Nursing homeActive

The Heights Of Bulverde

384 Harmony Hills, Spring Branch, TX 780708304381276124 certified beds · 97 residentsFor profit - CorporationMedicare and Medicaid
Surveys on file
12
since 2023
Deficiencies
47
0461
Penalties · 3 yrs
none on file
Last survey
2026-04-01
Complaint
CMS overall
2 / 5
stars as published by CMS
CMS overall 2/5
Health 2
Staffing 2
Quality 4
Star ratings as published by CMS · CMS’s caveats

Survey history

Source: CMS · Texas Health and Human Services Commission · data as of 2026-08-01
DateKindDeficienciesOfficial recordArchived PDF
2026-04-01Complaint010CMS-2567 (Care Compare)
2026-01-13Complaint010CMS-2567 (Care Compare)
2025-12-10Complaint030CMS-2567 (Care Compare)
2025-12-09Complaint030CMS-2567 (Care Compare)
2025-06-25Standard080CMS-2567 (Care Compare)
2025-04-24Complaint020CMS-2567 (Care Compare)
2025-04-19Complaint010CMS-2567 (Care Compare)
2025-03-21Complaint041CMS-2567 (Care Compare)
2024-07-22Complaint020CMS-2567 (Care Compare)
2024-05-05Standard0160CMS-2567 (Care Compare)
2024-03-21Complaint010CMS-2567 (Care Compare)
2023-03-24Standard040CMS-2567 (Care Compare)

Counts by class: paperwork · standard · harm.

Deficiencies

CMS · Texas Health and Human Services Commission publishes each citation’s tag, official description and scope/severity letter. The surveyor’s written findings are in the Statement of Deficiencies (CMS-2567) for each survey, linked above.

