8800 Fourwinds Dr., Windcrest, TX 78239 · Bexar County · (210) 637-2700
180 certified beds, about 73 residents a day · For profit - Corporation · Medicare and Medicaid since 1985
CMS Care Compare ratings, data as of September 1, 2026 · CCN 455533 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on August 14, 2025, inspectors cited 10 health deficiencies (the Texas average is 9.4, the national average 9.2).
Of 38 health citations since April 2023, 5 were rated as actual harm or immediate jeopardy to residents (5 immediate jeopardy).
CMS lists 4 fines totaling $199,073 in the last three years; the largest was $93,356, and the latest is dated July 31, 2025.
Nurses and nurse aides worked 2.90 hours per resident per day, against 3.39 across Texas and 3.86 nationally. Registered nurses accounted for 0.22 of those hours.
59.4% of nursing staff left within the year CMS measured (Texas average 55.3%).
CMS links it to Caraday Healthcare, an affiliated group of 8 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 38 health citations on file.
Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food for 1 of 1 kitchen in accordance with professional standards for food service safety. 1. The facility failed to label the name of food products (ice cream) in the food preparation refrigerator. 2. The facility failed to label dates on cheese and butter in the food preparation refrigerator. 3. In the walk-in refrigerator, the facility failed to keep food products 12 inches away from the ceiling and there was not a discard date on a pack of tortillas. These failures could place residents at risk for food borne illness.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident who was unable to carry out activities of daily living received the necessary services to maintain good nutrition, grooming, and personal hygiene for 3 of 8 residents (Residents #28, #69, and #76) reviewed for ADLs in that:The facility failed to ensure Resident #76 received consistent showers during August and July 2025. The facility failed to ensure Resident #28 was provided with appropriate feeding assistance for 08/14/25 lunch meal. The facility failed to help Resident #69 with eating on 08/14/25 lunch meal per his care plan. These failures could place residents at risk of not receiving care and services to meet their needs, including nutritional needs and/or a diminished quality of life.
Inspectors wroteBased on record reviews and interviews the facility failed to ensure the services of a Registered Nurse (RN) for at least 8 consecutive hours a day, 7 days a week, for 1 of 1 facility's reviewed for nursing staffing. The facility failed to have the services of an RN (Registered Nurse) 04/13/2025, 04/19/2025, 04/27/2025, 05/04/2025, 05/10/2025, and 05/11/2025. This failure could place residents at risk of not having the critical skills of a RN.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure all drugs and biologicals used in the facility were labeled in accordance with currently accepted professional principles; included the appropriate accessory and cautionary instructions and the expiration date when applicable; and under proper temperature control for 2 of 3 medication aide carts (B and C hall carts) reviewed for medication storage. The facility failed to ensure 3 vials of the medication Latanoprost, including one with no open date, were discarded within 6 weeks (42 days) of removal from refrigeration. These failures could lead to residents receiving ineffective medications and not receiving the intended therapeutic effect.
Inspectors wroteBased on observation, interview and record review, the facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 3 of 4 CNAs (CNAs M, N, and O) observed for infection control. The facility failed to: Ensure CNAs M and N bagged soiled linen prior to transporting. Ensure CNA O donned PPE properly and performed hand hygiene and glove changes while performing care to a foley catheter. These failures could lead to the spread of infection.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a safe, clean, comfortable and homelike environment for residents for 1 of 4 rooms reviewed for physical environment. room [ROOM NUMBER] had a broken drawer placed on top of the dresser. This failure could place residents at risk for injury and experiencing a diminished quality of life.
Inspectors wroteBased on interview and record review, the facility failed to ensure the assessment accurately reflected the resident's status for 1 of 9 residents (Resident #76) reviewed for assessments. The facility failed to ensure the MDS accurately reflected Resident #76's diagnosis depression. This failure could lead to residents not receiving necessary care.
