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The Heights of Alamo
Nursing Home, Memory Care, Respite Care & Skilled Nursing · Alamo, TX
CMS overall rating
5/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Nursing Home, Memory Care, Respite Care & Skilled Nursing · Alamo, TX
CMS overall rating
5/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
The Heights of Alamo accepts Medicaid, Medicare, and private pay.
Overview of The Heights of Alamo
Settled in the quiet neighborhood of Alamo, TX, The Heights of Alamo is an idyllic senior living community that offers short-term care, post-hospital recovery, skilled nursing, long-term care, rehabilitation therapy, and dementia support or respite care services. A wide array of large and cozy accommodations are available for its residents based on their preferences. With a highly trained and compassionate team, the community ensures individualized care and support for its residents that they deserve.
The community is committed to delivering exceptional amenities and services including tasty and healthy home-cooked meals, internet services, on-site beauty salon and barber services, Come and visit its beautiful outdoor garden, pergola, and covered patios. Engage in various social activities and community events that are essential in nourishing your physical, mental, social, and spiritual well-being. At The Heights of Alamo, seniors are guaranteed an empowering and secure stay.
Measured by Centers for Medicare & Medicaid Services (CMS)
Overall ratingThe Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Health InspectionBased on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
StaffingMeasures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Quality MeasuresBased on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Staffing hours
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
Hours per resident per day vs Texas averages
Rank#161 / 234Nurse hours — State benchmarkedThis home is ranked 161st out of 234 homes we track in Texas for nurse hours. Shows adjusted nurse hours per resident per day benchmarked to the Texas average, with a ranking across 234 Texas facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Texas that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Total nursing care
This home is ranked 161st out of 234 homes we track in Texas for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
3h 4m
15% below state avg
This facilityState avg 3h 38m
Staff type
Hours / day / resident
vs state avg
Registered Nurse (RN)RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
17m
−35% State avg: 27m per day · National avg: 42m per day
LPN / LVNLicensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
50m
−14% State avg: 58m per day · National avg: 52m per day
Nurse AideCertified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
1h 57m
−6% State avg: 2h 4m per day · National avg: 2h 24m per day
Weekend Total NursingCombined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
2h 36m
−15% State avg: 3h 3m per day · National avg: 3h 31m per day
Physical TherapistHours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
3m
−30% State avg: 4m per day · National avg: 4m per day
Weekend RNRegistered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
11m
−47% State avg: 21m per day · National avg: 29m per day
All 6 underlying metrics fall below the state average
By The Numbers
Community insights.
Bed count
A mid-sized community that may balance personal attention with shared amenities and social activities.130Rank#63 / 255Bed count — State benchmarkedThis home is ranked 63rd out of 255 homes we track in Texas for bed count. Shows this facility's certified or reported bed count compared to other Texas facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Texas that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Medium-capacity home
· Offers a balance of services and community atmosphere.
Years of operating
An established community with some operational experience and growing routines. This is the number of years in operation under current management.Rank#135 / 146Years in operation — State benchmarkedThis home is ranked 135th out of 146 homes we track in Texas for years in operation. Shows how long this facility has been in operation compared to other Texas facilities. Longer operating histories may benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Texas that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
8years
Walk Score
Car-dependent. Most errands require a car, with limited nearby walkable options.Rank#239 / 276Walk Score — State benchmarkedThis home is ranked 239th out of 276 homes we track in Texas for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Texas facilities. Higher scores benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Texas that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
19/ 100
Residents per day (avg) The average number of residents living at this facility on a given day. CMS calculates this figure from the facility's Minimum Data Set (MDS) assessments and uses this value for other measures like Hours Per Resident Per Day (HPRD) and 5-Star Staffing rating.
113
Avg. Length of Stay
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
49days
About this community
License Details
Facility TypeNursing
IssuanceJanuary 4, 2024
ExpirationJanuary 4, 2027
CountyHidalgo
License Number308218
Year Opened4/5/2018
QualificationNursing
Ownership & Operating Entity
The Heights of Alamo is administered by Federico Stutzner.
Management CompanyTOUCHSTONE STRATEGIES ALAMO LLC
OwnerUvalde County Hospital Authority
Ownership TypeHOSPITAL DISTRICT/AUTHORITY
Type Of Units
Medicare
10 units
Medicaid and Medicare
120 units
Total beds
130 units
Staffing
Key information about the people who lead and staff this community.
In Texas, the Health and Human Services Commission (HHSC) is the primary regulatory body that conducts unannounced inspections and publishes quality reports for all long-term care homes.
Since 2023 · 3 years of dataThese figures come from state-published data and the state inspection reports we hold on file. The period covered can vary depending on document availability. Includes all inspection records for this property, which could include management/ownership changes.12 citations
Inspection Scorecard
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Texas state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Since 2023 vs. Texas state average
Overall vs. TX average
1 Worse
Metrics worse than Texas average:
• Total citations (50% above)
0 Better
No metrics in this bucket.
Citations Citations are formal regulatory issues recorded during state inspections.
