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Skilled nursing facility · CMS certification number 676491

Mission Ridge Rehab & Nursing Center

Refugio, Texas · Medicare and Medicaid

Certified beds, as filed in Care Compare: 90

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 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 August 2025.

Revenue and expenses, fiscal year 2024
FigureAs filedWhere it comes from
Total patient revenue$4,899,296CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$376,435CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$4,522,861CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$4,593,835CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$70,974CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$420,122CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$349,148CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $349,148 (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
FigureAs filedWhere it comes from
Total facility beds, all components90CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components32,940CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days1,772CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days20,891CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days6,532CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components29,195CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges41CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges94CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges90CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components225CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days43.22CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days222.24CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days129.76CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1436100, read from the public cost report file SNF10FY2024.zip.

Fiscal year 2023, ended 31 December 2023

Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 8 August 2024.

Revenue and expenses, fiscal year 2023
FigureAs filedWhere it comes from
Total patient revenue$4,414,768CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$568,013CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$3,846,755CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$4,361,965CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$515,210CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$432,849CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$82,361CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$82,361 (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
FigureAs filedWhere it comes from
Total facility beds, all components90CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components15,958CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components87CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days42.53CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days381.68CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days183.43CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1391659, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2022, ended 31 December 2022

Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 16 October 2024.

Revenue and expenses, fiscal year 2022
FigureAs filedWhere it comes from
Total patient revenue$4,927,459CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$722,247CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$4,205,212CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$4,552,685CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$347,473CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$502,595CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$155,122CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $155,122 (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
FigureAs filedWhere it comes from
Total facility beds, all components90CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components18,942CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components103CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days69.29CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days472.48CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days183.9CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1397299, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended 31 December 2021

Cost report for 1 March 2021 to 31 December 2021 — a reporting period of 305 days, on form CMS-2540-10, settled, processed by CMS on 2 August 2022.

Revenue and expenses, fiscal year 2021
FigureAs filedWhere it comes from
Total patient revenue$3,845,302CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$464,009CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$3,381,293CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$3,851,341CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$470,048CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$234,115CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$235,933CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$235,933 (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
FigureAs filedWhere it comes from
Total facility beds, all components90CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components15,425CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components82CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days63CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days326.61CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days188.11CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1328685, read from the public cost report file SNF10FY2021.zip.

Fiscal year 2020, ended 31 December 2020

Cost report for 13 July 2020 to 31 December 2020 — a reporting period of 171 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 10 August 2021.

Revenue and expenses, fiscal year 2020
FigureAs filedWhere it comes from
Total patient revenue$644,183CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts−$517,202CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$1,161,385CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$2,549,908CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$1,388,523CMS-2540-10 worksheet G300000 line 500 column 100
Total other income−$22,306CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$1,410,829CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,022,342 (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
FigureAs filedWhere it comes from
Total facility beds, all components90CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components5,377CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components6CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days330.67CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days3,879CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days896.17CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1292762, 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 managerRoleTypeOwnership percentageAssociation
BLAKE, GARYOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 03/01/2021
BLAKE, MALISAOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 03/01/2021
CREATIVE SOLUTIONS IN HEALTHCARE INCOPERATIONAL/MANAGERIAL CONTROLOrganizationNOT APPLICABLEsince 02/01/2022
HUGGINS, LINDAW-2 MANAGING EMPLOYEEIndividualNOT APPLICABLEsince 03/01/2021

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of REFUGIO II ENTERPRISES, LLC (enrollment ID O20210308002399).

OwnerIndividual or organizationRoleOwnership percentageAssociation dateDescribed in the filing as
HONOR X ENTERPRISES, LLCOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST1003/1/2021
Private equity company: No
Real estate investment trust: No
Holding company: No
GARY R BLAKEIndividual5% OR GREATER INDIRECT OWNERSHIP INTEREST503/1/2021
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.
MALISA A BLAKEIndividual5% OR GREATER INDIRECT OWNERSHIP INTEREST503/1/2021
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.
CREATIVE SOLUTIONS IN HEALTHCARE INCOrganizationOPERATIONAL/MANAGERIAL CONTROL1002/1/2022
Private equity company: No
Real estate investment trust: No
Holding company: No
GARY R BLAKEIndividualOPERATIONAL/MANAGERIAL CONTROL503/1/2021
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.
MALISA A BLAKEIndividualOPERATIONAL/MANAGERIAL CONTROL503/1/2021
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.
LINDA F HUGGINSIndividualW-2 MANAGING EMPLOYEE03/1/2021
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

No change in ownership appears in the CMS files on record since 20 September 2022.

