SNF
THE RIO AT MISSION TRAILS
CCN: 676297 · SAN ANTONIO, TX 78223 · Bexar County
Overview
- Address
- 6211 S NEW BRAUNFELS AVE, SAN ANTONIO, TX 78223
- Phone
- 2105310569
- Certified beds
- 124
- Avg daily residents
- 89 (72% of beds filled)
- Ownership
- For-profit LLC
- Provider type
- Medicare and Medicaid
- Medicare/Medicaid since
- 2011-10-12
- 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.
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 | 3.16 | 5.22 | 2.34 | ≥ 3.48 | Below floor |
| Registered Nurse (RN) Licensed RN hours. Strongest driver of clinical outcomes. | 0.22 | 0.91 | 0.17 | ≥ 0.55 | Below floor |
| Licensed Practical Nurse (LPN) LPN/LVN hours. Often handles medication administration. | 1.22 | 1.16 | 0.90 | — | |
| Nurse aide CNA hours. Bulk of direct resident care — bathing, feeding, mobility. | 1.72 | 3.15 | 1.27 | — | |
| Licensed (RN + LPN) Combined licensed nurse coverage. | 1.44 | — | — | — | |
| 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)
2.80
hrs / resident / day
RN (weekend)
0.21
hrs / resident / day
Total nurse (adjusted, weekend)
2.07
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
51.2%
annual
RN turnover
20.0%
annual
Administrators departed
0
last 12 months
Resident acuity
Nursing Case-Mix Index
1.85
higher acuity than avg
Case-Mix Index Ratio
1.34
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) | 2024-12-18 | 8 | 6 | 2 | 36 | 1 | 36 |
| Cycle 2/3 (prior) | 2023-11-15 | 8 | 1 | 7 | 220 | 1 | 220 |
Total weighted health score
82.0
lower is better
Infection-control citations
0
last cycle
Deficiencies (18)
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).
1 A/B/C No actual harm — minor
14 D/E/F Actual harm — potential for minor
3 J/K/L Immediate jeopardy
| Tag | Description | Scope/Severity | Survey date | Corrected |
|---|---|---|---|---|
| 0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | 2025-04-10 | 2025-03-03 |
| 0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2025-04-10 | 2025-03-03 |
| 0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | J | 2025-02-24 | 2025-02-28 |
| 0695 | Provide safe and appropriate respiratory care for a resident when needed. | J | 2025-02-24 | 2025-02-28 |
| 0558 | Reasonably accommodate the needs and preferences of each resident. | E | 2024-12-18 | 2025-01-06 |
| 0641 | Ensure each resident receives an accurate assessment. | D | 2024-12-18 | 2025-01-06 |
| 0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | 2024-12-18 | 2025-01-06 |
| 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 | 2024-12-18 | 2025-01-06 |
| 0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | 2024-12-18 | 2025-01-06 |
| 0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | 2024-12-18 | 2025-01-06 |
| 0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | 2024-11-21 | 2024-11-25 |
| 0557 | Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. | D | 2024-07-14 | 2024-07-16 |
| 0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | 2024-07-14 | 2024-07-16 |
| 0825 | Provide or get specialized rehabilitative services as required for a resident. | D | 2024-07-14 | 2024-07-16 |
| 0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | J | 2024-06-20 | 2024-06-28 |
| 0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | 2023-11-15 | 2023-11-16 |
| 0641 | Ensure each resident receives an accurate assessment. | B | 2022-09-23 | 2022-09-24 |
| 0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | 2022-09-23 | 2022-09-24 |
Penalties (2)
Fines issued
2
last 3 years
Total fines
$153,825
| Date | Type | Fine amount |
|---|---|---|
| 2024-06-20 | Fine | $57,131 |
| 2025-02-24 | Fine | $96,694 |
Source: CMS Nursing Home Penalties.
Financial Health (FY 2024)
Payer mix (share of resident days)
Medicare 3.0% Medicaid 71.9% Other 25.1%
Operating performance
Operating Margin
-33.3%
Total Margin
-11.3%
Occupancy Rate
58.2%
Cost per Resident Day
$45
Revenue & costs
Net Patient Revenue
$6.7M
Total Costs
$1.2M
Net Income
-$906K
Balance sheet
Total Assets
$12.5M
Total Liabilities
$13.4M
Fund Balance
-$906K
Current Ratio
0.88
Source: CMS SNF Cost Report (FY 2024). Cost report data lags by ~2 years.