2026-04-01Complaint survey · 1 deficiencyOfficial report
F761Ensure 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.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2026-04-02Record 676418-20260401-F761
2026-01-13Complaint survey · 1 deficiencyOfficial report
F880Provide and implement an infection prevention and control program.Scope/severity DStandard
Infection control
Isolated; no actual harm, potential for more than minimal harm.Corrected 2026-01-14Record 676418-20260113-F880
2025-12-10Complaint survey · 3 deficienciesOfficial report
F603Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-12-11Record 676418-20251210-F603
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-12-11Record 676418-20251210-F842
F880Provide and implement an infection prevention and control program.Scope/severity DStandard
Infection control
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-12-11Record 676418-20251210-F880
2025-12-09Complaint survey · 3 deficienciesOfficial report
F641Ensure each resident receives an accurate assessment.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-12-10Record 676418-20251209-F641
F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-12-10Record 676418-20251209-F690
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-12-10Record 676418-20251209-F842
2025-06-25Standard survey · 8 deficienciesOfficial report
F552Ensure that residents are fully informed and understand their health status, care and treatments.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-26Record 676418-20250625-F552
F578Honor 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.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-26Record 676418-20250625-F578
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-26Record 676418-20250625-F656
F759Ensure medication error rates are not 5 percent or greater.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-26Record 676418-20250625-F759
F761Ensure 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.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-26Record 676418-20250625-F761
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-06-26Record 676418-20250625-F812
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-26Record 676418-20250625-F842
F880Provide and implement an infection prevention and control program.Scope/severity DStandard
Infection control
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-06-26Record 676418-20250625-F880
2025-04-24Complaint survey · 2 deficienciesOfficial report
F641Ensure each resident receives an accurate assessment.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-04-25Record 676418-20250424-F641
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-04-25Record 676418-20250424-F842
2025-04-19Complaint survey · 1 deficiencyOfficial report
F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Scope/severity EStandard
Care planningRecords
Pattern; no actual harm, potential for more than minimal harm.Corrected 2025-04-20Record 676418-20250419-F842
2025-03-21Complaint survey · 5 deficienciesOfficial report
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity JHarm
Care planningFalls
Isolated; immediate jeopardy to resident health or safety.Corrected 2025-03-22Record 676418-20250321-F689
F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-03-22Record 676418-20250321-F609
F610Respond appropriately to all alleged violations.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-03-22Record 676418-20250321-F610
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-12-24Record 676418-20250321-F656
F880Provide and implement an infection prevention and control program.Scope/severity DStandard
Infection control
Isolated; no actual harm, potential for more than minimal harm.Corrected 2025-03-22Record 676418-20250321-F880
2024-07-22Complaint survey · 2 deficienciesOfficial report
F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-07-23Record 676418-20240722-F656
F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-07-23Record 676418-20240722-F755
2024-05-05Standard survey · 16 deficienciesOfficial report
F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Scope/severity EStandard
Dignity & rights
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F582
F584Honor 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.Scope/severity DStandard
Dignity & rights
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F584
F635Provide doctor's orders for the resident's immediate care at the time the resident was admitted.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F635
F677Provide care and assistance to perform activities of daily living for any resident who is unable.Scope/severity EStandard
Care planning
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F677
F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F686
F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Scope/severity EStandard
Care planningFalls
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F689
F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Scope/severity DStandard
Care planning
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F690
F759Ensure medication error rates are not 5 percent or greater.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F759
F760Ensure that residents are free from significant medication errors.Scope/severity EStandard
Medication
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F760
F761Ensure 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.Scope/severity DStandard
Medication
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F761
F773Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.Scope/severity DStandard
Records
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F773
F806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F806
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity FStandard
Food & nutrition
Widespread; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F812
F813Have a policy regarding use and storage of foods brought to residents by family and other visitors.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F813
F814Dispose of garbage and refuse properly.Scope/severity FStandard
Food & nutrition
Widespread; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F814
F925Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.Scope/severity EStandard
Environment
Pattern; no actual harm, potential for more than minimal harm.Corrected 2024-05-06Record 676418-20240505-F925
2024-03-21Complaint survey · 1 deficiencyOfficial report
F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Scope/severity DStandard
Abuse & neglect
Isolated; no actual harm, potential for more than minimal harm.Corrected 2024-03-22Record 676418-20240321-F609
2023-03-24Standard survey · 4 deficienciesOfficial report
F641Ensure each resident receives an accurate assessment.Scope/severity DStandard
Care planningRecords
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-03-25Record 676418-20230324-F641
F808Ensure 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.Scope/severity DStandard
Food & nutrition
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-03-25Record 676418-20230324-F808
F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Scope/severity EStandard
Food & nutrition
Pattern; no actual harm, potential for more than minimal harm.Corrected 2023-03-25Record 676418-20230324-F812
F880Provide and implement an infection prevention and control program.Scope/severity DStandard
Infection control
Isolated; no actual harm, potential for more than minimal harm.Corrected 2023-03-25Record 676418-20230324-F880

Staffing

CMS Payroll-Based Journal · PBJ, as published Aug 2026 · explainer
RN hours per resident day0.52
Facility
Texas
National
Texas 0.43 · National 0.69
Total nurse hours per resident day3.13
Facility
Texas
National
Texas 3.39 · National 3.86
Weekend total nurse hours2.61
Facility
Texas
National
Texas 2.98 · National 3.42
Total nursing staff turnover56%
Facility
Texas
National
Texas 55% · National 46%
Registered nurse turnover30%
Facility
Texas
National
Texas 55% · National 43%

Quality measures

CMS MDS quality measures · 2025Q2-2026Q1 · definitions
MeasureFacilityTexasNational
Percentage of long-stay residents with pressure ulcers
lower is better
2.6%3.8%4.6%
Percentage of long-stay residents experiencing one or more falls with major injury
lower is better
4.9%3.3%3.2%
Percentage of long-stay residents who received an antipsychotic medication
lower is better
6.4%9.6%15.4%
Percentage of long-stay residents with a urinary tract infection
lower is better
0.0%0.8%1.6%
Percentage of long-stay residents who were physically restrained
lower is better
0.0%0.0%0.1%
Percentage of long-stay residents whose need for help with daily activities has increased
lower is better
13.6%15.8%13.9%
Percentage of long-stay residents who lose too much weight
lower is better
0.8%3.0%5.2%
Percentage of long-stay residents who received an antianxiety or hypnotic medication
lower is better
14.3%18.0%19.5%

Figures verbatim from CMS, with the state and national figures from the same release. The direction that counts as better is CMS’s own and is stated on every row.

