Skilled nursing facility · CMS certification number 676297
The Rio at Mission Trails
San Antonio, Texas · Medicare and Medicaid · 124 certified beds in Care Compare
Download The Rio at Mission Trails’s record (CSV, each figure with its worksheet, line and column)
In Care Compare’s provider information: Penalties: 2 · Fines: 2 · Fines, total amount: $153,825.00 · Payment denials: 0. The most recent penalty on file: February 24, 2025, Fine, $96,694. Every penalty on file ↓
The Rio at Mission Trails: its citable report, full history — $295 · an email when it changes — $99/month
What stands out
- Its latest cost report on file is for fiscal year 2025, covering April 1, 2024 to March 31, 2025 (364 days), and CMS processed it on October 10, 2025.
- Net patient revenue rose from $6.7M in fiscal year 2024 to $8.6M in fiscal year 2025.
- Its result from service to patients: −$1.2M (2023), −$2.2M (2024), −$861K (2025).
- Its cost reports on file run from fiscal year 2011 to fiscal year 2025.
- Since its cost report for fiscal year 2024 was filed on January 16, 2026, 1 change is listed on this record: a deficiency.
- Its net patient revenue of $8.6M ranks 157th of the 484 nursing facilities in Texas whose latest cost report on file is fiscal year 2025.
- 2 of the 5 nursing facilities in Texas closest in size to it, whose latest cost report on file is fiscal year 2025, also report a loss on service to patients.
The Rio at Mission Trails: Medicare cost reports
Form CMS-2540-10: every report is settled.
| Form CMS-2540-10 | 2025 · report 1440741 | 2024 · report 1446723 | 2023 · report 1366726 | 2022 · report 1335382 | 2021 · report 1328680 | 2020 · report 1301166 | 2019 · report 1270237 | 2018 · report 1274725 | 2017 · report 1244094 | 2016 · report 1216843 | 2015 · report 1154616 | 2014 · report 1148406 | 2013 · report 1114214 | 2012 · report 1076425 | 2011 · report 1058356 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Period began | April 1, 2024 | April 1, 2023 | April 1, 2022 | January 1, 2022 | January 1, 2021 | January 1, 2020 | January 1, 2019 | January 1, 2018 | January 1, 2017 | January 1, 2016 | January 1, 2015 | January 1, 2014 | January 1, 2013 | January 1, 2012 | October 12, 2011 |
| Period ended | March 31, 2025 | March 31, 2024 | March 31, 2023 | March 31, 2022 | December 31, 2021 | December 31, 2020 | December 31, 2019 | December 31, 2018 | December 31, 2017 | December 31, 2016 | July 31, 2015 | December 31, 2014 | December 31, 2013 | December 31, 2012 | December 31, 2011 |
| Days, where not a full year | — | — | — | 89 | — | — | — | — | — | — | 211 | — | — | — | 80 |
| Processed by CMS | October 10, 2025 | January 16, 2026 | October 16, 2023 | October 17, 2022 | August 2, 2022 | September 27, 2021 | September 30, 2020 | December 2, 2020 | October 16, 2019 | December 21, 2018 | March 16, 2017 | December 13, 2016 | December 9, 2015 | August 19, 2014 | April 18, 2014 |
| Total patient revenue | $8,907,955 | $7,538,159 | $6,565,003 | $1,456,144 | $5,797,102 | $7,487,633 | $9,287,461 | $11,704,978 | $12,402,248 | $7,608,480 | $4,459,071 | $7,274,300 | $6,428,137 | $7,492,740 | $455,881 |
| Contractual allowances and discounts | $311,830 | $871,952 | $900,262 | $260,134 | $471,335 | $943,470 | $1,064,257 | $2,581,021 | $3,032,650 | −$1,162,085 | $92,794 | $173,466 | $274,104 | $1,708,255 | $3,581 |
| Net patient revenue | $8,596,125 | $6,666,207 | $5,664,741 | $1,196,010 | $5,325,767 | $6,544,163 | $8,223,204 | $9,123,957 | $9,369,598 | $8,770,565 | $4,366,277 | $7,100,834 | $6,154,033 | $5,784,485 | $452,300 |
