Stone Oak Care Center
505 MADISON OAK DRIVE, San Antonio, TX, 78258
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: Touchstone Communities
- Certified beds
- 152 · avg 113 residents/day
- Total nursing staff turnover
- 57.3% — higher than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 57.1% — 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
Enforcement & Citations
- Fines (past 3 years)
- 1 fine · $13,980 total
State licensing & capacity
- License number
- 144720
- Service type
- Medicare/medicaid
- Licensed capacity
- 152 beds
- Bed type breakdown
- 21 Medicare-only · 131 Medicaid/Medicare
- Current license effective
- March 1, 2025
- Current license expires
- March 1, 2028
- Initial license date
- May 13, 2003
Texas HHS licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Bexar County Hospital District (HOSPITAL DISTRICT/AUTHORITY)
- Operator / manager
- Touchstone Strategies Stone Oak, Llc
- Administrator
- Monica Castaneda
Texas HHS licensing registry · as of April 16, 2026
About this community
Stone Oak Care Center is a 152-bed Medicare/Medicaid nursing home in San Antonio (Bexar County), licensed to Bexar County Hospital District and managed by Touchstone Communities. CMS rates it 2 stars overall, with a 1-star staffing rating — the lowest tier, shared by about 38% of Texas nursing homes. Quality-of-care measures for long-stay residents rate 5 stars. The facility is running at roughly 74% of licensed beds.
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. Each resident receives about 180 minutes of nursing care per day, roughly 61 minutes less than at a 4-star-staffing facility in Texas. Of that, only 19 minutes comes from a registered nurse. Residents here also require more hands-on care than at a typical facility — more dependent or medically complex on average — so those 180 minutes stretch thinner than the raw number suggests.
The facility had 1 CMS fine totaling $13,980 in the period covered by this record. That amount falls below the Texas median of $20,699 for facilities that received fines.
Stone Oak is operating at roughly 74% of its 152 licensed beds — about 112 residents on an average day. That level of vacancy, combined with a 1-star staffing rating, is a pattern worth examining directly with the facility.
Long-stay quality measures rate 5 stars — the top tier — while short-stay measures rate 2 stars. Residents living here long-term show markedly better measured outcomes than those coming for shorter rehabilitation stays.
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
With 180 minutes of daily nursing care per resident — 61 minutes below the Texas 4-star threshold — ask how many nurses and aides are on the floor during overnight and weekend shifts specifically.
RN coverage throughout the day
Reported RN time averages about 19 minutes per resident per day; ask which hours a registered nurse is physically present in the building, not just on call.
Why occupancy is at 74%
The facility averages about 112 residents against 152 licensed beds; ask whether the vacancy reflects a recent census drop, planned renovations, or staffing constraints.
Short-stay rehabilitation outcomes
Short-stay quality measures rate 2 stars while long-stay measures rate 5 stars; ask what the typical discharge destination is for rehabilitation patients and what the 30-day readmission rate looks like.
Touchstone Communities management role
Day-to-day operations are run by Touchstone Strategies Stone Oak LLC under the Touchstone Communities name; ask what decisions require approval from the management company versus the licensed owner, Bexar County Hospital District.
Resident Council meeting frequency
The facility has a Resident Council but no Family Council; ask how often the council meets, whether families may attend, and how concerns raised in meetings get resolved.
Where this information comes from
- License, capacity, ownership, administrator: Texas HHS 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.