Inspectors wroteBased on observation, interviews and records review, the facility failed to ensure that residents receive treatment and care in accordance with professional standards of practice for 1 of 3 residents (Resident #10) reviewed for oxygen use. The facility failed to ensure Resident #10 was monitored for oxygen saturation levels per physician's order to maintain oxygen saturations about 92%. This failure could place residents with respiratory illnesses at risk for a decline in health.
Inspectors wroteNumber of residents sampled: Number of residents cited: Based on observation, interview, and record review, the facility failed to ensure food was prepared in a form designed to meet individual needs for 1 of 8 residents (Resident #69) reviewed for dietary services. The facility failed to ensure Resident #69 received their prescribed diet (pureed diet) for 08/15/25 lunch meal service. This deficient practice could place residents, who were provided a mechanically altered diet, at risk of choking, aspiration (inhaling food), and diminished quality of life.
Inspectors wroteNumber of residents sampled: Number of residents cited: Based on interview and record review, the facility failed to maintain medical records in accordance with accepted professional standards and practices that were complete and accurately documented for 1 of 8 residents (Resident #6) reviewed for clinical documentation and medical records accuracy. The Electronic Health Record for Resident #6 did not reflect a diagnosis of depression on her admission record as was indicated for taking Remeron Oral Tablet 15 MG. Resident #6's care plan did not accurately reflect that she had a history of claiming someone beat her up when no one was around her. This failure could place residents at risk for incomplete or inaccurate clinical records, which could lead to miscommunication, a delay in services, or a potential decline in the resident's health.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that each resident received adequate supervision to prevent accidents for 1 of 2 residents (Resident #3) reviewed for quality of care. Resident #3 exited the facility through an alarming secure unit exit door on 5/14/2025. CNA A turned off the alarm without looking for Resident #3. Resident #3 left the facility and went missing for over 1.75 hours. The police found Resident #3 in a parking lot near an interstate highway and highway access roads. The noncompliance was identified as PNC. The IJ began on 5/14/2025 and ended on 6/4/25. The facility had corrected the noncompliance before this investigation survey began. This failure could place residents at risk of injury or death due to lack of supervision.
Inspectors wroteBased on observation, interviews and record reviews, the facility failed to ensure residents had the right to be free from abuse, neglect, and misappropriation of property for 1 of 6 residents (Resident #2) reviewed for abuse, in that: The facility did not properly monitor or put in place preventative measures for Resident #2, who had a severe cognitive impairment, to prevent an act of sexual abuse by Resident #1 on 02/13/25, when he kissed Resident #2, and 02/14/25, when he fondled Resident #2. An IJ was identified on 02/27/25. The IJ template was provided to the facility on [DATE] at 06:18 PM. While the IJ was removed on 03/01/25 at 05:00 PM, the facility remained out of compliance at a scope of isolated and a severity level of no actual harm with potential for more than minimal harm. [...]
Inspectors wroteBased on interviews, and record reviews the facility failed to provide treatment and care in accordance with professional standards of practice for 1 of 8 Residents (Resident #4) reviewed for neurological assessments after a fall. 1. On [DATE] at approximately 5:28 AM Resident #4 had an unwitnessed fall and was discovered on the floor in her bedroom, and LVN H failed to perform neurological assessments for Resident #4 at 6:45 AM, and at 7:15 AM, and failed to report to LVN I she had not assessed Resident #4 and at 8:00 AM Resident #4 and discovered deceased . 2. On [DATE] at approximately 7:40 AM LVN I assessed Resident #4 without performing a neurological assessment at 7:45 AM and did not document Resident #4's vital signs. The noncompliance was identified as PNC. The IJ began on [DATE] and ended on [DATE]. The facility had corrected the noncompliance before the survey began on [DATE]. [...]
