Castle Hills Rehabilitation and Care Center
8020 Blanco Rd · San Antonio, TX · 78216 · 2103444553
143 certified beds For profit - Limited Liability company Chain: Optima Care
Why this verdict
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
- Inspection record is far worse than the national median (deficiency count and severity).
- Federal penalties on record: $56,440 in fines in the last 24 months.
- Inspection results have improved across recent cycles.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
1 immediate-jeopardy citation in the most recent inspection cycle
Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.
1 abuse-related citation at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
$56,440 in federal fines in the last 24 months
3 fines — CMS fines are reserved for verified, serious non-compliance.
Total nurse staffing below 3.0 hours per resident-day
2.75 reported hours vs the 3.48 minimum CMS's own staffing study recommends.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 1 of 5 Staffing: 1 of 5 Quality measures: 1 of 5
| Total nurse hours / resident-day | 2.75 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.40 | 0.55–0.75 |
| Weekend hours / resident-day | 2.40 | ≈ weekday level |
| Nursing turnover / year | — | median 45% |
| Fines (3-yr window) | 5 · $117,166 |
Inspection citations (67 in the current record)
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Potential for harm · E April 24, 2026 · found via complaint
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected May 31, 2026 · Nutrition and Dietary
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Potential for harm · D April 24, 2026 · found via complaint
Provide and implement an infection prevention and control program.
Corrected May 31, 2026 · Infection Control
-
Potential for harm · E March 6, 2026 · found via complaint
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.
Corrected March 20, 2026 · Pharmacy Service
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Potential for harm · D February 22, 2026 · found via complaint
Ensure each resident receives an accurate assessment.
Corrected March 15, 2026 · Resident Assessment and Care Planning
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Potential for harm · D February 22, 2026 · found via complaint
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected March 15, 2026 · Resident Assessment and Care Planning
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Potential for harm · D February 22, 2026 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected March 15, 2026 · Resident Assessment and Care Planning
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Potential for harm · D January 16, 2026 · found via complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected February 20, 2026 · Pharmacy Service
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Potential for harm · D January 16, 2026 · found via complaint
Provide and implement an infection prevention and control program.
Corrected February 20, 2026 · Infection Control
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Potential for harm · E December 10, 2025 · found via complaint
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected January 10, 2026 · Nutrition and Dietary
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Potential for harm · E December 10, 2025 · found via complaint
Keep all essential equipment working safely.
Corrected December 12, 2025 · Environmental
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Potential for harm · D November 25, 2025 · found via complaint
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Corrected November 26, 2025 · Nursing and Physician Services
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Potential for harm · E November 14, 2025 · found via complaint
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected January 10, 2026 · Nutrition and Dietary
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Potential for harm · E November 14, 2025 · found via complaint
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Corrected November 30, 2025 · Environmental
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Immediate jeopardy · J September 12, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected September 13, 2025 · Quality of Life and Care
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Potential for harm · D September 12, 2025
Reasonably accommodate the needs and preferences of each resident.
Corrected September 13, 2025 · Resident Rights
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Potential for harm · D September 12, 2025
Ensure each resident receives an accurate assessment.
Corrected September 13, 2025 · Resident Assessment and Care Planning
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Potential for harm · D September 12, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected September 13, 2025 · Resident Assessment and Care Planning
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Potential for harm · D September 12, 2025
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected September 13, 2025 · Quality of Life and Care
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Potential for harm · D September 12, 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.
Corrected September 13, 2025 · Pharmacy Service
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Potential for harm · E September 12, 2025
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Corrected September 13, 2025 · Nutrition and Dietary
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Potential for harm · E September 12, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected September 13, 2025 · Nutrition and Dietary
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Potential for harm · D September 12, 2025
Provide and implement an infection prevention and control program.
Corrected September 13, 2025 · Infection Control
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Potential for harm · D September 12, 2025
Have policies on smoking.
Corrected September 13, 2025 · Environmental
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No harm found · C September 12, 2025
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Corrected September 13, 2025 · Resident Rights
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Potential for harm · D August 15, 2025 · found via complaint
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected September 14, 2025 · Resident Assessment and Care Planning
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| September 12, 2025 | Fine | $19,120 |
| May 2, 2025 | Fine | $27,094 |
| August 2, 2024 | Fine | $10,226 |
| March 16, 2024 | Fine | $55,648 |
| June 29, 2023 | Fine | $5,078 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 455510 · certified since July 1, 1985. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.