SNF

THE MISSION AT BLUE SKIES OF TEXAS EAST

CCN: 676041 · SAN ANTONIO, TX 78227 · Bexar County

ℹ CCRC

Overview

Address
4949 RAVENSWOOD DR, SAN ANTONIO, TX 78227
Phone
2105685100
Certified beds
80
Avg daily residents
47 (59% of beds filled)
Ownership
Non-profit corporation
Provider type
Medicare
Medicare/Medicaid since
2005-01-05
Setting
Urban
3 /5
★★★★★
CMS Overall Rating

CMS 5-Star Ratings

CMS rates every Medicare/Medicaid-certified nursing home on four domains. The Overall rating is driven primarily by Health Inspection results, then adjusted up or down by Staffing and Quality Measures.

Overall Rating
Composite of Health Inspection, Staffing, and Quality Measures.
★★★★★ 3/5
Health Inspection
Based on the three most recent standard surveys, with more weight on recent results.
★★★★★ 3/5
Staffing
Weighted combination of RN and total nurse staffing hours per resident per day, case-mix adjusted.
★★★★★ 4/5
Quality Measures
15 resident-level quality measures split between long-stay and short-stay (post-acute) residents.
★★★★★ 4/5
Quality Measures breakdown
Long-Stay Quality Measures ★★★★★ 4/5
Short-Stay Quality Measures ★★★★★ 4/5

Staffing & Workforce

Direct-care staffing is the strongest operational driver of quality in nursing homes. Values are hours per resident per day, derived from payroll-based journal (PBJ) submissions. "Case-mix" adjusts for resident acuity; "Adjusted" is the CMS rating-input value.

Role Reported Case-mix expected Adjusted Federal floor
Total nurse
All nursing staff combined: RN + LPN + Aide
 5.29 3.47 5.89 ≥ 3.48
Registered Nurse (RN)
Licensed RN hours. Strongest driver of clinical outcomes.
 0.89 0.61 0.99 ≥ 0.55
Licensed Practical Nurse (LPN)
LPN/LVN hours. Often handles medication administration.
 1.34 0.77 1.49 —
Nurse aide
CNA hours. Bulk of direct resident care — bathing, feeding, mobility.
 3.06 2.09 3.40 —
Licensed (RN + LPN)
Combined licensed nurse coverage.
 2.23 — — —
Physical therapist
Rehabilitation therapist hours — important for post-acute / rehab admissions.
 0.11 — — —

Federal minimums (phasing in under the CMS 2024 minimum staffing rule) shown for reference. RN: 0.55 hrs/resident/day. Total nurse: 3.48 hrs/resident/day.

Weekend staffing

Total nurse (weekend)
4.33
hrs / resident / day
RN (weekend)
0.65
hrs / resident / day
Total nurse (adjusted, weekend)
4.81
hrs / resident / day

Weekend under-staffing is a common quality-of-care concern — adverse events are more frequent when licensed coverage drops.

Staff turnover

Total nursing staff turnover
63.0%
annual
RN turnover
76.9%
annual
Administrators departed
1
last 12 months

Resident acuity

Nursing Case-Mix Index
1.23
higher acuity than avg
Case-Mix Index Ratio
0.89
facility / state ratio

Health Inspections

CMS weights three inspection cycles to compute the Health Inspection rating: the most recent (50%), the second most recent (33%), and the oldest (17%). Each standard-survey deficiency is assigned a score based on scope and severity; complaint-survey findings and revisit scores are added to produce the cycle total.

Cycle Date Total defs. Standard Complaint Deficiency score Revisits Total score
Cycle 1 (most recent) 2025-07-11 10 5 5 48 1 48
Cycle 2/3 (prior) 2024-05-10 14 9 5 108 1 108
Total weighted health score
63.0
lower is better
Infection-control citations
1
last cycle

Deficiencies (27)

Individual survey findings. Scope/severity uses the CMS A–L matrix: letters further down the alphabet indicate greater harm and wider scope, up through J–L (immediate jeopardy).

