F
CARE CHOICE OF BOERNE
12/100 score
0.22 hrs RN staffing
13 deficiencies
Town and Country Nursing and Rehabilitation Center
625 N Main St, Boerne, TX 78006
Operator
MEDINA COUNTY HOSPITAL DISTRICT · 6 facilities
- Provider number (CCN)
- 455796
- Certification
- Medicare and Medicaid
- Ownership
- Government - Hospital district
- Certified beds
- 126
- Phone
- (830) 249-3085
- CMS data as of
- July 1, 2026
F
What the records show
CMS rates Town and Country Nursing and Rehabilitation Center 1 out of 5 stars overall, with 2 of 5 for health inspections, 1 of 5 for staffing, 4 of 5 for quality measures. Federal inspectors cited 57 health deficiencies across the last three survey cycles, most recently surveyed in 2025, 3 at actual-harm level or higher. CMS enforcement records list 2 fines totalling $150,922.
Facility Assessment
Inspectors recorded 3 citations at the actual-harm level or worse in the last three survey cycles. This facility is operated by MEDINA COUNTY HOSPITAL DISTRICT, which scores 23 points below the national average. This facility staffs below 0.55 RN hours per resident day — the level the 2024 federal rule, repealed in February 2026, would have required.
Reviews, Ratings and Official Records
This page reviews Town and Country Nursing and Rehabilitation Center using federal government records — CMS star ratings, health-inspection findings, staffing data and enforcement actions. NursingHomeGrade does not collect, host or publish resident or family testimonials, and no star rating below is a consumer review score.
Below the repealed 0.55 hr RN benchmark — review inspection history before visiting.
Ratings and Grade Breakdown
|
RN Staffing
Registered nurse time each resident receives daily. 2024 federal benchmark: 0.55 hrs. Repealed February 2026.
|
0.41 — Below the repealed 0.55 hr benchmark |
The 0.55 hour RN standard was repealed effective February 2, 2026 and is not currently enforced. We still grade against it. Why |
|
|
Health Deficiencies (last 3 survey cycles)
Violations found during federal inspections, with how many remain open and how many involved actual harm.
|
Total
57
Outstanding
0
Actual harm or worse (G–L)
3
|
|
CMS Ratings
Federal five-star ratings published by CMS. These are regulatory ratings, not consumer review scores.
|
Overall: ★☆☆☆☆ (1/5)
Health inspection: ★★☆☆☆ (2/5)
Quality: ★★★★☆ (4/5)
Staffing: ★☆☆☆☆ (1/5)
|
|
NursingHomeGrade Score
|
24/100 |
Loaded into NursingHomeGrade on August 7, 2026. This is the load date, not the date CMS published the underlying survey data — see release dates.
CMS scores each facility from one to five stars — one is in the bottom fifth of facilities in its state on health inspections, five is in the top tenth. Our own A–F grade is a separate 0–100 score built from staffing hours, inspection citations, and the severity and correction status of those citations, weighted as described in our grading methodology.
Staffing Compared With State and National Levels
| This facility | 0.41 hrs |
|---|---|
| TX median | 0.38 hrs |
| National average | 0.69 hrs |
Registered nurse turnover: 44.4% · Total nursing staff turnover: 65.9%
Staffing figures are the values CMS published in its file processed July 1, 2026, drawn from payroll-based journal reporting.
Audit and Inspection Reports
Town and Country Nursing and Rehabilitation Center is a Government - Hospital district facility. The records on this page are the federal health-inspection and enforcement records CMS publishes. We do not hold, and have not reviewed, any separate financial or performance audit issued by a county, state or independent auditor — if one exists for this facility, it is not part of the data described below.
- Most recent standard health survey: May 22, 2025.
- Citations shown below span 3 recorded inspection cycles.
- Survey dates on file range from February 10, 2023 to April 24, 2026.
Source records: CMS Care Compare profile for provider 455796 ↗ · the federal files we load and when.
Inspection Deficiencies
Health inspections identify violations of federal standards. Severity ranges from no actual harm (A–F) to immediate jeopardy (J–L).
3 immediate jeopardy issues found among 57 total deficiencies. 57 corrected.
