nursing home in Spring Branch, TX
The Heights of Bulverde
384 Harmony Hills, Spring Branch, TX 78070 · (830) 438-1276
★★★★★2
Below average
CMS overall star rating
CMS overall star rating
- Health inspections★★★★★2
- Staffing★★★★★2
- Quality measures★★★★★4
Source: Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. We refresh our information from this source. About our data
The Heights of Bulverde at a glance
The Heights of Bulverde is a 124-bed for-profit nursing home in Spring Branch, Texas (Comal County).
CMS gives it 2 out of 5 stars on its overall star rating, worse than the Texas average of 2.7.
Residents receive about 3.1 hours of nursing care per day (0.5 of them from registered nurses), worse than the state average of 3.4 hours.
Its most recent standard health inspection (June 25, 2025) found 16 health citations. The Texas average is 9.4.
It has not received a federal fine in the past three years.
Nursing staff turnover is 55.9% per year (state average 55.3%).
Facility details
- Type
- Nursing home
- Ownership
- For Profit - Corporation
- Beds
- 124
- Certified for
- Medicare and Medicaid
- Chain / affiliated entity
- Touchstone Communities
- Medicare-certified since
- March 15, 2017
- Resident/family council
- Resident
- County
- Comal County
- CMS Certification Number
- 676418
Ratings
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Overall star rating ⓘ (higher is better) | 2 / 5 | 2.7 / 5 | 3 / 5 | Worse |
| Health inspection rating ⓘ (higher is better) | 2 / 5 | 2.8 / 5 | 2.8 / 5 | Worse |
| Staffing rating ⓘ (higher is better) | 2 / 5 | 1.9 / 5 | 2.9 / 5 | Worse |
| Quality measures rating ⓘ (higher is better) | 4 / 5 | 3.7 / 5 | 3.6 / 5 | Average |
| Long-stay quality rating (higher is better) | 5 / 5 | 4 / 5 | 3.8 / 5 | Better |
| Short-stay (rehab) quality rating (higher is better) | 3 / 5 | 3.2 / 5 | 3.3 / 5 | Average |
Staffing
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Total nurse staff hours per resident per day ⓘ (higher is better) | 3.13 hrs | 3.39 hrs | 3.86 hrs | Worse |
| Registered nurse hours per resident per day (higher is better) | 0.52 hrs | 0.43 hrs | 0.69 hrs | Worse |
| Nurse aide hours per resident per day (higher is better) | 1.74 hrs | 2.01 hrs | 2.32 hrs | Worse |
| Weekend nurse staff hours per resident per day (higher is better) | 2.61 hrs | 2.98 hrs | 3.42 hrs | Worse |
| Nursing staff turnover (yearly) (lower is better) | 55.9% | 55.3% | 45.8% | Worse |
| Registered nurse turnover (yearly) (lower is better) | 30% | 54.6% | 42.9% | Better |
| Administrators who left in the past year (lower is better) | 0 | 1 | 1 | Better |
Inspections
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Health citations in the most recent inspection (lower is better) | 16 | 9 | 9 | Worse |
| Citations from complaint investigations (latest cycle) (lower is better) | 8 | 4 | 3 | Worse |
| Weighted health inspection score ⓘ (lower is better) | 118.8 | 102 | 80.6 | Worse |
Penalties
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Fines in the past 3 years (lower is better) | 0 | 1 | 1 | Better |
| Total fines in the past 3 years (lower is better) | $0 | $44,141 | $30,972 | Better |
| All federal penalties in the past 3 years (lower is better) | 0 | 2 | 1 | Better |
Size
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Certified beds | 124 | 113 | 107 | |
| Average residents per day | 97 | 76 | 86 | |
| Occupancy | 78.5% | 67.6% | 80.9% |
Long-stay residents
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Long-stay residents with a fall causing major injury (lower is better) | 4.9% | 3.3% | 3.2% | Worse |
| Long-stay residents with pressure ulcers (lower is better) | 2.6% | 3.8% | 4.6% | Better |
| Long-stay residents given antipsychotic medication (lower is better) | 6.4% | 9.6% | 15.4% | Better |
| Long-stay residents with a urinary tract infection (lower is better) | 0% | 0.8% | 1.6% | Better |
| Long-stay residents with a catheter left in the bladder (lower is better) | 0% | 0.3% | 0.8% | Better |
| Long-stay residents needing more help with daily activities (lower is better) | 13.6% | 15.8% | 13.9% | Average |
| Long-stay residents whose walking worsened (lower is better) | 7.5% | 14% | 14.1% | Better |
| Long-stay residents who lose too much weight (lower is better) | 0.8% | 3% | 5.2% | Better |
| Long-stay residents with depressive symptoms (lower is better) | 5.2% | 2.4% | 12.8% | Better |
| Long-stay residents who were physically restrained (lower is better) | 0% | 0% | 0.1% | Better |
| Long-stay residents given anti-anxiety or sleep medication (lower is better) | 14.3% | 18% | 19.5% | Better |
| Long-stay residents with new or worse incontinence (lower is better) | 12.2% | 13.4% | 19% | Better |
| Long-stay residents given a flu vaccine (higher is better) | 96.9% | 98% | 95.5% | Average |
| Long-stay residents given a pneumonia vaccine (higher is better) | 77.1% | 96.6% | 93.6% | Worse |
