for harm, repeated | 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. |
| May 5, 2024 | E · Potential for harm, repeated | 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 5, 2024 | E · Potential for harm, repeated | 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. |
| May 5, 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. |
| May 5, 2024 | E · Potential for harm, repeated | The facility did not maintain an effective pest control program to prevent or deal with mice, insects, or other pests. |
| May 5, 2024 | D · Potential for harm, one-off | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. |
| May 5, 2024 | D · Potential for harm, one-off | The facility did not have doctor's orders in place for a resident's immediate care at the time the resident was admitted. |
| May 5, 2024 | 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. |
| May 5, 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. |
| May 5, 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. |
| May 5, 2024 | D · Potential for harm, one-off | The facility did not provide or obtain laboratory tests when a doctor ordered them, or did not promptly report the results back to the doctor who ordered them. |
| May 5, 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. · from a complaint |
| May 5, 2024 | D · Potential for harm, one-off | The facility did not have a policy covering how food brought in by family and visitors is used and stored safely. · from a complaint |
| Mar 21, 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 |
| Mar 24, 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. |
| Mar 24, 2023 | 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. |
| Mar 24, 2023 | D · Potential for harm, one-off | The facility did not make sure special medical diets — like low-sodium or diabetic diets — were properly ordered by the resident's doctor or managed by a qualified dietitian as state law allows. |
| Mar 24, 2023 | 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. |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (16 → 8).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 4 | 0 | E |
| 2024 | 19 | 0 | F |
| 2025 | 22 | 1 | J ▲ |
| 2026 | 2 | 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.
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) | 2.73 | 3.46 | 3.95 | bottom 9% in Texas; bottom 7% in the U.S. |
| Registered Nurse hours | 0.46 | 0.44 | 0.69 | top 33% in Texas; bottom 31% in the U.S. |
| Weekend total nurse staffing | 2.28 | 3.04 | 3.50 | bottom 6% in Texas; bottom 5% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.41 | 0.34 | 0.48 | top 25% in Texas; top 47% in the U.S. |
| Total nursing staff turnover (%) | 55.9 | 55.3 | 45.8 | bottom 41% in Texas; bottom 23% in the U.S. |
| RN turnover (%) | 30.0 | 54.6 | 42.9 | top 18% in Texas; top 29% 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 3.13, RN 0.52, weekend 2.61. Staffing rating: 2/5.
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 - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Aegis Therapies, INC. | Organization | ADP of the SNF | NOT APPLICABLE | 04/01/2019 |
| Alamo Advisors LP | Organization | ADP of the SNF | NOT APPLICABLE | 04/01/2019 |
| Apolinar, Adam | Individual | Corporate Officer | NOT APPLICABLE | 08/01/2015 |
| Campbell, Leslie | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2020 |
| Campbell, Leslie | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2020 |
| Carvajal Pharmacy LTC | Organization | ADP of the SNF | NOT APPLICABLE | 04/01/2019 |
| Castillo, Lynnea | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2019 |
| Castillo, Lynnea | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2019 |
| Clayton, Jonathon | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2023 |
| Clayton, Jonathon | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2023 |
| Dentino, Andrew | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2025 |
| Dentino, Andrew | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2025 |
| Fellbaum, Ernest | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2019 |
| Frost Bank | Organization | 5% or Greater Security Interest | NOT APPLICABLE | 05/23/2024 |
| Hackett, Edward | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/01/2025 |
| Hackett, Edward | Individual | ADP of the SNF | NOT APPLICABLE | 09/01/2025 |
| Nutritious Lifestyles, INC. | Organization | ADP of the SNF | NOT APPLICABLE | 04/01/2019 |
| Plante & Moran PLLC | Organization | ADP of the SNF | NOT APPLICABLE | 04/01/2019 |
| Prado, Aaron | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/28/2024 |
| Prado, Aaron | Individual | ADP of the SNF | NOT APPLICABLE | 03/28/2024 |
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?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "How do you keep residents' medical records accurate, complete, and secure?"
- "Under what circumstances, if any, would a resident ever be kept in their room or separated from others?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
- "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 |
|---|---|---|---|---|---|
| Coronado at Stone Oak | 12.8 mi | San Antonio, TX | ★★★★★ | 4/5 | |
| The Enclave | 13.5 mi | San Antonio, TX | ★☆☆☆☆ | 2/5 | |
| Stone Oak Care Center | 13.6 mi | San Antonio, TX | ★★☆☆☆ | 3/5 | |
| Sonterra Health Center | 14.1 mi | San Antonio, TX | ★☆☆☆☆ | 2/5 | |
| San Antonio Wellness & Rehabilitation | 15.4 mi | San Antonio, TX | ★★☆☆☆ | 2/5 | |
| Trucare Living Centers - Selma | 16.0 mi | Selma, TX | ★★☆☆☆ | 3/5 | |
| Avir at Schertz | 16.2 mi | Schertz, TX | ★★☆☆☆ | 1/5 | abuse |
| Cibolo Creek | 17.7 mi | Boerne, TX | ★★☆☆☆ | 2/5 | |
| Avir at Boerne | 17.7 mi | Boerne, TX | ★☆☆☆☆ | 1/5 | |
| Kirkwood Manor | 17.8 mi | New Braunfels, TX | ★★☆☆☆ | 2/5 | |
| Estates at Shavano Park | 17.9 mi | Shavano Park, TX | ★★★☆☆ | 3/5 | |
| Eden Home | 18.5 mi | New Braunfels, TX | ★★★☆☆ | 3/5 |
Compare this facility with the 3 closest →
All facilities in Spring Branch →
Facility data as of CMS processing date 2026-08-01. CCN 676418.