Most recent inspection (December 17, 2025)
D
Potential harm — isolated
F0609
Status: Corrected
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected December 18, 2025
D
Potential harm — isolated
F0609
Status: Corrected
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected December 5, 2025
D
Potential harm — isolated
F0604
Status: Corrected
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
D
Potential harm — isolated
F0880
Status: Corrected
Provide and implement an infection prevention and control program.
Infection Control Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
C
No harm — widespread
F0732
Status: Corrected
Post nurse staffing information every day.
Nursing and Physician Services Deficiencies — Deficient, Provider has date of correction, corrected January 9, 2026
D
Potential harm — isolated
F0812
Status: Corrected
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
D
Potential harm — isolated
F0755
Status: Corrected
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected April 25, 2026
E
Potential harm — pattern
F0759
Status: Corrected
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
D
Potential harm — isolated
F0684
Status: Corrected
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
D
Potential harm — isolated
F0685
Status: Corrected
Assist a resident in gaining access to vision and hearing services.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
D
Potential harm — isolated
F0689
Status: Corrected
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
D
Potential harm — isolated
F0842
Status: Corrected
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected April 25, 2026
D
Potential harm — isolated
F0641
Status: Corrected
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
D
Potential harm — isolated
F0656
Status: Corrected
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
D
Potential harm — isolated
F0552
Status: Corrected
Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
D
Potential harm — isolated
F0553
Status: Corrected
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected June 17, 2025
Inspection cycle 2 (March 31, 2024)
E
Potential harm — pattern
F0609
Status: Corrected
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected April 3, 2024
D
Potential harm — isolated
F0880
Status: Corrected
Provide and implement an infection prevention and control program.
Infection Control Deficiencies — Deficient, Provider has date of correction, corrected May 3, 2025
E
Potential harm — pattern
F0945
Status: Corrected
Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.
Infection Control Deficiencies — Deficient, Provider has date of correction, corrected February 26, 2025
D
Potential harm — isolated
F0880
Status: Corrected
Provide and implement an infection prevention and control program.
Infection Control Deficiencies — Deficient, Provider has date of correction, corrected February 26, 2025
D
Potential harm — isolated
F0726
Status: Corrected
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Nursing and Physician Services Deficiencies — Deficient, Provider has date of correction, corrected July 27, 2024
F
Potential harm — widespread
F0812
Status: Corrected
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies — Deficient, Provider has date of correction, corrected April 3, 2024
E
Potential harm — pattern
F0760
Status: Corrected
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies — Past Non-Compliance, corrected September 27, 2024
D
Potential harm — isolated
F0761
Status: Corrected
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.
Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected February 26, 2025
J
Immediate jeopardy — isolated
F0755
Status: Corrected
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected July 27, 2024
J
Immediate jeopardy — isolated
F0761
Status: Corrected
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.
Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected April 3, 2024
E
Potential harm — pattern
F0684
Status: Corrected
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected February 26, 2025
E
Potential harm — pattern
F0686
Status: Corrected
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected February 26, 2025
D
Potential harm — isolated
F0697
Status: Corrected
Provide safe, appropriate pain management for a resident who requires such services.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected February 26, 2025
K
Immediate jeopardy — pattern
F0689
Status: Corrected
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 3, 2024
E
Potential harm — pattern
F0677
Status: Corrected
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 3, 2024
E
Potential harm — pattern
F0679
Status: Corrected
Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 3, 2024
D
Potential harm — isolated
F0791
Status: Corrected
Provide or obtain dental services for each resident.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 3, 2024
D
Potential harm — isolated
F0842
Status: Corrected
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected May 3, 2025
E
Potential harm — pattern
F0842
Status: Corrected
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected February 26, 2025
D
Potential harm — isolated
F0657
Status: Corrected
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected April 3, 2024
D
Potential harm — isolated
F0583
Status: Corrected
Keep residents' personal and medical records private and confidential.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected May 3, 2025
Inspection cycle 3 (February 22, 2024)
E
Potential harm — pattern
F0839
Status: Corrected
Employ staff that are licensed, certified, or registered in accordance with state laws.
Administration Deficiencies — Deficient, Provider has date of correction, corrected March 14, 2024
D
Potential harm — isolated
F0919
Status: Corrected
Make sure that a working call system is available in each resident's bathroom and bathing area.
