River Hills Health and Rehabilitation Center

2091 Bandera Hwy, Kerrville, TX 78028 · (830) 257-9900
For profit - Individual · 150 certified beds

River Hills Health and Rehabilitation Center has a 1-star overall rating from Medicare, out of 5. Its last standard inspection, in June 2025, found 14 citations (the Texas average is 9.4). It was fined 3 times in the last three years, $112,133 in all.

Medicare ratings

How to read a nursing home's star ratings

Most recent health inspection

The standard health inspection on June 13, 2025 found 14 citations. What an inspection citation means

• Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.June 13, 2025 · F0656 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
• Provide care and assistance to perform activities of daily living for any resident who is unable.June 13, 2025 · F0677 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
• Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.June 13, 2025 · F0690 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
• 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.June 13, 2025 · F0727 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
• 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.June 13, 2025 · F0761 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
• Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.June 13, 2025 · F0812 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
• Keep residents' personal and medical records private and confidential.June 13, 2025 · F0583 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• 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.June 13, 2025 · F0584 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.June 13, 2025 · F0605 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Assist a resident in gaining access to vision and hearing services.June 13, 2025 · F0685 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.June 13, 2025 · F0689 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Ensure that residents are free from significant medication errors.June 13, 2025 · F0760 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Have a policy regarding use and storage of foods brought to residents by family and other visitors.June 13, 2025 · F0813 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Provide and implement an infection prevention and control program.June 13, 2025 · F0880 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few

Complaint inspections, last three years

Inspections after complaints found 26 citations.

• Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.June 19, 2026 · F0550 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.May 7, 2026 · F0609 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.May 7, 2026 · F0755 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• 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.May 7, 2026 · F0761 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.February 4, 2026 · F0628 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Ensure each resident receives an accurate assessment.February 4, 2026 · F0641 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.November 26, 2025 · F0882 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Many
• Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.September 16, 2025 · F0689 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.June 13, 2025 · F0605 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Reasonably accommodate the needs and preferences of each resident.May 13, 2025 · F0558 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
• Ensure each resident receives an accurate assessment.May 13, 2025 · F0641 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Provide appropriate treatment and care according to orders, resident’s preferences and goals.February 8, 2025 · F0684 · Level of harm: Immediate jeopardy to resident health or safety · Residents affected: Few
• Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.February 8, 2025 · F0755 · Level of harm: Immediate jeopardy to resident health or safety · Residents affected: Few
• Ensure that residents are free from significant medication errors.February 8, 2025 · F0760 · Level of harm: Immediate jeopardy to resident health or safety · Residents affected: Few
• Provide timely, quality laboratory services/tests to meet the needs of residents.February 8, 2025 · F0770 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedDecember 21, 2024 · F0655 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.December 21, 2024 · F0656 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.December 21, 2024 · F0657 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.December 21, 2024 · F0689 · Level of harm: Immediate jeopardy to resident health or safety · Residents affected: Few
• 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.December 21, 2024 · F0727 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Many
• Develop and implement policies and procedures to prevent abuse, neglect, and theft.September 9, 2024 · F0607 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
• Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.September 9, 2024 · F0609 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
• Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.September 9, 2024 · F0755 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Employ staff that are licensed, certified, or registered in accordance with state laws.September 9, 2024 · F0839 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
• Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.January 10, 2024 · F0580 · Level of harm: Immediate jeopardy to resident health or safety · Residents affected: Few
• Provide appropriate treatment and care according to orders, resident’s preferences and goals.January 10, 2024 · F0684 · Level of harm: Immediate jeopardy to resident health or safety · Residents affected: Few

Fines and payment denials

• Fine of $49,392February 8, 2025
• Fine of $47,467December 21, 2024
• Fine of $15,274January 10, 2024

Nurse staffing

Hours of nursing care per resident per day, as the home reports them to Medicare through payroll records.

About this home