Cibolo Creek — nursing home in Boerne, TX

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 120 CMS-certified beds (not state-licensed beds)
Licensed beds: State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.
Average residents per day: 86.1 CMS, MDS-derived
CMS Certification Number: 676240
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Dec 2, 2009
Ownership type: Government - Hospital district
Operator (legal business name): Medina County Hospital District
CMS chain: Not part of a CMS-reported chain
Phone: (830) 816-5095
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

8

latest Sep 5, 2025

Citations

33

26 health · 7 fire

Harm or worse

4

4 immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J4	K·	L·
Actual harm	G·	H·	I·
Potential harm	D13	E10	F6
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.

CMS Five-Star ratings

Federal · CMS

Overall

Health inspections

Staffing

Quality measures

Penalties · about the last 3 years

Fines

1

$13,627

Payment denials

1

Latest

Sep 5, 2025

Federal certification

Federal · CMS

Authority: Centers for Medicare & Medicaid Services (CMS), surveyed by the state survey agency
CCN: 676240
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 120
First approved: Dec 2, 2009
Located in a hospital: No
Status: Active CMS certification as of CMS release Oct 1, 2026
Evidence: Verified

State license

State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead. State coverage for Texas.

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.

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.

Date	Domain	Survey types	Citations	Most severe	Open
Sep 5, 2025	Fire safety	Fire Safety Standard	6	Potential harm	—	Open →
Sep 5, 2025	Health	Health Standard	6	Immediate jeopardy	—	Open →
Nov 23, 2024	Health	Health Complaint	6	Immediate jeopardy	—	Open →
Aug 2, 2024	Fire safety	Fire Safety Standard	0	No citations	—	Open →
Aug 2, 2024	Health	Health Standard	5	Potential harm	—	Open →
Dec 29, 2023	Health	Health Complaint	3	Potential harm	—	Open →
May 26, 2023	Fire safety	Fire Safety Standard	1	Potential harm	—	Open →
May 26, 2023	Health	Health Standard	6	Potential harm	—	Open →

Enforcement

Penalties

Civil money penalties and denials of payment for new admissions, as published by CMS (about the last three years). Amounts may change on appeal.

Date	Type	Amount	Payment denial	Record
Sep 5, 2025	Denial of payment for new admissions	—	Oct 4, 2025 · 11 days	676240\|Payment Denial\|2025-10-04
Nov 23, 2024	Civil money penalty (fine)	$13,627	—	676240\|Fine\|113415

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J4	K·	L·
Actual harm	G·	H·	I·
Potential harm	D13	E10	F6
Minimal	A·	B·	C·

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Sep 5, 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 Sep 6, 2025
Sep 5, 2025	K-0293	Have properly located and lighted "Exit" signs. Egress Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Oct 15, 2025
Sep 5, 2025	K-0712	Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Oct 15, 2025
Sep 5, 2025	K-0916	Have a battery powered remote alarm panel in a location accessible by operating personnel. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Oct 15, 2025
Sep 5, 2025	K-0918	Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Oct 15, 2025
Sep 5, 2025	K-0919	Meet requirements for the use of electrical equipment. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Oct 15, 2025
Sep 5, 2025	K-0923	Have proper medical gas storage and administration areas. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Oct 15, 2025
Sep 5, 2025	F-0607	Develop and implement policies and procedures to prevent abuse, neglect, and theft. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Sep 25, 2025
Sep 5, 2025	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 Sep 25, 2025
Sep 5, 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 Sep 25, 2025
Sep 5, 2025	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	E · Potential harm Pattern	Corrected Sep 25, 2025
Sep 5, 2025	F-0908	Keep all essential equipment working safely. Environmental Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Sep 25, 2025
Nov 23, 2024	F-0580	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect	J · Immediate jeopardy Isolated	Past non-compliance Nov 19, 2024	Complaint
Nov 23, 2024	F-0684	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care	J · Immediate jeopardy Isolated	Past non-compliance Nov 19, 2024	Complaint
Nov 23, 2024	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 Nov 24, 2024	Complaint
Nov 23, 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 Nov 24, 2024	Complaint
Nov 23, 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	E · Potential harm Pattern	Corrected Nov 24, 2024	Complaint
Nov 23, 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 Nov 24, 2024	Complaint
Aug 2, 2024	F-0558	Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Aug 3, 2024
Aug 2, 2024	F-0583	Keep residents' personal and medical records private and confidential. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Aug 3, 2024
Aug 2, 2024	F-0641	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Aug 3, 2024
Aug 2, 2024	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 3, 2024
Aug 2, 2024	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	E · Potential harm Pattern	Corrected Aug 3, 2024
Dec 29, 2023	F-0602	Protect each resident from the wrongful use of the resident's belongings or money. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Past non-compliance Oct 2, 2023	Complaint
Dec 29, 2023	F-0607	Develop and implement policies and procedures to prevent abuse, neglect, and theft. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Past non-compliance Aug 28, 2023	Complaint
Dec 29, 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	Past non-compliance Oct 7, 2023	Complaint
May 26, 2023	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Jun 8, 2023
May 26, 2023	F-0677	Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected May 27, 2023
May 26, 2023	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected May 27, 2023
May 26, 2023	F-0808	Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	D · Potential harm Isolated	Corrected May 27, 2023
May 26, 2023	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	D · Potential harm Isolated	Corrected May 27, 2023
May 26, 2023	F-0847	Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse. Administration Deficiencies · Administration & records	F · Potential harm Widespread	Corrected May 27, 2023
May 26, 2023	F-0848	Provide a neutral and fair arbitration process and agree to arbitrator and venue. Administration Deficiencies · Administration & records	D · Potential harm Isolated	Corrected May 27, 2023

“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.

