Floresville Nursing And Rehabilitation in Floresville, Wilson County, Texas

Floresville, Wilson County, Texas 78114

Status Medicare and Medicaid certifiedMedicare CCN 675469

HHSC license rosteras of November 9, 2026CMS nursing home filerelease October 28, 2026; processing date October 1, 2026CMS processing date for this home October 1, 2026

Verify on TULIP View on Medicare.gov

Location and contact

Address: 1811 6th ST
Floresville, TX 78114
Open map (OpenStreetMap)
Phone: (830) 393-2561
HHSC facility ID: 004552
License number: 312259

Medicare ratings

Star ratings below are copied from the CMS Provider Information file (official release October 28, 2026; processing date October 1, 2026). They are not assigned by NursingCareLookup. See how to read ratings and CMS Five-Star documentation.

Overall: 2 of 5Overall: 2 of 5 stars
Health inspection: 3 of 5Health inspection: 3 of 5 stars
Staffing: 1 of 5Staffing: 1 of 5 stars
Quality measures: 3 of 5Quality measures: 3 of 5 stars
Long-stay quality measures: 2 of 5Long-stay quality measures: 2 of 5 stars
Short-stay quality measures: 5 of 5Short-stay quality measures: 5 of 5 stars

Staffing hours

Hours are the facility’s reported nurse staffing hours per resident per day from the CMS file. The Texas average is computed on this site from Texas rows in that same file that include a numeric value. It is not copied from another website. Method: Methodology.

Staffing hours per resident per day
Measure	This facility	Texas average (this site)
Total nurse staffing	3.21 hours	3.42 hours n=1,152
Registered nurse	0.30 hours	0.44 hours
LPN	0.81 hours	0.95 hours
Nurse aide	2.11 hours	2.03 hours
Weekend nurse staffing	2.80 hours	2.99 hours

0.20 hours below this site’s computed Texas average.

Total nursing staff turnover: 58% (Texas average computed on this site: 50.8%, n=1,096)
RN turnover: 71.4%
Average residents per day: 87.3
Certified beds (CMS): 144

Penalties in the CMS Provider Information file: 3 finestotaling $87,066; 3 total penalties. These are the figures CMS published in this release. Confirm current figures on Medicare.gov.

Fines and payment denials

Individual fines and payment denials below come from the CMS Penalties file (official release October 28, 2026; processing date October 1, 2026). Dates and amounts are copied as published. They can lag later actions or successful appeals. Confirm current figures on Medicare.gov.

CMS fines and payment denials
Date	Type	Fine amount	Payment denial
March 21, 2025	Fine · Fine ID 113707	$60,452	—
January 31, 2025	Fine · Fine ID 113553	$18,185	—
May 15, 2024	Fine · Fine ID 112839	$8,429	—

MDS quality measures

These figures are the four-quarter averages published in the CMS MDS Quality Measures file (official release October 28, 2026; measure period 2025Q3-2026Q2; processing date October 1, 2026). They are not a grade this site assigned. A “used in Five-Star” flag is the published CMS field that says whether that measure feeds the quality-measure star rating. Quarterly scores are collapsed under each measure. Official definitions are on the CMS Five-Star page.