Inspectors wroteBased on interviews and record reviews the facility failed to ensure alleged violations involving neglect were reported immediately, but not later than 24 hours if the events that caused the allegation do not involve abuse and did not result in serious bodily injury, to the administrator of the facility and to other officials (including to the State Survey Agency where state law provides for jurisdiction in long-term care facilities) in accordance with State law through established procedures, for 1 of 8 residents (Resident #2) reviewed for reporting allegations of neglect. On 7/17/2024 CNA S assisted Resident #2 to dress while Resident #2 was seated on the bedside and during the attempt to stand CNA S and Resident #1 lost their balance and fell to the floor. CNA S failed to report the fall to the nurse, the DON, and or the Administrator. [...]
Inspectors wroteBased on interviews and record reviews, the facility failed to implement a comprehensive person-centered care plan for each resident, consistent with resident rights, that included measurable objectives and timeframes to meet residents' medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment and described the services to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being for 1 of 6 residents (Resident #1) reviewed for care plans in that: The facility failed to implement Resident #1's comprehensive person-centered care plan intervention for 1:1 supervision for Resident #1 to have fewer episodes of sexual behaviors. This deficient practice could affect residents and place them at risk for not having their needs and preferences met.
Inspectors wroteBased on interview and record review the facility failed to provide pharmaceutical services (including procedures that assure the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals) to meet the needs of each resident for 1 of 8 (Resident #5) residents in that: Resident #5 was not administered her Methadone oral tablet once in July 2024 and twice in February 2025. The effect could result in residents not provided medications as ordered.
Inspectors wroteBased on interviews and record review the facility failed to develop and implement written policies and procedures that prohibit and prevent abuse, neglect, exploitation of residents, and misappropriation of resident property for 3 of 5 (CNA A, B, C) new hired employee's files reviewed. 1. CNA A did not have EMR/NAR. 2. CNA B did not have EMR/NAR. 3. CNA C did not have EMR/NAR. This could place residents at risk of abuse, neglect, and exploitation.
Inspectors wroteBased on interviews and record review, in response to allegations of abuse, neglect, exploitation, or mistreatment, the facility failed to ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source and misappropriation of resident property, were reported immediately to Health and Human Services, but not later than 2 hours after the allegation was made, if the events that cause the allegation involve abuse or result in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury, to the administrator of the facility and to other officials (including to the State Survey Agency and adult protective services where state law provides for jurisdiction in long-term care facilities) in accordance with state law through established [...]
Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure residents who were unable to carry out activities of daily living received the necessary services to maintain good nutrition, grooming, and personal and oral hygiene for 1 of 8 residents (Resident #51) reviewed for activities of daily living. 1. Resident #51 was observed left in bed from 09:00 AM to 06:00 PM on 06/25/2024 and again from 07:30 AM to 12:00 PM on 06/26/2024. 2. Resident #51 was observed with no hydration at his bedside from 09:00 AM to 06:00 PM on 06/25/2024 and again from 07:30 AM to 12:00 PM on 06/26/2024. 3. Resident #51 was observed with the remnants of breakfast on his gown on 06/26/2024 from 08:30 AM to 12:00 PM. These failures could place residents at risk for harm by a decline in residents' abilities to perform ADL's.
Inspectors wroteBased on observations, interviews, and record reviews the facility failed to ensure that a resident who is continent of bladder and bowel on admission receives services and assistance to maintain continence unless his or her clinical condition is or becomes such that continence is not possible to maintain, for 1 of 8 (#30) residents reviewed for their right to use the bathroom. The facility failed to support Resident #30's continence and right to use the bathroom and not depend on his adult brief. This failure could place residents at risk for harm by an contributing to incontinence and an undignified lifestyle.
Inspectors wroteBased on interviews and record review, the facility failed to ensure there were no more than 14 hours between a substantial evening meal and breakfast the following day, except when a nourishing snack was served at bedtime, up to 16 hours may elapse between a substantial evening meal and breakfast the following day if a resident group agrees to this meal span for 4 of 7 residents (confidential residents in group) reviewed for frequency of meals. The facility failed to ensure residents were offered snacks at bedtime as required due to mealtimes being more than 14 hours apart. This failure could affect all residents who received meals served from the facility's only kitchen by placing residents at risk for, unplanned weight loss, and side effects from medication given without food, and diminished quality of life.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to provide a safe, clean, comfortable, and homelike environment for 1 of 8 residents (Resident #39) reviewed for homelike environment. The facility failed to ensure Resident #39's hard-shell helmet was cleaned adequately. These failures could place residents at risk for diminished quality of life due to exposure to an environment that is unpleasant, unsanitary, uncomfortable, and unsafe.