Five-Star ratings

Federal · CMS

Overallstate 2.8

Health inspectionsstate 2.8

Staffingstate 1.9

Quality measuresstate 3.8

Long-stay QM

Short-stay QM

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.

Nurse staffing · hours per resident per day

Total nurse staffing3.24

State avg 3.42US avg 3.90

Registered nurse (RN)0.41

State avg 0.44US avg 0.69

Licensed practical nurse0.97

State avg 0.94US avg 0.86

Nurse aide1.86

State avg 2.03US avg 2.35

Weekend total nurse2.98

State avg 2.99US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 3.60 (case-mix index 1.26).

Staff turnover

Total nursing staff turnover68.2%

State avg 50.8%US avg 45.3%

Registered nurse turnover57.1%

State avg 49.8%US avg 42.5%

Administrators who left2

State avg 1US avg 1

Health survey score

Cycle 1 standard survey: Sep 5, 2025
Cycle 1 health score: 111
Total weighted score: 127

Operating entity

Medina County Hospital District

CMS legal business name of the certified provider. Operates 7 facilities.

VerifiedLinked by exact legal name

CMS chain

Not part of a CMS-reported chain.

Ownership disclosures

Disclosures

10

Organizations

3

Individuals

7

Direct & indirect ownership

Owners of record

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Medina County Hospital District	Organization	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	May 1, 2021

CMS Ownership file

All disclosed roles

Operator, owners, managers, officers and lenders are distinct roles and are never flattened into one entity. Organizations link across facilities by exact normalized legal name; individuals are listed per facility only.

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Medina County Hospital District	Organization	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	100%	May 1, 2021
Marjorie Dorrow	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Nov 17, 2025
Max Haney	Individual	Partner	INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF	not provided	Nov 17, 2025
Cascade-Kendall Health Services, Ltd	Organization	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	May 1, 2021
Ronald Haney	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	May 1, 2021
Billie Bell	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Jun 3, 2023
Boerne Hc LLC	Organization	Additional disclosable party	ADP OF THE SNF	not provided	May 1, 2021
Taylor Collier	Individual	Additional disclosable party	ADP OF THE SNF	not provided	Aug 22, 2023
Ronald Haney	Individual	Additional disclosable party	ADP OF THE SNF	not provided	May 1, 2021
John Sorrells	Individual	Additional disclosable party	ADP OF THE SNF	not provided	May 1, 2021

Other facilities operated by Medina County Hospital District

All 6 →

Facility	Beds	Last inspection	Citations (window)	Fines
Windcrest Nursing and Rehabilitation 8800 Fourwinds Dr., Windcrest, TX 78239 CCN 455533	180	Aug 14, 2025	445 IJ	$199k
Community Care Center of Hondo 2001 Ave E, Hondo, TX 78861 CCN 455676	75	Sep 12, 2025	373 IJ	$19k
Town and Country Nursing and Rehabilitation Center 625 N Main St, Boerne, TX 78006 CCN 455796	126	Jul 31, 2026	763 IJ	$151k
Guadalupe Valley Nursing and Rehabilitation Center 1210 Eastwood Dr, Seguin, TX 78155 CCN 455869	148	Jun 30, 2026	62	$60k
Medina Valley Health & Rehabilitation Center 913 Hwy 90 W, Castroville, TX 78009 CCN 675974	116	Feb 27, 2026	54	—
Las Colinas of Westover 9738 Westover Hills Blvd, San Antonio, TX 78251 CCN 676328	140	Dec 5, 2025	454 IJ	$39k

No building or property record is linked to this facility yet. Parcel, assessor and building-permit joins will be added only where a valid site match exists.

Coordinates as published by CMS.

Address: 1440 River Rd, Boerne, TX 78006
ZIP: 78006
County: Kendall County FIPS 48259
State: Texas
Urban / rural (CMS): Urban

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	Last inspection	Citations (window)	Fines
Avir at Boerne 1102 River Road, Boerne, TX 78006 CCN 675371	0.1 km	96	May 8, 2026	454 IJ	$92k
Carechoice of Boerne 200 E Ryan St, Boerne, TX 78006 CCN 675678	1.8 km	74	May 28, 2026	392 IJ	$34k
Town and Country Nursing and Rehabilitation Center 625 N Main St, Boerne, TX 78006 CCN 455796	2.1 km	126	Jul 31, 2026	763 IJ	$151k
Kendall House Wellness & Rehabilitation 1050 Grand Blvd., Boerne, TX 78006 CCN 676228	2.2 km	40	Jan 23, 2026	241 IJ	$88k

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	676240	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	676240	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

Record-level source links for CCN 676240

First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction