Nursing homeFAID #14504
River Hills Health and Rehabilitation Center
★★★★★1/5CMS Five-Star overall1/5 health inspections1/5 staffing4/5 quality measuresSource: CMS Care Compare
Photo via Google · Brittany Ye
Public record summary
What we can show you for free.
Bed capacity
150
CMS facility ID
676114
Care type
Nursing home
County
Kerr
Facility name
River Hills Health and Rehabilitation Center
Street address
2091 BANDERA HWY
City / state / ZIP
Kerrville, TX 78028
Phone
(830) 257-9900
About this facility — River Hills Health and Rehabilitation Center
River Hills Health and Rehabilitation Center is a Medicare/Medicaid-certified skilled nursing facility in Kerrville, Texas. It is licensed for 150 beds — above the median for skilled nursing facilities in Texas (120 beds).
It is one of 14 senior care facilities in Kerrville and 1,178 skilled nursing facilities across Texas. Families comparing options should weigh inspection history, ownership record, and litigation — not just the tour — before deciding.
Federal inspectors have cited River Hills Health and Rehabilitation Center 68 times across 18 inspections in the last three years, including 7 food-safety citations, and CMS has imposed $112,133 in fines. Every citation is listed, dated, and graded in the inspection record below.
This listing draws on federal CMS Nursing Home Compare records, and was last updated on August 31, 2026. Background reports are compiled from primary sources — state inspection files, federal CMS data, corporate registrations, and court records — at the time of order.
Facility background
What the public record shows.
Ownership & operator
Ownership type
For profit - Individual
Registered owners & officers
Apolinar, Adam
Officer — since 2026
Aziz, Wesam
Governing body · Operational control · Additional disclosable party — since 2026
Bandera Hwy Health Holdings Llc
Additional disclosable party — since 2026
Burnam, Soon
Officer — since 2026
Crown Mountain Healthcare Llc
Operational control · Additional disclosable party — since 2026
Ensign Services, Inc.
Additional disclosable party — since 2026
Keetch, Chad
Director — since 2011
Lopez, Alan
Operational control · Additional disclosable party — since 2025
Standard Bearer Healthcare Op Lp
Additional disclosable party — since 2026
The Ensign Group, Inc.
Additional disclosable party — since 2026
Uvalde County Hospital Authority
Indirect owner — since 2026
Regulatory standing
Licensed / certified since
2006-10-01
CMS overall rating
1 of 5 stars
Health deficiencies
22 at the last standard inspection
Federal fines
$112,133 total
Last standard inspection
2025-06-13
Nurse staffing
3.1 hours per resident per day
Cost & payer profile (FY2024 cost report)
Average billed charges
$200 per day (≈ $6,080/month). Private-pay prices typically track billed charges; Medicare and Medicaid pay set rates.
Payer mix (resident days)
38% Medicaid · 10% Medicare · 53% private/other
Occupancy
80% (fiscal year 2024)
Vs. state median
28% below the TX median of $277/day — full state cost breakdown
Services & coverage
Licensed beds
150
Medicare
Accepted
Medicaid
Accepted
Wheelchair accessible
entrance and parking
Visiting hours
Daily Open 24 hours
Compiled from CMS Nursing Home Compare; owners/officers from the CMS Ownership dataset; cost & occupancy from the facility's own CMS cost report; hours/accessibility via Google · last verified 2026-08-31. Facilities can submit a correction.
Inspection record
Every citation, dated and graded.
Kitchen & food safety
Federal surveyors inspect the kitchen at every standard visit. This facility has 7 food-safety citations on its three-year record — flagged below among the inspections.
2026-06-19Health inspectionComplaint-triggered1 citation
F-0550
D · No harm foundFrom a complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2026-07-07
2026-05-07Health inspectionComplaint-triggered3 citations
F-0609
D · No harm foundFrom a complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2026-06-01
F-0755
D · No harm foundFrom a complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2026-06-01
F-0761
D · No harm foundFrom a complaint
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 2026-06-01
14 earlier / fire-safety inspections (64 citations)
2026-02-04Health inspectionComplaint-triggered2 citations
F-0628
D · No harm foundFrom a complaint
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected 2026-02-06
F-0641
D · No harm foundFrom a complaint
Ensure each resident receives an accurate assessment.