Short-stay residents
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Short-stay residents newly given antipsychotic medication (lower is better) | 0.8% | 1.5% | 1.6% | Better |
| Short-stay residents given a flu vaccine (higher is better) | 78.5% | 88% | 79.8% | Average |
| Short-stay residents given a pneumonia vaccine (higher is better) | 66.2% | 88.9% | 82% | Worse |
Inspection citations
State inspectors cited this home for 47 health deficiencies and 8 fire safety deficiencies in the inspection records CMS currently publishes. 1 citation involved actual harm, including 1 rated "immediate jeopardy".
| Date | Citation | Severity | Status |
|---|---|---|---|
| April 1, 2026 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. Pharmacy Service Deficiencies · Tag F0761 | E Potential harm, pattern | Corrected April 2, 2026 |
| January 13, 2026 Complaint | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected January 14, 2026 |
| December 10, 2025 Complaint | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · Tag F0842 | E Potential harm, pattern | Corrected December 11, 2025 |
| December 10, 2025 Complaint | Protect each resident from separation (from other residents, his/her room, or confinement to his/her room). Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0603 | D Potential harm, isolated | Corrected December 11, 2025 |
| December 10, 2025 Complaint | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected December 11, 2025 |
| December 9, 2025 Complaint | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · Tag F0842 | E Potential harm, pattern | Corrected December 10, 2025 |
| December 9, 2025 Complaint | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies · Tag F0690 | D Potential harm, isolated | Corrected December 10, 2025 |
| December 9, 2025 Complaint | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Tag F0641 | D Potential harm, isolated | Corrected December 10, 2025 |
| June 25, 2025 Fire safety | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Tag K0353 | D Potential harm, isolated | Corrected June 25, 2025 |
| June 25, 2025 Standard | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Tag F0812 | E Potential harm, pattern | Corrected June 26, 2025 |
| June 25, 2025 Standard | Honor 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. Resident Rights Deficiencies · Tag F0578 | D Potential harm, isolated | Corrected June 26, 2025 |
| June 25, 2025 Standard | 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. Pharmacy Service Deficiencies · Tag F0761 | D Potential harm, isolated | Corrected June 26, 2025 |
| June 25, 2025 Standard | Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Tag F0759 | D Potential harm, isolated | Corrected June 26, 2025 |
| June 25, 2025 Standard | 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 F0656 | D Potential harm, isolated | Corrected June 26, 2025 |
| June 25, 2025 Standard | Ensure that residents are fully informed and understand their health status, care and treatments. Resident Rights Deficiencies · Tag F0552 | D Potential harm, isolated | Corrected June 26, 2025 |
| June 25, 2025 Standard | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected June 26, 2025 |
| June 25, 2025 Standard | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · Tag F0842 | D Potential harm, isolated | Corrected June 26, 2025 |
| April 24, 2025 Complaint | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · Tag F0842 | E Potential harm, pattern | Corrected April 25, 2025 |
| April 24, 2025 Complaint | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Tag F0641 | D Potential harm, isolated | Corrected April 25, 2025 |
| April 19, 2025 Complaint | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · Tag F0842 | E Potential harm, pattern | Corrected April 20, 2025 |
| March 21, 2025 Complaint | 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 F0689 | J Immediate jeopardy, isolated | Corrected March 22, 2025 |
| March 21, 2025 Complaint | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 | D Potential harm, isolated | Corrected March 22, 2025 |
| March 21, 2025 Complaint | Respond appropriately to all alleged violations. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610 | D Potential harm, isolated | Corrected March 22, 2025 |
| March 21, 2025 Complaint | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected March 22, 2025 |
| March 21, 2025 Complaint | 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 F0656 | D Potential harm, isolated | Corrected December 24, 2024 |
| July 22, 2024 Complaint | 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 F0656 | D Potential harm, isolated | Corrected July 23, 2024 |
| July 22, 2024 Complaint | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Tag F0755 | D Potential harm, isolated | Corrected July 23, 2024 |
