River Hills Health and Rehabilitation CenterCMS ratings, inspections and fines
- Address
- 2091 Bandera Hwy, Kerrville, TX 78028
- CCN
- 676114
- Ownership type
- For-profit, individual
- Certified beds
- 150
- Chain
- None in the CMS record
- Residents per day
- 99
- CMS flags
- None in the CMS record
Open the watch listCare Compare record (Medicare.gov)
The watch list stays in this browser. After each CMS update, it shows the values that changed at the homes on the list.
CMS gives River Hills Health and Rehabilitation Center an overall rating of 1 of 5 stars. The last standard survey was on 13 Jun 2025. The latest survey cycle has 22 health citations. The median for nursing homes in Texas is 8. CMS lists 3 fines with a total of $112,133 for this home in its penalties file.
Facilities may see a change in their overall rating for a number of reasons. Since the overall rating is based on three individual domains, a change in any one of the domains can affect the overall rating. Any new data for a nursing home could potentially change a star rating domain.
Centers for Medicare & Medicaid Services, Five-Star Quality Rating System: Technical Users' Guide, July 2026. CMS processed this record on .
Since the last CMS update
The site has no recorded change for this home. In each CMS update, the site compares the ratings, the penalties and the citations of each home.
Ratings
CMS gives each home 1 to 5 stars for health inspections, for staffing and for quality measures, and one overall rating.
| Rating (1 to 5 stars) | This home | Kerr County median | Texas median | US average (CMS) |
|---|---|---|---|---|
| Overall rating | 1 | 1.0 | 3.0 | 3.0 |
| Health inspection rating | 1 | 1.0 | 3.0 | 2.8 |
| Staffing rating | 1 | 1.0 | 2.0 | 2.9 |
| Quality measure rating | 4 | 4.0 | 4.0 | 3.6 |
A median is the middle value of the homes in the group: 4 homes in the county, 1,177 homes in the state. What the CMS star ratings measure
Citations by survey cycle
CMS keeps the last three cycles, and cycle 1 is the latest. A cycle has one standard survey. Citations from complaint and infection control inspections go into cycles of 12 months.
| Survey cycle | Standard survey | Citations | Texas median |
|---|---|---|---|
| Cycle 1 (latest) | 13 Jun 2025 | 22 | 8 |
| Cycle 2 | 19 Apr 2024 | 26 | 8 |
| Cycle 3 | No date | 9 | 8 |
Health citations
The record of one deficiency in an inspection. One inspection can give many citations.
Scope and severity. A letter from A to L on each citation. Scope is the number of residents that the deficiency affected. Severity is the level of harm.
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy to resident health or safety | K0 | L0 | |
| Actual harm that is not immediate jeopardy | G0 | H0 | I0 |
| No actual harm, potential for more than minimal harm | |||
| No actual harm, potential for minimal harm | A0 | B0 |
Survey cycle 1 (latest): 22 citations
Standard survey of this cycle: .
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 19 Jun 2026 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Complaint investigation | 7 Jul 2026 |
| 7 May 2026 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | 1 Jun 2026 |
| 7 May 2026 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Complaint investigation | 1 Jun 2026 |
| 7 May 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. | D | Complaint investigation | 1 Jun 2026 |
| 4 Feb 2026 | F0628 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | Complaint investigation | 6 Feb 2026 |
| 4 Feb 2026 | F0641 | Ensure each resident receives an accurate assessment. | D | Complaint investigation | 6 Feb 2026 |
| 26 Nov 2025 | F0882 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | F | Complaint investigation | 19 Dec 2025 |
| 16 Sep 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 1 Oct 2025 |
| 13 Jun 2025 | F0583 | Keep residents' personal and medical records private and confidential. | D | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | 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. | D | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | F0605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | Complaint investigation | 11 Jul 2025 |
| 13 Jun 2025 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | F0685 | Assist a resident in gaining access to vision and hearing services. | D | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Standard survey | 11 Jul 2025 |
| 13 Jun 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. | E | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | F0727 | 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. | E | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | F0760 | Ensure that residents are free from significant medication errors. | D | Standard survey | 11 Jul 2025 |
| 13 Jun 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. | E | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | F0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors. | D | Standard survey | 11 Jul 2025 |
| 13 Jun 2025 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 11 Jul 2025 |
Survey cycle 2: 26 citations
Standard survey of this cycle: .
