Nursing home · SNF / NF

The Rio at Mission Trails

Federal · CMSActive CMS certificationCCN 676297Government CMS overall

6211 S New Braunfels Avenue, San Antonio, TX 78223 · Operated by West Wharton County Hospital District · Chain Creative Solutions in Healthcare

Source: CMS Provider Data Catalog, release Oct 1, 2026 · provenance

$25 Full Intelligence Report

Certified beds

124

Avg residents / day

Inspections

Citations

Harm-level

Fines

$154k

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 124 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: 77.2 CMS, MDS-derived
CMS Certification Number: 676297
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Oct 12, 2011
Ownership type: Government - Hospital district
Operator (legal business name): West Wharton County Hospital District
CMS chain: Creative Solutions in Healthcare 150 facilities
Phone: (210) 531-0569
Resident & family council: Both
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

latest Aug 4, 2026

Citations

35 health · 7 fire

Harm or worse

3 immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J3	K·	L·
Actual harm	G·	H·	I·
Potential harm	D25	E7	F5
Minimal	A·	B2	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

$153,825

Payment denials

Latest

Feb 24, 2025

Date	Domain	Survey types	Citations	Most severe	Open
Aug 4, 2026	Health	Health Complaint	1	Potential harm	—	Open →
Jun 23, 2026	Health	Health Complaint	2	Potential harm	—	Open →
May 7, 2026	Health	Health Complaint	2	Potential harm	—	Open →
Apr 17, 2026	Health	Health Complaint	2	Potential harm	—	Open →
Apr 7, 2026	Health	Health Complaint	1	Potential harm	—	Open →
Mar 25, 2026	Fire safety	Fire Safety Standard	3	Potential harm	—	Open →
Mar 25, 2026	Health	Health Standard	9	Potential harm	—	Open →
Mar 19, 2026	Health	Health Complaint	2	Potential harm	—	Open →
Apr 10, 2025	Health	Health Complaint	2	Potential harm	—	Open →
Feb 24, 2025	Health	Health Complaint	2	Immediate jeopardy	—	Open →
Dec 18, 2024	Fire safety	Fire Safety Standard	4	Potential harm	—	Open →
Dec 18, 2024	Health	Health Standard	6	Potential harm	—	Open →
Nov 21, 2024	Health	Health Complaint	1	Potential harm	—	Open →
Jul 14, 2024	Health	Health Complaint	3	Potential harm	—	Open →
Jun 20, 2024	Health	Health Complaint	1	Immediate jeopardy	—	Open →
Nov 15, 2023	Fire safety	Fire Safety Standard	0	No citations	—	Open →
Nov 15, 2023	Health	Health Standard	1	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
Feb 24, 2025	Civil money penalty (fine)	$96,694	—	676297\|Fine\|113635
Jun 20, 2024	Civil money penalty (fine)	$57,131	—	676297\|Fine\|113012

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J3	K·	L·
Actual harm	G·	H·	I·
Potential harm	D25	E7	F5
Minimal	A·	B2	C·

