Nursing home in Spring Branch, Texas
The Heights of Bulverde
Medicare and Medicaid
384 HARMONY HILLS, Spring Branch, TX 78070
(830) 438-1276
CMS star ratings
CMS gives this nursing home an overall star rating of 2 out of 5. Each rating is compared with the mean of rated nursing homes in Texas (1,165 for the overall rating) and in the U.S. (14,565). How to read an inspection report.
Overall rating
- This nursing home2
- Texas average2.7 (1,165 rated)
- U.S. average3.0 (14,565 rated)
Health inspections
- This nursing home2
- Texas average2.8 (1,165 rated)
- U.S. average2.8 (14,565 rated)
Staffing
- This nursing home2
- Texas average1.9 (1,163 rated)
- U.S. average2.9 (14,494 rated)
Quality measures
- This nursing home4
- Texas average3.7 (1,162 rated)
- U.S. average3.6 (14,495 rated)
Health inspections
Most recent standard health inspection (rating cycle 1): Jun 25, 2025. CMS counts 16 health deficiencies in rating cycle 1.
- This nursing home16
- Texas average9.4 (1,171 with data)
- U.S. average9.2 (14,652 with data)
Rating cycle 1 health deficiencies. Averages include every nursing home with a count in the CMS file; fewer is better.
Deficiencies since Sep 30, 2023
Inspectors cited 43 health deficiencies on 11 inspection dates since Sep 30, 2023. By level of harm: 1 immediate jeopardy, 42 potential for harm.
- 1 Immediate jeopardy to resident health or safety
- 0 Actual harm
- 42 No actual harm, potential for more than minimal harm
- 0 No actual harm, potential for minimal harm
| Date | Tag | Deficiency | Scope and severity | Inspection type | Status |
|---|---|---|---|---|---|
| Apr 1, 2026 | F0761 | 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.Pharmacy Service Deficiencies | E Potential for harm, pattern | Complaint | Deficient, Provider has date of correction Apr 2, 2026 |
| Jan 13, 2026 | F0880 | Provide and implement an infection prevention and control program.Infection Control Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Jan 14, 2026 |
| Dec 10, 2025 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care Planning Deficiencies | E Potential for harm, pattern | Complaint | Deficient, Provider has date of correction Dec 11, 2025 |
| Dec 10, 2025 | F0603 | Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).Freedom from Abuse, Neglect, and Exploitation Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Dec 11, 2025 |
| Dec 10, 2025 | F0880 | Provide and implement an infection prevention and control program.Infection Control Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Dec 11, 2025 |
| Dec 9, 2025 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care Planning Deficiencies | E Potential for harm, pattern | Complaint | Deficient, Provider has date of correction Dec 10, 2025 |
| Dec 9, 2025 | F0641 | Ensure each resident receives an accurate assessment.Resident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Dec 10, 2025 |
| Dec 9, 2025 | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Dec 10, 2025 |
| Jun 25, 2025 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and Dietary Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Jun 26, 2025 |
| Jun 25, 2025 | F0552 | Ensure that residents are fully informed and understand their health status, care and treatments.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 26, 2025 |
Show the other 33 deficiencies
| Date | Tag | Deficiency | Scope and severity | Inspection type | Status |
|---|---|---|---|---|---|
| Jun 25, 2025 | F0578 | 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.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 26, 2025 |
| Jun 25, 2025 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 26, 2025 |
| Jun 25, 2025 | F0759 | Ensure medication error rates are not 5 percent or greater.Pharmacy Service Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 26, 2025 |
| Jun 25, 2025 | F0761 | 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.Pharmacy Service Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 26, 2025 |
| Jun 25, 2025 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 26, 2025 |
| Jun 25, 2025 | F0880 | Provide and implement an infection prevention and control program.Infection Control Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 26, 2025 |
| Apr 24, 2025 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care Planning Deficiencies | E Potential for harm, pattern | Complaint | Deficient, Provider has date of correction Apr 25, 2025 |
| Apr 24, 2025 | F0641 | Ensure each resident receives an accurate assessment.Resident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Apr 25, 2025 |
| Apr 19, 2025 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care Planning Deficiencies | E Potential for harm, pattern | Complaint | Deficient, Provider has date of correction Apr 20, 2025 |
| Mar 21, 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and Care Deficiencies | J Immediate jeopardy, isolated | Complaint | Deficient, Provider has date of correction Mar 22, 2025 |
| Mar 21, 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and Exploitation Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Mar 22, 2025 |
| Mar 21, 2025 | F0610 | Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and Exploitation Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Mar 22, 2025 |
| Mar 21, 2025 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Complaint | Past Non-Compliance Dec 24, 2024 |
| Mar 21, 2025 | F0880 | Provide and implement an infection prevention and control program.Infection Control Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Mar 22, 2025 |
| Jul 22, 2024 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Jul 23, 2024 |
| Jul 22, 2024 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy Service Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Jul 23, 2024 |
| May 5, 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and Dietary Deficiencies | F Potential for harm, widespread | Standard, Complaint | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0814 | Dispose of garbage and refuse properly.Nutrition and Dietary Deficiencies | F Potential for harm, widespread | Standard, Complaint | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident Rights Deficiencies | E Potential for harm, pattern | Standard, Complaint | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and Care Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and Care Deficiencies | E Potential for harm, pattern | Standard, Complaint | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0759 | Ensure medication error rates are not 5 percent or greater.Pharmacy Service Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0760 | Ensure that residents are free from significant medication errors.Pharmacy Service Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.Environmental Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0635 | Provide doctor's orders for the resident's immediate care at the time the resident was admitted.Resident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0761 | 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.Pharmacy Service Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0773 | Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.Administration Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.Nutrition and Dietary Deficiencies | D Potential for harm, isolated | Standard, Complaint | Deficient, Provider has date of correction May 6, 2024 |
| May 5, 2024 | F0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors.Nutrition and Dietary Deficiencies | D Potential for harm, isolated | Standard, Complaint | Deficient, Provider has date of correction May 6, 2024 |
| Mar 21, 2024 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and Exploitation Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Mar 22, 2024 |
Staffing
Total nurse staffing
Reported hours per resident per day.
- This nursing home3.13 hours
- Texas average3.39 hours (1,148 with data)
- U.S. average3.86 hours (14,351 with data)
Registered nurse staffing
Reported hours per resident per day.
- This nursing home0.52 hours
- Texas average0.43 hours (1,148 with data)
- U.S. average0.69 hours (14,351 with data)
Nursing staff turnover
Share of nursing staff who left during the year, as reported to CMS.
- This nursing home55.9%
- Texas average55.3% (1,051 with data)
- U.S. average45.8% (13,538 with data)
Penalties
CMS lists 0 penalties for this nursing home: 0 fines totaling $0, and 0 payment denials. CMS counts penalties from the last 3 years.
Facility details
| Certified beds | 124 |
|---|---|
| Average residents per day | 97.3 |
| Ownership | For profit - Corporation |
| Provider type | Medicare and Medicaid |
| Inside a hospital | Yes |
| Continuing care retirement community | No |
| Resident and family council | Resident |
| Automatic sprinklers in all required areas | Yes |
| Chain | Touchstone Communities (25 facilities) |
| Legal business name | UVALDE COUNTY HOSPITAL AUTHORITY |
| First approved for Medicare and Medicaid | Mar 15, 2017 |
| County | Comal |
| CMS certification number | 676418 |