Skilled nursing facility · CMS certification number 676472

Sundance Inn Health Center

New Braunfels, Texas · Medicare and Medicaid

Certified beds, as filed in Care Compare: 128

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for 1 October 2023 to 30 September 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 4 March 2026.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$21,046,109	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$8,307,710	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$12,738,399	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$12,500,504	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$237,895	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$2,127	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$240,022	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $240,022 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	46,848	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	7,625	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	10,852	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	16,618	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	35,095	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	203	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	23	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	354	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	580	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	37.56	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	471.83	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	60.51	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1448288, read from the public cost report file SNF10FY2024.zip.

Fiscal year 2023, ended 30 September 2023

Cost report for 1 October 2022 to 30 September 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 22 March 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$19,564,305	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$7,843,080	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$11,721,225	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$10,604,185	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$1,117,040	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$897,412	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$2,014,452	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $2,014,452 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	33,965	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	576	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	34.95	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	294.35	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	58.97	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1375504, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2022, ended 30 September 2022

Cost report for 1 October 2021 to 30 September 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 March 2023.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$17,941,349	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$6,198,840	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$11,742,509	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$12,509,509	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$767,000	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,239,118	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$472,118	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $464,408 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	35,165	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	538	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	35.69	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	1,810.56	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	65.36	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1345264, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended 30 September 2021

Cost report for 1 October 2020 to 30 September 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 April 2022.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$13,913,520	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$3,872,690	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$10,040,830	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$10,671,815	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$630,985	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,093,365	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$462,380	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $462,380 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2021
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	32,524	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	446	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	33.08	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	161.81	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	72.92	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1314189, read from the public cost report file SNF10FY2021.zip.

Fiscal year 2020, ended 30 September 2020

Cost report for 1 May 2020 to 30 September 2020 — a reporting period of 152 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 19 March 2021.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$5,518,192	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,324,399	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,193,793	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,235,491	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$41,698	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$83,349	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$41,651	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $41,649 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2020
Figure	As filed	Where it comes from
Total facility beds, all components	128	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	14,427	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	116	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	39.52	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	1,717.8	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	124.37	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1281481, read from the public cost report file SNF10FY2020.zip.

Nurse staffing

Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.

The staffing record →

Ownership, as filed with CMS

Care Compare

As filed in the CMS file dated 1 August 2026 (Care Compare ownership).

Owner or manager	Role	Type	Ownership percentage	Association
COMAL HEALTH CARE CENTER LTD. CO.	ADP OF THE SNF	Organization	NOT APPLICABLE	since 04/04/2025
POMEROY, WILLIAM	ADP OF THE SNF	Individual	NOT APPLICABLE	since 05/01/2020
HOOPER, GRADY	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 12/01/2015
COMAL HEALTH CARE CENTER LTD. CO.	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 05/01/2020
POMEROY, WILLIAM	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 05/01/2020

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of HAMILTON COUNTY HOSPITAL DISTRICT (enrollment ID O20200505001191).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
HAMILTON COUNTY HOSPITAL DISTRICT	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	100	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
COMAL HEALTH CARE CENTER LTD. CO.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	4/4/2025	Private equity company: No Real estate investment trust: No Holding company: No
WILLIAM POMEROY	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	10/20/2025	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	9/1/2019	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2025	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	10/21/2025	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	10/21/2025	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	10/21/2025	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
GRADY HOOPER	Individual	CORPORATE OFFICER	0	12/1/2015	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
COMAL HEALTH CARE CENTER LTD. CO.	Organization	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
WILLIAM POMEROY	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.

Changes in ownership

1 July 2026: A listing under ADP OF THE SNF no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 December 2025: TRACY SIMMS no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: ROBIN F UNDERHILL no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: WILLIAM POMEROY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: WILLIAM POMEROY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: WILLIAM POMEROY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: COMAL HEALTH CARE CENTER LTD. CO. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: COMAL HEALTH CARE CENTER LTD. CO. appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: HAMILTON COUNTY HOSPITAL DISTRICT appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv

Recent changes on this record

1 July 2026: A listing under ADP OF THE SNF no longer appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
4 March 2026: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
1 December 2025: TRACY SIMMS no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: ROBIN F UNDERHILL no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: WILLIAM POMEROY no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: WILLIAM POMEROY appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: WILLIAM POMEROY appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: COMAL HEALTH CARE CENTER LTD. CO. appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: COMAL HEALTH CARE CENTER LTD. CO. appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: HAMILTON COUNTY HOSPITAL DISTRICT appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
1 December 2025: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
22 March 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
30 March 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
21 April 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
19 March 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
14 January 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	28 August 2025	28 August 2025	12	8
2	27 June 2024	27 June 2024	9	2
3	20 April 2023	20 April 2023	6	3

