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| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J3 | K· | L· |
| Actual harm | G2 | H· | I· |
| Potential harm | D7 | E4 | F3 |
| Minimal | A· | B· | C· |
CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.
Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.
| Date | Domain | Survey types | Citations | Most severe | Open | |
|---|---|---|---|---|---|---|
| Apr 17, 2026 | Health | Health Complaint | 1 | Actual harm | — | Open → |
| Aug 14, 2025 | Fire safety | Fire Safety Standard | 1 | Potential harm | — | Open → |
| Aug 14, 2025 | Health | Health Standard | 2 | Potential harm | — | Open → |
| Apr 18, 2025 | Health | Health Complaint | 2 | Immediate jeopardy | — | Open → |
| Oct 2, 2024 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Sep 9, 2024 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| Jul 30, 2024 | Health | Health Complaint | 1 | Immediate jeopardy | — | Open → |
| Jul 11, 2024 | Fire safety | Fire Safety Standard | 1 | Potential harm | — | Open → |
| Jul 11, 2024 | Health | Health Standard | 1 | Potential harm | — | Open → |
| Jan 10, 2024 | Health | Infection Control | 0 | No citations | — | Open → |
| Oct 2, 2023 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jun 2, 2023 | Fire safety | Fire Safety Standard | 2 | Potential harm | — | Open → |
| Jun 2, 2023 | Health | Health Standard | 4 | Actual harm | — | Open → |
| Date | Type | Amount | Payment denial | Record |
|---|---|---|---|---|
| Apr 17, 2026 | Civil money penalty (fine) | $10,628 | — | 455503|Fine|138759 |
| Apr 18, 2025 | Civil money penalty (fine) | $9,193 | — | 455503|Fine|113785 |
| Jul 11, 2024 | Civil money penalty (fine) | $16,755 | — | 455503|Fine|113080 |
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J3 | K· | L· |
| Actual harm | G2 | H· | I· |
| Potential harm | D7 | E4 | F3 |
| Minimal | A· | B· | C· |
| Date | Tag | Deficiency | Scope / severity | Correction | Flags |
|---|---|---|---|---|---|
| Apr 17, 2026 | F-0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · Clinical care | G · Actual harm Isolated | Corrected Apr 24, 2026 | Complaint |
| Aug 14, 2025 | K-0223 | Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. Egress Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Sep 15, 2025 | |
“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.
CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.
CMS legal business name of the certified provider. Operates 38 facilities.
25 facilities in 1 states. CMS chain ID 521.
Chain average overall rating (CMS): 2.8
| Name | Type | Role (Carefield group) | CMS role text | Share | Since |
|---|---|---|---|---|---|
| Ernest Fellbaum | Individual | Partner | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | not provided | Aug 29, 2025 |
| Kelly Fellbaum | Individual | Partner | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | not provided | Aug 29, 2025 |
| Laura Studer | Individual | Partner | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | not provided | Aug 29, 2025 |
| Stanley Studer | Individual | Partner | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | not provided | Aug 29, 2025 |
| Touchstone Strategies - Killeen LLC | Organization | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | May 1, 2024 |
| Christopher Boening | Individual |
| Facility | Beds | CMS overall | Last inspection | Citations (window) | Fines |
|---|---|---|---|---|---|
| Laredo West Nursing and Rehabilitation Center 1200 E Lane St, Laredo, TX 78043 CCN 455528 | 188 | Jul 28, 2026 | 583 IJ | $50k | |
| Memorial Medical Nursing and Rehabilitation 307 W Cypress St, San Antonio, TX 78212 CCN 455597 |
| Facility | Beds | CMS overall | Last inspection | Citations (window) | Fines |
|---|---|---|---|---|---|
| La Frontera Nursing & Rehabilitation 7001 Mcpherson Rd., Laredo, TX 78041 CCN 675030 | 186 | Aug 14, 2026 | 272 IJ | $32k | |
| West Oaks Nursing & Rehabilitation 3625 Green Crest Dr, Houston, TX 77082 CCN 675454 | 136 |
Coordinates as published by CMS.
