Town and Country Nursing and Rehabilitation Center
625 N Main St · Boerne, TX · 78006 · 8302493085
126 certified beds Government - Hospital district Chain: Wellsential Health
Why this verdict
- Inspection record is far worse than the national median (deficiency count and severity).
- Federal penalties on record: $75,832 in fines in the last 24 months.
- Inspection results have improved across recent cycles.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
3 immediate-jeopardy citations in prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
$75,832 in federal fines in the last 24 months
1 fine — CMS fines are reserved for verified, serious non-compliance.
61% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 3 of 5 Inspections: 2 of 5 Staffing: 2 of 5 Quality measures: 5 of 5
| Total nurse hours / resident-day | 3.36 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.55 | 0.55–0.75 |
| Weekend hours / resident-day | 3.03 | ≈ weekday level |
| Nursing turnover / year | 61% | median 45% |
| Fines (3-yr window) | 2 · $150,922 |
Inspection citations (57 in the current record)
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Potential for harm · D April 24, 2026 · found via complaint
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected April 25, 2026 · Pharmacy Service
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Potential for harm · D April 24, 2026 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected April 25, 2026 · Resident Assessment and Care Planning
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No harm found · C January 8, 2026 · found via complaint
Post nurse staffing information every day.
Corrected January 9, 2026 · Nursing and Physician Services
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Potential for harm · D December 17, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected December 18, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D December 4, 2025 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected December 5, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D May 22, 2025
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected June 17, 2025 · Resident Rights
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Potential for harm · D May 22, 2025
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Corrected June 17, 2025 · Resident Rights
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Potential for harm · D May 22, 2025
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Corrected June 17, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D May 22, 2025
Ensure each resident receives an accurate assessment.
Corrected June 17, 2025 · Resident Assessment and Care Planning
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Potential for harm · D May 22, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected June 17, 2025 · Resident Assessment and Care Planning
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Potential for harm · D May 22, 2025
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected June 17, 2025 · Quality of Life and Care
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Potential for harm · D May 22, 2025
Assist a resident in gaining access to vision and hearing services.
Corrected June 17, 2025 · Quality of Life and Care
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Potential for harm · D May 22, 2025
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected June 17, 2025 · Quality of Life and Care
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Potential for harm · E May 22, 2025
Ensure medication error rates are not 5 percent or greater.
Corrected June 17, 2025 · Pharmacy Service
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Potential for harm · D May 22, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected June 17, 2025 · Nutrition and Dietary
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Potential for harm · D May 22, 2025
Provide and implement an infection prevention and control program.
Corrected June 17, 2025 · Infection Control
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Potential for harm · D May 2, 2025 · found via complaint
Keep residents' personal and medical records private and confidential.
Corrected May 3, 2025 · Resident Rights
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Potential for harm · E May 2, 2025 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected September 27, 2024 · Pharmacy Service
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Potential for harm · D May 2, 2025 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected May 3, 2025 · Resident Assessment and Care Planning
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Potential for harm · D May 2, 2025 · found via complaint
Provide and implement an infection prevention and control program.
Corrected May 3, 2025 · Infection Control
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Potential for harm · E February 25, 2025 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected February 26, 2025 · Quality of Life and Care
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Potential for harm · E February 25, 2025 · found via complaint
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected February 26, 2025 · Quality of Life and Care
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Potential for harm · D February 25, 2025 · found via complaint
Provide safe, appropriate pain management for a resident who requires such services.
Corrected February 26, 2025 · Quality of Life and Care
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Potential for harm · D February 25, 2025 · found via complaint
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.
Corrected February 26, 2025 · Pharmacy Service
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Potential for harm · E February 25, 2025 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected February 26, 2025 · Resident Assessment and Care Planning
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| July 26, 2024 | Fine | $75,832 |
| March 31, 2024 | Fine | $75,090 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 455796 · certified since March 3, 1998. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.