Ownership & Corporate Structure
Chain: CREATIVE SOLUTIONS IN HEALTHCARE
- Chain ID
169- Facilities in chain
- 149
- Legal business name
- WEST WHARTON COUNTY HOSPITAL DISTRICT
Chain-average star ratings (for peer context)
Overall
2.7
Health
2.7
Staffing
2.0
QM
3.6
Owner / manager organizations (2)
| Organization | Role | Association |
|---|---|---|
| WEST WHARTON COUNTY HOSPITAL DISTRICT | 5% OR GREATER DIRECT OWNERSHIP INTEREST | since 04/01/2022 |
| SAN ANTONIO II ENTERPRISES, LLC | OPERATIONAL/MANAGERIAL CONTROL | since 04/01/2022 |
Owner / manager individuals (4)
| Name | Role | Association |
|---|---|---|
| BLAKE, GARY | OPERATIONAL/MANAGERIAL CONTROL | since 04/01/2022 |
| BLAKE, MALISA | OPERATIONAL/MANAGERIAL CONTROL | since 04/01/2022 |
| MAK, DAVID | CORPORATE OFFICER | since 05/17/2021 |
| HUGGINS, LINDA | W-2 MANAGING EMPLOYEE | since 04/01/2022 |
Source: CMS Nursing Home Ownership. Percent ownership is rarely disclosed — CMS only requires it for specific roles.
Facility Features
- CCRC
- No
- Hospital-based
- No
- Resident / family council
- Resident
- Sprinkler systems
- Yes
- Abuse citation flag
- No
Methodology & sources
- Nursing Home Provider Info (
nh-provider-info), vintage 2026, downloaded 2026-04-14 , 14,703 rows. - Nursing Home Penalties (
nh-penalties), vintage 2026, downloaded 2026-04-14 , 16,915 rows. - Nursing Home Health Deficiencies (
nh-deficiencies), vintage 2026, downloaded 2026-04-14 , 418,972 rows. - Nursing Home Ownership (
nh-ownership), vintage 2026, downloaded 2026-04-14 , 160,393 rows. - Skilled Nursing Facility Cost Report (
snf-cost-report), vintage 2024, downloaded 2026-04-14 , 14,120 rows.
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.
Show 113 rows
| Source | Metric | Value | Raw key |
|---|---|---|---|
| Cost Report | Cost per Resident Day ($) | $45 | metrics.cost_per_resident_day |
| Cost Report | Current Ratio | 0.88 | metrics.current_ratio |
| Cost Report | fiscal_year | 2,024 | fiscal_year |
| Cost Report | Medicaid Day Share (%) | 71.9% | metrics.medicaid_day_share |
| Cost Report | Medicare Day Share (%) | 3.0% | metrics.medicare_day_share |
| Cost Report | Net Income ($) | $-906,375 | metrics.net_income |
| Cost Report | Net Patient Revenue ($) | $6,666,207 | metrics.net_patient_revenue |
| Cost Report | Occupancy Rate (%) | 58.2% | metrics.occupancy_rate |
| Cost Report | Operating Margin (%) | -33.3% | metrics.operating_margin |
| Cost Report | Total Assets ($) | $12,505,520 | metrics.total_assets |
| Cost Report | Total Costs ($) | $1,192,656 | metrics.total_costs |
| Cost Report | Total Fund Balances ($) | $-906,375 | metrics.fund_balance |
| Cost Report | Total Liabilities ($) | $13,412,541 | metrics.total_liabilities |
| Cost Report | Total Margin (%) | -11.3% | metrics.total_margin |
| Provider Information | Abuse Icon | N | Abuse Icon |
| Provider Information | Adjusted LPN Staffing Hours per Resident per Day | 0.89962 | Adjusted LPN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Nurse Aide Staffing Hours per Resident per Day | 1.27189 | Adjusted Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Adjusted RN Staffing Hours per Resident per Day | 0.16602 | Adjusted RN Staffing Hours per Resident per Day |
| Provider Information | Adjusted Total Nurse Staffing Hours per Resident per Day | 2.33753 | Adjusted Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Adjusted Weekend Total Nurse Staffing Hours per Resident per Day | 2.06920 | 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 | 89.0 | 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 | 1.15934 | Case-Mix LPN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Nurse Aide Staffing Hours per Resident per Day | 3.15082 | Case-Mix Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Case-Mix RN Staffing Hours per Resident per Day | 0.91381 | Case-Mix RN Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Total Nurse Staffing Hours per Resident per Day | 5.22397 | Case-Mix Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day | 4.60438 | Case-Mix Weekend Total Nurse Staffing Hours per Resident per Day |
| Provider Information | Chain Average Health Inspection Rating | 2.7 | Chain Average Health Inspection Rating |
| Provider Information | Chain Average Overall 5-star Rating | 2.7 | Chain Average Overall 5-star Rating |
| Provider Information | Chain Average QM Rating | 3.6 | Chain Average QM Rating |
| Provider Information | Chain Average Staffing Rating | 2.0 | Chain Average Staffing Rating |
| Provider Information | Chain ID | 169 | Chain ID |
| Provider Information | Chain Name | CREATIVE SOLUTIONS IN HEALTHCARE | Chain Name |
| Provider Information | City/Town | SAN ANTONIO | City/Town |
| Provider Information | CMS Certification Number (CCN) | 676297 | CMS Certification Number (CCN) |
| Provider Information | Continuing Care Retirement Community | N | Continuing Care Retirement Community |
| Provider Information | County/Parish | Bexar | County/Parish |
| Provider Information | Date First Approved to Provide Medicare and Medicaid Services | 2011-10-12 | 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 | 29.3649 | Latitude |
