Castle Hills Rehabilitation And Care Center

Penalties

• Sep 12, 2025 — Fine ($19,418)
• May 2, 2025 — Fine ($27,094)
• Aug 2, 2024 — Fine ($10,226)
• Mar 16, 2024 — Fine ($55,648)

Inspection findings

1. May 20, 2026 Health · 3 findings
   • Not serious Scope/severity D Complaint

     F0580 Resident Rights Deficiencies

     Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

     Corrected May 21, 2026 · CMS health inspection

   • Not serious Scope/severity F Complaint

     F0727 Nursing and Physician Services Deficiencies

     Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

     Corrected May 21, 2026 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0755 Pharmacy Service Deficiencies

     Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

     Corrected May 21, 2026 · CMS health inspection

2. May 15, 2026 Health · 4 findings
   • Not serious Scope/severity D Complaint

     F0656 Resident Assessment and Care Planning Deficiencies

     Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

     Corrected May 16, 2026 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0761 Pharmacy Service Deficiencies

     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.

     Corrected May 16, 2026 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0842 Resident Assessment and Care Planning Deficiencies

     Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

     Corrected May 16, 2026 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected May 16, 2026 · CMS health inspection

3. Apr 24, 2026 Health · 2 findings
   • Not serious Scope/severity E Complaint

     F0812 Nutrition and Dietary Deficiencies

     Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

     Corrected May 31, 2026 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected May 31, 2026 · CMS health inspection

4. Mar 6, 2026 Health · 1 finding
   • Not serious Scope/severity E Complaint

     F0761 Pharmacy Service Deficiencies

     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.

     Corrected Mar 20, 2026 · CMS health inspection

5. Feb 22, 2026 Health · 3 findings
   • Not serious Scope/severity D Complaint

     F0641 Resident Assessment and Care Planning Deficiencies

     Ensure each resident receives an accurate assessment.

     Corrected Mar 15, 2026 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0656 Resident Assessment and Care Planning Deficiencies

     Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

     Corrected Mar 15, 2026 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0842 Resident Assessment and Care Planning Deficiencies

     Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

     Corrected Mar 15, 2026 · CMS health inspection

6. Jan 16, 2026 Health · 2 findings
   • Not serious Scope/severity D Complaint

     F0755 Pharmacy Service Deficiencies

     Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

     Corrected Feb 20, 2026 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Feb 20, 2026 · CMS health inspection

7. Dec 10, 2025 Health · 2 findings
   • Not serious Scope/severity E Complaint

     F0812 Nutrition and Dietary Deficiencies

     Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

     Corrected Jan 10, 2026 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0908 Environmental Deficiencies

     Keep all essential equipment working safely.

     Corrected Dec 12, 2025 · CMS health inspection

8. Nov 25, 2025 Health · 1 finding
   • Not serious Scope/severity D Complaint

     F0726 Nursing and Physician Services Deficiencies

     Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

     Corrected Nov 26, 2025 · CMS health inspection

9. Nov 14, 2025 Health · 2 findings
   • Not serious Scope/severity E Complaint

     F0812 Nutrition and Dietary Deficiencies

     Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

     Corrected Jan 10, 2026 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0925 Environmental Deficiencies

     Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

     Corrected Nov 30, 2025 · CMS health inspection

10. Sep 12, 2025 Fire Safety · 21 findings
    • Not serious Scope/severity F

      E0032 Emergency Preparedness Deficiencies

      Provide primary/alternate means for communication.

      Corrected Sep 11, 2025 · CMS fire safety

    • Not serious Scope/severity D

      F0558 Resident Rights Deficiencies

      Reasonably accommodate the needs and preferences of each resident.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity C

      F0577 Resident Rights Deficiencies

      Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity D

      F0641 Resident Assessment and Care Planning Deficiencies

      Ensure each resident receives an accurate assessment.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity D

      F0656 Resident Assessment and Care Planning Deficiencies

      Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity D

      F0677 Quality of Life and Care Deficiencies

      Provide care and assistance to perform activities of daily living for any resident who is unable.

