All 58 Medicare-certified nursing homes in San Antonio,
side by side on the things that separate them: how many nursing hours each resident gets, how much of the
staff leaves each year, and what inspectors found on their last visit.
Silver Creek runs lean on nursing hours: 3.04 per resident day against a national average of 3.86, which is roughly a fifth less hands-on time than most homes provide. Weekends dip about 15% below the home's own weekday staffing, so coverage thins out right when families tend to visit. The inspection record is stronger than the staffing number suggests, 4 out of 5 stars, last surveyed in July 2025, with 20 deficiencies on file and none rising to actual harm, though one is abuse-related. Turnover at 39.7% beats the national 45.8%, which means caregivers stick around longer here. The Limited Liability ownership structure is worth knowing about, but the numbers themselves tell the larger story: stable staff, thin hours.
Mystic Park runs at 3.23 nurse staffing hours per resident per day, about 16 percent under the national average, and weekends drop roughly 18 percent below its own weekday level, so the thinnest coverage lands when families tend to visit. Staff turnover sits at 35.6 percent, better than the 45.8 percent national figure, which suggests some stability in who's actually on the floor. The record also carries 22 deficiencies, including two at harm or jeopardy level and one tied to abuse, plus a single $111,121 fine. Inspectors last visited in April 2026. The quality measure score looks strong, but that's built from resident assessments, not direct observation of care, the staffing and inspection numbers tell a harder story.
Pecan Valley runs a 124-bed corporate-owned building where the aide and nurse hours per resident sit around 3.41 a day, roughly 12% under the national figure, and weekends get thinner still, about a fifth lighter than weekdays. That gap matters more than the turnover rate, which at 45.2% is basically the national norm. What stands out is the shape of the record: a five-star quality measure score sitting on top of a one-star staffing score, with 25 deficiencies logged and one serious enough to involve harm. The last inspection was January 30, 2026, so the picture is current rather than stale. If you're weighing this one, ask how they cover weekends and what that harm-level citation involved.
Hunters Pond runs 128 beds in San Antonio under corporate for-profit ownership, and the staffing numbers are where I'd start. At 3.31 nurse hours per resident day, it sits roughly 14% under the national average, and weekends dip about another 10% below its own weekday coverage, so the thinnest shifts land when families tend to visit. The inspection record shows 37 deficiencies, three of them at harm or jeopardy level and one abuse-related, with $66,531 in fines across three penalties; the last inspection was August 2025. Turnover at 40% is actually a bit better than the 45.8% national figure, and its quality measure score is strong. But the health inspection and staffing ratings both come in low, and that's the tension worth weighing.
Windemere at Westover Hills runs 112 certified beds under corporate ownership, and its staffing is the weak spot, a one-star rating against a national average, with 57% of staff turning over each year versus 45.8% nationally. That churn shows up on the inspection record too: 22 deficiencies, two of them serious enough to reach harm or jeopardy level, though none involved abuse. A single fine of $8,281 rounds out the enforcement history. The quality measure score of four stars is the brighter note here, and the most recent inspection came in December 2025, so the picture is current. If you're weighing this one, ask directly how they're holding onto aides and nurses, because the numbers say that's where the trouble lives.
Legend Oaks runs 126 certified beds in San Antonio under individual for-profit ownership, and its nurse staffing sits at 3.62 hours per resident day, about 6% under the national figure of 3.86. Weekends run roughly 13% leaner than weekdays there, and annual turnover is 46.2%, which is right at the national average of 45.8%, so retention isn't the outlier here; the hours per resident are. The current record shows 32 deficiencies, none at the harm or jeopardy level and none abuse-related, with the last inspection on December 4, 2025. Quality measures score well above its staffing marks, a gap worth asking about directly.