25 D/E/F Actual harm — potential for minor
1 G/H/I Actual harm
1 J/K/L Immediate jeopardy
Tag Description Scope/Severity Survey date Corrected
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2025-08-08 2025-09-01
0842 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. D 2025-08-08 2025-09-05
0580 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. D 2025-07-11 2025-07-12
0693 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. D 2025-07-11 2025-07-12
0755 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. D 2025-07-11 2025-07-15
0760 Ensure that residents are free from significant medication errors. D 2025-07-11 2025-07-12
0812 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. D 2025-07-11 2025-07-12
0580 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. E 2025-03-17 2025-03-20
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. D 2025-03-17 2025-04-10
0842 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. E 2025-03-17 2025-04-01
0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. D 2025-01-03 2024-10-18
0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. K 2025-01-03 2024-10-18
0578 Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. D 2024-05-10 2024-05-15
0583 Keep residents' personal and medical records private and confidential. D 2024-05-10 2024-05-15
0641 Ensure each resident receives an accurate assessment. D 2024-05-10 2024-05-15
0656 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. E 2024-05-10 2024-05-16
0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. D 2024-05-10 2024-05-15
0693 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. E 2024-05-10 2024-05-15
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. D 2024-05-10 2024-05-15
0842 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. E 2024-05-10 2024-05-15
0880 Provide and implement an infection prevention and control program. D 2024-05-10 2024-05-15
0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. G 2024-03-04 2024-04-01
0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. D 2023-04-07 2023-05-08
0759 Ensure medication error rates are not 5 percent or greater. E 2023-04-07 2023-05-08
0880 Provide and implement an infection prevention and control program. D 2023-04-07 2023-05-08
0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. E 2023-03-27 2023-04-14
0609 Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. E 2023-03-27 2023-04-14

Penalties (1)

Fines issued
1
last 3 years
Total fines
$17,345
Date Type Fine amount
2025-01-03 Fine $17,345

Source: CMS Nursing Home Penalties.

Financial Health (FY 2024)

Operating performance

Operating Margin
-32.4%
Total Margin
-30.2%
Occupancy Rate
68.3%
Cost per Resident Day
$172

Revenue & costs

Net Patient Revenue
$10.3M
Total Costs
$3.4M
Net Income
-$3.2M

Balance sheet

Total Assets
$2.0M
Total Liabilities
$13.5M
Fund Balance
-$11.5M
Current Ratio
4.00

Source: CMS SNF Cost Report (FY 2024). Cost report data lags by ~2 years.

Ownership & Corporate Structure

Owner / manager organizations (2)

Organization Role Association
AIR FORCE VILLAGE INC OPERATIONAL/MANAGERIAL CONTROL since 11/01/2011
BST HEALTH SERVICES CORP OPERATIONAL/MANAGERIAL CONTROL since 11/01/2011

Owner / manager individuals (25)

