Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
based on 114 Google reviews

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These current public-data fields deserve follow-up with the facility and the official Medicare record. They are not a clinical risk score or a substitute for an in-person assessment.
This facility has areas of concern that warrant careful consideration. Registered Nurse hours are 33% of the EveryPlace reference benchmark; ask how RN coverage is allocated across shifts. The latest standard survey recorded 16 findings, above the TX average of 9.1. We recommend asking the administrator directly: "How are you addressing recent staffing shortfalls?" These are not reasons to panic, but they are reasons to ask tough questions and visit in person.
Families considering The Rio at Mission Trails will find a facility with highly praised respiratory/ventilator care and a dedicated therapy team. However, there are significant and recurring reports of serious neglect, including issues with hygiene, medication management, and dangerous understaffing levels.
Quality Themes
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Concerns
Rating Trends
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Distribution · 117 analyzed
The owner uses highly repetitive, templated responses that follow a nearly identical script for almost every negative review. While they acknowledge the reviewer by name, they fail to address any of the specific, serious allegations (such as medical neglect or staffing issues) mentioned in the reviews.
Personalized based on this facility's data
Key Review Excerpts
“They have an amazing activities director who often puts together themed events to create a fun and inviting home for the residents.”
Both RN and total nursing hours are below the EveryPlace reference benchmarks. Ask the facility how it staffs each shift for current resident needs.
Reference benchmarks (0.75 RN and 4.1 total nursing hours per resident/day) are comparison targets, not current federal minimum requirements.
Resident outcomes compared with national, state, and local averages · 17 measures
15
measures
2
measures
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents on antipsychotic medication
Residents whose walking got worse
Residents whose bladder or bowel control got worse
Residents needing more daily help over time
Residents vaccinated for pneumonia
Short-stay residents vaccinated for the flu
Short-stay residents vaccinated for pneumonia
Short-stay residents newly given antipsychotics
US average from Medicare published data
Detailed Medicare record · up to 3-year lookback
This facility shows concerning patterns with families filing complaints that triggered 9 deficiencies, particularly around abuse prevention, resident dignity, and daily care assistance. The most recurring issues involve resident assessment and care planning, abuse and neglect protections, and fire safety systems. While the facility has corrected most deficiencies, the repeated problems with protecting residents from harm and ensuring proper assessments suggest ongoing quality challenges that warrant careful consideration during any visit.
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.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
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.
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
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.
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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.
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.
Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Federal Penalties
Fine
Feb 24, 2025
$96,694
Fine
Jun 20, 2024
$57,131
West Wharton County Hospital District
for profit
SAN ANTONIO II ENTERPRISES, LLC
ALEJANDRO GARCIA
Creative Solutions in Healthcare
149 facilities nationwide
Chain avg rating: 2.7/5 · Rank 51 of 148
Key personnel
Contact this facility directly and verify the details that matter most to your family.
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
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Google Reviews
114 reviews from families & visitors
Official Website
Visit rioatmissiontrails.com
Medicare data downloads
Original nursing home datasets
EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Some summaries, interpretations, suggested questions, and pricing research are AI-generated or AI-assisted and may contain errors or omit important context. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.
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