Legend Oaks Healthcare And Rehabilitation West San Antonio
222 BERTETTI DR, San Antonio, TX, 78227
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: The Ensign Group
- Certified beds
- 124 · avg 108 residents/day
- Total nursing staff turnover
- 32.5% — lower than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 35.7% — lower 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
Enforcement & Citations
- Fines (past 3 years)
- 1 fine · $8,632 total
State licensing & capacity
- License number
- 149068
- Service type
- Medicare/medicaid
- Licensed capacity
- 124 beds
- Bed type breakdown
- 4 Medicare-only · 120 Medicaid/Medicare
- Current license effective
- April 1, 2024
- Current license expires
- April 1, 2027
- Initial license date
- May 31, 2012
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Dewitt Medical District (HOSPITAL DISTRICT/AUTHORITY)
- Operator / manager
- Bertetti Healthcare, Inc
- Administrator
- Robert Gray
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Chain affiliation
Part of the The Ensign Group chain — 329 facilities across 17 states. Chain-wide average overall rating 3.2 / 5.
Disclosed owners (10 on record)
- Bertetti Healthcare, Inc.
Adp of The Snf · since 2025
- Saad md Mansoor
Operational/managerial Control · since 2023
- Alma Alexander
Corporate Officer · since 2020
- Robert Gray
Operational/managerial Control · since 2017
- Dewitt Medical District
5% or Greater Indirect Ownership Interest · 100% · since 2017
- National Health Investors, Inc.
Adp of The Snf · since 2017
+ 4 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 12)
- D0880·Dec 9, 2025Complaint
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
- D0657·Oct 31, 2024
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.
- F0576·Oct 31, 2024
Resident Rights Deficiencies
Ensure residents have reasonable access to and privacy in their use of communication methods.
- J0689·Apr 12, 2024Complaint
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D0609·Apr 12, 2024Complaint
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D0812·Sep 15, 2023
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D0689·Sep 15, 2023
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D0645·Sep 15, 2023
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Federal penalties
By year
- 20241 fine · $8,632
Most recent events
- Apr 12, 2024Fine · $8,632
Fire-safety citations
1 Life-Safety-Code citation on file. Most recent: Oct 31, 2024. 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
Legend Oaks Healthcare and Rehabilitation – West San Antonio is a 124-bed nursing home in San Antonio's Bexar County, operated under management by Bertetti Healthcare, Inc. CMS rates it 5 stars overall, with 5-star quality-of-care ratings for both long-stay and short-stay residents and a 4-star health inspection score. Staffing comes in at 3 stars. About 108 residents are in the facility on an average day, leaving some open beds.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here at 3 stars — each resident receives about 209 minutes of nursing care per day, roughly 32 minutes less than at a 4-star-staffing facility in Texas. Around 19% of Texas nursing homes fall at this staffing level or below, so this facility sits in the lower fifth of the state on that measure alone.
Nursing staff turnover runs exceptionally low: roughly 3 in 10 nursing staff left in the past year. Texas nursing homes at the 25th percentile see about 42% annual turnover, so this facility is well below that cutoff — better than about three-quarters of nursing homes in the state. Residents who stay long-term are less likely to cycle through multiple primary caregivers.
CMS recorded one fine totaling $8,632. For context, the median fine among Texas nursing homes that received any fine at all is about $20,699, and about 30% of Texas facilities have no fines on record.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
Staffing levels on nights and weekends
Weekend nursing hours here run about 3.1 hours per resident per day — lower than the weekday average — so ask how staffing is scheduled on evenings and weekends.
How the 3-star staffing gap is managed
With daily nursing care about 32 minutes below the Texas 4-star threshold, ask which tasks or care routines are prioritized when staff are stretched.
RN coverage during off-hours
Reported RN hours average about 28 minutes per resident per day; ask how many registered nurses are on-site overnight and on weekends.
Current bed availability and wait time
The facility averages about 108 residents against 124 licensed beds; ask whether the beds that match your loved one's care needs are currently open or have a wait.
Resident Council activity
The facility has a Resident Council but no Family Council; ask how families receive updates on concerns raised in those meetings.
Management company's role in daily operations
The licensed owner is a hospital district, but day-to-day management is handled by Bertetti Healthcare — ask which entity sets staffing ratios and care policies.
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.