Ownership

As reported to CMS (Provider Enrollment)
EntityRoleInterestSinceRegistry
Campbell, Leslie
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Castillo, Lynnea
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Clayton, Jonathon
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Dentino, Andrew
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Hackett, Edward
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Prado, Aaron
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Sehlke, Bryon
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Touchstone Strategies - Bulverde LLC
Organization
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Zurovec, Darrell
Individual
OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Aegis Therapies, Inc.
Organization
ADP OF THE SNFNOT APPLICABLE
Alamo Advisors LP
Organization
ADP OF THE SNFNOT APPLICABLE
Apolinar, Adam
Individual
CORPORATE OFFICERNOT APPLICABLE
Campbell, Leslie
Individual
ADP OF THE SNFNOT APPLICABLE
Carvajal Pharmacy Ltc
Organization
ADP OF THE SNFNOT APPLICABLE
Castillo, Lynnea
Individual
ADP OF THE SNFNOT APPLICABLE
Clayton, Jonathon
Individual
ADP OF THE SNFNOT APPLICABLE
Dentino, Andrew
Individual
ADP OF THE SNFNOT APPLICABLE
Fellbaum, Ernest
Individual
ADP OF THE SNFNOT APPLICABLE
Frost Bank
Organization
5% OR GREATER SECURITY INTERESTNOT APPLICABLE
Hackett, Edward
Individual
ADP OF THE SNFNOT APPLICABLE
Nutritious Lifestyles, Inc.
Organization
ADP OF THE SNFNOT APPLICABLE
Plante & Moran Pllc
Organization
ADP OF THE SNFNOT APPLICABLE
Prado, Aaron
Individual
ADP OF THE SNFNOT APPLICABLE
Sehlke, Bryon
Individual
ADP OF THE SNFNOT APPLICABLE
Studer, Stanley
Individual
ADP OF THE SNFNOT APPLICABLE
The Bryon And Rena Sehlke Living Trust
Organization
ADP OF THE SNFNOT APPLICABLE
Touchstone Communities Inc
Organization
ADP OF THE SNFNOT APPLICABLE
Touchstone Realty - Bulverde LLC
Organization
ADP OF THE SNFNOT APPLICABLE
Touchstone Strategies - Bulverde LLC
Organization
ADP OF THE SNFNOT APPLICABLE
Trident Health Services Inc
Organization
ADP OF THE SNFNOT APPLICABLE
Zurovec, Darrell
Individual
ADP OF THE SNFNOT APPLICABLE
Part of a chain
Touchstone Communities25 facilities
View chain record

Ownership as reported to CMS/state. CMS ownership data has known gaps; merges between entities are published only after human review.

Cost context

County figures from public surveys. Not this facility’s price. Nursing-home rates are not published by CMS or Texas.

No county cost figures on file for Comal.

Nearby nursing homes

FacilityDistanceLast surveyDeficiencies · 3 yrs
Coronado At Stone Oak
San Antonio
12.8 mi2026-01-280210
The Enclave
San Antonio
13.5 mi2026-02-262381
Stone Oak Care Center
San Antonio
13.6 mi2026-06-040291
Sonterra Health Center
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14.1 mi2026-06-170345
San Antonio Wellness & Rehabilitation
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Watch this facility

One email when a new survey, harm-class deficiency, penalty, Special Focus change or ownership change is recorded. Nothing else, ever.

Sources & provenance

SectionAgency · datasetRetrieved
Facility, ratingsCMS Provider Data · Nursing Home Provider Information2026-08-01
SurveysCMS · Survey Summary2026-08-01
DeficienciesCMS · Health Deficiencies (CMS-2567 findings via Care Compare)2026-08-01
PenaltiesCMS · Penalties2026-08-01
StaffingCMS · Payroll-Based Journal (PBJ, as published Aug 2026)2026-08-01
Quality measuresCMS · MDS Quality Measures2026-08-01
OwnershipCMS · Ownership2026-08-01