Inspectors wroteBased on observations, interviews, and record review, the facility failed to develop and implement a comprehensive person-centered care plan that included services furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being for 2 of 16 residents (Residents #1 and #60 ) reviewed for comprehensive person-centered care plans. 1. The facility failed to ensure Resident #60's diagnosis and treatment methods of generalized anxiety disorder were included in the resident's comprehensive person-centered care plan. 2. Resident # 1 did not have a care plan for use of non-verbal pain scale. Staff did not bath/shower her and facial hair and communication was no care planned. [...]
Inspectors wroteBased on observations, interviews, and record reviews the facility failed to provide the necessary care and services to ensure that a resident's abilities in activities of daily living do not diminish unless circumstances of the individual's clinical condition demonstrate that such diminution was unavoidable. This includes the facility ensuring that: A resident is given the appropriate treatment and services to maintain or improve his or her ability to carry out the activities of daily living, including those specified in paragraph (b) of this section . Activities of daily living. The facility must provide care and services in accordance with paragraph (a) for the following activities of daily living: Hygiene -bathing, dressing, grooming, and oral care. Communication, including, Speech, Language, and Other functional communication systems for 1 of 16 (#1) residents reviewed in that: [...]
Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure a resident with pressure ulcers received necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection, and prevent new ulcers from developing for 1 of 8 Residents (Resident #53) reviewed for skin integrity. The facility failed to ensure Resident #53's pressure relieving cushion was equipped on her wheelchair. This failure could affect residents' ability to decrease likelihood of pressure ulcers and potentially worsen existing pressure ulcers.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that each resident received adequate supervision and assistance devices to prevent accidents for 1 (Resident #39) of 8 residents reviewed for accidents. The facility failed to ensure Resident #39 was supervised while she was in the dining room. This failure could place residents at risk of injuries and a decline in quality of life.
Inspectors wroteBased on interviews and record reviews the facility failed to ensure residents were free of any significant medication errors for 1 of 8 residents (Resident #57) reviewed for medication administration. The facility failed to ensure Resident #57 received Midodrine as ordered twice in July 2024. This failure could place residents at risk for not receiving the therapeutic effects of their prescribed medications.
Inspectors wroteBased on interview and record review, the facility failed to immediately notify a resident's representative when there was a significant change in the resident's physical, mental, or psychosocial status for 1 of 5 residents (Resident #1) reviewed for notification of changes in that: The facility failed to ensure Resident #1's RP (Family Member A) was notified when Resident #1 had a change in her condition on 06/12/24. This deficient practice could place residents at risk of not having their family or legal representative notified when having a change of condition.
Inspectors wroteBased on interviews and record review, the facility failed to ensure residents had the right to be free from abuse, neglect, misappropriation of resident property, and exploitation for 1 of 21 residents (Resident #1) reviewed for abuse. The facility failed to ensure CNA B reported when HA A allegedly abused Resident #1 on [DATE]. The facility failed to ensure HA A was not working after this alleged abuse and had access to residents for her overnight shift. The facility failed to ensure all staff members were properly educated on abuse, neglect, and exploitation after this incident. On [DATE] at 03:52 PM an Immediate Jeopardy (IJ) was identified. [...]
Inspectors wroteBased on observations, interviews, and record reviews the facility failed to ensure that residents received treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices for 1 of 6 (Resident #3) reviewed for quality of care. Resident #3 had signs and symptoms of a stroke and was not sent to the hospital for evaluation for approximately 6 hours after a change of condition was reported. The non-compliance was identified as past non-compliance. The immediate jeopardy began on 2/23/2024 and ended on 2/28/2024. The facility corrected the non-compliance before the investigation began. This deficient practice placed all residents at risk of experiencing a delay in treatment that could have resulted in harm or potentially death.