| Total operating expenses | $9,457,058 | $8,888,882 | $6,870,356 | $1,707,728 | $8,006,095 | $8,485,458 | $8,592,682 | $9,967,730 | $10,414,376 | $8,992,318 | $4,600,852 | $6,944,551 | $6,549,683 | $6,055,767 | $1,036,342 |
| Net income from service to patients | −$860,933 | −$2,222,675 | −$1,205,615 | −$511,718 | −$2,680,328 | −$1,941,295 | −$369,478 | −$843,773 | −$1,044,778 | −$221,753 | −$234,575 | $156,283 | −$395,650 | −$271,282 | −$584,042 |
| Total other income | $518,170 | $1,316,300 | $1,870,334 | $290,139 | $1,215,623 | $1,396,058 | $12,237 | $475,508 | $21,185 | $14,962 | −$5,130 | −$43,356 | $369 | $993 | $19 |
| Net income after other income | −$342,763 | −$906,375 | $664,719 | −$221,579 | −$1,464,705 | −$545,237 | −$357,241 | −$368,265 | −$1,023,593 | −$206,791 | −$239,705 | $112,927 | −$395,281 | −$270,289 | −$584,023 |
| Net income | −$342,763 | −$906,375 | $664,719 | −$221,579 | −$1,464,705 | −$545,237 | −$357,241 | −$368,265 | −$1,023,593 | −$206,791 | −$239,705 | $112,927 | −$395,281 | −$270,289 | −$584,023 |
| Total facility beds, all components | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 248 |
| Bed days available, all components | 45,260 | — | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicare (Title XVIII) patient days | 1,474 | — | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicaid (Title XIX) patient days | 20,422 | — | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Other-payer patient days | 7,312 | — | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Total patient days, all components | 29,208 | 26,416 | 25,201 | 5,742 | 23,260 | 30,011 | 35,065 | 39,874 | 38,297 | 36,366 | 14,482 | 32,684 | 28,657 | 28,384 | 2,506 |
| Medicare discharges | 60 | — | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicaid discharges | 198 | — | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Other-payer discharges | 166 | — | — | — | — | — | — | — | — | — | — | — | — | — | — |
| Total discharges, all components | 424 | 228 | 244 | 47 | 220 | 251 | 344 | 423 | 497 | 313 | 159 | 170 | 172 | 204 | 15 |
| Average length of stay, Medicare, in days | 24.57 | 31.44 | 28.12 | 106 | 23.79 | 39.32 | 25.3 | 44.13 | 41.15 | 43.69 | 53.29 | 51.07 | 57.1 | 46.94 | 46 |
| Average length of stay, Medicaid, in days | 103.14 | 146.14 | 149.36 | 133.94 | 156.52 | 174.15 | 169.37 | 302.36 | 58.6 | 275.71 | 103.71 | 382.33 | 285.24 | 295.26 | 243.29 |
| Average length of stay, all patients, in days | 68.89 | 115.86 | 103.28 | 122.17 | 105.73 | 119.57 | 101.93 | 94.26 | 77.06 | 116.19 | 91.08 | 192.26 | 166.61 | 139.14 | 167.07 |
Net income, fiscal years 2025, 2024, 2023, 2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015, 2014, 2013, 2012, 2011. Checked against the form’s own arithmetic: what that check shows.
The Rio at Mission Trails: nurse staffing hours by quarter →
Who owns The Rio at Mission Trails, as filed with CMS
Care Compare
- CORPORATE OFFICER: MAK, DAVID (individual), since 05/17/2021
- OPERATIONAL/MANAGERIAL CONTROL: BLAKE, GARY (individual), since 04/01/2022; BLAKE, MALISA (individual), since 04/01/2022; SAN ANTONIO II ENTERPRISES, LLC (organization), since 04/01/2022
- W-2 MANAGING EMPLOYEE: HUGGINS, LINDA (individual), since 04/01/2022
Ownership percentage for each: NOT APPLICABLE.
Medicare enrollment
As filed in the CMS file dated October 1, 2026 (Medicare enrollment ownership), under the enrollment of WEST WHARTON COUNTY HOSPITAL DISTRICT (enrollment ID O20220705001182).