Northeast Rehabilitation runs on 3.45 nursing hours per resident day, about 11% under the national average, and weekends drop roughly 15% below its own weekday staffing. Turnover sits at 41.8%, a bit better than the 45.8% national figure, but the inspection record is where the real trouble shows: 45 deficiencies, two at harm or jeopardy level, and five tied to abuse. Fines total $16,449 across two penalties, and the last inspection was March 2025. It's a government hospital-district home, so ownership isn't the issue here, the staffing shortfall and that deficiency count are what a family should weigh before deciding.
The Sarah Roberts French Home runs 3.27 nurse hours per resident day, about 15% under the national average, and weekend coverage drops roughly another 15% below its own weekday level, so the thinnest staffing lands when families tend to visit. Its record shows 32 deficiencies, two at harm or jeopardy level and three abuse-related, with a 3/5 inspection rating and a 4/5 on quality measures. The staffing star sits at 1/5, and the last inspection was February 2026. A for-profit corporation owns the 60-bed home. Quality scores can look fine while daily coverage stays lean, which is the tension running through this record.
San Antonio Wellness & Rehabilitation runs 154 certified beds under corporate ownership, and the staffing numbers are where your attention should go first. Nurses provide 3.45 hours per resident day, roughly 11% below the national average, and weekends drop another 11% below the home's own weekday levels, so coverage is thinnest exactly when families tend to visit. Turnover sits at 35.4%, better than the 45.8% national figure, but that's the one bright spot. The inspection record shows 47 deficiencies, including one at harm or jeopardy level and four tied to abuse, plus a $104,627 fine. The most recent inspection was in November 2024. Quality measures score well, but quality scores reflect resident outcomes on paper, not whether enough hands are on the floor.
Windsor Mission Oaks runs lean on direct care: 2.74 nurse hours per resident day, roughly 29% under the national average, with weekends dropping about 19% below its own weekday staffing. That thin coverage sits behind 37 deficiencies on the current record, including one at the harm or jeopardy level and three tied to abuse. Retention is the bright spot, 23.2% turnover against a national 45.8% means far fewer unfamiliar faces than at a typical home. But a June 2025 inspection, a $10,842 fine, and a nonprofit owner don't offset what the staffing numbers say about daily coverage.
Las Colinas Of Westover runs 140 beds on the city's northwest side, and the staffing numbers are where the story starts. At 3.34 nurse hours per resident day, it sits about 13% under the national average, and weekends dip roughly another 9% below its own weekday level, so coverage is thinnest exactly when families tend to visit. Turnover at 43.9% is slightly better than the 45.8% national figure, which helps, but doesn't offset the thin hours.
The inspection record is heavier: 39 deficiencies, four of them serious enough to involve harm or jeopardy, plus two fines totaling $38,630. State surveyors were last in on December 3, 2025. The quality measure scores look good on paper, but those come from resident assessments, not from someone watching the floor at 7 p.m. on a Sunday.
Sorrento runs 112 certified beds in San Antonio under for-profit LLC ownership, and the staffing numbers are where the trouble shows. At 3.55 nurse hours per resident day, it sits about 8% under the national average, and weekends drop roughly 16% below its own weekday coverage, so the thinnest shifts land when families tend to visit. Annual turnover at 55.2% runs nearly ten points above the national rate, meaning the people providing that care are frequently new. Inspections closed in August 2025 with 50 deficiencies on record, two tied to abuse, though none reached harm or jeopardy level. The five-star quality measure score reflects reported clinical outcomes, not the hands available to deliver them.
Oak Park runs on 3.19 nursing hours per resident each day, roughly 17% under the national average of 3.86, and weekends dip even below its own weekday numbers. Staff turnover sits at 50% against a national rate near 46%, so the people caring for residents keep changing. Behind those numbers is an inspection record with 53 deficiencies, including one at the harm level and two tied to abuse, plus a $9,280 fine. All three CMS star ratings, health inspections, quality measures, staffing, come in at 2 out of 5. Ownership is for-profit and individual. The last inspection was March 13, 2026, so the record is recent, not stale.
