CCN 675968 · Bexar County, Texas
Stone Oak Care Center
505 Madison Oak Drive, San Antonio, TX 78258
Stone Oak Care Center is a 152-bed for-profit nursing home in San Antonio, Texas, first certified for Medicare or Medicaid in 2003. CMS rates it 2 out of 5 stars overall in its September 2026 data, and it averaged 125.3 residents a day, about 82% of its certified beds. It has an active FHA-insured Section 232 loan: $13 million originally, at 3.88%, with $9.5 million outstanding as of September 30, 2026 and maturity in December 2046.
Facility facts
- Certified beds
- 152
- Average residents per day
- 125.3 (82.4% of beds)
- Ownership type
- For profit - Limited Liability company
- Certification
- Medicare and Medicaid
- Legal business name
- Bexar County Hospital District
- Certified since
- May 13, 2003
- Chain or affiliated group
- Touchstone Communities (25 facilities, chain average 2.9 stars)
- Location
- Urban
Ratings and staffing
Star ratings run from 1 to 5. Staffing is nurse hours per resident per day from CMS Payroll Based Journal data; turnover is the CMS annual nursing staff turnover rate. Occupancy is CMS's average daily census divided by certified beds.
| Measure | This facility | Texas median | US median |
|---|---|---|---|
| Overall rating | 2 of 5 | State spread: 322 at 1, 244 at 2, 247 at 3, 211 at 4, 141 at 5 | |
| Health inspections | 3 of 5 | ||
| Quality measures | 4 of 5 | ||
| Staffing | 1 of 5 | ||
| Total nurse hours per resident per day | 2.88 | 3.27 | 3.68 |
| RN hours per resident per day | 0.23 | 0.38 | 0.58 |
| Weekend nurse hours per resident per day | 2.48 | ||
| Nursing staff turnover | 59.8% | 52.1% | 44.9% |
| Occupancy (residents / beds) | 82.4% | 68.6% | 85.7% |
| Fines reported by CMS | 1 totaling $9,087 | ||
| Health deficiencies, latest standard survey | 18 (Jul 25, 2025) | ||
HUD 223(f) Express Lane: the CMS part
HUD gives 223(f) applications queue priority when the facility has CMS overall and health inspection ratings of at least 2 stars and no abuse icon, among other tests (ORCF criteria of March 31, 2026). Stone Oak Care Center meets that part today: 2 stars overall, 3 on health inspections, no abuse icon. The loan-to-value, coverage and operator tests depend on the deal. All the criteria.
Who owns and operates it
These are the owners and operators the facility reported to CMS: anyone with a 5% or greater direct or indirect stake, and any organization with operational or managerial control.
| Name | Role | Share | Since |
|---|---|---|---|
| Bexar County Hospital DistrictOrganization | Direct Ownership Interest | 100% | 03/01/2016 |
| International Bank of CommerceOrganization | Security Interest | n/a | 04/16/2018 |
| Touchstone Strategies Stone Oak LLCOrganization | Operational / Managerial Control | n/a | 03/01/2016 |
| Basaldua, RolandoIndividual | Operational / Managerial Control | n/a | 11/24/2025 |
| Campbell, LeslieIndividual | Operational / Managerial Control | n/a | 04/01/2020 |
| Castaneda, MonicaIndividual | Operational / Managerial Control | n/a | 06/06/2023 |
| Castillo, LynneaIndividual | Operational / Managerial Control | n/a | 03/01/2016 |
| Clayton, JonathonIndividual | Operational / Managerial Control | n/a | 05/01/2023 |
| Sehlke, BryonIndividual | Operational / Managerial Control | n/a | 03/01/2016 |
| Zurovec, DarrellIndividual | Operational / Managerial Control | n/a | 08/01/2017 |
Changes of ownership
| Effective | Buyer | Seller |
|---|---|---|
| Mar 1, 2016 | Bexar County Hospital District | Madison Oak Management, Inc. |
HUD Section 232 loans
HUD's Office of Healthcare Programs lists these FHA-insured loans for a project we matched to this facility by name, city and bed count. Status, rate and balance come from HUD's insured-mortgage files as of September 30, 2026. Check the FHA number against the loan documents before relying on the match.
| Endorsed | Program | Original amount | Status | FHA number |
|---|---|---|---|---|
| Nov 29, 2011 | 223(f) refinance or purchaseHUD project name: Stone Oak Care Center, 152 beds. Lender at endorsement: Berkadia Commercial Mortgage LLC | $12,958,800 | Active: 3.88%, $9,490,836 balanceMatures Dec 1, 2046. Servicer: Berkadia Commercial Mortgage | 11522254 |
| Mar 19, 2002 | 232 new construction or substantial rehabHUD project name: Stone Oak Care Center, 150 beds. Lender at endorsement: Hunt Mortgage Capital, LLC | $7,300,000 | Ended Apr 22, 2008Prepayment | 11543045 |
Sources and dates
Facility, rating, staffing and ownership data: CMS Provider Information and CMS Ownership, processing date September 2026. Private equity, REIT and mortgage-interest flags and changes of ownership: CMS Skilled Nursing Facility All Owners and Change of Ownership files (2026-10-01). FHA-insured loans: HUD Office of Healthcare Programs endorsement database, data run July 8, 2026. How we join them, and what the join can get wrong: methodology.
SNF Register is independent. It is not affiliated with or endorsed by CMS, HUD or FHA. Spotted an error? Write to hello@hudskillednursing.loan.