Inspectors wroteBased on interviews and record review, the facility failed to ensure residents had the right to be free of misappropriation of resident property and exploitation for 1 of 4 residents (Resident #4) for misappropriation and exploitation. The facility did not prevent misappropriation when MA G stole Resident #4's debit card and obtained $5,000 from Resident #4's bank account after the resident passed away. This failure could place residents at risk of misappropriation of money, possessions, and feelings of loss.
Inspectors wroteBased on interviews and record review the facility failed to ensure the comprehensive care plan was reviewed and revised by the interdisciplinary team after each assessment including both the comprehensive and quarterly review assessments person-centered care plan to reflect the current condition for 1 of 21 residents (Resident #2) reviewed for care plan revisions. The facility failed to ensure Resident #2's care plan was comprehensive and updated to reflect Resident #2 had a doctor's order of needing honey consistency liquids instead of nectar thick liquids. This deficient practice could place residents at risk of not receiving appropriate interventions to meet their current needs.
Inspectors wroteBased on observation, interviews and record review, the facility failed to manage the resident's funds for 3 of 4 resident (Residents #1, #3, and #4) reviewed for protection and management of personal funds, 1. The facility failed to manage the transfer of the Resident #1's Trust Fund in a way that prevented the Beautician from overcharging for services. 2. The facility failed to manage the transfer of the Resident #3's Trust Fund in a way that prevented the Beautician from overcharging for services. 3. The facility failed to manage the transfer of the Resident #4's Trust Fund in a way that prevented the Beautician from overcharging for services. This failure could place resident at risk of not being over charged for services and losing money.
Inspectors wroteBased on interview and record review, the facility failed to ensure the resident's responsible party has the right to exercise the resident's rights for one (Resident #4) of seven residents reviewed for resident rights. The facility failed to ensure Resident #1's RP was involved in the decision making before providing for a haircut and mustache trim. This failure could place residents at risk of not having their preferred responsible party represent them in care decisions.
Inspectors wroteBased on interview and record review, the facility failed to implement written policies and procedures to prohibit and prevent abuse and neglect for 1 of 3 staff reviewed for develop/implement abuse policies, The facility failed to have proof of EMR prior to hire and annually for the Beautician. This failure could place residents at risk of abuse, neglect, and exploitation due to staff not properly screened for employability.
Inspectors wroteBased on interview, and record review, the facility failed to develop and implement a comprehensive person-centered care plan for each resident, consistent with resident rights, that include measurable objectives and time frames to meet residents' mental, nursing, and mental and psychosocial needs that are identified in the comprehensive assessment and to ensure that the comprehensive care plan described the services that were to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being, including the right to refuse treatment for 1 of 8 residents (Resident #1) reviewed for care plans, in that: The facility failed to ensure Resident #1's care plan indicated his and his families wishes for DNR (Do Not Resuscitate) status. These failures could place residents at risk of not receiving inappropriate care.
Inspectors wroteBased on interview and record review, the facility failed to provide laboratory services to meet the needs of the resident, for 1 of 4 residents (Residents # 1) reviewed for laboratory services, The facility failed to obtain a 14-panel drug screen for Resident #1 as ordered by a NP. This failure could place residents at risk for delays in treatment.
Inspectors wroteBased on interview and record review, the facility failed to ensure agreements pertaining to services furnished by outside resources specified in writing that the facility assumes responsibility for obtaining services that meet professional standards and principles that apply to professionals providing services in such a facility for 1 of 1 outside resources reviewed The facility did not have a written agreement or contract for the Beautician. This failure could place residents at risk for not having access to outside resources.
