Bluebonnet Nursing & Rehabilitation
696 FM 99, Karnes City, TX, 78118
Federal Quality Data
Official records from CMS Care Compare — reported by the facility and audited by the Centers for Medicare & Medicaid Services. We present them unmodified. Refreshed March 2026.
CMS Star Ratings
Facility & Staffing
- Ownership
- For profit - Corporation · Chain: Creative Solutions In Healthcare
- Certified beds
- 120 · avg 42 residents/day
- Total nursing staff turnover
- 66.7% — higher than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- Administrators who left
- 2 departed — near the Texas averageTexas avg: 0.6 · National avg: 0.5 · per CMS Care Compare
Enforcement & Citations
- Fines (past 3 years)
- 3 fines · $89,538 total
State licensing & capacity
- License number
- 308166
- Service type
- Medicare/medicaid
- Licensed capacity
- 120 beds
- Bed type breakdown
- 56 Medicare-only · 64 Medicaid/Medicare
- Current license effective
- January 1, 2024
- Current license expires
- January 1, 2027
- Initial license date
- March 28, 1994
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Karnes I Enterprises, Llc (Limited Liability Company (LLC))
- Operator / manager
- Creative Solutions In Healthcare, Inc
- Administrator
- Susan Peters
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Chain affiliation
Part of the Creative Solutions in Healthcare chain — 149 facilities. Chain-wide average overall rating 2.7 / 5.
Disclosed owners (5 on record)
- Creative Solutions in Healthcare Inc
Operational/managerial Control · 100% · since 2021
- Gary r Blake
5% or Greater Indirect Ownership Interest · 50% · since 2021
- Linda f Huggins
W-2 Managing Employee · since 2021
- Malisa a Blake
5% or Greater Indirect Ownership Interest · 50% · since 2021
- Honor x Enterprises, Llc
5% or Greater Direct Ownership Interest · 100% · since 2020
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Chain Performance Measures, as of April 2026.
Federal inspection record
Immediate-jeopardy citations (CMS scope/severity J–L) are the most serious category federal inspectors issue — meaning a deficiency placed residents in immediate risk of serious harm. Ask the facility for the corrective-action plan filed with CMS, and consider contacting your state long-term care ombudsman for context.
Recent health-deficiency citations (most recent 8 of 32)
- D0695·Aug 22, 2025Complaint
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
- D0689·Aug 22, 2025Complaint
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D0880·Aug 22, 2025
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
- D0761·Aug 22, 2025
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.
- D0755·Aug 22, 2025
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D0690·Aug 22, 2025
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.
- D0657·Aug 22, 2025
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D0656·Aug 22, 2025
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.
Federal penalties
By year
- 20243 fines · $90K
Most recent events
- Jun 1, 2024Fine · $32K
- Apr 9, 2024Fine · $17K
- Feb 26, 2024Fine · $41K
Largest single fine on record: $41K.
Fire-safety citations
11 Life-Safety-Code citations on file. Most recent: Aug 22, 2025. Fire-safety inspections cover building-level Life Safety Code compliance, separate from the resident-care health survey.
Source: CMS Provider Data Catalog — Health Deficiencies, Fire Safety Deficiencies, and Penalties datasets, snapshot Mar 1, 2026.
About this community
Bluebonnet Nursing & Rehabilitation is a 120-bed nursing home in Karnes City, TX, licensed for Medicare and Medicaid. CMS rates it 1 star overall — the lowest rating — with a 1-star staffing score and three fines totaling $89,538 since the last inspection cycle. Quality-measure outcomes rate 4 stars. The facility is currently operating at roughly 35% of licensed capacity, with about 42 residents on a given day.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here at 1 star — the bottom tier, shared by about 38% of Texas nursing homes. Each resident receives roughly 181 minutes of nursing care per day, about 60 minutes less than at a 4-star-staffing facility in Texas. Residents here also require more hands-on care than at a typical facility — they tend to be sicker or less mobile on average — so those 181 minutes stretch thinner than the raw number suggests.
About 7 in 10 nursing staff left in the past year. Texas nursing homes at the 75th percentile of turnover see a 60% annual rate; this facility, at 66.7%, sits above that mark. A long-stay resident will likely cycle through multiple primary caregivers over the course of a year.
Two administrators have turned over in the past year. That level of leadership change introduces organizational instability that residents and frontline staff feel directly.
CMS recorded three fines totaling $89,538. The state median fine total across Texas nursing homes that received any fine is about $20,699 — this facility's total is roughly four times that figure. About 30% of Texas nursing homes have received no fines at all.
The facility is operating at roughly 35% of its 120 licensed beds, with about 42 residents on a given day. Paired with 1-star staffing, high staff turnover, and two administrator changes in a year, that low census adds context to the facility's overall trajectory.
Quality-measure outcomes rate 4 stars — both for long-stay residents. That means clinical outcome metrics, such as rates of falls, pressure wounds, and hospital readmissions, compare favorably to peers, even as staffing and inspection results do not.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
Current administrator tenure
Two administrators have left in the past year — ask who the current administrator is, how long they have been in the role, and whether leadership is expected to remain stable.
Staffing coverage on weekends
CMS data shows weekend nursing hours drop to 2.56 per resident per day — ask how weekend staffing is scheduled and whether call-outs are covered consistently.
What the three CMS fines covered
Three fines totaling $89,538 were assessed — ask staff to walk through what each citation was for and what specific changes were made in response.
How high turnover affects care continuity
About 7 in 10 nursing staff left in the past year — ask how the facility assigns caregivers to residents and what the current vacancy rate looks like.
Why occupancy is this low
Only about 42 of 120 licensed beds are filled — ask whether the low census affects staffing ratios, services offered, or any planned changes to the facility's operations.
How 4-star outcomes are sustained
Quality-measure ratings reach 4 stars despite 1-star staffing — ask which specific outcome measures score highest and how care plans are monitored to maintain those results.
Where this information comes from
- License, capacity, ownership, administrator: Texas HHSC licensing registry, snapshot as of April 16, 2026.
- Star ratings, staffing, fines, deficiencies: CMS Care Compare, processed March 1, 2026.
- Summary, insights, and tour questions: Written from the state licensing and CMS records above, last updated April 19, 2026.
Read our methodology for how this information is collected and verified.