Bexar County, Texas · Nursing home
The Mission at Blue Skies of Texas East
5 of 5 overall from CMS
4949 Ravenswood Drive, San Antonio, TX 78227
At a glance
- Overall rating 5 of 5 Above the state average of 2.7
- Nurse time per resident, per day 4.87 hours Above the state average of 3.39
- Nursing staff who left in a year 57.6% Above the state average of 55.3%
- Health citations, last 3 inspection cycles 25 2 at the harm level or above
- Fines in 3 years $17,345 1 fine
- Certified beds in use 69.4% of 80 beds, on an average day
Arrows only show whether a figure is above or below the state average. They are not a judgment of the home.
The Mission at Blue Skies of Texas East is a 80-bed nursing home in San Antonio, Texas (Bexar County). CMS rates it 5 of 5 stars overall as of Sep 2026. It reports 4.87 nurse staffing hours per resident per day, above the Texas average of 3.39. CMS lists 1 fine totaling $17,345 in the past three years.
- Certified beds
- 80
- Residents per day (average)
- 55.5
- Certified since
- 2005 (21 yrs)
Non profit - Corporation Participates in MedicareContinuing care retirement community
Bed use is this site's calculation: average residents per day divided by certified beds. It is an average, so it does not show today's openings.
Terms used on this page
- CMS
- The Centers for Medicare & Medicaid Services, the federal agency that publishes the ratings, staffing figures, inspection results and penalties shown here.
- Certified beds
- The number of federally certified beds CMS lists for the home.
- Deficiency or citation
- A federal requirement that inspectors found the home did not meet. Each one gets a letter from A to L for how serious it was and how many residents were affected. What the letters mean
- Actual harm
- Letters G, H and I: actual harm to a resident that is not immediate jeopardy.
- Immediate jeopardy
- Letters J, K and L: the problem caused, or was likely to cause, serious injury, harm, impairment or death to a resident.
- Inspection cycle
- A standard inspection plus the complaint and infection-control citations CMS assigns to it. This page shows the three most recent cycles.
- Special Focus Facility (SFF)
- A home CMS has placed under closer oversight because of its inspection record. More about the program
Questions to ask The Mission at Blue Skies of Texas East
Chosen from this home's public data.
- CMS lists 1 fine totaling $17,345 in the past three years. What changed after the most recent one?Penalties in CMS data
- Nursing staff turnover is 57.6%, above the Texas average of 55.3%. How often would the same aides care for my relative?Turnover in CMS data
- Reported nurse staffing is 3.97 hours per resident on weekends against 4.87 overall. Who covers Saturdays and Sundays?Weekend staffing in CMS data
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 5 of 5 Texas average 2.7
- Health inspections 4 of 5 Texas average 2.8
- Staffing 4 of 5 Texas average 1.9
- Quality measures 5 of 5 Texas average 3.7
The vertical line marks the Texas average. Ratings run from 1 to 5. How to read CMS star ratings
Nurse staffing
Hours of care per resident per day, as the home reported to CMS.
What these roles do
Nurse aides give most hands-on daily care, such as help with bathing, dressing and meals. Licensed practical nurses give medications and routine nursing care. Registered nurses assess residents and direct their care.
- All nursing staff 4.87 h Texas average 3.39
- Nurse aides 2.72 h Texas average 2.01
- Licensed practical nurses 1.35 h Texas average 0.95
- Registered nurses 0.80 h Texas average 0.43
- All staff, weekends 3.97 h Texas average 2.98
How much nurse staffing is enough? All bars share one scale, 0 to 11 hours. The vertical line marks the Texas average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnover57.6%
- Texas average55.3%
- Registered nurse turnover50.0%
- Texas average54.6%
- Administrators who left1
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the Texas and national averages. marks the measures CMS uses in its quality star rating; for those, the rating gives more points for a lower rate.
Long-stay residents
| Measure | This home | Texas | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 8.8% | 15.8% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 5.8% | 3.0% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.6% | 0.3% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 0.7% | 0.8% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 2.2% | 2.4% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 0.0% | 0.0% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 1.3% | 3.3% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% | 96.6% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 11.8% | 14.0% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 24.0% | 18.0% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% | 98.0% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 5.4% | 3.8% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 10.8% | 13.4% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | Too few residents or stays to report | 9.6% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | 1.91 | 2.17 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | 0.65 | 2.06 | 1.78 |
Short-stay residents
| Measure | This home | Texas | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% | 88.9% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | 2.4% | 1.5% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 97.5% | 88.0% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | 26.8% | 25.7% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | 7.6% | 12.3% | 12.0% |
Measure periods: April 2025 to March 2026 for most measures; July 2024 to June 2025 for the flu vaccine measures; January to December 2025 for the hospital and emergency department measures, which CMS risk-adjusts. See the measures on Medicare.gov
Inspection history
Inspectors cited 25 health deficiencies in the three most recent inspection cycles. Of these, 1 was at the immediate jeopardy level and 1 involved actual harm; the rest were graded as no actual harm. 8 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on Jan 3, 2025: Provide appropriate treatment and care according to orders, resident’s preferences and goals.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Jul 11, 2025 | 5 | 3 |
| May 10, 2024 | 16 | 0 |
| Apr 7, 2023 | 4 | 1 |
Texas homes averaged 9.4 health deficiencies in the latest cycle; the national average is 9.2. Each cycle's health count covers the standard inspection on that date plus the complaint and infection-control citations CMS assigns to that cycle.