6 fire safety citations on file: 2 on August 14, 2025, 1 on June 28, 2024, 3 on April 14, 2023.
| Date | Penalty | Amount or length |
|---|---|---|
| July 31, 2025 | Fine | $9,113 |
| March 3, 2025 | Fine | $16,149 |
| March 3, 2025 | Fine | $93,356 |
| May 30, 2024 | Fine | $80,455 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Texas | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 2.90 | 3.39 | 3.86 |
| Registered nurses | 0.22 | 0.43 | 0.69 |
| All nursing staff on weekends | 2.71 | 2.98 | 3.42 |
| Nurse aides | 1.67 | ||
| Licensed practical nurses | 1.00 | ||
| Nursing staff turnover (share who left in a year) | 59.4% | 55.3% | 45.8% |
| Registered nurse turnover | 60.0% | 54.6% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.66 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 2.97 on weekdays and 2.71 on weekends, 9% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 3.3% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 2.88 in April to June 2025 to 2.90 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 2.90 | 0.22 | 2.97 | 2.71 | 3.3% | 0 of 90 | 73 |
| Oct to Dec 2025 | 2.91 | 0.21 | 3.01 | 2.65 | 8.0% | 2 of 92 | 79 |
| Jul to Sep 2025 | 2.91 | 0.28 | 2.99 | 2.70 | 3.9% | 0 of 92 | 77 |
| Apr to Jun 2025 | 2.88 | 0.25 | 2.96 | 2.67 | 3.5% | 0 of 91 | 74 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Texas, Jan to Mar 2026 | 3.33 | 0.40 | 3.50 | 2.93 | 2.2% | 0.7% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Texas, all employers | |||
| CNAs (nursing assistants) | $18.03 | $16.97 to $20.71 | 88,680 |
| LPNs and LVNs | $29.92 | $27.46 to $32.89 | 57,560 |
| Registered nurses | $46.14 | $38.06 to $50.53 | 271,380 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Texas | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 12.1 | 15.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 0.3 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.0 | 0.8 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 5.9 | 3.3 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.5 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 14.2 | 14.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.1 | 3.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 11.6 | 9.6 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 24.6 | 25.7 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 5.4 | 12.3 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.6 | 2.2 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.1 | 2.1 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Windcrest Nursing and Rehabilitation's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (50.0% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
50.0% this home
No different from the national rate
US median of homes 51.5% · Texas: 116 better, 50 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 78 eligible stays.
11.3% this home
No different from the national rate
US median of homes 10.7% · Texas: 0 better, 9 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 103 eligible stays.
6.2% this home
No different from the national rate
US median of homes 7.1% · Texas: 4 better, 11 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 63 eligible stays.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: Texas57.3% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 19 residents counted.
5.1% this home
Median of homes: Texas0.0% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 39 residents counted.
2.2% this home
Median of homes: Texas1.3% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 39 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: Texas98.5% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 19 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: MEDINA COUNTY HOSPITAL DISTRICT. CMS links this home to Caraday Healthcare, a group of 8 nursing homes averaging 2.8 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Medina County Hospital District | 5% or greater direct ownership interest | Organization | 100% | 05/01/2025 |
| Bell, Billie | Corporate officer | Individual | 05/01/2025 | |
| Caraday Windcrest LLC | Operational/managerial control | Organization | 05/01/2025 | |
| Moore, Gregory | Operational/managerial control | Individual | 05/01/2025 | |
| Zarate, Rudolfo | Operational/managerial control | Individual | 05/01/2025 | |
| Choi, Maryann | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/08/2025 | |
| Choi, Robert | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/08/2025 | |
| Cunningham, Ernest | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/08/2025 | |
| O'Donoghue-Stallard, Maire | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/08/2025 | |
| Stallard, Thomas | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 05/08/2025 | |
| Granite Windcrest, LLC | Adp of the SNF | Organization | 05/08/2025 | |
| Cantu, Elizabeth | Adp of the SNF | Individual | 05/01/2025 | |
| Zarate, Rudolfo | Adp of the SNF | Individual | 05/01/2025 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
These are the official offices in Texas. NursingHomeClear cannot take or act on complaints.