| May 5, 2024 Fire safety | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0918 | E Potential harm, pattern | Corrected May 6, 2024 |
| May 5, 2024 Fire safety | Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies · Tag K0741 | E Potential harm, pattern | Corrected May 7, 2024 |
| May 5, 2024 Fire safety | Have proper medical gas storage and administration areas. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0923 | E Potential harm, pattern | Corrected May 6, 2024 |
| May 5, 2024 Fire safety | Ensure proper usage of power strips and extension cords. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0920 | E Potential harm, pattern | Corrected May 6, 2024 |
| May 5, 2024 Complaint | Dispose of garbage and refuse properly. Nutrition and Dietary Deficiencies · Tag F0814 | F Potential harm, widespread | Corrected May 6, 2024 |
| May 5, 2024 Complaint | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Tag F0812 | F Potential harm, widespread | Corrected May 6, 2024 |
| May 5, 2024 Standard | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Environmental Deficiencies · Tag F0925 | E Potential harm, pattern | Corrected May 6, 2024 |
| May 5, 2024 Standard | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Tag F0760 | E Potential harm, pattern | Corrected May 6, 2024 |
| May 5, 2024 Standard | Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Tag F0759 | E Potential harm, pattern | Corrected May 6, 2024 |
| May 5, 2024 Complaint | 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 F0689 | E Potential harm, pattern | Corrected May 6, 2024 |
| May 5, 2024 Standard | Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Tag F0677 | E Potential harm, pattern | Corrected May 6, 2024 |
| May 5, 2024 Complaint | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Resident Rights Deficiencies · Tag F0582 | E Potential harm, pattern | Corrected May 6, 2024 |
| May 5, 2024 Complaint | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. Nutrition and Dietary Deficiencies · Tag F0806 | D Potential harm, isolated | Corrected May 6, 2024 |
| May 5, 2024 Standard | 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. Pharmacy Service Deficiencies · Tag F0761 | D Potential harm, isolated | Corrected May 6, 2024 |
| May 5, 2024 Standard | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Quality of Life and Care Deficiencies · Tag F0690 | D Potential harm, isolated | Corrected May 6, 2024 |
| May 5, 2024 Standard | Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. Administration Deficiencies · Tag F0773 | D Potential harm, isolated | Corrected May 6, 2024 |
| May 5, 2024 Standard | Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · Tag F0686 | D Potential harm, isolated | Corrected May 6, 2024 |
| May 5, 2024 Complaint | Have a policy regarding use and storage of foods brought to residents by family and other visitors. Nutrition and Dietary Deficiencies · Tag F0813 | D Potential harm, isolated | Corrected May 6, 2024 |
| May 5, 2024 Standard | Provide doctor's orders for the resident's immediate care at the time the resident was admitted. Resident Assessment and Care Planning Deficiencies · Tag F0635 | D Potential harm, isolated | Corrected May 6, 2024 |
| May 5, 2024 Standard | 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 F0584 | D Potential harm, isolated | Corrected May 6, 2024 |
| March 21, 2024 Complaint | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 | D Potential harm, isolated | Corrected March 22, 2024 |
| March 24, 2023 Fire safety | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0918 | F Potential harm, widespread | Corrected March 24, 2023 |
| March 24, 2023 Fire safety | Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. Miscellaneous Deficiencies · Tag K0741 | E Potential harm, pattern | Corrected March 24, 2023 |
| March 24, 2023 Fire safety | Have properly installed electrical wiring and gas equipment. Services Deficiencies · Tag K0511 | E Potential harm, pattern | Corrected March 24, 2023 |
| March 24, 2023 Standard | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Tag F0812 | E Potential harm, pattern | Corrected March 25, 2023 |
| March 24, 2023 Standard | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | D Potential harm, isolated | Corrected March 25, 2023 |
| March 24, 2023 Standard | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Tag F0641 | D Potential harm, isolated | Corrected March 25, 2023 |
| March 24, 2023 Standard | Ensure 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. Nutrition and Dietary Deficiencies · Tag F0808 | D Potential harm, isolated | Corrected March 25, 2023 |
Severity letters follow the CMS scope-and-severity grid: A–C no actual harm with potential for minimal harm; D–F potential for more than minimal harm; G–I actual harm; J–L immediate jeopardy to resident health or safety. How to read inspection citations.
