The Heights of Bulverde
384 Harmony Hills · Spring Branch, TX · 78070 · 8304381276
124 certified beds For profit - Corporation Chain: Touchstone Communities Hospital-based
Why this verdict
- Inspection record is far worse than the national median (deficiency count and severity).
- No federal fines or payment denials in CMS’s 3-year window.
- 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 prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
Total nurse staffing below 3.0 hours per resident-day
3.00 reported hours vs the 3.48 minimum CMS's own staffing study recommends.
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: 2 of 5 Staffing: 1 of 5 Quality measures: 4 of 5
| Total nurse hours / resident-day | 3.00 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.44 | 0.55–0.75 |
| Weekend hours / resident-day | 2.56 | ≈ weekday level |
| Nursing turnover / year | 60% | median 45% |
| Fines (3-yr window) | none |
Inspection citations (46 in the current record)
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Potential for harm · D January 13, 2026 · found via complaint
Provide and implement an infection prevention and control program.
Corrected January 14, 2026 · Infection Control
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Potential for harm · D December 10, 2025 · found via complaint
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
Corrected December 11, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E December 10, 2025 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected December 11, 2025 · Resident Assessment and Care Planning
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Potential for harm · D December 10, 2025 · found via complaint
Provide and implement an infection prevention and control program.
Corrected December 11, 2025 · Infection Control
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Potential for harm · D December 9, 2025 · found via complaint
Ensure each resident receives an accurate assessment.
Corrected December 10, 2025 · Resident Assessment and Care Planning
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Potential for harm · D December 9, 2025 · found via complaint
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected December 10, 2025 · Quality of Life and Care
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Potential for harm · E December 9, 2025 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected December 10, 2025 · Resident Assessment and Care Planning
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Potential for harm · D June 25, 2025
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected June 26, 2025 · Resident Rights
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Potential for harm · D June 25, 2025
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected June 26, 2025 · Resident Rights
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Potential for harm · D June 25, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected June 26, 2025 · Resident Assessment and Care Planning
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Potential for harm · D June 25, 2025
Ensure medication error rates are not 5 percent or greater.
Corrected June 26, 2025 · Pharmacy Service
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Potential for harm · D June 25, 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 June 26, 2025 · Pharmacy Service
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Potential for harm · E June 25, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected June 26, 2025 · Nutrition and Dietary
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Potential for harm · D June 25, 2025
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected June 26, 2025 · Resident Assessment and Care Planning
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Potential for harm · D June 25, 2025
Provide and implement an infection prevention and control program.
Corrected June 26, 2025 · Infection Control
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Potential for harm · D April 24, 2025 · found via complaint
Ensure each resident receives an accurate assessment.
Corrected April 25, 2025 · Resident Assessment and Care Planning
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Potential for harm · E April 24, 2025 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected April 25, 2025 · Resident Assessment and Care Planning
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Potential for harm · E April 19, 2025 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected April 20, 2025 · Resident Assessment and Care Planning
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Immediate jeopardy · J March 21, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected March 22, 2025 · Quality of Life and Care
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Potential for harm · D March 21, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected March 22, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 21, 2025 · found via complaint
Respond appropriately to all alleged violations.
Corrected March 22, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 21, 2025 · 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 December 24, 2024 · Resident Assessment and Care Planning
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Potential for harm · D March 21, 2025 · found via complaint
Provide and implement an infection prevention and control program.
Corrected March 22, 2025 · Infection Control
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Potential for harm · D July 22, 2024 · 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 July 23, 2024 · Resident Assessment and Care Planning
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Potential for harm · D July 22, 2024 · found via complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected July 23, 2024 · Pharmacy Service
Showing the 25 most recent. The Safety Report includes every citation with full findings.
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 676418 · certified since March 15, 2017. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.