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

27 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
30 April 2026	Health	F 0628	Resident Rights Deficiencies	Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.	E	Yes	Deficient, Provider has date of correction	4 May 2026
17 April 2026	Health	F 0842	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	D	Yes	Deficient, Provider has date of correction	20 April 2026
28 August 2025	Health	F 0580	Resident Rights Deficiencies	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.	D	No	Deficient, Provider has date of correction	29 August 2025
28 August 2025	Health	F 0628	Resident Rights Deficiencies	Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.	D	No	Deficient, Provider has date of correction	29 August 2025
28 August 2025	Health	F 0656	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D	No	Deficient, Provider has date of correction	29 August 2025
28 August 2025	Health	F 0687	Quality of Life and Care Deficiencies	Provide appropriate foot care.	D	No	Deficient, Provider has date of correction	1 October 2025
28 August 2025	Health	F 0803	Nutrition and Dietary Deficiencies	Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.	D	No	Deficient, Provider has date of correction	29 August 2025
28 August 2025	Health	F 0842	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	D	No	Deficient, Provider has date of correction	29 August 2025
3 August 2025	Health	F 0600	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	J	Yes	Deficient, Provider has date of correction	4 August 2025
3 August 2025	Health	F 0607	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Develop and implement policies and procedures to prevent abuse, neglect, and theft.	J	Yes	Deficient, Provider has date of correction	4 August 2025
3 August 2025	Health	F 0677	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	D	Yes	Deficient, Provider has date of correction	4 August 2025
3 August 2025	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	D	Yes	Deficient, Provider has date of correction	4 August 2025
9 June 2025	Health	F 0761	Pharmacy Service Deficiencies	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.	D	Yes	Deficient, Provider has date of correction	10 June 2025
11 April 2025	Health	F 0583	Resident Rights Deficiencies	Keep residents' personal and medical records private and confidential.	D	Yes	Deficient, Provider has date of correction	12 April 2025
11 April 2025	Health	F 0602	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from the wrongful use of the resident's belongings or money.	D	Yes	Past Non-Compliance	11 November 2024
11 April 2025	Health	F 0609	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D	Yes	Deficient, Provider has date of correction	12 April 2025
11 April 2025	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	D	Yes	Deficient, Provider has date of correction	12 April 2025
27 June 2024	Health	F 0550	Resident Rights Deficiencies	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.	D	No	Deficient, Provider has date of correction	2 August 2024
27 June 2024	Health	F 0558	Resident Rights Deficiencies	Reasonably accommodate the needs and preferences of each resident.	D	No	Deficient, Provider has date of correction	2 August 2024
27 June 2024	Health	F 0656	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D	No	Deficient, Provider has date of correction	2 August 2024
27 June 2024	Health	F 0760	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	D	No	Deficient, Provider has date of correction	2 August 2024
31 May 2024	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	Yes	Deficient, Provider has date of correction	28 June 2024
20 April 2023	Health	F 0656	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	D	No	Deficient, Provider has date of correction	21 April 2023
20 April 2023	Health	F 0677	Quality of Life and Care Deficiencies	Provide care and assistance to perform activities of daily living for any resident who is unable.	D	No	Deficient, Provider has date of correction	21 April 2023
20 April 2023	Health	F 0695	Quality of Life and Care Deficiencies	Provide safe and appropriate respiratory care for a resident when needed.	D	No	Deficient, Provider has date of correction	21 April 2023
20 April 2023	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F	No	Deficient, Provider has date of correction	21 April 2023
20 April 2023	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	E	No	Deficient, Provider has date of correction	21 April 2023

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

Penalties

Penalty date	Type	Fine amount	Payment denial began	Payment denial, days	Fine ID
3 August 2025	Fine	$6,364			134429

From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.

Care Compare provider information

Field	As filed
Provider Type	Medicare and Medicaid
Ownership Type	For profit - Corporation
Legal Business Name	HAMILTON COUNTY HOSPITAL DISTRICT
Date First Approved to Provide Medicare and Medicaid Services	2019-12-14
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	Y
County/Parish	Comal
Telephone Number	8302211400
Chain Name	CANTEX CONTINUING CARE
Chain ID	100
Provider Changed Ownership in Last 12 Months	N
With a Resident and Family Council	Resident
Automatic Sprinkler Systems in All Required Areas	Yes
Number of Certified Beds	128
Average Number of Residents per Day	87.7
Overall Rating	2
Health Inspection Rating	2
QM Rating	4
Long-Stay QM Rating	5
Short-Stay QM Rating	3
Processing Date	2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

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On 1 July 2026: A listing under ADP OF THE SNF no longer appears in the Medicare enrollment ownership file, with no owner named. That is one line of the alert.

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The citable document for Sundance Inn Health Center

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