Fines and payment denials
CMS reports no federal fines or payment denials in the past three years.
Owners and managers
Individuals and organizations reported to CMS as owning or operating this nursing home.
| Name | Role | Share | Since |
|---|---|---|---|
| FROST BANK Organization | 5% or greater security interest | NOT APPLICABLE | 05/23/2024 |
| AEGIS THERAPIES, INC. Organization | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| ALAMO ADVISORS LP Organization | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| CAMPBELL, LESLIE Individual | adp of the snf | NOT APPLICABLE | 04/01/2020 |
| CARVAJAL PHARMACY LTC Organization | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| CASTILLO, LYNNEA Individual | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| CLAYTON, JONATHON Individual | adp of the snf | NOT APPLICABLE | 05/01/2023 |
| DENTINO, ANDREW Individual | adp of the snf | NOT APPLICABLE | 10/01/2025 |
| FELLBAUM, ERNEST Individual | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| HACKETT, EDWARD Individual | adp of the snf | NOT APPLICABLE | 09/01/2025 |
| NUTRITIOUS LIFESTYLES, INC. Organization | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| PLANTE & MORAN PLLC Organization | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| PRADO, AARON Individual | adp of the snf | NOT APPLICABLE | 03/28/2024 |
| SEHLKE, BRYON Individual | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| STUDER, STANLEY Individual | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| THE BRYON AND RENA SEHLKE LIVING TRUST Organization | adp of the snf | NOT APPLICABLE | 01/01/2023 |
| TOUCHSTONE COMMUNITIES INC Organization | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| TOUCHSTONE REALTY - BULVERDE LLC Organization | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| TOUCHSTONE STRATEGIES - BULVERDE LLC Organization | adp of the snf | NOT APPLICABLE | 08/26/2025 |
| TRIDENT HEALTH SERVICES INC Organization | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| ZUROVEC, DARRELL Individual | adp of the snf | NOT APPLICABLE | 04/01/2019 |
| APOLINAR, ADAM Individual | corporate officer | NOT APPLICABLE | 08/01/2015 |
| CAMPBELL, LESLIE Individual | operational/managerial control | NOT APPLICABLE | 04/01/2020 |
| CASTILLO, LYNNEA Individual | operational/managerial control | NOT APPLICABLE | 04/01/2019 |
| CLAYTON, JONATHON Individual | operational/managerial control | NOT APPLICABLE | 05/01/2023 |
| DENTINO, ANDREW Individual | operational/managerial control | NOT APPLICABLE | 10/01/2025 |
| HACKETT, EDWARD Individual | operational/managerial control | NOT APPLICABLE | 09/01/2025 |
| PRADO, AARON Individual | operational/managerial control | NOT APPLICABLE | 03/28/2024 |
| SEHLKE, BRYON Individual | operational/managerial control | NOT APPLICABLE | 04/01/2019 |
| TOUCHSTONE STRATEGIES - BULVERDE LLC Organization | operational/managerial control | NOT APPLICABLE | 04/01/2019 |
| ZUROVEC, DARRELL Individual | operational/managerial control | NOT APPLICABLE | 04/01/2019 |
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Frequently asked questions
What is The Heights of Bulverde's rating?
The Heights of Bulverde has 2 out of 5 stars on the CMS overall star rating. The average for Texas nursing homes is 2.7 stars.
How many inspection citations did The Heights of Bulverde receive?
Its most recent standard health inspection found 16 citations, compared with a Texas average of 9.4. Every citation is listed on this page with its severity.
Does The Heights of Bulverde accept Medicare and Medicaid?
CMS lists it as certified for: Medicare and Medicaid. Call the facility to confirm bed availability and whether it accepts your specific plan.
Who owns The Heights of Bulverde?
It is for profit - corporation and part of Touchstone Communities. The ownership section on this page lists the owners and managers reported to CMS.
Where is The Heights of Bulverde and how do I contact it?
The Heights of Bulverde is at 384 Harmony Hills, Spring Branch, TX 78070. Phone: (830) 438-1276.
About this data
Ratings and measures come from the Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. They're based on state inspections, patient surveys and facility reports, and they describe the past. Facilities change, so visit in person and confirm details directly. About our data · Spotted an error? Let us know.