The Rio At Mission Trails
6211 S NEW BRAUNFELS AVENUE, San Antonio, TX, 78223
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 - Limited Liability company · Chain: Creative Solutions In Healthcare
- Certified beds
- 124 · avg 89 residents/day
- Total nursing staff turnover
- 51.2% — near the Texas averageTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 20% — 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)
- 2 fines · $153,825 total
State licensing & capacity
- License number
- 308538
- Service type
- Medicare/medicaid
- Licensed capacity
- 124 beds
- Bed type breakdown
- 26 Medicare-only · 98 Medicaid/Medicare
- Current license effective
- April 1, 2025
- Current license expires
- April 1, 2028
- Initial license date
- October 12, 2011
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- West Wharton County Hospital District (HOSPITAL DISTRICT/AUTHORITY)
- Operator / manager
- San Antonio Ii Enterprises, Llc
- Administrator
- Alejandro Garcia
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 (7 on record)
- Gary r Blake
Operational/managerial Control · 50% · since 2022
- Honor x Enterprises, Llc
Other · 100% · since 2022
- Linda f Huggins
W-2 Managing Employee · since 2022
- Malisa a Blake
Operational/managerial Control · 50% · since 2022
- San Antonio ii Enterprises, Llc
Operational/managerial Control · 100% · since 2022
- West Wharton County Hospital District
5% or Greater Direct Ownership Interest · 100% · since 2022
+ 1 additional owner on the federal record.
Recent change of ownership
April 2022 (4 years ago) · acquired from The Rio at Mission Trails
Transaction type: Change of Ownership
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Chain Performance Measures + Change of Ownership, 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 18)
- D0609·Apr 10, 2025Complaint
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D0607·Apr 10, 2025Complaint
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- J0695·Feb 24, 2025Complaint
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
- J0600·Feb 24, 2025Complaint
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D0842·Dec 18, 2024
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D0812·Dec 18, 2024
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D0761·Dec 18, 2024
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.
- D0656·Dec 18, 2024
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
- 20251 fine · $97K
- 20241 fine · $57K
Most recent events
- Feb 24, 2025Fine · $97K
- Jun 20, 2024Fine · $57K
Largest single fine on record: $97K.
Fire-safety citations
5 Life-Safety-Code citations on file. Most recent: Dec 18, 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
The Rio At Mission Trails is a 124-bed nursing home in San Antonio (Bexar County) accepting Medicare and Medicaid. CMS rates it 3 stars overall, with a 1-star staffing rating — the bottom tier in Texas — alongside $153,825 in fines from 2 CMS citations. Quality-of-care outcomes rate 5 stars. The facility operates at roughly 72% of licensed beds, and its license runs through April 2028.
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 lowest tier, shared by about 38% of Texas nursing homes. Each resident receives approximately 190 minutes of nursing care per day, roughly 51 minutes less than at a 4-star-staffing facility in Texas. Residents here require more hands-on care than at a typical facility — they tend to be sicker or less mobile on average — so those 190 minutes stretch thinner than the raw number suggests.
RN turnover is a different story: roughly 2 in 10 registered nurses left in the past year, placing this facility below the state's 25th-percentile cutoff — better than about three-quarters of nursing homes in Texas on that measure. The registered nurses who set care plans and supervise daily care are staying.
Two CMS fines totaling $153,825 have been assessed here. The state median across fined Texas facilities is about $20,699, and roughly 30% of Texas nursing homes have no fines at all — so both the count and the dollar amount sit well above typical.
The facility is operating at approximately 72% of its licensed 124 beds, paired with a 1-star staffing rating and the fine history above.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
Staffing levels on evenings and weekends
With a 1-star staffing rating and 190 daily nursing minutes per resident, ask how many nurses and aides are scheduled during nights, weekends, and holidays specifically.
What the two fines were for
Two CMS citations produced $153,825 in fines — ask what the violations involved and what policy or staffing changes followed each one.
How care plans are monitored
Quality-of-care outcomes rate 5 stars despite low staffing — ask who reviews care plans, how often, and what triggers a reassessment for a resident whose condition changes.
Current bed availability and wait time
At 72% occupancy, beds appear available now — ask whether that reflects recent admissions activity or a longer-term pattern, and what the typical wait time has been.
Resident Council access and meeting schedule
The facility has a Resident Council but no Family Council — ask how families raise concerns formally, and how often the Resident Council meets.
Management company's role day to day
The licensee is West Wharton County Hospital District, but day-to-day management is listed under San Antonio II Enterprises — ask which entity sets staffing budgets and responds to complaints.
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.