Nursing home in San Antonio, Texas
The Enclave
Medicare and Medicaid
18803 HARDY OAK, San Antonio, TX 78258
(210) 982-4600
CMS star ratings
CMS gives this nursing home an overall star rating of 1 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 home1
- 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 home1
- Texas average1.9 (1,163 rated)
- U.S. average2.9 (14,494 rated)
Quality measures
- This nursing home3
- Texas average3.7 (1,162 rated)
- U.S. average3.6 (14,495 rated)
Health inspections
Most recent standard health inspection (rating cycle 1): Aug 27, 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 41 health deficiencies on 9 inspection dates since Sep 30, 2023. By level of harm: 1 immediate jeopardy, 38 potential for harm, 2 minimal harm potential.
- 1 Immediate jeopardy to resident health or safety
- 0 Actual harm
- 38 No actual harm, potential for more than minimal harm
- 2 No actual harm, potential for minimal harm
| Date | Tag | Deficiency | Scope and severity | Inspection type | Status |
|---|---|---|---|---|---|
| Feb 26, 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 | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Feb 27, 2026 |
| Feb 6, 2026 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and Exploitation Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Feb 7, 2026 |
| Feb 6, 2026 | 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 Feb 7, 2026 |
| Aug 27, 2025 | F0641 | Ensure each resident receives an accurate assessment.Resident Assessment and Care Planning Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
| Aug 27, 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 | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
| Aug 27, 2025 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy Service Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
| Aug 27, 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 Aug 28, 2025 |
| Aug 27, 2025 | F0880 | Provide and implement an infection prevention and control program.Infection Control Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
| Aug 27, 2025 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
| Aug 27, 2025 | F0558 | Reasonably accommodate the needs and preferences of each resident.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
Show the other 31 deficiencies
| Date | Tag | Deficiency | Scope and severity | Inspection type | Status |
|---|---|---|---|---|---|
| Aug 27, 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 | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
| Aug 27, 2025 | F0695 | Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
| Aug 27, 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 Aug 28, 2025 |
| Aug 27, 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 Aug 28, 2025 |
| Aug 27, 2025 | F0732 | Post nurse staffing information every day.Nursing and Physician Services Deficiencies | C Minimal harm potential, widespread | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
| Aug 27, 2025 | F0640 | Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.Resident Assessment and Care Planning Deficiencies | B Minimal harm potential, pattern | Standard | Deficient, Provider has date of correction Aug 28, 2025 |
| Jul 24, 2025 | 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 25, 2025 |
| May 5, 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 May 6, 2025 |
| Jun 28, 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 | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | F0760 | Ensure that residents are free from significant medication errors.Pharmacy Service Deficiencies | E Potential for harm, pattern | Standard, Complaint | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | F0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors.Nutrition and Dietary Deficiencies | E Potential for harm, pattern | Standard | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | F0558 | Reasonably accommodate the needs and preferences of each resident.Resident Rights Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | F0641 | Ensure each resident receives an accurate assessment.Resident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | F0645 | PASARR screening for Mental disorders or Intellectual DisabilitiesResident Assessment and Care Planning Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | F0693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | F0695 | Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | F0700 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.Quality of Life and Care Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 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 Jun 29, 2024 |
| Jun 28, 2024 | F0803 | 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.Nutrition and Dietary Deficiencies | D Potential for harm, isolated | Standard | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 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 | Deficient, Provider has date of correction Jun 29, 2024 |
| Jun 28, 2024 | 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 29, 2024 |
| Jun 7, 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 | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction Jun 8, 2024 |
| May 4, 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 | J Immediate jeopardy, isolated | Complaint | Deficient, Provider has date of correction Jun 8, 2024 |
| May 4, 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 | E Potential for harm, pattern | Complaint | Deficient, Provider has date of correction May 5, 2024 |
| May 4, 2024 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident Rights Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction May 5, 2024 |
| May 4, 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 May 5, 2024 |
| May 4, 2024 | F0760 | Ensure that residents are free from significant medication errors.Pharmacy Service Deficiencies | D Potential for harm, isolated | Complaint | Deficient, Provider has date of correction May 5, 2024 |
| May 4, 2024 | 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 May 5, 2024 |
| Jan 29, 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 Jan 30, 2024 |
| Jan 29, 2024 | 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 30, 2024 |
Staffing
Total nurse staffing
Reported hours per resident per day.
- This nursing home3.63 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 home0.33 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 home60.9%
- Texas average55.3% (1,051 with data)
- U.S. average45.8% (13,538 with data)
Penalties
CMS lists 2 penalties for this nursing home: 1 fine totaling $10,039, and 1 payment denial. CMS counts penalties from the last 3 years.
Facility details
| Certified beds | 142 |
|---|---|
| Average residents per day | 119.5 |
| Ownership | For profit - Corporation |
| Provider type | Medicare and Medicaid |
| Inside a hospital | No |
| Continuing care retirement community | No |
| Resident and family council | Both |
| Automatic sprinklers in all required areas | Yes |
| Chain | Touchstone Communities (25 facilities) |
| Legal business name | WEST WHARTON COUNTY HOSPITAL DISTRICT |
| First approved for Medicare and Medicaid | Apr 27, 2017 |
| County | Bexar |
| CMS certification number | 676425 |
Also in San Antonio
| Nursing home | CMS overall rating | Health inspection rating | Certified beds | Ownership |
|---|---|---|---|---|
| Morningside Manor | 147 | Non profit - Corporation | ||
| San Pedro Manor | 150 | Government - Hospital district | ||
| Silver Creek Nursing and Rehabilitation | 120 | For profit - Limited Liability company | ||
| Avir at San Antonio | 119 | For profit - Corporation | ||
| Broadway Nursing & Rehabilitation | 237 | For profit - Limited Liability company | ||
| Buena Vida Nursing and Rehab-San Antonio | 222 | Government - Hospital district | ||
| Castle Hills Rehabilitation and Care Center | 143 | For profit - Limited Liability company | ||
| Memorial Medical Nursing and Rehabilitation | 135 | Government - Hospital district | ||
| Meridian Care Monte Vista | 106 | For profit - Individual | ||
| Mesa Vista Inn Health Center | 144 | For profit - Corporation | ||
| Northeast Rehabilitation and Healthcare Center | 120 | Government - Hospital district | ||
| The Lev at San Antonio | 106 | For profit - Limited Liability company |
| Hospital | CMS overall rating | Type | Emergency services |
|---|---|---|---|
| San Antonio VA Medical Center (VA South Texas Healthcare System) | Acute Care - Veterans Administration | Yes | |
| Methodist Hospital | Acute Care Hospitals | Yes | |
| Baptist Medical Center | Acute Care Hospitals | Yes | |
| CHRISTUS Santa Rosa Medical Center | Acute Care Hospitals | Yes | |
| University Health System | Acute Care Hospitals | Yes | |
| Children's Hospital of San Antonio | Not available | Childrens | Yes |
| San Antonio State Hosp State School | Not available | Psychiatric | No |
| South Texas Spine and Surgical Hospital | Not available | Acute Care Hospitals | Yes |