Nursing Care Index

The Heights Of Bulverde

Spring Branch, Comal County, Texas · CCN 676418 · For-profit (Corporation) · part of Touchstone Communities (25 facilities, chain average 2.9 stars)

CMS rates The Heights Of Bulverde 2 of 5 overall as of August 2026. 124 certified beds, 97 residents a day on average. 47 citations on record from the current inspection cycles, 1 at immediate jeopardy; no fines on record.

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★★☆☆☆ 2 of 5
Health inspections★★☆☆☆ 2 of 5
Staffing★★☆☆☆ 2 of 5
Quality measures★★★★☆ 4 of 5
Quality: long-stay / short-stay5 / 3 of 5

Staffing

Total nurse staffing3.12701 hours per resident per day
Registered nurses0.5213 hours per resident per day
Weekend total2.60793 hours per resident per day
Nursing staff turnover55.9% (registered nurses 30%)
Administrators who left0

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2026-04-01
complaint survey
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 · tag F0761
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-02
2026-01-13
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-01-14
2025-12-10
complaint survey
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 · tag F0842
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-12-11
2025-12-10
complaint survey
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0603
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-11
2025-12-10
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-11
2025-12-09
complaint survey
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 · tag F0842
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-12-10
2025-12-09
complaint survey
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-10
2025-12-09
complaint survey
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies · tag F0690
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-12-10
2025-06-25 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-26
2025-06-25 Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies · tag F0552
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-26
2025-06-25 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.
Resident Rights Deficiencies · tag F0578
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-26
2025-06-25 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 · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-26
2025-06-25 Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies · tag F0759
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-26
2025-06-25 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 · tag F0761
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-26
2025-06-25 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 · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-26
2025-06-25 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-26
2025-04-24
complaint survey
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 · tag F0842
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-25
2025-04-24
complaint survey
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-25
2025-04-19
complaint survey
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 · tag F0842
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-20
2025-03-21
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2025-03-22
2025-03-21
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-22
2025-03-21
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-22
2025-03-21
complaint survey
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 · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Past Non-Compliance
2024-12-24
2025-03-21
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-22
2024-07-22
complaint survey
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 · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-07-23
2024-07-22
complaint survey
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies · tag F0755
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-07-23
2024-05-05
complaint survey
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-05-06
2024-05-05
complaint survey
Dispose of garbage and refuse properly.
Nutrition and Dietary Deficiencies · tag F0814
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-05-06
2024-05-05
complaint survey
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-05-06
2024-05-05 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-05-06
2024-05-05
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-05-06
2024-05-05 Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies · tag F0759
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-05-06
2024-05-05 Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-05-06
2024-05-05 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Environmental Deficiencies · tag F0925
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-05-06
2024-05-05 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies · tag F0584
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-05-06
2024-05-05 Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
Resident Assessment and Care Planning Deficiencies · tag F0635
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-05-06
2024-05-05 Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-05-06
2024-05-05 Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies · tag F0690
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-05-06
2024-05-05 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 · tag F0761
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-05-06
2024-05-05 Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
Administration Deficiencies · tag F0773
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-05-06
2024-05-05
complaint survey
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Nutrition and Dietary Deficiencies · tag F0806
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-05-06
2024-05-05
complaint survey
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Nutrition and Dietary Deficiencies · tag F0813
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-05-06
2024-03-21
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-03-22
2023-03-24 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-03-25
2023-03-24 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-25
2023-03-24 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 · tag F0808
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-25
2023-03-24 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-03-25

Fines and payment denials

No fines or payment denials on record since 2023.

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Frost Bank
Organization
5% or greater security interest2024-05-23
Aegis Therapies, Inc.
Organization
adp of the snf2019-04-01
Alamo Advisors Lp
Organization
adp of the snf2019-04-01
Carvajal Pharmacy Ltc
Organization
adp of the snf2019-04-01
Nutritious Lifestyles, Inc.
Organization
adp of the snf2019-04-01
Plante & Moran PLLC
Organization
adp of the snf2019-04-01
The Bryon And Rena Sehlke Living Trust
Organization
adp of the snf2023-01-01
Touchstone Communities Inc.
Organization
adp of the snf2019-04-01
Touchstone Realty - Bulverde LLC
Organization
adp of the snf2019-04-01
Touchstone Strategies - Bulverde LLC
Organization
adp of the snf2025-08-26
Trident Health Services Inc.
Organization
adp of the snf2019-04-01
Touchstone Strategies - Bulverde LLC
Organization
operational/managerial control2019-04-01
Campbell, Leslie
Individual
adp of the snf2020-04-01
Castillo, Lynnea
Individual
adp of the snf2019-04-01
Clayton, Jonathon
Individual
adp of the snf2023-05-01
Dentino, Andrew
Individual
adp of the snf2025-10-01
Fellbaum, Ernest
Individual
adp of the snf2019-04-01
Hackett, Edward
Individual
adp of the snf2025-09-01
Prado, Aaron
Individual
adp of the snf2024-03-28
Sehlke, Bryon
Individual
adp of the snf2019-04-01
Studer, Stanley
Individual
adp of the snf2019-04-01
Zurovec, Darrell
Individual
adp of the snf2019-04-01
Apolinar, Adam
Individual
corporate officer2015-08-01
Campbell, Leslie
Individual
operational/managerial control2020-04-01
Castillo, Lynnea
Individual
operational/managerial control2019-04-01
Clayton, Jonathon
Individual
operational/managerial control2023-05-01
Dentino, Andrew
Individual
operational/managerial control2025-10-01
Hackett, Edward
Individual
operational/managerial control2025-09-01
Prado, Aaron
Individual
operational/managerial control2024-03-28
Sehlke, Bryon
Individual
operational/managerial control2019-04-01
Zurovec, Darrell
Individual
operational/managerial control2019-04-01

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Comal County.