- 5% OR GREATER DIRECT OWNERSHIP INTEREST: WEST WHARTON COUNTY HOSPITAL DISTRICT (organization), 100.00%, since 04/01/2022
- CORPORATE OFFICER: DAVID MAK (individual), 0.00%, since 05/17/2021
- OPERATIONAL/MANAGERIAL CONTROL: GARY R BLAKE (individual), 50.00%, since 04/01/2022; MALISA A BLAKE (individual), 50.00%, since 04/01/2022; SAN ANTONIO II ENTERPRISES, LLC (organization), 100.00%, since 04/01/2022
- OTHER: HONOR X ENTERPRISES, LLC (organization), 100.00%, since 04/01/2022
- W-2 MANAGING EMPLOYEE: LINDA F HUGGINS (individual), 0.00%, since 04/01/2022
Paused by CMS: Form CMS-855A, December 11, 2025.
Private equity company, real estate investment trust and holding company: No: WEST WHARTON COUNTY HOSPITAL DISTRICT; SAN ANTONIO II ENTERPRISES, LLC; HONOR X ENTERPRISES, LLC.
Private equity company, real estate investment trust and holding company: Paused by CMS: DAVID MAK; GARY R BLAKE; MALISA A BLAKE; LINDA F HUGGINS.
Changes in ownership
- October 31, 2022, enrollment ownership file; no longer listed: CREATIVE SOLUTIONS IN HEALTHCARE INC (OPERATIONAL/MANAGERIAL CONTROL); HONOR X ENTERPRISES, LLC (5% OR GREATER DIRECT OWNERSHIP INTEREST); LINDA F HUGGINS (W-2 MANAGING EMPLOYEE); GARY R BLAKE (OPERATIONAL/MANAGERIAL CONTROL); GARY R BLAKE (5% OR GREATER INDIRECT OWNERSHIP INTEREST); MALISA A BLAKE-DEANE (OPERATIONAL/MANAGERIAL CONTROL); MALISA A BLAKE-DEANE (5% OR GREATER INDIRECT OWNERSHIP INTEREST); first listed: SAN ANTONIO II ENTERPRISES, LLC (OPERATIONAL/MANAGERIAL CONTROL), associated since April 1, 2022; WEST WHARTON COUNTY HOSPITAL DISTRICT (5% OR GREATER DIRECT OWNERSHIP INTEREST), associated since April 1, 2022; HONOR X ENTERPRISES, LLC (OTHER), associated since April 1, 2022; LINDA F HUGGINS (W-2 MANAGING EMPLOYEE), associated since April 1, 2022; GARY R BLAKE (OPERATIONAL/MANAGERIAL CONTROL), associated since April 1, 2022; MALISA A BLAKE-DEANE (OPERATIONAL/MANAGERIAL CONTROL), associated since April 1, 2022; DAVID MAK (OFFICER), associated since May 17, 2021. Skilled_Nursing_Facility_All_Owners_:_2022-10-31.csv
Recent changes on this record
- August 4, 2026: A deficiency was cited under tag F 0842, scope and severity D. NH_HealthCitations_Oct2026.csv
Inspections of The Rio at Mission Trails
- Cycle 1: health March 25, 2026 (19 deficiencies), fire safety March 25, 2026 (3)
- Cycle 2: health December 18, 2024 (11 deficiencies), fire safety December 18, 2024 (4)
- Cycle 3: health November 15, 2023 (5 deficiencies), fire safety November 15, 2023 (0)
Deficiencies cited at The Rio at Mission Trails
35 deficiencies on file, by tag, newest citation first
every one from a health inspection; 19 cited from a complaint, marked below. Letter after a date: scope and severity grade.
- F 0842, resident assessment and care planning: August 4, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected August 20, 2026); June 23, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected July 13, 2026); May 7, 2026 (E, from a complaint, Deficient, Provider has date of correction, corrected May 21, 2026); March 25, 2026 (B, Deficient, Provider has date of correction, corrected April 22, 2026); December 18, 2024 (D, Deficient, Provider has date of correction, corrected January 6, 2025).
- F 0585, resident rights: June 23, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected July 13, 2026); March 25, 2026 (E, Deficient, Provider has date of correction, corrected April 8, 2026).
- F 0880, infection control: May 7, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected May 21, 2026); March 19, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected March 24, 2026).
- F 0656, resident assessment and care planning: April 17, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected April 19, 2026); April 7, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected May 1, 2026); December 18, 2024 (D, Deficient, Provider has date of correction, corrected January 6, 2025).
- F 0695, quality of life and care: April 17, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected May 31, 2026); February 24, 2025 (J, from a complaint, Deficient, Provider has date of correction, corrected February 28, 2025).
