River Hills Health And Rehabilitation Center
Nursing Home · 2091 Bandera Hwy, Kerrville, TX 78028 · 8302579900
C-
graded on 75% of our rubric
Why you can trust this grade. HearthGrades is independent and free to use. Every grade is computed from public CMS and state records on a fixed, published rubric — safety inspections, staffing, clinical outcomes, enforcement and financial stability. This provider was graded on 75% of that rubric. No facility can pay to change its grade or where it appears, and we take no money from the providers we grade. See the full methodology.
Scores by dimension
| Dimension | Score | Data confidence |
|---|---|---|
| Safety & compliance | 1.0 / 5 | high |
| Staffing | 1.0 / 5 | high |
| Clinical outcomes | 4.0 / 5 | high |
| Enforcement | 2.1 / 5 | high |
| Financial stability | 3.8 / 5 | med |
Key facts
| Care type | Nursing Home |
| Beds | 150 |
| Ownership | For Profit - Individual |
| Operator | Uvalde County Hospital Authority |
| Certified since | 2006-10-01 |
| CMS overall star | 1 / 5 |
| Accepts Medicaid | Yes |
| Price tier | $$ of 5 · ~$279/day reported charge (within TX) |
Inspection & enforcement record
- Health-inspection citations: 6 immediate jeopardy · 0 actual harm · 49 potential for harm · 1 minor
- Federal fines: $112,133 · payment denials: 0 · penalty actions: 3
Recent inspection findings
The 8 most recent health-inspection deficiencies on file with CMS, newest first. Severity is the CMS scope/severity scale (A–L); G and above mean actual harm or immediate jeopardy. "Corrected" shows the date the facility certified the fix.
| Date | Finding | Severity | Status |
|---|---|---|---|
| 2026-02-04 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. (Resident Rights Deficiencies, tag 0628) | D | corrected 2026-02-06 |
| 2026-02-04 | Ensure each resident receives an accurate assessment. (Resident Assessment and Care Planning Deficiencies, tag 0641) | D | corrected 2026-02-06 |
| 2025-11-26 | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. (Infection Control Deficiencies, tag 0882) | F | corrected 2025-12-19 |
| 2025-09-16 | 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 0689) | D | corrected 2025-10-01 |
| 2025-06-13 | Keep residents' personal and medical records private and confidential. (Resident Rights Deficiencies, tag 0583) | D | corrected 2025-07-11 |
| 2025-06-13 | 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 0584) | D | corrected 2025-07-11 |
| 2025-06-13 | 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 0656) | E | corrected 2025-07-11 |
| 2025-06-13 | Provide care and assistance to perform activities of daily living for any resident who is unable. (Quality of Life and Care Deficiencies, tag 0677) | E | corrected 2025-07-11 |
Staffing
Nurse hours per resident per day (CMS Payroll-Based Journal) — the strongest objective predictor of care. "Expected" is what CMS's case-mix model says this facility's resident acuity calls for.
- Total nurse staffing: 3.16 hrs/resident/day (expected 3.71 for this facility's resident acuity — below expected) (US median 3.69 · TX 3.27)
- Registered-nurse staffing: 0.23 hrs/resident/day (expected 0.65 for this facility's resident acuity — below expected) (US median 0.58)
- Breakdown: nurse aide 1.85 · LPN 1.08 hrs/resident/day
- Weekend total staffing: 2.73 hrs/resident/day (expected 3.29 for this facility's resident acuity — below expected)
- Annual nursing-staff turnover: 77.3% · RN turnover 100.0% (US median 45.3% · lower is better)
- Resident acuity (nursing case-mix index): 1.33 (1.0 ≈ national average; higher = more care-intensive residents)
Clinical outcomes — the measures behind the score
The 8 CMS MDS quality measures (2025Q1-2025Q4) driving this facility's clinical score — the same measures behind the CMS QM star. All are adverse-event rates: lower is better. Worst first. The quarterly column shows the four most recent quarters (Q1→Q4); benchmarks are the national percentile and the TX state median.
| Measure | 4-qtr avg | Quarterly (Q1→Q4) | Benchmark |
|---|---|---|---|
| Percentage of long-stay residents with a catheter inserted and left in their bladder (long stay) | 0.9% | 2 → 0.8 → 0.8 → 0 | worse than 70% of US homes · TX median 0% |
| Percentage of long-stay residents with pressure ulcers (long stay) | 5.2% | 6.9 → 6.2 → 4.1 → 3.5 | worse than 62% of US homes · TX median 3.4% |
| Percentage of long-stay residents experiencing one or more falls with major injury (long stay) | 2% | 1.1 → 2.4 → 2.3 → 2.4 | better than 65% of US homes · TX median 3% |
| Percentage of long-stay residents with a urinary tract infection (long stay) | 0.3% | 0 → 0 → 0 → 1.2 | better than 72% of US homes · TX median 0.3% |
| Percentage of long-stay residents whose need for help with daily activities has increased (long stay) | 6.3% | 3.1 → 9.2 → 6.5 → 6.7 | better than 81% of US homes · TX median 14.8% |
| Percentage of long-stay residents whose ability to walk independently worsened (long stay) | 4.4% | · → · → · → 7.9 | better than 90% of US homes · TX median 13% |
| Percentage of long-stay residents who received an antipsychotic medication (long stay) | 2.7% | 0 → 4.1 → 2.3 → 4.4 | better than 94% of US homes · TX median 8.1% |
| Percentage of short-stay residents who newly received an antipsychotic medication (short stay) | 0% | 0 → 0 → 0 → 0 | better than 100% of US homes · TX median 0.7% |
What this costs
- This facility's reported avg daily charge: $279/day · $$ (price tier 2 of 5 among Texas nursing homes) — from its own federal cost report, FY ending 2025-06. Gross charges across all payers and services: higher than a quoted private rate, but computed identically for every facility, which makes the tier a fair within-state comparison.
- Payer mix (resident days): 37% Medicaid · 7% Medicare · 56% other/private · 74% occupancy
- Texas median (quoted rates): $185/day semi-private · $250/day private (national: $315 · $355)
- Accepts Medicaid: yes
- This facility's quoted rate: not public. This facility's quoted private rate isn't published by any federal or state source. Medicare covers short rehab stays (up to 100 days, copays after day 20); long-term stays are private pay until savings spend down to Medicaid. How to get the real number →
Market medians: CareScout Cost of Care Survey 2025 (collected July–November 2025), state-level — individual providers vary widely around a median. Facility-level prices aren't published by any government source; how to get a real quote.
Hospitals serving Kerr County
Hospitals in the same county — those with an emergency department first, then by CMS hospital star rating. Useful for transfers and emergencies.
| Hospital | City | ER | CMS star | Type |
|---|---|---|---|---|
| Peterson Regional Medical Center | Kerrville | Yes | 4★ | Acute care |
Compare nearby
- C Hilltop Village Nursing And Rehabilitation · Kerrville
- C- Avir At Kerrville · Kerrville
- D Arbor View Nursing & Rehabilitation · Kerrville
Full interactive report card → CMS Care Compare ↗
Source: CMS Provider Information + Health Deficiencies + Penalties (as of 2026-05). Part of our Kerr County nursing homes coverage. Spot an error? Tell us.