Corrected 2026-02-06
2025-11-26Health inspectionComplaint-triggered1 citation
F-0882
F · No harm foundFrom a complaint
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Corrected 2025-12-19
2025-09-16Health inspectionComplaint-triggered1 citation
F-0689
D · No harm foundFrom a complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-10-01
2025-06-13Health inspectionComplaint-triggered14 citations
F-0583
D · No harm found
Keep residents' personal and medical records private and confidential.
Corrected 2025-07-11
F-0584
D · No harm found
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 2025-07-11
F-0605
D · No harm foundFrom a complaint
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Corrected 2025-07-11
F-0656
E · No harm found
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2025-07-11
F-0677
E · No harm found
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2025-07-11
F-0685
D · No harm found
Assist a resident in gaining access to vision and hearing services.
Corrected 2025-07-11
F-0689
D · No harm found
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-07-11
F-0690
E · No harm found
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 2025-07-11
F-0727
E · No harm found
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 2025-07-11
F-0760
D · No harm found
Ensure that residents are free from significant medication errors.
Corrected 2025-07-11
F-0761
E · No harm found
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 2025-07-11
F-0812
E · No harm foundFood safety
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-07-11
F-0813
D · No harm foundFood safety
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Corrected 2025-07-11
F-0880
D · No harm found
Provide and implement an infection prevention and control program.
Corrected 2025-07-11
2025-05-13Health inspectionComplaint-triggered2 citations
F-0558
E · No harm foundFrom a complaint
Reasonably accommodate the needs and preferences of each resident.
Corrected 2025-06-03
F-0641
D · No harm foundFrom a complaint
Ensure each resident receives an accurate assessment.
Corrected 2025-06-03
2025-02-08Health inspectionComplaint-triggered4 citations
F-0684
J · Immediate jeopardyFrom a complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2025-02-09
F-0755
J · Immediate jeopardyFrom a complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2025-02-09
F-0760
J · Immediate jeopardyFrom a complaint
Ensure that residents are free from significant medication errors.
Corrected 2025-02-09
F-0770
D · No harm foundFrom a complaint
Provide timely, quality laboratory services/tests to meet the needs of residents.
Corrected 2025-02-09
2024-12-21Health inspectionComplaint-triggered5 citations
F-0655
D · No harm foundFrom a complaint
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2024-12-22
F-0656
D · No harm foundFrom a complaint
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2024-12-22
F-0657
D · No harm foundFrom a complaint
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2024-12-22
F-0689
J · Immediate jeopardyFrom a complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-12-22
F-0727
F · No harm foundFrom a complaint
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 2024-12-22
2024-09-09Health inspectionComplaint-triggered4 citations
F-0607
E · No harm foundFrom a complaint
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2024-09-30
F-0609
E · No harm foundFrom a complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2024-09-30
F-0755
D · No harm foundFrom a complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2024-09-30
F-0839
D · No harm foundFrom a complaint
Employ staff that are licensed, certified, or registered in accordance with state laws.
Corrected 2024-09-30
2024-04-19Health inspection11 citations
F-0583
E · No harm found
Keep residents' personal and medical records private and confidential.
Corrected 2024-05-31
F-0641
D · No harm found
Ensure each resident receives an accurate assessment.
Corrected 2024-05-31
F-0656
D · No harm found
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2024-05-31
F-0758
D · No harm found
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Corrected 2024-05-31
F-0759
D · No harm found
Ensure medication error rates are not 5 percent or greater.
Corrected 2024-05-31
F-0801
E · No harm foundFood safety
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Corrected 2024-05-31
F-0812
F · No harm foundFood safety
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-05-31
F-0813
D · No harm foundFood safety
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Corrected 2024-05-31
F-0849
E · No harm found
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Corrected 2024-05-31
F-0880
E · No harm found
Provide and implement an infection prevention and control program.