- F 0645, resident assessment and care planning: March 25, 2026 (D, Deficient, Provider has date of correction, corrected April 8, 2026).
- F 0727, nursing and physician services: March 25, 2026 (E, Deficient, Provider has date of correction, corrected April 22, 2026).
- F 0755, pharmacy service: March 25, 2026 (D, Deficient, Provider has date of correction, corrected April 22, 2026).
- F 0759, pharmacy service: March 25, 2026 (E, Deficient, Provider has date of correction, corrected April 8, 2026).
- F 0760, pharmacy service: March 25, 2026 (E, Deficient, Provider has date of correction, corrected April 8, 2026).
- F 0761, pharmacy service: March 25, 2026 (D, Deficient, Provider has date of correction, corrected April 8, 2026); December 18, 2024 (D, Deficient, Provider has date of correction, corrected January 6, 2025).
- F 0919, environmental: March 25, 2026 (B, Deficient, Provider has date of correction, corrected April 8, 2026).
- F 0641, resident assessment and care planning: March 19, 2026 (D, from a complaint, Deficient, Provider has date of correction, corrected March 24, 2026); December 18, 2024 (D, Deficient, Provider has date of correction, corrected January 6, 2025).
- F 0607, freedom from abuse, neglect, and exploitation: April 10, 2025 (D, from a complaint, Past Non-Compliance, corrected March 3, 2025).
- F 0609, freedom from abuse, neglect, and exploitation: April 10, 2025 (D, from a complaint, Past Non-Compliance, corrected March 3, 2025); November 21, 2024 (D, from a complaint, Deficient, Provider has date of correction, corrected November 25, 2024).
- F 0600, freedom from abuse, neglect, and exploitation: February 24, 2025 (J, from a complaint, Deficient, Provider has date of correction, corrected February 28, 2025).
- F 0558, resident rights: December 18, 2024 (E, Deficient, Provider has date of correction, corrected January 6, 2025).
- F 0812, nutrition and dietary: December 18, 2024 (D, Deficient, Provider has date of correction, corrected January 6, 2025).
- F 0557, resident rights: July 14, 2024 (D, from a complaint, Deficient, Provider has date of correction, corrected July 16, 2024).
- F 0677, quality of life and care: July 14, 2024 (D, from a complaint, Deficient, Provider has date of correction, corrected July 16, 2024).
- F 0825, quality of life and care: July 14, 2024 (D, from a complaint, Deficient, Provider has date of correction, corrected July 16, 2024).
- F 0925, environmental: June 20, 2024 (J, from a complaint, Deficient, Provider has date of correction, corrected June 28, 2024).
- F 0657, resident assessment and care planning: November 15, 2023 (D, Deficient, Provider has date of correction, corrected November 16, 2023).
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| February 24, 2025 | Fine | $96,694 | 113635 | ||
| June 20, 2024 | Fine | $57,131 | 113012 |
From the Care Compare penalties file NH_Penalties_Oct2026.csv, processed on October 1, 2026.
The Rio at Mission Trails in Care Compare
- Ownership Type: Government - Hospital district
- Legal Business Name: WEST WHARTON COUNTY HOSPITAL DISTRICT
- Date First Approved to Provide Medicare and Medicaid Services: 2011-10-12
- Provider Resides in Hospital: Y
- Continuing Care Retirement Community: N
- Urban: Y
- County/Parish: Bexar
- Telephone Number: 2105310569
- Chain Name: CREATIVE SOLUTIONS IN HEALTHCARE
- Chain ID: 169
- Provider Changed Ownership in Last 12 Months: N
- With a Resident and Family Council: Both
- Automatic Sprinkler Systems in All Required Areas: Yes
- Average Number of Residents per Day: 77.2
- Overall Rating: 1
- Health Inspection Rating: 2
- QM Rating: 4
- Long-Stay QM Rating: 5
- Short-Stay QM Rating: 4
Care Compare, October 1, 2026: provider information NH_ProviderInfo_Oct2026.csv · inspections NH_SurveySummary_Oct2026.csv · citations NH_HealthCitations_Oct2026.csv · penalties NH_Penalties_Oct2026.csv · ownership NH_Ownership_Oct2026.csv.
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Report a figure on The Rio at Mission Trails’s record that differs from its CMS file, quoting 676297.