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 13 May 2025 | F0558 | Reasonably accommodate the needs and preferences of each resident. | E | Complaint investigation | 3 Jun 2025 |
| 13 May 2025 | F0641 | Ensure each resident receives an accurate assessment. | D | Complaint investigation | 3 Jun 2025 |
| 8 Feb 2025 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | Complaint investigation | 9 Feb 2025 |
| 8 Feb 2025 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | J | Complaint investigation | 9 Feb 2025 |
| 8 Feb 2025 | F0760 | Ensure that residents are free from significant medication errors. | J | Complaint investigation | 9 Feb 2025 |
| 8 Feb 2025 | F0770 | Provide timely, quality laboratory services/tests to meet the needs of residents. | D | Complaint investigation | 9 Feb 2025 |
| 21 Dec 2024 | F0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Complaint investigation | 22 Dec 2024 |
| 21 Dec 2024 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Complaint investigation | 22 Dec 2024 |
| 21 Dec 2024 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Complaint investigation | 22 Dec 2024 |
| 21 Dec 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | J | Complaint investigation | 22 Dec 2024 |
| 21 Dec 2024 | F0727 | 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. | F | Complaint investigation | 22 Dec 2024 |
| 9 Sep 2024 | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | E | Complaint investigation | 30 Sep 2024 |
| 9 Sep 2024 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | E | Complaint investigation | 30 Sep 2024 |
| 9 Sep 2024 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Complaint investigation | 30 Sep 2024 |
| 9 Sep 2024 | F0839 | Employ staff that are licensed, certified, or registered in accordance with state laws. | D | Complaint investigation | 30 Sep 2024 |
| 19 Apr 2024 | F0583 | Keep residents' personal and medical records private and confidential. | E | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0759 | Ensure medication error rates are not 5 percent or greater. | D | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0801 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | E | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors. | D | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0849 | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | E | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 31 May 2024 |
| 19 Apr 2024 | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Standard survey | 31 May 2024 |
Survey cycle 3: 9 citations
The CMS provider file has no standard survey date for this cycle.
| Survey date | F-tag | Requirement (CMS text) | Scope and severity | Survey type | Corrected |
|---|---|---|---|---|---|
| 10 Jan 2024 | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | J | Complaint investigation | 29 Jan 2024 |
| 10 Jan 2024 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | Complaint investigation | 29 Jan 2024 |
| 4 Mar 2023 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | E | Standard survey | 5 Mar 2023 |
| 4 Mar 2023 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Standard survey | 5 Mar 2023 |
| 4 Mar 2023 | F0727 | 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. | E | Standard survey | 5 Mar 2023 |
| 4 Mar 2023 | F0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | E | Standard survey | 5 Mar 2023 |
| 4 Mar 2023 | 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. | E | Standard survey | 5 Mar 2023 |
| 4 Mar 2023 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 5 Mar 2023 |
| 4 Mar 2023 | F0814 | Dispose of garbage and refuse properly. | C | Standard survey | 5 Mar 2023 |
The requirement text is the CMS summary of the F-tag. It is not the report of the surveyor. How to read an inspection report
Penalties
A fine, or a payment denial: a period in which Medicare or Medicaid does not pay for new admissions. The CMS penalties file holds three years.
| Date | Type | Fine | Days without payment |
|---|---|---|---|
| 8 Feb 2025 | Fine | $49,392 | |
| 21 Dec 2024 | Fine | $47,467 | |
| 10 Jan 2024 | Fine | $15,274 |
Staffing
Hours per resident per day. The nurse hours for one resident on an average day. CMS calculates the figure from the hours that the home reports for a quarter.
| Staff | This home | Texas median | Texas average (CMS) |
|---|---|---|---|
| All nurse staff | 3.11 | 3.30 | 3.39 |
| Registered nurses (RN) | 0.23 | 0.40 | 0.43 |
| Licensed practical nurses (LPN) | 1.04 | 0.95 | |
| Nurse aides | 1.83 | 2.00 | |
| All nurse staff, weekends | 2.73 | 2.90 | 2.98 |
- Nurse staff turnover in a year
- 75.9%
- Nurse staff turnover, Texas median
- 52.1%
- RN turnover in a year
- 83.3%
- Administrators who left in a year
- No data
Homes report the hours to CMS in the Payroll-Based Journal.