CMS MDS quality measures, four-quarter averages
Measure	Stay	Four-quarter average	Used in Five-Star QM rating
Percentage of long-stay residents whose need for help with daily activities has increased Quarterly scores Q1 32.8% · Q2 27.1% · Q3 15.9% · Q4 26.2% · Period 2025Q3-2026Q2 · Measure code 401	Long Stay	25.5%	Yes, as published by CMS
Percentage of long-stay residents with a catheter inserted and left in their bladder Quarterly scores Q1 2.6% · Q2 4.0% · Q3 0.0% · Q4 1.0% · Period 2025Q3-2026Q2 · Measure code 406	Long Stay	1.9%	Yes, as published by CMS
Percentage of long-stay residents with a urinary tract infection Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 5.2% · Period 2025Q3-2026Q2 · Measure code 407	Long Stay	1.3%	Yes, as published by CMS
Percentage of long-stay residents experiencing one or more falls with major injury Quarterly scores Q1 3.8% · Q2 3.7% · Q3 3.7% · Q4 1.3% · Period 2025Q3-2026Q2 · Measure code 410	Long Stay	3.1%	Yes, as published by CMS
Percentage of long-stay residents whose ability to walk independently worsened Quarterly scores Q1 30.7% · Q2 20.0% · Q3 11.6% · Q4 16.9% · Period 2025Q3-2026Q2 · Measure code 451	Long Stay	18.8%	Yes, as published by CMS
Percentage of long-stay residents with pressure ulcers Quarterly scores Q1 1.9% · Q2 5.0% · Q3 4.0% · Q4 3.9% · Period 2025Q3-2026Q2 · Measure code 479	Long Stay	3.7%	Yes, as published by CMS
Percentage of long-stay residents who received an antipsychotic medication Quarterly scores Q1 16.7% · Q2 17.5% · Q3 12.7% · Q4 14.5% · Period 2025Q3-2026Q2 · Measure code 481	Long Stay	15.4%	Yes, as published by CMS
Percentage of long-stay residents who lose too much weight Quarterly scores Q1 4.5% · Q2 10.1% · Q3 3.1% · Q4 3.0% · Period 2025Q3-2026Q2 · Measure code 404	Long Stay	5.3%	No, as published by CMS
Percentage of long-stay residents who have depressive symptoms Quarterly scores Q1 1.3% · Q2 0.0% · Q3 1.3% · Q4 1.4% · Period 2025Q3-2026Q2 · Measure code 408	Long Stay	1.0%	No, as published by CMS
Percentage of long-stay residents who were physically restrained Quarterly scores Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 409	Long Stay	0.0%	No, as published by CMS
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Quarterly scores Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · Period 2025Q3-2026Q2 · Measure code 415	Long Stay	100.0%	No, as published by CMS
Percentage of long-stay residents who received an antianxiety or hypnotic medication Quarterly scores Q1 20.3% · Q2 33.8% · Q3 30.0% · Q4 33.8% · Period 2025Q3-2026Q2 · Measure code 452	Long Stay	29.5%	No, as published by CMS
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Quarterly scores Q1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 454	Long Stay	97.8%	No, as published by CMS
Percentage of long-stay residents with new or worsened bowel or bladder incontinence Quarterly scores Q1 25.4% · Q2 16.9% · Q3 27.4% · Q4 15.7% · Period 2025Q3-2026Q2 · Measure code 480	Long Stay	21.3%	No, as published by CMS
Percentage of short-stay residents who newly received an antipsychotic medication Quarterly scores Q1 2.1% · Q2 0.0% · Q3 0.0% · Q4 0.0% · Period 2025Q3-2026Q2 · Measure code 434	Short Stay	0.6%	Yes, as published by CMS
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine Quarterly scores Q1 98.8% · Q2 100.0% · Q3 95.7% · Q4 100.0% · Period 2025Q3-2026Q2 · Measure code 430	Short Stay	98.6%	No, as published by CMS
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine Quarterly scores Q1 — (CMS footnote 28) · Q2 — (CMS footnote 28) · Q3 — (CMS footnote 28) · Q4 — (CMS footnote 28) · Period 2025Q3-2026Q2 · Measure code 472	Short Stay	95.6%	No, as published by CMS

Inspection citations

41 health citations in the CMS file (31 from complaint surveys). Highest scope/severity letter in the file: J — Isolated, immediate jeopardy.

The list below is drawn from the CMS Health Deficiencies file. We show the tag, a plain-language reading of the scope and severity letter, whether the survey was a standard or complaint survey, the survey date, and whether CMS recorded a correction. We do not reprint the official deficiency narrative here. Read that text on TULIP or Medicare.gov. A facility may appeal a finding; a successful appeal can alter or remove a citation.

Scope and severity letters (A–L)

CMS assigns one letter from a grid of scope (how widely a problem was found) and severity (how serious the harm was or could be). The short labels below are our wording of that grid, not a different rating system.

Scope and severity letters used in CMS health citations
Severity	Isolated	Pattern	Widespread
Potential for minimal harm	A	B	C
No actual harm, potential for more than minimal harm	D	E	F
Actual harm	G	H	I
Immediate jeopardy	J	K	L

2026 — 8 citations

Tag 0761D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: July 30, 2026

CMS records a correction date (August 21, 2026)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0640D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: June 12, 2026

CMS records a correction date (July 5, 2026)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0912B

B — Pattern, potential for minimal harm

Standard survey

Survey date: May 8, 2026

No revisit needed, as recorded by CMS

More detail

Environmental Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0880D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: May 8, 2026

CMS records a correction date (June 5, 2026)

More detail

Infection Control Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0813D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: May 8, 2026

CMS records a correction date (June 5, 2026)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0812E

E — Pattern, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: May 8, 2026

CMS records a correction date (June 5, 2026)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0695D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: May 8, 2026

CMS records a correction date (June 5, 2026)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

Tag 0583D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: May 8, 2026

CMS records a correction date (June 5, 2026)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 1

2025 — 15 citations

Tag 0802D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: September 12, 2025

CMS records a correction date (September 27, 2025)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0921B

B — Pattern, potential for minimal harm

Standard survey

Survey date: March 21, 2025

CMS records a correction date (April 12, 2025)