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Aug 4, 2026	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 Aug 20, 2026	Complaint
Jun 23, 2026	F-0585	Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Jul 13, 2026	Complaint
Jun 23, 2026	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 Jul 13, 2026	Complaint
May 7, 2026	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 May 21, 2026	Complaint
May 7, 2026	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	D · Potential harm Isolated	Corrected May 21, 2026	Complaint
Apr 17, 2026	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 Apr 19, 2026	Complaint
Apr 17, 2026	F-0695	Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected May 31, 2026	Complaint
Apr 7, 2026	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 May 1, 2026	Complaint
Mar 25, 2026	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Apr 8, 2026
Mar 25, 2026	K-0353	Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected May 5, 2026
Mar 25, 2026	K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Apr 30, 2026
Mar 25, 2026	F-0585	Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Resident Rights Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Apr 8, 2026
Mar 25, 2026	F-0645	PASARR screening for Mental disorders or Intellectual Disabilities Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Apr 8, 2026
Mar 25, 2026	F-0727	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. Nursing and Physician Services Deficiencies · Staffing & supervision	E · Potential harm Pattern	Corrected Apr 22, 2026
Mar 25, 2026	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 Apr 22, 2026
Mar 25, 2026	F-0759	Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Apr 8, 2026
Mar 25, 2026	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Apr 8, 2026
Mar 25, 2026	F-0761	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 · Medication management	D · Potential harm Isolated	Corrected Apr 8, 2026
Mar 25, 2026	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	B · Minimal Pattern	Corrected Apr 22, 2026
Mar 25, 2026	F-0919	Make sure that a working call system is available in each resident's bathroom and bathing area. Environmental Deficiencies · Environment & life safety	B · Minimal Pattern	Corrected Apr 8, 2026
Mar 19, 2026	F-0641	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Mar 24, 2026	Complaint
Mar 19, 2026	F-0880	Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention	D · Potential harm Isolated	Corrected Mar 24, 2026	Complaint
Apr 10, 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	D · Potential harm Isolated	Past non-compliance Mar 3, 2025	Complaint
Apr 10, 2025	F-0609	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Past non-compliance Mar 3, 2025	Complaint
Feb 24, 2025	F-0600	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 · Resident rights & abuse/neglect	J · Immediate jeopardy Isolated	Corrected Feb 28, 2025	Complaint
Feb 24, 2025	F-0695	Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Clinical care	J · Immediate jeopardy Isolated	Corrected Feb 28, 2025	Complaint
Dec 18, 2024	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jan 6, 2025
Dec 18, 2024	K-0372	Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected Jan 6, 2025
Dec 18, 2024	K-0920	Ensure proper usage of power strips and extension cords. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected Jan 6, 2025
Dec 18, 2024	K-0923	Have proper medical gas storage and administration areas. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jan 6, 2025
Dec 18, 2024	F-0558	Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · Resident rights & abuse/neglect	E · Potential harm Pattern	Corrected Jan 6, 2025
Dec 18, 2024	F-0641	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jan 6, 2025
Dec 18, 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 Jan 6, 2025
Dec 18, 2024	F-0761	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 · Medication management	D · Potential harm Isolated	Corrected Jan 6, 2025
Dec 18, 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	D · Potential harm Isolated	Corrected Jan 6, 2025
Dec 18, 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 Jan 6, 2025
Nov 21, 2024	F-0609	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Nov 25, 2024	Complaint
Jul 14, 2024	F-0557	Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. Resident Rights Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Jul 16, 2024	Complaint
Jul 14, 2024	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 Jul 16, 2024	Complaint
Jul 14, 2024	F-0825	Provide or get specialized rehabilitative services as required for a resident. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jul 16, 2024	Complaint
Jun 20, 2024	F-0925	Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Environmental Deficiencies · Environment & life safety	J · Immediate jeopardy Isolated	Corrected Jun 28, 2024	Complaint
Nov 15, 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 Nov 16, 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.

Operating entity

West Wharton County Hospital District

CMS legal business name of the certified provider. Operates 101 facilities.

VerifiedLinked by exact legal name

CMS chain

Creative Solutions in Healthcare

150 facilities in 1 states. CMS chain ID 169.

VerifiedAssigned by CMS

Chain average overall rating (CMS): 2.3

Ownership disclosures

Disclosures

Organizations

Individuals

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
San Antonio II Enterprises, LLC	Organization	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Apr 1, 2022
Gary Blake	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Apr 1, 2022
Malisa Blake	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Apr 1, 2022
David Mak	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	May 17, 2021
Linda Huggins	Individual	Managing employee	W-2 MANAGING EMPLOYEE	not provided	Apr 1, 2022

Other facilities operated by West Wharton County Hospital District

All 100 →

Facility	Beds	Last inspection	Citations (window)	Fines
Buena Vida Nursing and Rehab-San Antonio 5027 Pecan Grove, San Antonio, TX 78222 CCN 455390SFF CandidateAbuse icon	222	Jul 24, 2026	595 IJ1 harm	$198k
Avir at Rose Trail 930 S Baxter, Tyler, TX 75701 CCN 455429SFF Candidate	172	Aug 14, 2026	639 IJ3 harm	$484k
Mesa Vista Inn Health Center 5756 North Knoll Drive, San Antonio, TX 78240 CCN 455444	144	Jul 2, 2026	531 IJ	$8,160
Avir at Petal Hill 900 S Baxter Ave, Tyler, TX 75701 CCN 455485Abuse icon	120	May 13, 2026	352 IJ	$26k
Sterling Hills Rehabilitation and Healthcare Cente 705 NE Georgia Ave, Sweetwater, TX 79556 CCN 455509	96	Mar 26, 2026	17	—
Amistad Nursing and Rehabilitation Center 200 Riverside Drive, Uvalde, TX 78801 CCN 455536	200	Aug 7, 2026	44	—
Mineral Wells Nursing & Rehabilitation 316 Southwest 25th Avenue, Mineral Wells, TX 76067 CCN 455570	109	Jun 24, 2026	19	—
Concho Health & Rehabilitation Center 613 Eaker St, Eden, TX 76837 CCN 455737	66	Aug 11, 2026	28	—