Name Role Association
GOSWAMI, SUSHANTA OPERATIONAL/MANAGERIAL CONTROL since 01/13/2025
JONES, DARRELL OPERATIONAL/MANAGERIAL CONTROL since 12/18/2024
KELLY-RANK, SALLY OPERATIONAL/MANAGERIAL CONTROL since 12/19/2024
LYONS, AMY OPERATIONAL/MANAGERIAL CONTROL since 12/18/2024
MANZKE, SARAH OPERATIONAL/MANAGERIAL CONTROL since 12/19/2024
RANSOM, HEATHER OPERATIONAL/MANAGERIAL CONTROL since 12/19/2024
BIERY, DIANE CORPORATE DIRECTOR since 01/01/2023
BRYAN, HELEN CORPORATE DIRECTOR since 11/09/2023
DUBENSKY, MICHAEL CORPORATE DIRECTOR since 01/01/2023
FLOWERS, ALFRED CORPORATE DIRECTOR since 01/01/2022
HANSEN, ROGER CORPORATE DIRECTOR since 01/01/2021
HEPBURN, DEBORAH CORPORATE DIRECTOR since 01/01/2023
HOSTAGE, KATHERINE CORPORATE DIRECTOR since 11/01/2016
KARDYS, RICHARD CORPORATE DIRECTOR since 01/01/2023
KRUGER, ROBERT CORPORATE DIRECTOR since 11/09/2023
MEIGS, STEPHEN CORPORATE DIRECTOR since 11/09/2023
MORAN, JOSEPH CORPORATE DIRECTOR since 11/09/2023
OLSEN, JANICE CORPORATE DIRECTOR since 05/01/2017
POTTER, CHARLES CORPORATE DIRECTOR since 11/01/2022
PROFENNA, LEONARDO CORPORATE DIRECTOR since 01/01/2018
SCHNELZER, GARY CORPORATE DIRECTOR since 11/01/2022
JONES, DARRELL CORPORATE OFFICER since 01/14/2018
LYONS, AMY CORPORATE OFFICER since 07/01/2024
MANZKE, SARAH CORPORATE OFFICER since 10/01/2023
RANSOM, HEATHER CORPORATE OFFICER since 01/01/2024

Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.

Facility Features

CCRC
Yes
Hospital-based
No
Resident / family council
Resident
Sprinkler systems
Yes
Abuse citation flag
No
Methodology & sources

Full methodology →

All Data

Every labeled field shipped for this facility by CMS. No national median or percentile context is available for SNFs in the current release.