      Corrected Sep 13, 2025 · CMS health inspection

    • Serious Scope/severity J Complaint

      F0689 Quality of Life and Care Deficiencies

      Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity D

      F0761 Pharmacy Service Deficiencies

      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.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity E

      F0803 Nutrition and Dietary Deficiencies

      Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity E

      F0812 Nutrition and Dietary Deficiencies

      Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity D

      F0880 Infection Control Deficiencies

      Provide and implement an infection prevention and control program.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity D

      F0926 Environmental Deficiencies

      Have policies on smoking.

      Corrected Sep 13, 2025 · CMS health inspection

    • Not serious Scope/severity C

      K0211 Egress Deficiencies

      Keep aisles, corridors, and exits free of obstruction in case of emergency.

      CMS fire safety

    • Not serious Scope/severity E

      K0321 Smoke Deficiencies

      Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

      Corrected Sep 11, 2025 · CMS fire safety

    • Not serious Scope/severity E

      K0353 Smoke Deficiencies

      Inspect, test, and maintain automatic sprinkler systems.

      Corrected Sep 11, 2025 · CMS fire safety

    • Not serious Scope/severity E

      K0355 Smoke Deficiencies

      Properly select, install, inspect, or maintain portable fire extinguishes.

      Corrected Sep 11, 2025 · CMS fire safety

    • Not serious Scope/severity E

      K0372 Smoke Deficiencies

      Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

      Corrected Sep 11, 2025 · CMS fire safety

    • Not serious Scope/severity E

      K0374 Smoke Deficiencies

      Install smoke barrier doors that can resist smoke for at least 20 minutes.

      Corrected Sep 11, 2025 · CMS fire safety

    • Not serious Scope/severity C

      K0521 Services Deficiencies

      Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

      CMS fire safety

    • Not serious Scope/severity E

      K0741 Miscellaneous Deficiencies

      Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

      Corrected Sep 11, 2025 · CMS fire safety

    • Not serious Scope/severity E

      K0920 Gas, Vacuum, and Electrical Systems Deficiencies

      Ensure proper usage of power strips and extension cords.

      Corrected Sep 11, 2025 · CMS fire safety

11. Aug 15, 2025 Health · 1 finding
    • Not serious Scope/severity D Complaint

      F0644 Resident Assessment and Care Planning Deficiencies

      Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

      Corrected Sep 14, 2025 · CMS health inspection

12. Jun 26, 2025 Health · 1 finding
    • Not serious Scope/severity D Complaint

      F0609 Freedom from Abuse, Neglect, and Exploitation Deficiencies

      Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

      Corrected Jun 30, 2025 · CMS health inspection

13. May 2, 2025 Health · 2 findings
    • Serious Scope/severity J Complaint

      F0655 Resident Assessment and Care Planning Deficiencies

      Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

      Corrected May 3, 2025 · CMS health inspection

    • Serious Scope/severity J Complaint

      F0690 Quality of Life and Care Deficiencies

      Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

      Corrected May 3, 2025 · CMS health inspection

14. Sep 13, 2024 Health · 1 finding
    • Not serious Scope/severity D Complaint

      F0755 Pharmacy Service Deficiencies

      Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

      Corrected Sep 30, 2024 · CMS health inspection

15. Sep 10, 2024 Health · 1 finding
    • Not serious Scope/severity D Complaint

      F0880 Infection Control Deficiencies

      Provide and implement an infection prevention and control program.

      Corrected Sep 30, 2024 · CMS health inspection

16. Aug 23, 2024 Health · 18 findings
    • Not serious Scope/severity D

      F0558 Resident Rights Deficiencies

      Reasonably accommodate the needs and preferences of each resident.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity E

      F0641 Resident Assessment and Care Planning Deficiencies

      Ensure each resident receives an accurate assessment.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity D

      F0689 Quality of Life and Care Deficiencies

      Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity D

      F0690 Quality of Life and Care Deficiencies

      Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity D

      F0726 Nursing and Physician Services Deficiencies

      Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity D

      F0755 Pharmacy Service Deficiencies

      Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity D

      F0761 Pharmacy Service Deficiencies

      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.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity D

      F0810 Nutrition and Dietary Deficiencies

      Provide special eating equipment and utensils for residents who need them and appropriate assistance.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity E

      F0812 Nutrition and Dietary Deficiencies

      Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity D

      F0908 Environmental Deficiencies

      Keep all essential equipment working safely.