Same chain in Texas

All 149 in chain →

Facility	Beds	Last inspection	Citations (window)	Fines
Buena Vida Nursing and Rehab-San Antonio 5027 Pecan Grove, San Antonio, TX 78222 CCN 455390SFF CandidateAbuse icon	222	Jul 24, 2026	595 IJ1 harm	$198k
Mesa Vista Inn Health Center 5756 North Knoll Drive, San Antonio, TX 78240 CCN 455444	144	Jul 2, 2026	531 IJ	$8,160
Mountain View Health & Rehabilitation 1600 Muchison Rd, El Paso, TX 79902 CCN 455471	187	Jul 2, 2026	836 IJ	$123k
Vista Hills Health Care Center 1599 Lomaland Drive, El Paso, TX 79935 CCN 455493	120	Aug 24, 2026	832 IJ	$40k
Pleasant Springs Healthcare Center 2003 North Edwards Avenue, Mount Pleasant, TX 75455 CCN 455532SFF CandidateAbuse icon	90	Aug 7, 2026	774 IJ2 harm	$66k
Amistad Nursing and Rehabilitation Center 200 Riverside Drive, Uvalde, TX 78801 CCN 455536	200	Aug 7, 2026	44	—
Heritage at Longview Healthcare Center 112 Ruthlynn Dr, Longview, TX 75605 CCN 455569	140	Apr 28, 2026	401 IJ1 harm1 open	$82k
Mineral Wells Nursing & Rehabilitation 316 Southwest 25th Avenue, Mineral Wells, TX 76067 CCN 455570	109	Jun 24, 2026	19	—

Coordinates as published by CMS.

Address: 6211 S New Braunfels Avenue, San Antonio, TX 78223
ZIP: 78223
County: Bexar County FIPS 48029
State: Texas
Urban / rural (CMS): Urban

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	Last inspection	Citations (window)	Fines
Highland Nursing Center 5819 Pecan Valley Dr, San Antonio, TX 78223 CCN 45E341	2.2 km	51	Mar 27, 2026	601 IJ	—
Windsor Mission Oaks 3030 S Roosevelt Ave, San Antonio, TX 78214 CCN 675409	2.3 km	150	Jun 12, 2026	521 IJ	$11k
Pecan Valley Rehabilitation and Healthcare 3838 E Southcross Blvd, San Antonio, TX 78222 CCN 676250	3.7 km	124	Apr 29, 2026	301 IJ	—
Buena Vida Nursing and Rehab-San Antonio 5027 Pecan Grove, San Antonio, TX 78222 CCN 455390SFF CandidateAbuse icon	3.9 km	222	Jul 24, 2026	595 IJ1 harm	$198k
Southeast Nursing & Rehabilitation Center 4302 East Southcross Blvd, San Antonio, TX 78222 CCN 675883	4.7 km	116	Jul 31, 2026	561 IJ	$11k
San Jose Nursing Center 406 Sharmain Pl, San Antonio, TX 78221 CCN 45E312	5.1 km	54	Jun 26, 2026	50	—
River City Care Center 921 Nolan St, San Antonio, TX 78202 CCN 675896Abuse icon	7.1 km	92	Jul 2, 2026	462 IJ	$19k
Normandy Terrace Nursing & Rehabilitation Center 841 Rice Road, San Antonio, TX 78220 CCN 675823SFF Candidate	7.2 km	320	Aug 21, 2026	848 IJ	$349k

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	676297	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	676297	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 676297

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

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The Rio at Mission Trails

Federal certification

State license

Penalties

All disclosed roles

Other facilities operated by West Wharton County Hospital District

Same chain in Texas

Nearby nursing homes

The Rio at Mission Trails

Federal certification

State license

Penalties

All disclosed roles

Other facilities operated by West Wharton County Hospital District

Same chain in Texas

Nearby nursing homes