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.
Sonterra Health Center runs on thin nursing coverage, 3.53 hours per resident day, roughly 9% under the national average, and weekends are leaner still, about 19% below its own weekday level. That shortfall shows up in the federal staffing rating, which sits at the bottom of the scale, and in a turnover rate of 54.6%, nearly nine points above the national figure. Its current record carries 50 deficiencies, including five at the harm or jeopardy level and five tied to abuse, along with three fines totaling $80,964. A May 2025 inspection is recent, but the inspection rating is still below average. It's owned by a hospital district, which may explain some stability, but the numbers here are hard to read as reassuring.
The Heights At Medical Center runs on 3.00 nurse hours per resident day, roughly 22% under the national average, and its own weekend coverage drops another 10% below weekdays. Staff turnover sits at 56.3%, well above the 45.8% national figure, so the people left covering those shifts are often new. Inspectors cited 44 deficiencies, three of them serious enough to put residents in harm's way, and fined the home twice for $22,052 combined. A for-profit LLC operates the 134-bed building, and its last inspection was August 2025. Resident outcome measures look better than the staffing does, but the hands-on care numbers are what families feel day to day.
Huebner Creek runs on thin nursing coverage. At 2.52 nurse hours per resident day, it sits about 35% under the national average of 3.86, and weekends drop roughly 24% below what the home already staffs on weekdays. That matters when you're thinking about who answers a call light on a Saturday.
The inspection record is heavier than the staffing picture alone would suggest: 54 deficiencies, including one at the harm or jeopardy level and two tied to abuse. The last inspection was March 2026, so the findings are recent, not stale. A single fine of $14,327 is on file. Limited liability ownership, 146 beds, and quality measures that rate better than the staffing and inspection scores, a gap worth asking about directly.
Golden Estates runs 3.29 nurse hours per resident day, about 15% under the national average, and weekends drop roughly another 20% below its own weekday staffing. Nearly six in ten staff left over the past year, 58.5% turnover against a 45.8% national figure, which means the people caring for your relative are often new and still learning the building. The record shows 32 deficiencies, including six at harm or jeopardy level and two tied to abuse, plus three fines totaling $161,844. That inspection history and thin staffing sit behind the low marks, even though the quality measure score looks better on paper.
Broadway Nursing & Rehabilitation runs 237 certified beds in San Antonio under for-profit LLC ownership, and the staffing numbers are the first thing to look at: 3.65 nurse hours per resident day, under the national average, with weekends about 13% leaner than weekdays. Annual turnover sits at 51.4%, so more than half the nursing staff leaves each year. The inspection record shows 50 deficiencies, including 3 at harm or jeopardy level and 8 abuse-related, with two fines totaling $84,129. CMS rated staffing 1 out of 5 stars and health inspections 2 out of 5, though quality measures scored 4. Ask about weekend coverage and how they screen and supervise staff.
The Lev At San Antonio runs about 106 certified beds under for-profit LLC ownership, and the staffing numbers are the first thing to look at. At 3.09 nurse hours per resident per day, it sits roughly 20 percent under the national average of 3.86, and weekends drop about 12 percent below its own weekday level, so coverage thins out exactly when families tend to visit. Turnover lands at 41.5 percent, a bit better than the 45.8 percent national figure, but the inspection record carries more weight: 40 deficiencies, including one at harm or jeopardy level and one abuse-related, plus a single $174,496 fine. The most recent inspection was September 11, 2025.
The Enclave runs on thinner nursing coverage than most homes, 3.63 nurse hours per resident day against a national average of 3.86, and weekends drop roughly 15% below what it manages on weekdays, so the thinnest shifts land when families tend to visit. Staff turnover sits at 60.9%, well above the 45.8% national figure, which means the people caring for residents keep changing. Inspectors cited 46 deficiencies on the current record, including three tied to abuse and one at the harm level, and the last inspection was in August 2025. That combination of low staffing, high turnover, and repeat citations is what drives the low rating here.
San Antonio North runs on 2.67 nursing hours per resident per day, roughly a third below the national average, and weekend coverage drops another 13% below its own weekday level. That thin staffing shows up in the numbers: a 55.9% annual turnover rate, well above the 45.8% national figure, and 62 deficiencies on the current record, including four at the harm or jeopardy level and six tied to abuse. Inspectors were last on site July 31, 2025, and the state has fined the for-profit operator three times, totaling $37,800. When a building is cited this often while running this lean, families should ask direct questions about who is on the floor at night.
Memorial Medical Nursing Center runs on 2.60 nursing hours per resident day, roughly a third less than the national average of 3.86, and weekends drop about 19% below what the home already provides on weekdays. The inspection record shows 57 deficiencies, including two at the harm or jeopardy level and three tied to abuse, with $35,396 in fines across two penalties. Staff turnover sits at 51.4%, above the 45.8% national figure. It's a hospital-district home, so public ownership doesn't automatically mean better oversight here. The most recent inspection was June 11, 2025, so the picture is current, not stale. Ask direct questions about weekend coverage and how the abuse-related findings were resolved.