Avir At Heritage runs on thin nursing coverage: 3.26 nurse hours per resident each day, roughly 16 percent under the national figure, and weekends drop about 14 percent below its own weekday levels. That staffing picture is the main reason its CMS staffing rating sits at just one star out of five, even though its last inspection in April 2025 produced no deficiencies at the harm or jeopardy level and nothing abuse-related. Staff turnover of 54.3 percent tops the national average of 45.8 percent, which matters for a 150-bed for-profit home because residents see more unfamiliar faces. The inspection record looks clean on paper, but consistently low hours and high churn are what a family should weigh when deciding.
Wurzbach runs on thinner nursing coverage than most homes nationally, 3.13 hours per resident day against a 3.86 average, and it gets thinner on weekends, dropping about 15% below its own weekday level. That matters more when you consider 62.3% of staff turned over last year, well above the 45.8% national average, meaning the people providing that care are often new. The inspection record is heavy: 56 deficiencies, four serious enough to put residents in harm's way and nine tied to abuse, with three fines totaling $34,945 and a June 2025 inspection. Quality measures score well, but strong numbers on paper don't offset thin weekend staffing and that turnover.
Patriot Heights runs 3.46 nurse hours per resident day, roughly 11% under the national average, and weekends dip about 15% below what the home itself staffs Monday through Friday. That thin weekend coverage matters more when you look at the record: 25 deficiencies, three at harm or jeopardy level, two tied to abuse, and $28,033 in fines across two penalties. Annual turnover sits at 50%, above the 45.8% national figure, so the people providing care keep changing. The quality measure score looks strong, but that reflects charted clinical outcomes, not whether enough hands are present on a Saturday. The last inspection was September 5, 2025.
River City Care Center runs 92 certified beds under individual for-profit ownership, and its nurse staffing sits at 3.22 hours per resident day, roughly 17% under the national average, with weekends about 13% thinner than weekdays. That shortfall shows up in the federal staffing rating, which lands at the lowest tier. The inspection record is the heavier concern: 36 deficiencies on file, including two at the level where residents were actually harmed or put in jeopardy, plus one tied to abuse, and $23,410 in fines across two penalties. Its quality measure score looks good on paper, but that's largely self-reported data, and the last full inspection was in July 2025. The families I'd tell to look hardest at this one are those needing consistent hands-on care, especially on weekends.
Harbor Valley runs leaner on nursing hours than most homes in the country, 3.58 per resident day against a national average of 3.86, and weekends get thinner still, with about 12% less coverage than weekdays. That matters, because 40 deficiencies sit on the current record, including two at the harm level and three tied to abuse, and the last inspection was in December 2025. Staff turnover at 43.8% is actually slightly better than the typical home, which suggests the problem isn't retention so much as how many hands are scheduled. For-profit, individually owned, 120 beds. Ask about weekend staffing and how the abuse citations were resolved.
Stone Oak Care Center runs about 2.88 nurse hours per resident per day, roughly a quarter below the national average of 3.86, and weekends drop another 14% below its own weekday levels. That matters because the people in these beds need help every day, not just Monday through Friday. Annual turnover sits at 59.8%, well above the 45.8% national figure, so the staff who are there are often new. The current record includes 39 deficiencies, one at the harm level and three tied to abuse. The last inspection was July 2025, so that record is recent.
Mesa Vista Inn Health Center runs 144 certified beds in San Antonio under corporate for-profit ownership, and its nurse staffing sits at 2.59 hours per resident day, about a third below the national average of 3.86. Weekends drop roughly another 12% below the home's own weekday levels, so coverage thins out exactly when families tend to visit. The inspection record shows 44 deficiencies, including one at the harm or jeopardy level and three tied to abuse, with a single fine of $8,160. CMS gives the home one star for staffing and two for health inspections, though its quality measure score is a middle-of-the-road three. The most recent inspection was April 24, 2026.