The Rio At Mission Trails in San Antonio, Bexar County, Texas

San Antonio, Bexar County, Texas 78223

Status Medicare and Medicaid certifiedMedicare CCN 676297

HHSC license rosteras of November 9, 2026CMS nursing home filerelease October 28, 2026; processing date October 1, 2026CMS processing date for this home October 1, 2026

Verify on TULIP View on Medicare.gov

Location and contact

Address: 6211 S New Braunfels Avenue
San Antonio, TX 78223
Open map (OpenStreetMap)
Phone: (210) 531-0569
HHSC facility ID: 104934
License number: 308538

Medicare ratings

Star ratings below are copied from the CMS Provider Information file (official release October 28, 2026; processing date October 1, 2026). They are not assigned by NursingCareLookup. See how to read ratings and CMS Five-Star documentation.

Overall: 1 of 5Overall: 1 of 5 stars
Health inspection: 2 of 5Health inspection: 2 of 5 stars
Staffing: 1 of 5Staffing: 1 of 5 stars
Quality measures: 4 of 5Quality measures: 4 of 5 stars
Long-stay quality measures: 5 of 5Long-stay quality measures: 5 of 5 stars
Short-stay quality measures: 4 of 5Short-stay quality measures: 4 of 5 stars

Staffing hours

Hours are the facility’s reported nurse staffing hours per resident per day from the CMS file. The Texas average is computed on this site from Texas rows in that same file that include a numeric value. It is not copied from another website. Method: Methodology.

Staffing hours per resident per day
Measure	This facility	Texas average (this site)
Total nurse staffing	3.73 hours	3.42 hours n=1,152
Registered nurse	0.34 hours	0.44 hours
LPN	1.19 hours	0.95 hours
Nurse aide	2.19 hours	2.03 hours
Weekend nurse staffing	3.23 hours	2.99 hours

0.31 hours above this site’s computed Texas average.

Total nursing staff turnover: 43.1% (Texas average computed on this site: 50.8%, n=1,096)
RN turnover: 80%
Average residents per day: 77.2
Certified beds (CMS): 124

Penalties in the CMS Provider Information file: 2 finestotaling $153,825; 2 total penalties. These are the figures CMS published in this release. Confirm current figures on Medicare.gov.

Fines and payment denials

Individual fines and payment denials below come from the CMS Penalties file (official release October 28, 2026; processing date October 1, 2026). Dates and amounts are copied as published. They can lag later actions or successful appeals. Confirm current figures on Medicare.gov.

CMS fines and payment denials
Date	Type	Fine amount	Payment denial
February 24, 2025	Fine · Fine ID 113635	$96,694	—
June 20, 2024	Fine · Fine ID 113012	$57,131	—

MDS quality measures

These figures are the four-quarter averages published in the CMS MDS Quality Measures file (official release October 28, 2026; measure period 2025Q3-2026Q2; processing date October 1, 2026). They are not a grade this site assigned. A “used in Five-Star” flag is the published CMS field that says whether that measure feeds the quality-measure star rating. Quarterly scores are collapsed under each measure. Official definitions are on the CMS Five-Star page.

