Compiled from official CMS federal data
RIVER HILLS HEALTH AND REHABILITATION CENTER, KERRVILLE, TX — Violations & Inspection Reports
Does RIVER HILLS HEALTH AND REHABILITATION CENTER have a federal violation or abuse history?
According to the public federal record on file with the Centers for Medicare & Medicaid Services (CMS), RIVER HILLS HEALTH AND REHABILITATION CENTER (CCN 676114), in KERRVILLE, TX, has federal inspection findings.
In its current inspection cycle, CMS cited the facility for 18 deficiencies; the most severe is rated F — which CMS classifies as "potential for harm," a level below actual harm (risk, but no harm confirmed). The latest standard health inspection on file is dated 2025-06-13. Earlier-cycle citations appear in the dated timeline below as historical, not current. CMS has $112,133 in civil money penalties on file against the facility. The record also includes 3 abuse- or neglect-related citations in CMS's "Freedom from Abuse, Neglect, and Exploitation" family (F600-series; most recent Jun 2025). This page restates the federal record and draws no conclusion of its own.
Abuse-, fall-, and care-related findings on the federal record
- 3 citations in CMS's "Freedom from Abuse, Neglect, and Exploitation" family (F600-series) — most recent Jun 2025.
- 3 citations for accident hazards or inadequate supervision (F689) — the deficiency family behind fall-related findings; most recent Sep 2025.
- 25 findings on file from complaint-triggered inspections.
Every figure above restates CMS’s own dated record; this page draws no conclusion of its own. Strict state filing deadlines can apply to nursing-home injury claims — a licensed attorney in your state can review this record.
FOR FAMILIES
What brings you to this record?
The Federal Record
CMS has $112,133 in civil money penalties on file against this facility.
Below is this facility's federal inspection record as on file with CMS.
Scope & Severity — current cycle
CMS's own A–L scope/severity grid. Plotted cells mark this facility's most recent (current-cycle) citations.
Civil money penalties on file
$112,133
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About this record: Federal nursing-home surveys are conducted on a recurring cycle by state survey agencies acting on CMS's behalf, and the figures on this page are compiled from CMS's published provider data, as on file with CMS; the federal record may understate what actually occurred, and inspection findings are point-in-time survey results, not a determination that any specific resident was harmed.
Deficiency timeline
Citations are listed by scope/severity (most severe first), not chronologically; each entry is labeled current-cycle or historical.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Ensure that residents are free from significant medication errors.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
52 more citations on file — Abuse & neglect 3 · Accidents & supervision 2 · Medication & pharmacy 9 · Resident rights 5 · Other citations 31 (expand)
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Ensure each resident receives an accurate assessment.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Provide care and assistance to perform activities of daily living for any resident who is unable.
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.
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Keep residents' personal and medical records private and confidential.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
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.
Assist a resident in gaining access to vision and hearing services.
Provide and implement an infection prevention and control program.
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Ensure that residents are free from significant medication errors.
Reasonably accommodate the needs and preferences of each resident.
Ensure each resident receives an accurate assessment.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Provide timely, quality laboratory services/tests to meet the needs of residents.
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Employ staff that are licensed, certified, or registered in accordance with state laws.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Keep residents' personal and medical records private and confidential.
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Provide and implement an infection prevention and control program.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Ensure medication error rates are not 5 percent or greater.
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Ensure each resident receives an accurate assessment.
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
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.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Dispose of garbage and refuse properly.
Overall CMS star rating
This facility: 1 · CMS state average: 2.7
Both figures as published by CMS.
You may be reading this record for the first time.
If something happened to someone you love at this facility, this federal record may be new to you today. The company that operates a nursing home, by contrast, is rarely seeing records like this for the first time — operators like these typically retain standing legal, risk, and insurance teams whose routine work includes records exactly like the one on this page. That is not a judgment of this facility; it is how the business is structured. Because strict time limits can apply, families often find it helps to have a qualified person review the record with them sooner rather than later.
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Federal record
RIVER HILLS HEALTH AND REHABILITATION CENTER — Federal Record
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SECTION 7 — CASE CONTEXT
Add what you saw at RIVER HILLS HEALTH AND REHABILITATION CENTER to this record
No call centers, no auctions. CareSentinel is an independent service that compiles the public CMS record and does not provide legal advice. The federal record is a point-in-time inspection record and may understate what actually occurred. CareSentinel is operated by Nodal Logics LLC.
Strict time limits can apply to taking legal action — consider consulting a qualified attorney promptly.
If you believe a resident is in immediate danger, call 911. Care concerns can also be reported at no cost to your state survey agency or the Long-Term Care Ombudsman program (ltcombudsman.org) — independent of any legal inquiry.
How to read this record
Making sense of a CMS inspection record
CMS scores every citation on a grid from A to L, combining how widespread a finding was with how serious it was. A–C is a deficiency CMS classifies as no harm; D–F as the potential for harm; G–I as actual harm that reached a resident; and J–L as immediate jeopardy, CMS’s most serious level. Later letters mark more serious findings.
Three questions to ask on a tour
- How is the home staffed on nights, weekends, and holidays?
- What happens when a resident’s condition changes suddenly?
- How, and how quickly, are families told about an incident?