Corrected 2024-05-31
F-0921
E · No harm found
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected 2024-05-31
2024-01-10Health inspectionComplaint-triggered2 citations
F-0580
J · Immediate jeopardyFrom a complaint
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2024-01-29
F-0684
J · Immediate jeopardyFrom a complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2024-01-29
2023-03-04Health inspection7 citations
F-0657
E · No harm found
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-03-05
F-0684
D · No harm found
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-03-05
F-0727
E · No harm found
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 2023-03-05
F-0755
E · No harm found
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2023-03-05
F-0761
E · No harm found
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 2023-03-05
F-0812
E · No harm foundFood safety
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-03-05
F-0814
C · No harm foundFood safety
Dispose of garbage and refuse properly.
Corrected 2023-03-05
2025-06-13Fire-safety inspection4 citations
E-0032
E · No harm found
Provide primary/alternate means for communication.
Corrected 2025-07-11
K-0372
E · No harm found
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2025-07-11
K-0511
E · No harm found
Have properly installed electrical wiring and gas equipment.
Corrected 2025-07-11
K-0712
F · No harm found
Have simulated fire drills held at unexpected times.
Corrected 2025-07-11
2024-04-19Fire-safety inspection5 citations
E-0004
F · No harm found
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2024-05-17
E-0039
F · No harm found
Conduct testing and exercise requirements.
Corrected 2024-05-22
K-0353
E · No harm found
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-04-19
K-0741
E · No harm found
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2024-04-22
K-0918
F · No harm found
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-04-19
2023-03-04Fire-safety inspection2 citations
K-0222
D · No harm found
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2023-03-05
K-0353
D · No harm found
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-03-10
Federal penalties
2025-02-08Fine$49,392
2024-12-21Fine$47,467
2024-01-10Fine$15,274
Total fines$112,133
Citations and penalties from the CMS Provider Data Catalog (three-year survey window, refreshed monthly). Severity codes follow the federal scope/severity grid; “Immediate jeopardy” is the most serious grade CMS issues. CCN 676114.
Visitor reviews
What people say on Google.
4.1★★★★★73 ratings on Google
★★★★★Dian Follett · 2026-06-10 · via Google“My stay at River Hills was overall excellent. The food was good although usually cold. The staff, however was an excellent experience for me!!! Not only were they well trained, very knowledgeable and capable, they were so kind and thoughtful, they treated me like they would have treated their own family member. They explained everything I was needing to do, assisted me in doing it. Upon my compl…”
★★★★★Brittany Ye · 2025-08-09 · via Google“In spite of some negative reviews, my experience with River Hills Health and Rehab has been nothing short of excellent. The care, attention, and compassion my mother-in-law receives here truly stand out. The facility itself is clean, comfortable, and aesthetically welcoming, which brings peace of mind to our family. With nearly 20 years of experience in healthcare and pharmaceuticals, I can confi…”
★★★★★Briana Gonzales · 2026-06-08 · via Google“The staff treat residents with kindness, patience, and respect. They don’t just provide care — they build relationships, encourage the resident to keep going. The facility is clean, welcoming, and always has activities that bring smiles and laughter. The leadership is an amazing team and will help you with a questions you may have.”
Ratings and reviews are from Google and reflect visitor opinions, not our verification. See all reviews on Google
Inside your report
What unlocks when you order.
Ownership & corporate history
Primary tierPrior operators & transfers
Corporate network & affiliates
,
Owners' other facilities
· · 2 more
Inspection citations — last 5 years
LockedThe 68 citations above are shown free. The report takes each one and explains it in plain English — what the tag requires, how serious the scope/severity grade really is, whether it recurred across surveys — plus the five-year pattern a single inspection can't show.
Civil & criminal lawsuits
Advanced tier onlyActive civil suits
#
Federal dockets
CDC infection data
Unlock the full file
Citations, owner history, lawsuits — decoded into one PDF.
Original records
Sources we pull for this facility.
Source
CMS Nursing Home Compare
data.cms.gov Provider Data Catalog
Last verified 2026-08-31
Source
Google Business Profile
Photos, reviews & hours
Displayed with attribution · refreshed on re-run
Source
Secretary of State filings
Entity & officer search
Pulled when a report is ordered
Source
PACER federal dockets
pacer.uscourts.gov
Pulled when a report is ordered