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Show 112 rows
Source Metric Value Raw key
Cost Report Cost per Resident Day ($) $172 metrics.cost_per_resident_day
Cost Report Current Ratio 4 metrics.current_ratio
Cost Report fiscal_year 2,024 fiscal_year
Cost Report Medicare Day Share (%) 21.4% metrics.medicare_day_share
Cost Report Net Income ($) $-3,164,092 metrics.net_income
Cost Report Net Patient Revenue ($) $10,309,616 metrics.net_patient_revenue
Cost Report Occupancy Rate (%) 68.3% metrics.occupancy_rate
Cost Report Operating Margin (%) -32.4% metrics.operating_margin
Cost Report Total Assets ($) $1,999,414 metrics.total_assets
Cost Report Total Costs ($) $3,434,159 metrics.total_costs
Cost Report Total Fund Balances ($) $-11,493,904 metrics.fund_balance
Cost Report Total Liabilities ($) $13,493,318 metrics.total_liabilities
Cost Report Total Margin (%) -30.2% metrics.total_margin
Provider Information Abuse Icon N Abuse Icon
Provider Information Adjusted LPN Staffing Hours per Resident per Day 1.49077 Adjusted LPN Staffing Hours per Resident per Day
Provider Information Adjusted Nurse Aide Staffing Hours per Resident per Day 3.40115 Adjusted Nurse Aide Staffing Hours per Resident per Day
Provider Information Adjusted RN Staffing Hours per Resident per Day 0.99474 Adjusted RN Staffing Hours per Resident per Day
Provider Information Adjusted Total Nurse Staffing Hours per Resident per Day 5.88666 Adjusted Total Nurse Staffing Hours per Resident per Day
Provider Information Adjusted Weekend Total Nurse Staffing Hours per Resident per Day 4.81302 Adjusted Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Administrator turnover footnote — Administrator turnover footnote
Provider Information Automatic Sprinkler Systems in All Required Areas Yes Automatic Sprinkler Systems in All Required Areas
Provider Information Average Number of Residents per Day 47.1 Average Number of Residents per Day
Provider Information Average Number of Residents per Day Footnote — Average Number of Residents per Day Footnote
Provider Information Case-Mix LPN Staffing Hours per Resident per Day 0.77002 Case-Mix LPN Staffing Hours per Resident per Day
Provider Information Case-Mix Nurse Aide Staffing Hours per Resident per Day 2.09274 Case-Mix Nurse Aide Staffing Hours per Resident per Day
Provider Information Case-Mix RN Staffing Hours per Resident per Day 0.60694 Case-Mix RN Staffing Hours per Resident per Day
Provider Information Case-Mix Total Nurse Staffing Hours per Resident per Day 3.46971 Case-Mix Total Nurse Staffing Hours per Resident per Day
Provider Information Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day 3.05818 Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day
Provider Information Chain Average Health Inspection Rating — Chain Average Health Inspection Rating
Provider Information Chain Average Overall 5-star Rating — Chain Average Overall 5-star Rating
Provider Information Chain Average QM Rating — Chain Average QM Rating
Provider Information Chain Average Staffing Rating — Chain Average Staffing Rating
Provider Information Chain ID — Chain ID
Provider Information Chain Name — Chain Name
Provider Information City/Town SAN ANTONIO City/Town
Provider Information CMS Certification Number (CCN) 676041 CMS Certification Number (CCN)
Provider Information Continuing Care Retirement Community Y Continuing Care Retirement Community
Provider Information County/Parish Bexar County/Parish
Provider Information Date First Approved to Provide Medicare and Medicaid Services 2005-01-05 Date First Approved to Provide Medicare and Medicaid Services
Provider Information Geocoding Footnote — Geocoding Footnote
Provider Information Health Inspection Rating 3 Health Inspection Rating
Provider Information Health Inspection Rating Footnote — Health Inspection Rating Footnote
Provider Information Latitude 29.383 Latitude
Provider Information Legal Business Name BST HEALTH SERVICES CORP Legal Business Name
Provider Information Location 4949 RAVENSWOOD DR,SAN ANTONIO,TX,78227 Location
Provider Information Long-Stay QM Rating 4 Long-Stay QM Rating
Provider Information Long-Stay QM Rating Footnote — Long-Stay QM Rating Footnote
Provider Information Longitude -98.645 Longitude
Provider Information Most Recent Health Inspection More Than 2 Years Ago N Most Recent Health Inspection More Than 2 Years Ago
Provider Information Number of administrators who have left the nursing home 1 Number of administrators who have left the nursing home
Provider Information Number of Certified Beds 80 Number of Certified Beds
Provider Information Number of Citations from Infection Control Inspections 1 Number of Citations from Infection Control Inspections
Provider Information Number of Facilities in Chain — Number of Facilities in Chain
Provider Information Number of Fines 1 Number of Fines
Provider Information Number of Payment Denials 0 Number of Payment Denials
Provider Information Nursing Case-Mix Index 1.22916 Nursing Case-Mix Index
Provider Information Nursing Case-Mix Index Ratio 0.89222 Nursing Case-Mix Index Ratio
Provider Information Overall Rating 3 Overall Rating
