Hilltop Village Nursing And Rehabilitation
1400 HILLTOP RD, Kerrville, TX, 78028
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 Abuse Flag
CMS has flagged this facility for a substantiated finding of resident abuse, neglect, or exploitation in its current or recent inspection cycle. Ask the facility for the specific citation and corrective-action plan during your visit, and consider contacting your state's long-term care ombudsman for context.
Source: CMS Care Compare.
CMS Star Ratings
Facility & Staffing
- Ownership
- For profit - Limited Liability company · Chain: Cross Healthcare Management
- Certified beds
- 150 · avg 105 residents/day
- Total nursing staff turnover
- 80.2% — higher than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 80% — higher than most Texas nursing homesTexas avg: 50.5% · National avg: 43.6% · per CMS Care Compare
- Administrators who left
- 0 departed — near the Texas averageTexas avg: 0.6 · National avg: 0.5 · per CMS Care Compare
State licensing & capacity
- License number
- 144766
- Service type
- Medicare/medicaid
- Licensed capacity
- 150 beds
- Bed type breakdown
- 18 Medicare-only · 132 Medicaid/Medicare
- Current license effective
- February 28, 2025
- Current license expires
- February 28, 2028
- Initial license date
- September 1, 1971
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Uvalde County Hospital Authority (HOSPITAL DISTRICT/AUTHORITY)
- Operator / manager
- Hilltop Opco Llc
- Administrator
- Natasha Garcia
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Chain affiliation
Part of the Cross Healthcare Management chain — 6 facilities. Chain-wide average overall rating 3.0 / 5.
Parent entity
Uvalde County Hospital Authority
Disclosed owners (9 on record)
- Hilltop Opco Llc
Adp of The Snf · since 2025
- Christopher r Lockhart
Operational/managerial Control · since 2025
- Natasha Garcia
Operational/managerial Control · since 2025
- Crystal Dorado
Corporate Director · since 2022
- Terri Contreras
Corporate Officer · since 2019
- Christopher Martin
5% or Greater Direct Ownership Interest · 50% · since 2017
+ 3 additional owners on the federal record.
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 53)
- D0926·Aug 27, 2025
Environmental Deficiencies
Have policies on smoking.
- B0912·Aug 27, 2025
Environmental Deficiencies
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
- E0812·Aug 27, 2025
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D0803·Aug 27, 2025
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.
- E0757·Aug 27, 2025
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
- E0756·Aug 27, 2025
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
- D0755·Aug 27, 2025
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D0689·Aug 27, 2025
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Fire-safety citations
7 Life-Safety-Code citations on file. Most recent: Aug 27, 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
Hilltop Village Nursing and Rehabilitation is a 150-bed Medicare/Medicaid nursing home in Kerrville, TX, licensed since 1971 and currently managed by Hilltop Opco LLC under a Hospital District authority. CMS rates it 1 star overall — the lowest possible — with a substantiated finding of resident abuse or neglect within the past 36 months. Staffing also rates 1 star. Quality measures rate 4 stars, the one area where the facility performs above average.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here 1 star — the bottom tier, shared by roughly 38% of Texas nursing homes. Each resident receives about 184 minutes of nursing care per day, approximately 57 minutes less than at a 4-star-staffing facility in Texas. Of that, only 9 minutes per day comes from a registered nurse. Residents here also tend to need more hands-on care than at a typical facility — less mobile or more medically complex on average — so those hours stretch thinner than the raw numbers suggest.
About 8 in 10 nursing staff left in the past year. For a long-stay resident, that means cycling through multiple caregivers over the course of a year. RN turnover runs at the same rate — also in the high tier for Texas. The state's median nursing home sees roughly half that turnover.
CMS has substantiated findings of resident abuse or neglect at this facility within the past 36 months. That finding is separate from inspection scores and reflects a federal determination, not an allegation.
The facility is operating at roughly 70% of its 150 licensed beds — about 105 residents on an average day. That occupancy level, alongside the staffing and safety signals above, is context for the overall 1-star rating.
Quality measures rate 4 stars — long-stay residents rate 5 stars and short-stay residents rate 4 stars. These scores reflect clinical outcomes such as pressure wounds, falls, and medication management, drawn from resident assessments submitted to CMS.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
Steps taken after abuse finding
CMS has a substantiated abuse or neglect finding here in the past 36 months — ask what specific changes were made in response and who is responsible for ongoing oversight.
Current registered nurse coverage
CMS data shows only 9 minutes of RN time per resident per day — ask how many RNs are on each shift and what hours an RN is physically present in the building.
Staffing continuity for a new resident
About 8 in 10 nursing staff left in the past year — ask how the facility assigns consistent caregivers and how quickly open positions are typically filled.
Why occupancy is at 70%
The facility averages about 105 residents against 150 licensed beds — ask whether beds are vacant due to staffing limits, a construction phase, or another operational reason.
How quality scores stay high despite low staffing
Quality measures rate 4–5 stars while staffing rates 1 star — ask how care plans are monitored and what systems catch problems between nurse rounds.
Resident and family input channels
CMS does not show an active Resident Council or Family Council here — ask whether any formal group exists for residents or families to raise concerns directly with management.
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.