Health citations, three most recent inspection cycles (25)
-
DPotential for more than minimal harm, isolated
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Sep 1, 2025)
-
DPotential for more than minimal harm, isolated
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Sep 5, 2025)
-
DPotential for more than minimal harm, isolated
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights · Deficient, Provider has date of correction (Jul 12, 2025)
-
DPotential for more than minimal harm, isolated
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Quality of Life and Care · Deficient, Provider has date of correction (Jul 12, 2025)
-
DPotential for more than minimal harm, isolated
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service · Deficient, Provider has date of correction (Jul 15, 2025)
Show 20 more
-
DPotential for more than minimal harm, isolated
Ensure that residents are free from significant medication errors.
Pharmacy Service · Deficient, Provider has date of correction (Jul 12, 2025)
-
DPotential for more than minimal harm, isolated
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Jul 12, 2025)
-
EPotential for more than minimal harm, pattern
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Mar 20, 2025)
-
EPotential for more than minimal harm, pattern
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Apr 1, 2025)
-
DPotential for more than minimal harm, isolated
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Apr 10, 2025)
-
KImmediate jeopardy, pattern
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Complaint investigation · Quality of Life and Care · Past Non-Compliance (Oct 18, 2024)
-
DPotential for more than minimal harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Past Non-Compliance (Oct 18, 2024)
-
EPotential for more than minimal harm, pattern
Develop 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 Planning · Deficient, Provider has date of correction (May 16, 2024)
-
EPotential for more than minimal harm, pattern
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Quality of Life and Care · Deficient, Provider has date of correction (May 15, 2024)
-
EPotential for more than minimal harm, pattern
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (May 15, 2024)
-
DPotential for more than minimal harm, isolated
Honor 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.
Resident Rights · Deficient, Provider has date of correction (May 15, 2024)
-
DPotential for more than minimal harm, isolated
Keep residents' personal and medical records private and confidential.
Resident Rights · Deficient, Provider has date of correction (May 15, 2024)
-
DPotential for more than minimal harm, isolated
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (May 15, 2024)
-
DPotential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care · Deficient, Provider has date of correction (May 15, 2024)
-
DPotential for more than minimal harm, isolated
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.
Pharmacy Service · Deficient, Provider has date of correction (May 15, 2024)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (May 15, 2024)
-
GActual harm, isolated
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Apr 1, 2024)
-
EPotential for more than minimal harm, pattern
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service · Deficient, Provider has date of correction (May 8, 2023)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights · Deficient, Provider has date of correction (May 8, 2023)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (May 8, 2023)
What severity letters A to L mean
Each sentence above is the requirement that was not met, in CMS's wording. For the inspection results as Medicare publishes them, open this home's page on Medicare.gov and look under "Health inspections".
Penalties, past three years
| Date | Type | Amount |
|---|---|---|
| Jan 3, 2025 | Fine | $17,345 |
Texas homes averaged 1.5 fines and $44,141 in fine amounts; the national averages are 0.9 and $30,972.
Cost
Not in the public data. CMS does not publish what a nursing home charges.
Ask the home for its daily private-pay rate and whether a bed is open for your coverage. See what Medicare covers and how Medicaid pays for a nursing home.
Compared within Texas
Common questions
What is the CMS star rating for The Mission at Blue Skies of Texas East?
The Mission at Blue Skies of Texas East has an overall rating of 5 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 4, staffing is 4 and quality measures is 5.
How many beds does The Mission at Blue Skies of Texas East have?
The Mission at Blue Skies of Texas East has 80 certified beds. It averages 55.5 residents per day, about 69.4% of its certified beds.
How much nursing care do residents get at The Mission at Blue Skies of Texas East?
The home reports 4.87 hours of nurse staffing per resident per day, including 0.80 hours from registered nurses. The Texas average is 3.39 hours and 0.43 hours from registered nurses.
Has The Mission at Blue Skies of Texas East been fined?
Yes. CMS lists 1 fine totaling $17,345 in the past three years.
Does The Mission at Blue Skies of Texas East accept Medicare or Medicaid?
CMS lists its participation as "Medicare". Ask the home whether a bed is open for your coverage.
Guides for families looking at this home
- Understanding the recordWhat to ask on a nursing home tourQuestions that turn a home's public record into a useful conversation when you tour, plus what to look for yourself.
- Understanding the recordInspection severity letters A to LHow inspectors grade each deficiency by harm and by how many residents were affected.
- Understanding the recordHow to read CMS star ratingsWhat the overall, health inspection, staffing and quality measure ratings cover, and what they leave out.
Nearest nursing homes
- 3 of 5 Legend Oaks Healthcare and Rehabilitation - West S 124beds 87.7%in use 3.64nurse hours a day
- 2 of 5 Harbor Valley Health and Rehabilitation 120beds 68.1%in use 3.58nurse hours a day
- 5 of 5 Lakeside Nursing and Rehabilitation Center 118beds 95.2%in use 3.33nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Bexar County
Who to call in Texas
These offices serve residents of every nursing home in Texas.
- Long-term care ombudsman Office of the State Long-Term Care Ombudsman 1-800-252-2412 An advocate for residents and their families.
- File a complaint about a nursing home Complaint and Incident Intake 1-800-458-9858 (Monday to Friday, 7 a.m. to 7 p.m. Central) The state agency that inspects nursing homes.
Texas staffing, bed-hold and Medicaid rules · Residents' rights in every state
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 676041. See this home's official record on Medicare.gov
See something shown incorrectly? Tell us. This site shows each record as CMS publishes it and cannot change the underlying record.