| Facility | Distance | Beds | CMS overall | Last inspection | Citations (window) | Fines |
|---|---|---|---|---|---|---|
| Avir at Killeen 5000 Thayer Dr., Killeen, TX 76549 CCN 676438 | 0.9 km | 120 | Aug 22, 2026 | 596 IJ1 harm | $66k | |
| Harker Heights Nursing & Rehabilitation 415 Indian Oaks Dr, Harker Heights, TX 76548 CCN 675909 | 7.4 km | 199 | Aug 26, 2026 | 613 IJ | $65k | |
| Hill Country Heights 810 Industrial Ave, Copperas Cove, TX 76522 CCN 675536 | 16.4 km | 96 | May 21, 2026 | 241 IJ | $12k | |
| Copperas Cove Nursing & Rehabilitation 607 W. Ave. B, Copperas Cove, TX 76522 CCN 455515 | 17.7 km | 123 | Aug 19, 2026 | 472 IJ | $24k |
| Source | Record | Facts | Evidence | Source release | Retrieved |
|---|---|---|---|---|---|
| CMS Provider Information US-CMS | 455503 | name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain | Verified | Oct 1, 2026 | Nov 7, 2026 |
| CMS Provider Information US-CMS | 455503 | ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only. | Verified | Oct 1, 2026 | Nov 7, 2026 |
First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction
| F-0803 |
| E · Potential harm Pattern |
| Corrected Aug 22, 2025 |
| Aug 14, 2025 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Aug 22, 2025 |
| Apr 18, 2025 | F-0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · Clinical care | J · Immediate jeopardy Isolated | Corrected Apr 19, 2025 | Complaint |
| Apr 18, 2025 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care | J · Immediate jeopardy Isolated | Corrected Apr 19, 2025 | Complaint |
| Oct 2, 2024 | F-0842 | 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 · Clinical care | D · Potential harm Isolated | Corrected Oct 17, 2024 | Complaint |
| Sep 9, 2024 | F-0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Sep 13, 2024 | Complaint |
| Sep 9, 2024 | F-0760 | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Sep 13, 2024 | Complaint |
| Jul 30, 2024 | F-0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · Clinical care | J · Immediate jeopardy Isolated | Past non-compliance Jul 26, 2024 | Complaint |
| Jul 11, 2024 | K-0351 | Install an approved automatic sprinkler system. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Feb 28, 2025 |
| Jul 11, 2024 | F-0656 | 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 · Clinical care | D · Potential harm Isolated | Corrected Jul 12, 2024 |
| Oct 2, 2023 | F-0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Oct 30, 2023 | Complaint |
| Jun 2, 2023 | F-0697 | Provide safe, appropriate pain management for a resident who requires such services. Quality of Life and Care Deficiencies · Clinical care | G · Actual harm Isolated | Corrected Jul 7, 2023 |
| Jun 2, 2023 | E-0004 | Develop and maintain an Emergency Preparedness Program (EP). Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected Mar 4, 2024 |
| Jun 2, 2023 | E-0006 | Conduct risk assessment and an All-Hazards approach. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected Mar 4, 2024 |
| Jun 2, 2023 | F-0695 | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Clinical care | E · Potential harm Pattern | Corrected Jul 7, 2023 |
| Jun 2, 2023 | F-0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Aug 11, 2023 |
| Jun 2, 2023 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Jul 7, 2023 |
Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 3.37 (case-mix index 1.61).