      Corrected Sep 23, 2024 · CMS health inspection

    • Not serious Scope/severity C

      K0211 Egress Deficiencies

      Keep aisles, corridors, and exits free of obstruction in case of emergency.

      Corrected Aug 23, 2024 · CMS fire safety

    • Not serious Scope/severity F

      K0353 Smoke Deficiencies

      Inspect, test, and maintain automatic sprinkler systems.

      Corrected Oct 7, 2024 · CMS fire safety

    • Not serious Scope/severity F

      K0372 Smoke Deficiencies

      Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

      Corrected Oct 7, 2024 · CMS fire safety

    • Not serious Scope/severity F

      K0374 Smoke Deficiencies

      Install smoke barrier doors that can resist smoke for at least 20 minutes.

      Corrected Oct 7, 2024 · CMS fire safety

    • Not serious Scope/severity E

      K0511 Services Deficiencies

      Have properly installed electrical wiring and gas equipment.

      Corrected Oct 7, 2024 · CMS fire safety

    • Not serious Scope/severity C

      K0521 Services Deficiencies

      Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

      Corrected Aug 23, 2024 · CMS fire safety

    • Not serious Scope/severity E

      K0741 Miscellaneous Deficiencies

      Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

      Corrected Oct 7, 2024 · CMS fire safety

    • Not serious Scope/severity E

      K0923 Gas, Vacuum, and Electrical Systems Deficiencies

      Have proper medical gas storage and administration areas.

      Corrected Oct 7, 2024 · CMS fire safety

17. Aug 2, 2024 Health · 1 finding
    • Serious Scope/severity J Complaint

      F0689 Quality of Life and Care Deficiencies

      Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

      Corrected Jun 20, 2024 · CMS health inspection

18. Mar 23, 2024 Health · 2 findings
    • Serious Scope/severity J Complaint

      F0600 Freedom from Abuse, Neglect, and Exploitation Deficiencies

      Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

      Corrected Mar 24, 2024 · CMS health inspection

    • Serious Scope/severity J Complaint

      F0689 Quality of Life and Care Deficiencies

      Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

      Corrected Mar 24, 2024 · CMS health inspection

19. Mar 16, 2024 Health · 4 findings
    • Serious Scope/severity K Complaint

      F0580 Resident Rights Deficiencies

      Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

      Corrected Mar 17, 2024 · CMS health inspection

    • Not serious Scope/severity D Complaint

      F0656 Resident Assessment and Care Planning Deficiencies

      Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

      Corrected Apr 15, 2024 · CMS health inspection

    • Serious Scope/severity K Complaint

      F0760 Pharmacy Service Deficiencies

      Ensure that residents are free from significant medication errors.

      Corrected Mar 17, 2024 · CMS health inspection

    • Not serious Scope/severity E Complaint

      F0842 Resident Assessment and Care Planning Deficiencies

      Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

      Corrected Mar 17, 2024 · CMS health inspection

20. Dec 21, 2023 Health · 2 findings
    • Not serious Scope/severity D Complaint

      F0551 Resident Rights Deficiencies

      Give the resident's representative the ability to exercise the resident's rights.

      Corrected Jan 20, 2024 · CMS health inspection

    • Not serious Scope/severity D Complaint

      F0880 Infection Control Deficiencies

      Provide and implement an infection prevention and control program.

      Corrected Jan 20, 2024 · CMS health inspection

21. Jul 14, 2023 Fire Safety · 25 findings
    • Not serious Scope/severity D

      E0004 Emergency Preparedness Deficiencies

      Develop and maintain an Emergency Preparedness Program (EP).

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity D

      E0006 Emergency Preparedness Deficiencies

      Conduct risk assessment and an All-Hazards approach.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity E

      F0582 Resident Rights Deficiencies

      Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

      Corrected Aug 14, 2023 · CMS health inspection

    • Not serious Scope/severity E

      F0584 Resident Rights Deficiencies

      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.

