Map showing the location of Harker Heights Nursing & Rehabilitation in Harker Heights, Texas
415 Indian Oaks Dr, Harker Heights, TX, 76548

Overall Score

CMS Five-Star Quality Rating
2/5Below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • TexasAbove only 23% of peers1,167 rated homes · average 2.8★
  • Bell CountyAbove only 40% of peers16 rated homes · average 2.4★
  • United StatesAbove only 20% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point1★−1.8 vs TX avg
  • StaffingCan add or remove a star2★−0.1 vs TX avg
  • Quality measuresCan add or remove a star5★+1.2 vs TX avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersTX avg2.8★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover2★Above only 37% of peersTX avg2.1★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments5★Above 68% of peersTX avg3.8★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.56hrsAbove 75% of peersTX avg3.40Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.37hrsAbove only 47% of peersTX avg0.44Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better66%Above only 16% of peersTX avg51%RN turnover46%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$83,951Above only 21% of peersTX avg$55,368Fines · denials3 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
45citations
17inspection dates
0actual harm (G–I)
4immediate jeopardy (J–L)
Nov 18, 2025most recent

Citations by monthOct 2022 – Nov 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Nov 18, 20251 citationCycle 1worst D · no actual harm
  1. F559Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.Resident RightsD · isolatedCorrected Nov 20, 2025
Sep 16, 20251 citationCycle 1worst D · no actual harm
  1. F926Have policies on smoking.EnvironmentalD · isolatedCorrected Sep 17, 2025
Aug 11, 20251 citationCycle 1worst E · no actual harm
  1. F584Honor 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.Resident RightsE · patternCorrected Aug 12, 2025
Jul 3, 20252 citationsCycle 1worst E · no actual harm
  1. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryD · isolatedCorrected Jul 7, 2025
  2. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareE · patternCorrected Jul 7, 2025
Feb 14, 20251 citationCycle 1worst E · no actual harm$12,441
  1. F697Provide safe, appropriate pain management for a resident who requires such services.Quality of Life and CareE · patternCorrected Feb 17, 2025
Feb 7, 20259 citationsCycle 1worst J · immediate jeopardy$12,441
  1. F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryE · patternCorrected Feb 10, 2025
  2. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Feb 10, 2025
  3. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Feb 10, 2025
  4. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsE · patternCorrected Feb 10, 2025
  5. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected Feb 10, 2025
  6. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareJ · isolatedCorrected Feb 10, 2025
  7. F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy ServiceF · widespreadCorrected Feb 10, 2025
  8. F806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.Nutrition and DietaryD · isolatedCorrected Feb 10, 2025
  9. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryE · patternCorrected Feb 10, 2025
Feb 3, 20251 citationCycle 1worst D · no actual harm$12,441
  1. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Feb 5, 2025
Dec 5, 20243 citationsCycle 2worst K · immediate jeopardy$52,319
  1. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareJ · isolatedCorrected Dec 6, 2024
  2. F680Ensure the activities program is directed by a qualified professional.Quality of Life and CareE · patternCorrected Dec 6, 2024
  3. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceK · patternCorrected Dec 6, 2024
Oct 29, 20243 citationsCycle 2worst D · no actual harm
  1. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Oct 31, 2024
  2. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Oct 31, 2024
  3. F584Honor 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.Resident RightsD · isolatedCorrected Oct 31, 2024
Dec 29, 202310 citationsCycle 2worst E · no actual harm
  1. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareE · patternCorrected Jan 31, 2024
  2. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsD · isolatedCorrected Jan 31, 2024
  3. F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedResident Assessment and Care PlanningD · isolatedCorrected Jan 31, 2024
  4. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Jan 31, 2024
  5. F695Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and CareE · patternCorrected Jan 31, 2024
  6. F758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.Pharmacy ServiceD · isolatedCorrected Jan 31, 2024
  7. F761Ensure 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.Pharmacy ServiceE · patternCorrected Jan 31, 2024
  8. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryE · patternCorrected Jan 31, 2024
  9. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Jan 31, 2024
  10. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningE · patternCorrected Jan 31, 2024
Dec 13, 20233 citationsCycle 3worst F · no actual harm
  1. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Dec 14, 2023
  2. F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy ServiceD · isolatedCorrected Dec 14, 2023
  3. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Dec 13, 2023
Oct 26, 20231 citationCycle 3worst D · no actual harm
  1. F558Reasonably accommodate the needs and preferences of each resident.Resident RightsD · isolatedCorrected Nov 24, 2023
Sep 22, 20231 citationCycle 3worst E · no actual harm
  1. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Oct 19, 2023
Sep 1, 20231 citationCycle 3worst D · no actual harm
  1. F561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.Resident RightsD · isolatedCorrected Sep 27, 2023
May 10, 20231 citationCycle 3worst J · immediate jeopardy
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareJ · isolatedCorrected May 11, 2023
Apr 10, 20231 citationCycle 3worst D · no actual harm$19,191
  1. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected May 4, 2023
Oct 13, 20225 citationsCycle 3worst E · no actual harm
  1. F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.Resident RightsD · isolatedCorrected Nov 14, 2022
  2. F561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.Resident RightsE · patternCorrected Nov 14, 2022
  3. F583Keep residents' personal and medical records private and confidential.Resident RightsD · isolatedCorrected Nov 14, 2022
  4. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareE · patternCorrected Nov 14, 2022
  5. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryE · patternCorrected Nov 14, 2022

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.56hrsAbove 75% of peers+0.16 vs TX avg
  • Registered nursesRN hours only0.37hrsAbove only 47% of peers−0.07 vs TX avg
  • Licensed practical nursesLPN hours0.77hrs
  • Nurse aidesCNA hours2.41hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.22hrs
  • Texas average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better66%Above only 16% of peersTX avg 51%
  • RN turnoverRegistered nurses only46%Not ranked by CMS
  • Administrators who leftIn the past year1Leadership changed
  • Occupancy199 certified beds · ~126 residents a day63%Above only 41% of peersTX avg 67%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $83,951In fines
  • 3Fines
  • 0Payment denials
  • $55,368TX avg in fines
Above only 21% of peersFewer fines than 21% of rated homes in Texas

Actions on record

  1. Feb 7, 2025Civil money penalty$12,441
  2. Dec 5, 2024Civil money penalty$52,319
  3. Apr 10, 2023Civil money penalty$19,191

Ownership

As filed with CMS

Structure

Ownership type
For profit - Corporation
Chain
Touchstone Communities29 facilities in the chain2.8★ chain average
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Uvalde County Hospital Authority
Operational or managerial control
  • Touchstone Strategies - Harker Heights LLC
  • Christopher Boening
  • Leslie Campbell
  • Lynnea Castillo
  • Leonardo Garcia
  • Tosha Hamilton
  • Bryon Sehlke
  • Darrell Zurovec
Corporate officers
  • Adam Apolinar
5% Or Greater Security Interest
  • International Bank of Commerce
Mortgage or security interest (5%+)
  • Keybank National Association

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 675909 · 415 Indian Oaks Dr, Harker Heights, TX, 76548.
  • Percentiles compare this facility with every rated nursing home in Texas and Bell County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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