Recent changes on this record

  • 28 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
  • 16 October 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
  • 8 August 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
  • 2 August 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
  • 25 January 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
  • 10 August 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip

Inspections

Inspection cycleHealth inspectionFire safety inspectionHealth deficienciesFire safety deficiencies
126 February 202626 February 202690
223 November 202423 November 2024120
33 August 20233 August 202340

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

Deficiencies cited

25 deficiencies on file, newest inspection first
Inspection dateInspection typeTagCategoryWhat was citedScope and severityComplaintCorrectedCorrection date
14 May 2026HealthF 0761Pharmacy Service DeficienciesEnsure 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.DYesDeficient, Provider has date of correction5 June 2026
26 February 2026HealthF 0550Resident Rights DeficienciesHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.DNoDeficient, Provider has date of correction6 March 2026
26 February 2026HealthF 0578Resident Rights DeficienciesHonor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.DNoDeficient, Provider has date of correction6 March 2026
26 February 2026HealthF 0760Pharmacy Service DeficienciesEnsure that residents are free from significant medication errors.ENoDeficient, Provider has date of correction6 March 2026
26 February 2026HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.ENoDeficient, Provider has date of correction6 March 2026
26 February 2026HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.DNoDeficient, Provider has date of correction6 March 2026
5 February 2026HealthF 0583Resident Rights DeficienciesKeep residents' personal and medical records private and confidential.DYesDeficient, Provider has date of correction6 February 2026
11 September 2025HealthF 0684Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.DYesDeficient, Provider has date of correction12 September 2025
11 September 2025HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.JYesPast Non-Compliance30 June 2025
23 November 2024HealthF 0609Freedom from Abuse, Neglect, and Exploitation DeficienciesTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.DYesDeficient, Provider has date of correction24 November 2024
23 November 2024HealthF 0645Resident Assessment and Care Planning DeficienciesPASARR screening for Mental disorders or Intellectual DisabilitiesDNoDeficient, Provider has date of correction24 November 2024
23 November 2024HealthF 0657Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DNoDeficient, Provider has date of correction24 November 2024
23 November 2024HealthF 0684Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.GYesDeficient, Provider has date of correction24 November 2024
23 November 2024HealthF 0761Pharmacy Service DeficienciesEnsure 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.DNoDeficient, Provider has date of correction24 November 2024
23 November 2024HealthF 0842Resident Assessment and Care Planning DeficienciesSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.DYesDeficient, Provider has date of correction24 November 2024
23 November 2024HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.ENoDeficient, Provider has date of correction24 November 2024
10 October 2024HealthF 0623Resident Rights DeficienciesProvide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.DYesDeficient, Provider has date of correction11 October 2024
10 October 2024HealthF 0656Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.EYesDeficient, Provider has date of correction11 October 2024
10 October 2024HealthF 0657Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DYesDeficient, Provider has date of correction11 October 2024
10 October 2024HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.JYesDeficient, Provider has date of correction11 October 2024
10 October 2024HealthF 0921Environmental DeficienciesMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.DYesDeficient, Provider has date of correction11 October 2024
3 August 2023HealthF 0578Resident Rights DeficienciesHonor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.DYesDeficient, Provider has date of correction4 August 2023
3 August 2023HealthF 0692Quality of Life and Care DeficienciesProvide enough food/fluids to maintain a resident's health.DYesDeficient, Provider has date of correction4 August 2023
3 August 2023HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.EYesDeficient, Provider has date of correction4 August 2023
3 August 2023HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.ENoDeficient, Provider has date of correction4 August 2023

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

Penalties

Penalty dateTypeFine amountPayment denial beganPayment denial, daysFine ID
11 September 2025Fine$14,325135673
23 November 2024Fine$15,216113389
10 October 2024Fine$8,157113300

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

Care Compare provider information

FieldAs filed
Provider TypeMedicare and Medicaid
Ownership TypeFor profit - Limited Liability company
Legal Business NameREFUGIO II ENTERPRISES, LLC
Date First Approved to Provide Medicare and Medicaid Services2020-08-14
Provider Resides in HospitalN
Continuing Care Retirement CommunityN
UrbanN
County/ParishRefugio
Telephone Number3615269223
Chain NameCREATIVE SOLUTIONS IN HEALTHCARE
Chain ID169
Provider Changed Ownership in Last 12 MonthsN
With a Resident and Family CouncilResident
Automatic Sprinkler Systems in All Required AreasYes
Number of Certified Beds90
Average Number of Residents per Day41.4
Overall Rating2
Health Inspection Rating3
QM Rating3
Long-Stay QM Rating3
Short-Stay QM Rating3
Processing Date2026-08-01

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

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The citable document for Mission Ridge Rehab & Nursing Center

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