More detail

Environmental Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0880E

E — Pattern, potential for more than minimal harm

Standard survey

Survey date: March 21, 2025

CMS records a correction date (April 12, 2025)

More detail

Infection Control Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0812D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 21, 2025

CMS records a correction date (April 12, 2025)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0761D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 21, 2025

CMS records a correction date (April 12, 2025)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0695D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 21, 2025

CMS records a correction date (April 12, 2025)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0656D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 21, 2025

CMS records a correction date (April 12, 2025)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0655D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 21, 2025

CMS records a correction date (April 12, 2025)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0641D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 21, 2025

CMS records a correction date (April 12, 2025)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0578D

D — Isolated, potential for more than minimal harm

Standard survey

Survey date: March 21, 2025

CMS records a correction date (April 1, 2025)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0727E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: January 31, 2025

CMS records a correction date (February 28, 2025)

More detail

Nursing and Physician Services Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0689J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: January 31, 2025

Past non-compliance, as recorded by CMS (January 13, 2025)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0656D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: January 31, 2025

CMS records a correction date (February 28, 2025)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0583D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: January 31, 2025

CMS records a correction date (February 28, 2025)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

Tag 0558D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: January 31, 2025

CMS records a correction date (February 28, 2025)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 2

2024 — 17 citations

Tag 0761D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: August 8, 2024

CMS records a correction date (September 6, 2024)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0693E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: August 8, 2024

CMS records a correction date (September 6, 2024)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0583D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: August 8, 2024

CMS records a correction date (September 6, 2024)

More detail

Resident Rights Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0689J

J — Isolated, immediate jeopardy

Complaint survey

Survey date: May 15, 2024

CMS records a correction date (June 7, 2024)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0609D

D — Isolated, potential for more than minimal harm

Complaint survey

Survey date: May 15, 2024

CMS records a correction date (June 7, 2024)

More detail

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0921D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Environmental Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0912D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Environmental Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0842E

E — Pattern, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0812D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Nutrition and Dietary Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0761D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0757D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Pharmacy Service Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0690D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0680D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Quality of Life and Care Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0656D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0655D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0645D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

Tag 0644D

D — Isolated, potential for more than minimal harm

Complaint survey, Standard survey

Survey date: February 16, 2024

CMS records a correction date (March 18, 2024)

More detail

Resident Assessment and Care Planning Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

2023 — 1 citation

Tag 0921E

E — Pattern, potential for more than minimal harm

Complaint survey

Survey date: December 7, 2023

CMS records a correction date (January 3, 2024)

More detail

Environmental Deficiencies

Survey type in the file: Health

Survey cycle in the file: 3

License and identity (HHSC)

License effective: December 25, 2024
License expires: December 25, 2027
Initial license date: February 26, 1974
Facility licensed: Yes
Facility certified (HHSC): Yes
Service type: MEDICARE/MEDICAID
Total licensed capacity: 144 beds
Bed mix (HHSC): Licensed only 0; Medicaid only 0; Medicare only 14; Medicare/Medicaid 130; ICF/IID 0
Alzheimer capacity: 0
Administrator: Elizabeth J Ruehle
Management company: Floresville Opco, LLC

Ownership

Ownership below comes from the CMS file when a row joined on this home’s Medicare number. HHSC also records an owner and entity type; those appear after the CMS data. The HHSC entity type “HOSPITAL DISTRICT/AUTHORITY” is very common in the state roster and may not describe day-to-day control. It is not used as a headline here.

CMS ownership type: For profit - Corporation · Affiliated / chain name in the file: HARMONY CARE GROUP (6 facilities in the chain, as listed)

CMS ownership records
Name	Role	Type	Share	Associated
FRIO HOSPITAL DISTRICT	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	100%	since 12/25/2024
RUFF, MICHAEL	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 12/25/2024
BECHTHOLD, SAM	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 07/29/2026
CURRIER, DARYL	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 07/29/2026
RUEHLE, ELIZABETH	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 07/29/2026
CURRIER, DARYL	ADP OF THE SNF	Individual	NOT APPLICABLE	since 07/29/2026
RUEHLE, ELIZABETH	ADP OF THE SNF	Individual	NOT APPLICABLE	since 07/29/2026

HHSC owner fields

Owner (HHSC): Dewitt Medical District
Type of entity (HHSC): HOSPITAL DISTRICT/AUTHORITY

Public data compiled by NursingCareLookup, not an endorsement or a recommendation, and not medical or legal advice. This site is not affiliated with HHSC, CMS, or Medicare. Figures can lag events at the facility, including surveys, corrections, and successful appeals (an appeal can alter or remove a citation). Verify current facts on TULIP and Medicare.gov, and visit in person before you decide. HHSC roster as of November 9, 2026 (America/Chicago). CMS file: official release October 28, 2026; processing date October 1, 2026.