CMS MDS quality measures, four-quarter averages
Measure	Stay	Four-quarter average	Used in Five-Star QM rating
Percentage of long-stay residents whose need for help with daily activities has increased Quarterly scores Q1 13.6% · Q2 7.0% · Q3 4.9% · Q4 16.7% · Period 2025Q3-2026Q2 · Measure code 401	Long Stay	10.6%	Yes, as published by CMS
Percentage of long-stay residents with a catheter inserted and left in their bladder Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 406	Long Stay	0.0%	Yes, as published by CMS
Percentage of long-stay residents with a urinary tract infection Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 407	Long Stay	0.0%	Yes, as published by CMS
Percentage of long-stay residents experiencing one or more falls with major injury Quarterly scores Q1 1.3% · Q2 2.6% · Q3 2.8% · Q4 1.5% · Period 2025Q3-2026Q2 · Measure code 410	Long Stay	2.0%	Yes, as published by CMS
Percentage of long-stay residents whose ability to walk independently worsened Quarterly scores Q1 — (CMS footnote 9) · Q2 — (CMS footnote 9) · Q3 — (CMS footnote 9) · Q4 — (CMS footnote 9) · Period 2025Q3-2026Q2 · Measure code 451	Long Stay	8.9%	Yes, as published by CMS
Percentage of long-stay residents with pressure ulcers Quarterly scores Q1 3.8% · Q2 6.8% · Q3 7.0% · Q4 6.8% · Period 2025Q3-2026Q2 · Measure code 479	Long Stay	6.0%	Yes, as published by CMS
Percentage of long-stay residents who received an antipsychotic medication Quarterly scores Q1 5.3% · Q2 4.7% · Q3 2.5% · Q4 2.6% · Period 2025Q3-2026Q2 · Measure code 481	Long Stay	3.8%	Yes, as published by CMS
Percentage of long-stay residents who lose too much weight Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 404	Long Stay	0.0%	No, as published by CMS
Percentage of long-stay residents who have depressive symptoms Quarterly scores Q1 1.6% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 408	Long Stay	0.4%	No, as published by CMS
Percentage of long-stay residents who were physically restrained Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 409	Long Stay	0.0%	No, as published by CMS
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Quarterly scores Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · Period 2025Q3-2026Q2 · Measure code 415	Long Stay	100.0%	No, as published by CMS
Percentage of long-stay residents who received an antianxiety or hypnotic medication Quarterly scores Q1 14.8% · Q2 19.0% · Q3 14.0% · Q4 19.0% · Period 2025Q3-2026Q2 · Measure code 452	Long Stay	16.7%	No, as published by CMS
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Quarterly scores Q1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 454	Long Stay	100.0%	No, as published by CMS
Percentage of long-stay residents with new or worsened bowel or bladder incontinence Quarterly scores Q1 19.6% · Q2 20.7% · Q3 18.2% · Q4 13.1% · Period 2025Q3-2026Q2 · Measure code 480	Long Stay	18.0%	No, as published by CMS
Percentage of short-stay residents who newly received an antipsychotic medication Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 434	Short Stay	0.0%	Yes, as published by CMS
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine Quarterly scores Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · Period 2025Q3-2026Q2 · Measure code 430	Short Stay	100.0%	No, as published by CMS
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine Quarterly scores Q1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 472	Short Stay	100.0%	No, as published by CMS

Inspection citations

35 health citations in the CMS file (19 from complaint surveys). Highest scope/severity letter in the file: J — Isolated, immediate jeopardy.

The list below is drawn from the CMS Health Deficiencies file. We show the tag, a plain-language reading of the scope and severity letter, whether the survey was a standard or complaint survey, the survey date, and whether CMS recorded a correction. We do not reprint the official deficiency narrative here. Read that text on TULIP or Medicare.gov. A facility may appeal a finding; a successful appeal can alter or remove a citation.

Scope and severity letters (A–L)

CMS assigns one letter from a grid of scope (how widely a problem was found) and severity (how serious the harm was or could be). The short labels below are our wording of that grid, not a different rating system.

Scope and severity letters used in CMS health citations
Severity	Isolated	Pattern	Widespread
Potential for minimal harm	A	B	C
No actual harm, potential for more than minimal harm	D	E	F
Actual harm	G	H	I
Immediate jeopardy	J	K	L

2026 — 19 citations

Tag 0842D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: August 4, 2026

CMS records a correction date (August 20, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0842D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: June 23, 2026

CMS records a correction date (July 13, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0585D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: June 23, 2026

CMS records a correction date (July 13, 2026)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0880D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: May 7, 2026

CMS records a correction date (May 21, 2026)

More detail

Infection Control Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0842E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: May 7, 2026

CMS records a correction date (May 21, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0695D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: April 17, 2026

CMS records a correction date (May 31, 2026)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0656D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: April 17, 2026

CMS records a correction date (April 19, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0656D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: April 7, 2026

CMS records a correction date (May 1, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0919B

B — Pattern, potential for minimal harm

Standard survey

Survey date: March 25, 2026

CMS records a correction date (April 8, 2026)

More detail

Environmental Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0842B

B — Pattern, potential for minimal harm

Standard survey

Survey date: March 25, 2026

CMS records a correction date (April 22, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0761D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 25, 2026

