The Enclave

A nursing home in San Antonio, Texas 78258

18803 Hardy Oak, San Antonio, Texas 78258. (210) 982-4600.

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The short answer

Record last released by CMS on Oct 28, 2026.

1of 5 CMS’s overall rating
17 health citations at the latest inspection cycle Texas average: 9.6
3.52 nurse hours per resident per day Texas average: 3.42
1 fine in the last three years (needs attention)

The last 24 months 42 citations in 8 months of the last 36. Last cited Aug 2026. Most serious: immediate jeopardy to health or safety (J). Every month

Each figure’s source sits beside it, in its section below.

What these words mean8

Star ratings: CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
Inspection (survey): A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
Deficiency, citation, violation: What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
Scope and severity (A to L): CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
Nurse staffing hours: The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
Fines and payment denials: A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
Immediate jeopardy: CMS’s most serious finding: the place’s failure to meet a rule caused, or was likely to cause, serious injury, harm, impairment or death to someone in its care. Source: CMS; 42 CFR 489.3.
Capacity: The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.

What did inspectors find?

17 health citations at the latest inspection cycle

The Texas average is 9.6.

Last standard inspection Aug 27, 2025.

Most serious in three years: immediate jeopardy to health or safety (J), at a complaint inspection on May 4, 2024

CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

When those citations happened

42 citations in 8 months of the last 36. Last cited Aug 2026. Most serious: immediate jeopardy to health or safety (J). The last 3 years, to Nov 5, 2026.

42 citations by month over the last 3 years. Each cell is one month.
	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec
2023												Dec
2024	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec
2025	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec
2026	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov

Hover or focus a month to read it.

No visit on record Visited, nothing cited A stronger orange is more serious, on its source’s own levels, read onto four bands: from the least serious it publishes to the most

Hearth Record drew this from the dates and levels in the source’s own records.

All 42 citations in the last three years

Grouped by inspection, newest first. Each carries , from A, the least serious, to L, the most. 16 came from complaint inspections.

CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Aug 27, 2026: complaint inspection1 citation

Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 28, 2026.

Feb 26, 2026: complaint inspection1 citation

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.

Rule F0761. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Feb 27, 2026.

Feb 6, 2026: complaint inspection2 citations

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Rule F0600. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Feb 7, 2026.
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Rule F0609. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Feb 7, 2026.

Aug 27, 2025: standard inspection13 citations

Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Rule F0550. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Reasonably accommodate the needs and preferences of each resident.

Rule F0558. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Ensure each resident receives an accurate assessment.

Rule F0641. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

Rule F0656. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Rule F0690. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Provide safe and appropriate respiratory care for a resident when needed.

Rule F0695. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Rule F0755. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Ensure medication error rates are not 5 percent or greater.

Rule F0759. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
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.

Rule F0761. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Rule F0812. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Provide and implement an infection prevention and control program.

Rule F0880. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

Rule F0640. B: no actual harm, potential for minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.
Post nurse staffing information every day.

Rule F0732. C: no actual harm, potential for minimal harm. Correction date, as CMS recorded it: Aug 28, 2025.

Jul 24, 2025: complaint inspection1 citation

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

Rule F0755. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 25, 2025.

May 5, 2025: complaint inspection1 citation

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Rule F0842. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 6, 2025.

Jun 28, 2024: standard inspection13 citations

Reasonably accommodate the needs and preferences of each resident.

Rule F0558. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
Ensure each resident receives an accurate assessment.

Rule F0641. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
PASARR screening for Mental disorders or Intellectual Disabilities

Rule F0645. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
Provide care and assistance to perform activities of daily living for any resident who is unable.

Rule F0677. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

Rule F0693. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
Provide safe and appropriate respiratory care for a resident when needed.

Rule F0695. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.

Rule F0700. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
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.

Rule F0761. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
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.

Rule F0803. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.

Rule F0806. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Rule F0812. F: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
Have a policy regarding use and storage of foods brought to residents by family and other visitors.

Rule F0813. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.
Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Jun 29, 2024.

Jun 28, 2024: standard and complaint inspection1 citation

Ensure that residents are free from significant medication errors.

Rule F0760. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 29, 2024.

Jun 7, 2024: complaint inspection1 citation

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

Rule F0689. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jun 8, 2024.

May 4, 2024: complaint inspection6 citations

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

Rule F0689. J: immediate jeopardy to health or safety. From a complaint. Correction date, as CMS recorded it: Jun 8, 2024.
Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Rule F0550. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 5, 2024.
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Rule F0609. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 5, 2024.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Rule F0755. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 5, 2024.
Ensure that residents are free from significant medication errors.

Rule F0760. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 5, 2024.
Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 5, 2024.

Jan 29, 2024: complaint inspection2 citations

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

Rule F0755. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jan 30, 2024.
Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jan 30, 2024.

Is it certified, and in good standing?

Certified for Medicare and Medicaid since Apr 27, 2017.
Not on CMS’s special focus list.
No abuse icon from CMS.
No change of ownership in the last 12 months.
CMS lists its ownership as for profit, corporation.
142 certified beds.

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Has it been fined or penalized?

1 fine in the last three years, $10,039 in all.
1 Medicare payment denial in the last three years.
16 citations in the last three years came from complaint inspections.

CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Fines and payment denials, newest first
Date	Kind	Amount
May 4, 2024	Medicare payment denial	Not given
May 4, 2024	Fine	$10,039

Who does the caring?

3.52 nurse hours per resident per day

The Texas average is 3.42.

CMS publishes staffing about four months after the fact.

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

Staffing measures
Measure	This home	Texas average
Nurse hours per resident per day	3.52	3.42
Of which registered nurses	0.32	0.44
At weekends	2.97	2.99
Nursing staff turnover	57.9%	50.8%
Registered nurse turnover	66.7%	49.8%
Administrators who left	1	Not given

Who owns it?

West Wharton County Hospital District owns 100% directly since Mar 1, 2023.
Touchstone Strategies - Stone Oak2 LLC runs it.
18 owners or officers are people: Johnny Thompson (corporate officer, 0%); Lynnea Castillo (runs it (operational or managerial control)); Lynnea Castillo (additional disclosable party (controls, leases property to, or provides services to the home)); Ying Collingwood (runs it (operational or managerial control)); Ying Collingwood (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Elizabeth Cruz (runs it (operational or managerial control)); Elizabeth Cruz (additional disclosable party (controls, leases property to, or provides services to the home)); Darrell D Zurovec (runs it (operational or managerial control)); Darrell D Zurovec (additional disclosable party (controls, leases property to, or provides services to the home)); Bryon Sehlke (runs it (operational or managerial control)); Bryon Sehlke (additional disclosable party (controls, leases property to, or provides services to the home)); Leslie D Campbell (runs it (operational or managerial control)); Leslie D Campbell (additional disclosable party (controls, leases property to, or provides services to the home)); Ernest C Fellbaum (additional disclosable party (controls, leases property to, or provides services to the home)); Jonathon Dewey Clayton (runs it (operational or managerial control)); Jonathon Dewey Clayton (additional disclosable party (controls, leases property to, or provides services to the home)); Stanley S Studer (additional disclosable party (controls, leases property to, or provides services to the home)).
Part of Touchstone Communities (25 homes in CMS’s data).
No private-equity firm among the owners CMS lists.
No real-estate investment trust among the owners CMS lists.

CMS, All Owners. Checked Nov 5, 2026. Updated monthly.

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Organisations CMS lists
Organisation	Role	Share	Since
West Wharton County Hospital District	Owns 5% or more directly	100%	Mar 1, 2023
International Bank of Commerce	Holds 5% or more security interest	9%	Apr 28, 2021
Carvajal Pharmacy LTC	Additional disclosable party (controls, leases property to, or provides services to the home)		Mar 1, 2023
Plante & Moran PLLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Mar 1, 2023
Nutritious Lifestyles, Inc.	Additional disclosable party (controls, leases property to, or provides services to the home)		Mar 1, 2023
Touchstone Strategies - Stone Oak2 LLC	Runs it (operational or managerial control)		Mar 1, 2023
Touchstone Strategies - Stone Oak2 LLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Jul 14, 2025
An organisation CMS lists without a name	Additional disclosable party (controls, leases property to, or provides services to the home)		Jul 14, 2025
Touchstone Communities Inc.	Additional disclosable party (controls, leases property to, or provides services to the home)		Mar 1, 2023
Aegis Therapies, Inc.	Additional disclosable party (controls, leases property to, or provides services to the home)		Mar 1, 2023
Touchstone Realty - Stone Oak2 LLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Mar 1, 2023
Trident Health Services Inc.	Additional disclosable party (controls, leases property to, or provides services to the home)		Mar 1, 2023

How do residents fare?

CMS rates its quality measures 4 of 5 (Texas average 3.8).

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

CMS’s star ratings, from 1 to 5
Measure	Rating
Overall rating	1 of 5
Health inspections	2 of 5
Staffing	1 of 5
Quality measures	4 of 5

How does it compare nearby?

Among the 12 nearest homes, within 8.6 miles, this one had the 3rd most health citations at the latest inspection cycle (17; the middle value was 10.5).

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

The 12 nearest, by straight-line distance
Place	Miles away	Citations, latest cycle
The Enclave This nursing home		17
Stone Oak Care Center	1.1	18
Sonterra Health Center	1.2	9
Coronado at Stone Oak	1.6	9
Castle Hills Rehabilitation and Care Center	5.9	41
Estates at Shavano Park	6.0	17
San Antonio Wellness & Rehabilitation	6.2	8
Broadway Nursing & Rehabilitation	7.3	14
Sage Park San Antonio	8.2	11
Windcrest Nursing and Rehabilitation	8.4	10
The Heights at Medical Center	8.4	7
The Heights on Huebner	8.6	9

What the record doesn’t say

Complaints that didn’t lead to a citation aren’t published.
Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.

Sources

Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).

Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).

Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).

Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).

Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).

Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.

This copy of the record was made on Nov 5, 2026.

From the home

The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.

Replies

None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.

Paid listing

None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.

The Enclave

The short answer

What did inspectors find?

When those citations happened

All 42 citations in the last three years

Is it certified, and in good standing?

Has it been fined or penalized?

Who does the caring?

Who owns it?

How do residents fare?

How does it compare nearby?

What the record doesn’t say

Sources

From the home

Replies

Paid listing

How to read a record

Every fact names its source.

A number never stands alone.

What needs attention is marked.

The public record comes first.