CMS PUBLIC RECORD · AUGUST 2026 RELEASERECORDS ARE ONE INPUT—NOT A PLACEMENT RECOMMENDATION
NURSING HOMELEDGERINSPECTIONS · OWNERSHIP · PENALTIES
CMS CCN 4557962026-08-01 PROCESSING DATE

NURSING HOME PUBLIC RECORD

Town And Country Nursing And Rehabilitation Center

625 N Main St · Boerne, TX 78006 · Kendall County

CMS OVERALL RATING★☆☆☆☆1/5CMS field—not our score or recommendation
Certified beds126CMS provider file
Recent citation rows78current CMS citation release
Penalty rows2current CMS penalties file
Read this record carefully.

The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.

01 / INSPECTION LEDGER

Survey cycles in this release

CycleHealth dateHealth deficienciesFire dateFire deficiencies
Cycle 12025-05-22162025-05-2213
Cycle 22024-03-31192024-03-314
Cycle 32023-02-10222023-02-104
02 / CITATION DETAIL

78 rows in the current release

3 rows carry G–L scope/severity codes; 3 carry J–L. 18 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.

2026-04-24 · HEALTHF0755Severity D · isolated; potential for more than minimal harm

Pharmacy Service Deficiencies

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Correction field: Deficient, Provider has date of correction · 2026-04-25 · complaint
2026-04-24 · HEALTHF0842Severity D · isolated; potential for more than minimal harm

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.

Correction field: Deficient, Provider has date of correction · 2026-04-25 · complaint
2026-01-08 · HEALTHF0732Severity C · widespread; potential for minimal harm

Nursing and Physician Services Deficiencies

Post nurse staffing information every day.

Correction field: Deficient, Provider has date of correction · 2026-01-09 · complaint
2025-12-17 · HEALTHF0609Severity D · isolated; potential for more than minimal harm

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Correction field: Deficient, Provider has date of correction · 2025-12-18 · complaint
2025-12-04 · HEALTHF0609Severity D · isolated; potential for more than minimal harm

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Correction field: Deficient, Provider has date of correction · 2025-12-05 · complaint
2025-05-22 · HEALTHF0552Severity D · isolated; potential for more than minimal harm

Resident Rights Deficiencies

Ensure that residents are fully informed and understand their health status, care and treatments.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0553Severity D · isolated; potential for more than minimal harm

Resident Rights Deficiencies

Allow resident to participate in the development and implementation of his or her person-centered plan of care.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0604Severity D · isolated; potential for more than minimal harm

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0641Severity D · isolated; potential for more than minimal harm

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0656Severity D · isolated; potential for more than minimal harm

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.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0684Severity D · isolated; potential for more than minimal harm

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0685Severity D · isolated; potential for more than minimal harm

Quality of Life and Care Deficiencies

Assist a resident in gaining access to vision and hearing services.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0689Severity D · isolated; potential for more than minimal harm

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0759Severity E · pattern; potential for more than minimal harm

Pharmacy Service Deficiencies

Ensure medication error rates are not 5 percent or greater.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0812Severity D · isolated; potential for more than minimal harm

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · HEALTHF0880Severity D · isolated; potential for more than minimal harm

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · FIREK0211Severity F · widespread; potential for more than minimal harm

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · FIREK0222Severity D · isolated; potential for more than minimal harm

Egress Deficiencies

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · FIREK0227Severity D · isolated; potential for more than minimal harm

Egress Deficiencies

Have ramps, exits, fire escape ladders, steps, and areas of refuge that meet safety requirements.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · FIREK0281Severity E · pattern; potential for more than minimal harm

Egress Deficiencies

Install proper backup exit lighting.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · FIREK0321Severity D · isolated; potential for more than minimal harm

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · FIREK0324Severity D · isolated; potential for more than minimal harm

Smoke Deficiencies

Provide properly protected cooking facilities.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · FIREK0341Severity F · widespread; potential for more than minimal harm

Smoke Deficiencies

Install a fire alarm system that can be heard throughout the facility.

Correction field: Deficient, Provider has date of correction · 2025-06-17
2025-05-22 · FIREK0351Severity E · pattern; potential for more than minimal harm

Smoke Deficiencies

Install an approved automatic sprinkler system.

Correction field: Deficient, Provider has date of correction · 2025-06-17
03 / ENFORCEMENT FILE

Penalties reported by CMS

Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.

DateTypeFine amountPayment-denial days
2024-07-26Fine$75,8320
2024-03-31Fine$75,0900
04 / OWNERSHIP DISCLOSURES

Who appears in the CMS file

  • MEDINA COUNTY HOSPITAL DISTRICTOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST
    100% · since 06/01/2014
  • BAIRD, DANIELIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 04/13/2021
  • CARVAJAL, ANTONIOIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 05/16/2024
  • CLAPP, BARBARAIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 06/01/2021
  • CORTESE, DARENIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 08/10/2021
  • GIBSON, PATRICIAIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 08/01/2021
  • GONZALES, VERONICAIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 05/16/2024
  • KAUFMAN, NICOLEIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 08/10/2021
  • MANDELBAUM, ELLIOTIndividual · MANAGING CONTROL - GOVERNING BODY
    NOT APPLICABLE · since 01/01/2025
  • BAIN, WILLIAMIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 05/23/2011
  • BELL, BILLIEIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 06/03/2023
  • FROSCH, KEVINIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 02/01/2010
  • HARDT, TIMOTHYIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 01/27/2020
  • JOHNSON, TONYIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 11/26/2012
  • MANGOLD, MARYIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 08/31/2023
  • WINDROW, ZACHARYIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 11/26/2012
  • WINKLER, JUDYIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 05/01/2004
  • YOUNG, CARLTONIndividual · CORPORATE OFFICER
    NOT APPLICABLE · since 05/01/2006

Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.

05 / CMS STAFFING FIELDS

Reported hours and turnover

Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.

Total nurse hours3.33per resident day
RN hours0.41per resident day
Weekend nurse hours2.98per resident day
Staff turnover65.9%CMS reported field
BEFORE A CARE DECISION

Verify the current record and visit in person.

Use this ledger to frame questions—not to choose care on its own. Recheck Medicare Care Compare, contact the state survey agency and long-term care ombudsman, and ask the facility about anything you find.