| Operational / managerial control |
| OPERATIONAL/MANAGERIAL CONTROL |
| not provided |
| May 1, 2024 |
| Leslie Campbell | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | May 1, 2024 |
| Lynnea Castillo | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | May 1, 2024 |
| Lisa Landers | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | May 1, 2024 |
| Bryon Sehlke | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | May 1, 2024 |
| Darrell Zurovec | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | May 1, 2024 |
| Adam Apolinar | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Aug 1, 2015 |
| Keybank National Association | Organization | Mortgage / security interest | 5% OR GREATER MORTGAGE INTEREST | not provided | May 1, 2024 |
| International Bank of Commerce | Organization | Mortgage / security interest | 5% OR GREATER SECURITY INTEREST | not provided | May 1, 2024 |
| Aegis Therapies, Inc | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Alamo Advisors LP | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Carvajal Pharmacy Ltc | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Fellbaum 2023 Descendants Trust | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Hc-Rw Associates, Ltd | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Healthcare Investments - Killeen LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Healthcare Services Group Inc | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Jan Studer 2023 Spousal Trust | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Kelly Fellbaum 2023 Spousal Trust | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Plante & Moran PLLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Studer 2023 Descendants Trust | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| The Bryon and Rena Sehlke Living Trust | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Touchstone Communities Inc | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Touchstone Strategies - Killeen LLC | Organization | Additional disclosable party | ADP OF THE SNF | not provided | Aug 29, 2025 |
| Trident Health Services Inc | Organization | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Christopher Boening | Individual | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Leslie Campbell | Individual | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Lynnea Castillo | Individual | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Lisa Landers | Individual | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Biju Oommen | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Dec 1, 2024 |
| Debbie Palo | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Sep 30, 2024 |
| Bryon Sehlke | Individual | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Darrell Zurovec | Individual | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| 135 |
| Aug 5, 2026 |
872 IJ11 open |
| $35k |
| Hilltop Village Nursing and Rehabilitation 1400 Hilltop Rd, Kerrville, TX 78028 CCN 455628 | 150 | Aug 20, 2026 | 601 IJ | — |
| Silver Creek Nursing and Rehabilitation 9014 Timber Path, San Antonio, TX 78250 CCN 455652 | 120 | Jul 2, 2025 | 28 | — |
| Kirkwood Manor 2590 Loop 337 N, New Braunfels, TX 78130 CCN 455732 | 162 | Jun 17, 2026 | 691 IJ | $29k |
| Avir at San Knoll 5757 N. Knoll, San Antonio, TX 78240 CCN 455804 | 120 | Jul 24, 2026 | 711 IJ | $28k |
| San Antonio North Nursing and Rehabilitation 501 Ogden, San Antonio, TX 78212 CCN 455817 | 118 | Aug 6, 2026 | 762 IJ | $17k |
| Deer Creek Nursing and Rehabilitation 555 Ranch Rd 3237, Wimberley, TX 78676 CCN 455917 | 122 | Aug 20, 2026 | 544 IJ1 harm | $50k |
| Jul 29, 2026 |
261 harm |
| — |
| Hill Country Heights 810 Industrial Ave, Copperas Cove, TX 76522 CCN 675536 | 96 | May 21, 2026 | 241 IJ | $12k |
| Del Rio Nursing and Rehabilitation Center 301 W. Martin Street, Del Rio, TX 78840 CCN 675677Abuse icon | 60 | Aug 6, 2026 | 411 IJ1 harm | $22k |
| The Heights at Medical Center 3935 Medical Drive, San Antonio, TX 78229 CCN 675890 | 134 | Aug 15, 2025 | 633 IJ | $22k |
| Harker Heights Nursing & Rehabilitation 415 Indian Oaks Dr, Harker Heights, TX 76548 CCN 675909 | 199 | Aug 26, 2026 | 613 IJ | $65k |
| Country Care Manor 2736 Fm 775, La Vernia, TX 78121 CCN 675947 | 91 | Dec 17, 2025 | 16 | $22k |
| Stone Oak Care Center 505 Madison Oak Drive, San Antonio, TX 78258 CCN 675968 | 152 | Jun 4, 2026 | 421 IJ | $9,087 |