| Provider Information | Legal Business Name | WEST WHARTON COUNTY HOSPITAL DISTRICT | Legal Business Name |
| Provider Information | Location | 6211 S NEW BRAUNFELS AVE,SAN ANTONIO,TX,78223 | Location |
| Provider Information | Long-Stay QM Rating | 5 | Long-Stay QM Rating |
| Provider Information | Long-Stay QM Rating Footnote | — | Long-Stay QM Rating Footnote |
| Provider Information | Longitude | -98.458 | 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 | 0 | Number of administrators who have left the nursing home |
| Provider Information | Number of Certified Beds | 124 | Number of Certified Beds |
| Provider Information | Number of Citations from Infection Control Inspections | 0 | Number of Citations from Infection Control Inspections |
| Provider Information | Number of Facilities in Chain | 149 | Number of Facilities in Chain |
| Provider Information | Number of Fines | 2 | Number of Fines |
| Provider Information | Number of Payment Denials | 0 | Number of Payment Denials |
| Provider Information | Nursing Case-Mix Index | 1.85062 | Nursing Case-Mix Index |
| Provider Information | Nursing Case-Mix Index Ratio | 1.34332 | Nursing Case-Mix Index Ratio |
| Provider Information | Overall Rating | 3 | Overall Rating |
| Provider Information | Overall Rating Footnote | — | Overall Rating Footnote |
| Provider Information | Ownership Type | For profit - Limited Liability company | 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 | 6211 S NEW BRAUNFELS AVE | Provider Address |
| Provider Information | Provider Changed Ownership in Last 12 Months | N | Provider Changed Ownership in Last 12 Months |
| Provider Information | Provider Name | THE RIO AT MISSION TRAILS | 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 and Medicaid | Provider Type |
| Provider Information | QM Rating | 5 | QM Rating |
| Provider Information | QM Rating Footnote | — | QM Rating Footnote |
| Provider Information | Rating Cycle 1 Health Deficiency Score | 36 | 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 | 2 | 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 | 6 | Rating Cycle 1 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 1 Standard Survey Health Date | 2024-12-18 | Rating Cycle 1 Standard Survey Health Date |
| Provider Information | Rating Cycle 1 Total Health Score | 36 | Rating Cycle 1 Total Health Score |
| Provider Information | Rating Cycle 1 Total Number of Health Deficiencies | 8 | Rating Cycle 1 Total Number of Health Deficiencies |
| Provider Information | Rating Cycle 2 Number of Standard Health Deficiencies | 1 | Rating Cycle 2 Number of Standard Health Deficiencies |
| Provider Information | Rating Cycle 2 Standard Health Survey Date | 2023-11-15 | Rating Cycle 2 Standard Health Survey Date |
| Provider Information | Rating Cycle 2/3 Health Deficiency Score | 220 | 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 | 7 | 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 | 220 | Rating Cycle 2/3 Total Health Score |
| Provider Information | Rating Cycle 2/3 Total Number of Health Deficiencies | 8 | Rating Cycle 2/3 Total Number of Health Deficiencies |
| Provider Information | Registered Nurse hours per resident per day on the weekend | 0.20640 | Registered Nurse hours per resident per day on the weekend |
| Provider Information | Registered Nurse turnover | 20.0 | Registered Nurse turnover |
| Provider Information | Registered Nurse turnover footnote | — | Registered Nurse turnover footnote |
| Provider Information | Reported Licensed Staffing Hours per Resident per Day | 1.44184 | Reported Licensed Staffing Hours per Resident per Day |
| Provider Information | Reported LPN Staffing Hours per Resident per Day | 1.21721 | Reported LPN Staffing Hours per Resident per Day |
| Provider Information | Reported Nurse Aide Staffing Hours per Resident per Day | 1.72092 | Reported Nurse Aide Staffing Hours per Resident per Day |
| Provider Information | Reported Physical Therapist Staffing Hours per Resident Per Day | 0.11285 | Reported Physical Therapist Staffing Hours per Resident Per Day |
| Provider Information | Reported RN Staffing Hours per Resident per Day | 0.22463 | 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 | 3.16276 | 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 | 1 | Staffing Rating |
| Provider Information | Staffing Rating Footnote | — | Staffing Rating Footnote |
| Provider Information | State | TX | State |
| Provider Information | Telephone Number | 2105310569 | Telephone Number |
| Provider Information | Total Amount of Fines in Dollars | 153825.00 | Total Amount of Fines in Dollars |
| Provider Information | Total number of nurse staff hours per resident per day on the weekend | 2.79969 | Total number of nurse staff hours per resident per day on the weekend |
| Provider Information | Total Number of Penalties | 2 | Total Number of Penalties |
| Provider Information | Total nursing staff turnover | 51.2 | Total nursing staff turnover |
| Provider Information | Total nursing staff turnover footnote | — | Total nursing staff turnover footnote |
| Provider Information | Total Weighted Health Survey Score | 82.000 | 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 | 78223 | ZIP Code |