CMS records a correction date (April 8, 2026)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0760E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: March 25, 2026

CMS records a correction date (April 8, 2026)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0759E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: March 25, 2026

CMS records a correction date (April 8, 2026)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0755D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 25, 2026

CMS records a correction date (April 22, 2026)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0727E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: March 25, 2026

CMS records a correction date (April 22, 2026)

More detail

Nursing and Physician Services Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0645D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 25, 2026

CMS records a correction date (April 8, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0585E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: March 25, 2026

CMS records a correction date (April 8, 2026)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0880D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: March 19, 2026

CMS records a correction date (March 24, 2026)

More detail

Infection Control Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0641D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: March 19, 2026

CMS records a correction date (March 24, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

2025 — 4 citations

Tag 0609D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: April 10, 2025

Past non-compliance, as recorded by CMS (March 3, 2025)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0607D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: April 10, 2025

Past non-compliance, as recorded by CMS (March 3, 2025)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0695J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: February 24, 2025

CMS records a correction date (February 28, 2025)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0600J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: February 24, 2025

CMS records a correction date (February 28, 2025)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

2024 — 11 citations

Tag 0842D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: December 18, 2024

CMS records a correction date (January 6, 2025)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0812D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: December 18, 2024

CMS records a correction date (January 6, 2025)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0761D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: December 18, 2024

CMS records a correction date (January 6, 2025)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0656D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: December 18, 2024

CMS records a correction date (January 6, 2025)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0641D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: December 18, 2024

CMS records a correction date (January 6, 2025)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0558E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: December 18, 2024

CMS records a correction date (January 6, 2025)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0609D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: November 21, 2024

CMS records a correction date (November 25, 2024)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0825D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: July 14, 2024

CMS records a correction date (July 16, 2024)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0677D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: July 14, 2024

CMS records a correction date (July 16, 2024)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0557D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: July 14, 2024

CMS records a correction date (July 16, 2024)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0925J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: June 20, 2024

CMS records a correction date (June 28, 2024)

More detail

Environmental Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

2023 — 1 citation

Tag 0657D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: November 15, 2023

CMS records a correction date (November 16, 2023)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

License and identity (HHSC)

License effective: April 1, 2025
License expires: April 1, 2028
Initial license date: October 12, 2011
Facility licensed: Yes
Facility certified (HHSC): Yes
Service type: MEDICARE/MEDICAID
Total licensed capacity: 124 beds
Bed mix (HHSC): Licensed only 0; Medicaid only 0; Medicare only 26; Medicare/Medicaid 98; ICF/IID 0
Alzheimer capacity: 0
Administrator: Sebastian Rock
Management company: San Antonio II Enterprises, LLC

Ownership

Ownership below comes from the CMS file when a row joined on this home’s Medicare number. HHSC also records an owner and entity type; those appear after the CMS data. The HHSC entity type “HOSPITAL DISTRICT/AUTHORITY” is very common in the state roster and may not describe day-to-day control. It is not used as a headline here.

CMS ownership type: Government - Hospital district · Affiliated / chain name in the file: CREATIVE SOLUTIONS IN HEALTHCARE (150 facilities in the chain, as listed)

CMS ownership records
Name	Role	Type	Share	Associated
HUGGINS, LINDA	W-2 MANAGING EMPLOYEE	Individual	NOT APPLICABLE	since 04/01/2022
MAK, DAVID	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 05/17/2021
SAN ANTONIO II ENTERPRISES, LLC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 04/01/2022
BLAKE, GARY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 04/01/2022
BLAKE, MALISA	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 04/01/2022

HHSC owner fields

Owner (HHSC): West Wharton County Hospital District
Type of entity (HHSC): HOSPITAL DISTRICT/AUTHORITY

Public data compiled by NursingCareLookup, not an endorsement or a recommendation, and not medical or legal advice. This site is not affiliated with HHSC, CMS, or Medicare. Figures can lag events at the facility, including surveys, corrections, and successful appeals (an appeal can alter or remove a citation). Verify current facts on TULIP and Medicare.gov, and visit in person before you decide. HHSC roster as of November 9, 2026 (America/Chicago). CMS file: official release October 28, 2026; processing date October 1, 2026.