The Rio at Mission Trails
6211 S New Braunfels Ave · San Antonio, TX · 78223 · 2105310569
124 certified beds Government - Hospital district Chain: Creative Solutions in Healthcare Hospital-based
Why this verdict
- Inspection record is far worse than the national median (deficiency count and severity).
- Federal penalties on record: $96,694 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
3 immediate-jeopardy citations in prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
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.
$96,694 in federal fines in the last 24 months
1 fine — CMS fines are reserved for verified, serious non-compliance.
RN staffing in the bottom 10% nationally
0.28 registered-nurse hours per resident per day, vs a 0.58 national median and 0.75 benchmark.
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: 2 of 5 Inspections: 2 of 5 Staffing: 1 of 5 Quality measures: 5 of 5
| Total nurse hours / resident-day | 3.68 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.28 | 0.55–0.75 |
| Weekend hours / resident-day | 3.21 | ≈ weekday level |
| Nursing turnover / year | — | median 45% |
| Fines (3-yr window) | 2 · $153,825 |
Inspection citations (30 in the current record)
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Potential for harm · D April 17, 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 April 19, 2026 · Resident Assessment and Care Planning
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Potential for harm · D April 17, 2026 · found via complaint
Provide safe and appropriate respiratory care for a resident when needed.
Corrected May 31, 2026 · Quality of Life and Care
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Potential for harm · D April 7, 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 May 1, 2026 · Resident Assessment and Care Planning
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Potential for harm · E March 25, 2026
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Corrected April 8, 2026 · Resident Rights
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Potential for harm · D March 25, 2026
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected April 8, 2026 · Resident Assessment and Care Planning
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Potential for harm · E March 25, 2026
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Corrected April 22, 2026 · Nursing and Physician Services
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Potential for harm · D March 25, 2026
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected April 22, 2026 · Pharmacy Service
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Potential for harm · E March 25, 2026
Ensure medication error rates are not 5 percent or greater.
Corrected April 8, 2026 · Pharmacy Service
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Potential for harm · E March 25, 2026
Ensure that residents are free from significant medication errors.
Corrected April 8, 2026 · Pharmacy Service
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Potential for harm · D March 25, 2026
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 April 8, 2026 · Pharmacy Service
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No harm found · B March 25, 2026
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected April 22, 2026 · Resident Assessment and Care Planning
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No harm found · B March 25, 2026
Make sure that a working call system is available in each resident's bathroom and bathing area.
Corrected April 8, 2026 · Environmental
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Potential for harm · D March 19, 2026 · found via complaint
Ensure each resident receives an accurate assessment.
Corrected March 24, 2026 · Resident Assessment and Care Planning
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Potential for harm · D March 19, 2026 · found via complaint
Provide and implement an infection prevention and control program.
Corrected March 24, 2026 · Infection Control
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Potential for harm · D April 10, 2025 · found via complaint
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected March 3, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 10, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected March 3, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Immediate jeopardy · J February 24, 2025 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected February 28, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Immediate jeopardy · J February 24, 2025 · found via complaint
Provide safe and appropriate respiratory care for a resident when needed.
Corrected February 28, 2025 · Quality of Life and Care
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Potential for harm · E December 18, 2024
Reasonably accommodate the needs and preferences of each resident.
Corrected January 6, 2025 · Resident Rights
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Potential for harm · D December 18, 2024
Ensure each resident receives an accurate assessment.
Corrected January 6, 2025 · Resident Assessment and Care Planning
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Potential for harm · D December 18, 2024
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected January 6, 2025 · Resident Assessment and Care Planning
-
Potential for harm · D December 18, 2024
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 January 6, 2025 · Pharmacy Service
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Potential for harm · D December 18, 2024
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected January 6, 2025 · Nutrition and Dietary
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Potential for harm · D December 18, 2024
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected January 6, 2025 · Resident Assessment and Care Planning
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Potential for harm · D November 21, 2024 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected November 25, 2024 · Freedom from Abuse, Neglect, and Exploitation
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| February 24, 2025 | Fine | $96,694 |
| June 20, 2024 | Fine | $57,131 |
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 676297 · certified since October 12, 2011. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.