Environmental Deficiencies — Deficient, Provider has date of correction, corrected August 23, 2023
D
Potential harm — isolated
F0609
Status: Corrected
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies — Deficient, Provider has date of correction, corrected February 11, 2023
D
Potential harm — isolated
F0880
Status: Corrected
Provide and implement an infection prevention and control program.
Infection Control Deficiencies — Deficient, Provider has date of correction, corrected August 25, 2023
C
No harm — widespread
F0732
Status: Corrected
Post nurse staffing information every day.
Nursing and Physician Services Deficiencies — Deficient, Provider has date of correction, corrected August 23, 2023
E
Potential harm — pattern
F0812
Status: Corrected
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies — Deficient, Provider has date of correction, corrected February 11, 2023
E
Potential harm — pattern
F0759
Status: Corrected
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected October 20, 2023
D
Potential harm — isolated
F0755
Status: Corrected
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected August 25, 2023
D
Potential harm — isolated
F0684
Status: Corrected
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected August 25, 2023
D
Potential harm — isolated
F0686
Status: Corrected
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected August 25, 2023
D
Potential harm — isolated
F0656
Status: Corrected
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected May 4, 2024
D
Potential harm — isolated
F0656
Status: Corrected
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected March 14, 2024
D
Potential harm — isolated
F0842
Status: Corrected
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected October 20, 2023
D
Potential harm — isolated
F0656
Status: Corrected
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected February 11, 2023
D
Potential harm — isolated
F0657
Status: Corrected
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected February 11, 2023
E
Potential harm — pattern
F0624
Status: Corrected
Prepare residents for a safe transfer or discharge from the nursing home.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected March 14, 2024
D
Potential harm — isolated
F0578
Status: Corrected
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected March 14, 2024
D
Potential harm — isolated
F0558
Status: Corrected
Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected October 20, 2023
D
Potential harm — isolated
F0584
Status: Corrected
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected February 11, 2023
D
Potential harm — isolated
F0585
Status: Corrected
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Resident Rights Deficiencies — Deficient, Provider has date of correction, corrected February 11, 2023
Fines and Enforcement Actions
Penalties CMS has imposed on this facility. A fine is a civil money penalty; a payment denial suspends Medicare or Medicaid payment for new admissions.
| Date | Action | Amount or length |
|---|---|---|
| July 26, 2024 | Fine | $75,832 |
| March 31, 2024 | Fine | $75,090 |
2 fines totalling $150,922.
Source: CMS Penalties file (dataset g6vv-u9sr).
Ownership and Contact Information
- Facility name
- Town and Country Nursing and Rehabilitation Center
- Legal business name
- MEDINA COUNTY HOSPITAL DISTRICT
- Address
- 625 N Main St, Boerne, TX 78006
- Phone
- (830) 249-3085
- Provider number (CCN)
- 455796
- Ownership type
- Government - Hospital district
- Operator
- MEDINA COUNTY HOSPITAL DISTRICT · 6 facilities
- Medicare/Medicaid certified since
- March 3, 1998
- Official record
- CMS Care Compare profile ↗
- Details verified against CMS data dated
- July 1, 2026
The federal nursing-home files publish no email address for certified facilities, so none is listed here. We do not guess or construct contact addresses. Contact details above are reproduced from CMS Provider Information; call the facility to confirm before relying on them.
How We Stay Independent
NursingHomeGrade is strictly independent. We do not accept payments from facilities. Our grades are calculated solely from federal CMS datasets.
Learn about our data methodology →Nearby facilities in Boerne
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0.28 hrs RN staffing
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F
KENDALL HOUSE WELLNESS & REHABILITATION
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Sources and Methodology
- CMS Provider Information (file processed July 1, 2026) — ratings, staffing, ownership, certification and contact details. Dataset 4pq5-n9py ↗
- CMS Health Deficiencies — inspection citations, scope and severity, correction status. Dataset r5ix-sfxw ↗
- CMS Penalties — fines and payment denials with the dates CMS recorded them. Dataset g6vv-u9sr ↗
- CMS Ownership — owning and managing organisations. Dataset y2hd-n93e ↗
The NursingHomeGrade score is our own calculation from these federal files — it is not a CMS rating and not a consumer review score. See exactly how the score is calculated · full methodology · source files and load dates.
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