Quality measures
A figure that CMS calculates from the assessments of residents. One example is the percentage of long-stay residents with a fall and a major injury.
| Measure (CMS text) | Residents | This home | Texas median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 7.6% | 14.9% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.4% | 0.0% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 0.3% | 0.3% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 2.1% | 3.0% | 2.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 0.0% | 0.7% | 1.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 5.0% | 12.4% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 4.2% | 3.4% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 3.8% | 8.3% | 13.4% |
For each measure in this table, CMS gives more points in the quality measure rating for a lower percentage. The site calculates the medians from the CMS file. What the CMS star ratings measure
Ownership
An organisation in the CMS ownership file. CMS records its role, for example an ownership interest, operational or managerial control, or a mortgage interest.
- Ownership type
- For-profit, individual
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Uvalde County Hospital Authority | Indirect ownership interest | 1 May 2026 | |
| Crown Mountain Healthcare LLC | Operational/managerial control | 1 May 2026 | |
| Bandera Hwy Health Holdings LLC | Adp of the snf | 1 May 2026 | |
| Crown Mountain Healthcare LLC | Adp of the snf | 19 May 2026 | |
| Ensign Services, Inc. | Adp of the snf | 13 Feb 2026 | |
| Standard Bearer Healthcare Op LP | Adp of the snf | 1 May 2026 | |
| The Ensign Group, Inc. | Adp of the snf | 1 May 2026 |
The site shows organisations only. It does not show the names of persons.
Other homes in Kerr County
| Nursing home | City | Overall rating | Citations, latest cycle | Fines | Last standard survey | |
|---|---|---|---|---|---|---|
| Avir at Kerrville | Kerrville | 1 of 5 | 38 | $20,467 | 27 Jun 2025 | |
| Arbor View Nursing & RehabilitationSpecial Focus candidate | Kerrville | 1 of 5 | 24 | $154,617 | 31 Jul 2025 | |
| Hilltop Village Nursing and Rehabilitation | Kerrville | 2 of 5 | 10 | $0 | 27 Aug 2025 |
Official channels
- Care Compare record of this nursing homeMedicare.gov. The official CMS record of this home.
- Texas Health and Human Services: complaint and incident intakeThe complaint page of the State Survey Agency for Texas, from the CMS list of agencies.
- Contact information for State Survey AgenciesCMS. The web address and the telephone number of the State Survey Agency of each state. These agencies investigate complaints about nursing homes.
- Filing a complaintMedicare.gov. The page names the State Survey Agency as the place for a complaint about nursing home care or facility conditions.
- Eldercare LocatorAdministration for Community Living. A public service that connects older adults and their families to local services. Telephone: 1-800-677-1116.
Cite this page
Centers for Medicare & Medicaid Services, Care Compare. Record of River Hills Health and Rehabilitation Center (CCN 676114). Data processed 1 Aug 2026. Elder Care Record, https://eldercarerecord.com/facility/river-hills-health-and-rehabilitation-center-kerrville-tx-676114/
Provenance
- Licence
- US government work, public domain
- CMS processed the data on
A program makes this page from the CMS files, and the same files always give the same text. How the site makes the figures. Report an error.
Questions
- When was River Hills Health and Rehabilitation Center last inspected?
- The latest inspection with a citation in the CMS record was on 19 Jun 2026. It was a complaint investigation. It gave 1 citation. The standard survey before the last one was on 19 Apr 2024.
- Who operates River Hills Health and Rehabilitation Center?
- The CMS record gives the ownership type as for-profit, individual. CMS lists no chain for the home. The CMS ownership file names Crown Mountain Healthcare LLC for operational or managerial control. This site does not show the names of persons.
- Is River Hills Health and Rehabilitation Center a Special Focus Facility?
- No. The CMS provider file lists no Special Focus status for this home. CMS lists 6 homes in Texas as Special Focus Facilities and 30 as candidates.
- Where does the data on this page come from?
- The data comes from the CMS Care Compare files for nursing homes. CMS processed the files on 1 Aug 2026. The Care Compare record on Medicare.gov is the official record of the home.