Northgate runs on 3.10 nurse hours per resident per day, about a fifth below the national average, and weekends dip even further. Three in four employees left last year, against a national rate around 46%, which means the people at the bedside keep changing. Inspectors have written 54 deficiencies, including one at the harm level and three tied to abuse, with a $27,710 fine on record from a July 2025 visit. The quality star is high, but that measure leans on self-reported data. Licensed staffing and inspection results are where this home sits at the bottom.
Meridian Care Monte Vista runs 4.74 nurse hours per resident day, roughly a quarter above the national average, but that raw number hides two problems: weekend staffing drops about 15% below its own weekday level, and annual turnover sits at 68.4% against a national 45.8%, meaning most of the people providing that care are new and likely to leave. The inspection record is where it gets harder to defend, 49 deficiencies, including two at the harm or jeopardy level and four tied to abuse, with fines totaling $28,345 and a February 2026 inspection still the most recent. The staffing ratio looks good on paper, but a home where two-thirds of caregivers turn over each year and inspectors keep finding serious problems isn't one where that number translates into steady care.
Normandy Terrace is a 320-bed for-profit home in San Antonio, and the numbers that stand out are about people. Nurse staffing sits at 3.01 hours per resident day, roughly 22 percent under the national average, and weekends run about 18 percent thinner than weekdays. Staff turnover is 95.8 percent, more than double the national figure, meaning the aides and nurses caring for residents are, in large part, new or on their way out. The inspection record shows 49 deficiencies, six at the harm or jeopardy level and four abuse-related, with five fines totaling $287,359. A 1-out-of-5 inspection rating and a 1-out-of-5 staffing rating back that up. If you're considering this home, ask hard questions about who's on the floor at night and on weekends.
The Rio at Mission Trails runs 124 beds under hospital district ownership in San Antonio, and its nurse staffing sits just under the national average, 3.71 hours per resident day against 3.86. That small gap is not the real story. Weekend staffing drops roughly 16% below its own weekday level, and annual turnover hits 97.2%, more than double the national rate of 45.8%, meaning the aides and nurses at your mother's bedside are, statistically, almost certain to be new within the year. On inspections, the home carries 32 deficiencies, three at harm or jeopardy level and four abuse-related, with two fines totaling $153,825.
Castle Hills Rehabilitation and Care Center is a for-profit, limited liability operation with 143 certified beds in San Antonio. Nurse staffing runs about 2.96 hours per resident per day, roughly 23 percent below the national average, and weekends fall about 15 percent under its own weekday levels. Every CMS star category here lands at 1 out of 5: health inspections, quality measures, and staffing. The deficiency record shows 72 citations, eight of them at harm or jeopardy level and two tied to abuse, with four fines totaling $112,386 and a recent inspection on September 12, 2025. That combination of thin staffing, low inspection scores, and serious deficiencies is what any family should weigh before choosing this home.
Avir At San Antonio runs on 2.63 nurse staffing hours per resident per day, roughly a third below the national average, and weekends drop about 9% below its own weekday level, so coverage is thinnest when families tend to visit. Staff turnover sits at 60.7%, well above the 45.8% national figure, which means the people caring for your relative are often new to the building. The inspection record shows 43 deficiencies, including three at the harm or jeopardy level and four tied to abuse, with $29,494 in fines across three penalties. Its most recent inspection was August 30, 2025, and the corporation that owns it holds a for-profit license.
Buena Vida Nursing and Rehab in San Antonio runs 222 certified beds under hospital district ownership, and federal data shows it struggling on every measure CMS tracks. Nurse staffing sits at 2.93 hours per resident day, roughly a quarter below the national average of 3.86, and weekends drop about 9% below its own weekday level, so coverage thins out exactly when families tend to visit. The inspection record is the bigger concern: 49 deficiencies, five serious enough to put residents in harm's way, three tied to abuse, and $187,608 in fines. That combination landed it in CMS's Special Focus Facility program, a designation reserved for the country's most persistently troubled homes.
San Antonio West runs on 2.75 nurse staffing hours per resident day, about 29 percent under the national average, and weekends dip roughly 12 percent below its own weekday levels. Turnover sits at 63.6 percent against a national 45.8, most of the people caring for your family member will be new within a year. The inspection record backs this up: 73 deficiencies, six at harm or jeopardy level, four abuse-related, and $364,695 in fines. Its most recent inspection was April 2026, so the picture is current, and it includes one star each for health inspections and staffing. A for-profit corporation owns the 135-bed building.
Crestway runs on thin staffing, 3.57 nurse hours per resident day, about 8% under the national average, and weekends dip another 7% below its own weekday levels. Turnover is the bigger red flag: 100% of nursing staff leaving annually, against a national average near 46%, which means the people caring for your family member are, on average, brand new to the building.
The inspection record is heavy, 65 deficiencies, five serious enough to cause harm, three tied to abuse, and five fines totaling nearly $74,000, with the most recent inspection in July 2025. This is a for-profit LLC where every federal staffing and inspection measure sits near the bottom. Worth asking hard questions before admission.