Provider Information Overall Rating Footnote — Overall Rating Footnote
Provider Information Ownership Type Non profit - Corporation Ownership Type
Provider Information Physical Therapist Staffing Footnote — Physical Therapist Staffing Footnote
Provider Information Processing Date 2026-03-01 Processing Date
Provider Information Provider Address 4949 RAVENSWOOD DR Provider Address
Provider Information Provider Changed Ownership in Last 12 Months N Provider Changed Ownership in Last 12 Months
Provider Information Provider Name THE MISSION AT BLUE SKIES OF TEXAS EAST Provider Name
Provider Information Provider Resides in Hospital N Provider Resides in Hospital
Provider Information Provider SSA County Code 130 Provider SSA County Code
Provider Information Provider Type Medicare Provider Type
Provider Information QM Rating 4 QM Rating
Provider Information QM Rating Footnote — QM Rating Footnote
Provider Information Rating Cycle 1 Health Deficiency Score 48 Rating Cycle 1 Health Deficiency Score
Provider Information Rating Cycle 1 Health Revisit Score 0 Rating Cycle 1 Health Revisit Score
Provider Information Rating Cycle 1 Number of Complaint Health Deficiencies 5 Rating Cycle 1 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 1 Number of Health Revisits 1 Rating Cycle 1 Number of Health Revisits
Provider Information Rating Cycle 1 Number of Standard Health Deficiencies 5 Rating Cycle 1 Number of Standard Health Deficiencies
Provider Information Rating Cycle 1 Standard Survey Health Date 2025-07-11 Rating Cycle 1 Standard Survey Health Date
Provider Information Rating Cycle 1 Total Health Score 48 Rating Cycle 1 Total Health Score
Provider Information Rating Cycle 1 Total Number of Health Deficiencies 10 Rating Cycle 1 Total Number of Health Deficiencies
Provider Information Rating Cycle 2 Number of Standard Health Deficiencies 9 Rating Cycle 2 Number of Standard Health Deficiencies
Provider Information Rating Cycle 2 Standard Health Survey Date 2024-05-10 Rating Cycle 2 Standard Health Survey Date
Provider Information Rating Cycle 2/3 Health Deficiency Score 108 Rating Cycle 2/3 Health Deficiency Score
Provider Information Rating Cycle 2/3 Health Revisit Score 0 Rating Cycle 2/3 Health Revisit Score
Provider Information Rating Cycle 2/3 Number of Complaint Health Deficiencies 5 Rating Cycle 2/3 Number of Complaint Health Deficiencies
Provider Information Rating Cycle 2/3 Number of Health Revisits 1 Rating Cycle 2/3 Number of Health Revisits
Provider Information Rating Cycle 2/3 Total Health Score 108 Rating Cycle 2/3 Total Health Score
Provider Information Rating Cycle 2/3 Total Number of Health Deficiencies 14 Rating Cycle 2/3 Total Number of Health Deficiencies
Provider Information Registered Nurse hours per resident per day on the weekend 0.65221 Registered Nurse hours per resident per day on the weekend
Provider Information Registered Nurse turnover 76.9 Registered Nurse turnover
Provider Information Registered Nurse turnover footnote — Registered Nurse turnover footnote
Provider Information Reported Licensed Staffing Hours per Resident per Day 2.23366 Reported Licensed Staffing Hours per Resident per Day
Provider Information Reported LPN Staffing Hours per Resident per Day 1.33971 Reported LPN Staffing Hours per Resident per Day
Provider Information Reported Nurse Aide Staffing Hours per Resident per Day 3.05652 Reported Nurse Aide Staffing Hours per Resident per Day
Provider Information Reported Physical Therapist Staffing Hours per Resident Per Day 0.10631 Reported Physical Therapist Staffing Hours per Resident Per Day
Provider Information Reported RN Staffing Hours per Resident per Day 0.89395 Reported RN Staffing Hours per Resident per Day
Provider Information Reported Staffing Footnote — Reported Staffing Footnote
Provider Information Reported Total Nurse Staffing Hours per Resident per Day 5.29018 Reported Total Nurse Staffing Hours per Resident per Day
Provider Information Short-Stay QM Rating 4 Short-Stay QM Rating
Provider Information Short-Stay QM Rating Footnote — Short-Stay QM Rating Footnote
Provider Information Special Focus Status — Special Focus Status
Provider Information Staffing Rating 4 Staffing Rating
Provider Information Staffing Rating Footnote — Staffing Rating Footnote
Provider Information State TX State
Provider Information Telephone Number 2105685100 Telephone Number
Provider Information Total Amount of Fines in Dollars 17345.00 Total Amount of Fines in Dollars
Provider Information Total number of nurse staff hours per resident per day on the weekend 4.32533 Total number of nurse staff hours per resident per day on the weekend
Provider Information Total Number of Penalties 1 Total Number of Penalties
Provider Information Total nursing staff turnover 63.0 Total nursing staff turnover
Provider Information Total nursing staff turnover footnote — Total nursing staff turnover footnote
Provider Information Total Weighted Health Survey Score 63.000 Total Weighted Health Survey Score
Provider Information Urban Y Urban
Provider Information With a Resident and Family Council Resident With a Resident and Family Council
Provider Information ZIP Code 78227 ZIP Code