This Facility
TX Average
vs. TX Avg
Total citations Formal regulatory issues recorded by inspectors across all inspection types.
12
8
This facility has 50% more total citations than a typical Texas nursing home (12 vs. TX avg 8).↑ 50% worse
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines)
and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
Breakdown by payment type
Medicare
13% of new residents, usually for short-term rehab.
Typical stay1 months
Private pay
59% of new residents, often for short stays.
Typical stay23 days
Medicaid
28% of new residents, often for long-term daily care.
Typical stay3 - 4 months
Finances and operations
Based on CMS SNF Cost Report for fiscal year ending in 06/2024.
For-profit
Operated by a business corporation.
Net patient revenueNet patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$10.5M
Net patient incomeNet patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$793.6K
For-profit Operated by a business corporation.
Net patient revenueNet patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$10.5M Rank#56 / 218Net patient revenue — State benchmarkedThis home is ranked 56th out of 218 homes we track in Texas. Shows this facility's net patient revenue compared to the Texas average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Texas that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
Net patient incomeNet patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$793.6K
Other incomeMoney the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
$1.1M
Payroll costsStaff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.Rank#164 / 218Payroll costs — State benchmarkedThis home is ranked 164th out of 218 homes we track in Texas. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Texas average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Texas that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
$3.6M
34.4% of net patient revenue
Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.Rank#195 / 199Payroll % of net patient revenue — State benchmarkedThis home is ranked 195th out of 199 homes we track in Texas. Shows payroll as a percentage of net patient revenue versus the Texas average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Texas that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
Other operating costsEverything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
$6.1M
Total costsThe home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$9.7M
Certification details
License Number:676441
Owner Name:Uvalde County Hospital Authority
Rural vs. Urban:Urban
County:Hidalgo
Type of Control:For-profit — Operated by a business corporation.
Source: Centers for Medicare & Medicaid Services (CMS) and State data
How we calculate these figures
We use the home's most recent CMS SNF Cost Report — the annual financial statement every Medicare- and Medicaid-certified nursing home is required to file — to show how it earns and spends on resident care.
This includes
Net patient revenue — what the home collects for resident care after contractual allowances, bad debt and discounts.
Payroll — staff salaries plus wage-related benefits. Contract and agency labor is counted separately, under other operating costs.
Net patient income — what's left after the home's total operating expenses.
How we calculate net patient income and payroll %
Net patient income is net patient revenue minus the home's total operating expenses. Payroll % is payroll divided by net patient revenue — the share of each revenue dollar that goes to staff pay.
Net patient revenue vs. other income
Net patient revenue is money earned from resident care only. Anything the home earns outside of care — investments, grants, rentals and other non-operating sources — is reported separately as other income. Other income is not part of net patient revenue, and it is not included in net patient income.
What does this home offer?
No pets allowed
Housing Options: Private / Semi Private
Building Type: Single-story
Who this home usually serves
TYPE OF STAY
Mix of rehab and long-term care
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
Most new residents arrive under private pay (59% of admissions), and a typical private pay stay runs around 23 days.
Admissions
714 total
Coverage residents most often arrive under.
Medicare13%
Private pay59%
Medicaid28%
Discharges
714 total
Coverage residents most often leave under.
Medicare14%
Private pay58%
Medicaid28%
How we assess these insights
We analyze official CMS data on admissions and discharges to understand the types of residents a nursing home most often serves.
This includes
Medicare, Medicaid, and private-pay admissions and discharges
Number of nights covered by each payment type
Typical length of stay
How we calculate length of stay
We calculate length of stay separately for each payment type (Medicare, Medicaid and private) by dividing total number of nights by total number of admissions.
Places of interest near The Heights of Alamo
1.7 miles from city center Estimated distance in miles from Alamo's city center to The Heights of Alamo's address, calculated via Google Maps.
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Info below is compiled from CMS reports & the TX Health & Human Services Commission (HHSC), senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest-ranked to lowest-ranked based on our methodology.
The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
Care Types in This TableAL (Assisted Living):
Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing.
NH (Nursing Home):
24/7 skilled nursing care for residents with complex, ongoing medical needs.
SNF (Skilled Nursing Facility):
Round-the-clock nursing care, often for recovery after surgery, injury, or illness.
MC (Memory Care):
Secured, specialized care for people living with Alzheimer's or dementia.
RC (Respite Care):
Short-term temporary care that gives family caregivers a break.
IL (Independent Living):
Community living with dining, activities, and transportation for active seniors who need little personal care.
HOS (Hospice Care):
Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
CCRC (Continuing Care Retirement Community):
A campus with multiple care levels so residents can age in place without moving.
Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Texas average is: 71.6% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
CMS Certification Number: the unique federal identifier for this skilled nursing provider.
$7.8M*Fiscal year ending 12/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind.
$3.4M*Fiscal year ending 12/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind.
43.2%*Fiscal year ending 12/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind.
675606
Rank badges are statewide: each nursing home is ranked against every TX nursing home we track that reports that metric, not just the 4 on this page. See how we rank facilities