      Corrected Aug 14, 2023 · CMS health inspection

    • Not serious Scope/severity D

      F0645 Resident Assessment and Care Planning Deficiencies

      PASARR screening for Mental disorders or Intellectual Disabilities

      Corrected Aug 14, 2023 · CMS health inspection

    • Not serious Scope/severity D

      F0656 Resident Assessment and Care Planning Deficiencies

      Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

      Corrected Aug 14, 2023 · CMS health inspection

    • Not serious Scope/severity D

      F0661 Resident Assessment and Care Planning Deficiencies

      Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.

      Corrected Aug 14, 2023 · CMS health inspection

    • Not serious Scope/severity D

      F0695 Quality of Life and Care Deficiencies

      Provide safe and appropriate respiratory care for a resident when needed.

      Corrected Jul 15, 2023 · CMS health inspection

    • Not serious Scope/severity E

      F0760 Pharmacy Service Deficiencies

      Ensure that residents are free from significant medication errors.

      Corrected Jul 15, 2023 · CMS health inspection

    • Not serious Scope/severity E

      F0812 Nutrition and Dietary Deficiencies

      Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

      Corrected Jul 15, 2023 · CMS health inspection

    • Not serious Scope/severity D

      F0814 Nutrition and Dietary Deficiencies

      Dispose of garbage and refuse properly.

      Corrected Aug 14, 2023 · CMS health inspection

    • Not serious Scope/severity E

      F0921 Environmental Deficiencies

      Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

      Corrected Aug 14, 2023 · CMS health inspection

    • Not serious Scope/severity E

      F0944 Administration Deficiencies

      Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.

      Corrected Jul 28, 2023 · CMS health inspection

    • Not serious Scope/severity D

      K0200 Egress Deficiencies

      Meet other general requirements.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity C

      K0211 Egress Deficiencies

      Keep aisles, corridors, and exits free of obstruction in case of emergency.

      Corrected Jul 13, 2023 · CMS fire safety

    • Not serious Scope/severity E

      K0321 Smoke Deficiencies

      Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity F

      K0324 Smoke Deficiencies

      Provide properly protected cooking facilities.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity F

      K0345 Smoke Deficiencies

      Have approved installation, maintenance and testing program for fire alarm systems.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity F

      K0353 Smoke Deficiencies

      Inspect, test, and maintain automatic sprinkler systems.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity D

      K0511 Services Deficiencies

      Have properly installed electrical wiring and gas equipment.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity C

      K0521 Services Deficiencies

      Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

      Corrected Jul 13, 2023 · CMS fire safety

    • Not serious Scope/severity F

      K0712 Miscellaneous Deficiencies

      Have simulated fire drills held at unexpected times.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity D

      K0741 Miscellaneous Deficiencies

      Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity E

      K0918 Gas, Vacuum, and Electrical Systems Deficiencies

      Have generator or other power source capable of supplying service within 10 seconds.

      Corrected Aug 25, 2023 · CMS fire safety

    • Not serious Scope/severity E

      K0920 Gas, Vacuum, and Electrical Systems Deficiencies

      Ensure proper usage of power strips and extension cords.

      Corrected Aug 25, 2023 · CMS fire safety

Owners and managers (as published by CMS)

• AZIZ, WESAM — adp of the snf, NOT APPLICABLE, since 02/01/2025
• BEWSEY, MICHAEL — operational/managerial control, NOT APPLICABLE, since 02/01/2025
• PORRAS, PETER — operational/managerial control, NOT APPLICABLE, since 02/01/2025
• PORRAS, PETER — adp of the snf, NOT APPLICABLE, since 02/01/2025
• RUFF, MICHAEL — managing control - governing body, NOT APPLICABLE, since 02/01/2024
• RUFF, MICHAEL — corporate officer, NOT APPLICABLE, since 02/01/2024
• CASTLE HILLS NURSING AND REHAB CENTER LLC — adp of the snf, NOT APPLICABLE, since 02/21/2025
• CASTLE HILLS NURSING AND REHAB CENTER LLC — operational/managerial control, NOT APPLICABLE, since 02/01/2025
• FRIO HOSPITAL DISTRICT — 5% or greater direct ownership interest, 100%, since 02/01/2024