Skilled nursing facility · CMS certification number 676312
Legend Oaks Healthcare and Rehabilitation - West S
San Antonio, Texas · Medicare and Medicaid · 124 certified beds in Care Compare
In Care Compare’s provider information: Penalties: 1 · Fines: 1 · Fines, total amount: $8,632.00 · Payment denials: 0. The most recent penalty on file: April 12, 2024, Fine, $8,632. Every penalty on file ↓
Legend Oaks Healthcare and Rehabilitation - West S: its citable report, full history — $295 · an email when it changes — $99/month
What stands out
- Its latest cost report on file is for fiscal year 2024, covering October 1, 2023 to September 30, 2024 (365 days), and CMS processed it on January 13, 2025.
- Net patient revenue rose from $13.5M in fiscal year 2023 to $14.1M in fiscal year 2024.
- Its result from service to patients: $968K (2022), $1.0M (2023), $1.1M (2024).
- Its cost reports on file run from fiscal year 2012 to fiscal year 2024.
- Since its cost report for fiscal year 2024 was filed on January 13, 2025, 16 changes are listed on this record: 4 owner changes and 12 owner changes.
- Its net patient revenue of $14.1M ranks 32nd of the 681 nursing facilities in Texas whose latest cost report on file is fiscal year 2024.
- 1 of the 5 nursing facilities in Texas closest in size to it, whose latest cost report on file is fiscal year 2024, also reports a gain on service to patients.
Legend Oaks Healthcare and Rehabilitation - West S: Medicare cost reports
| Form CMS-2540-10 | 2024 · report 1402191 | 2023 · report 1375241 | 2022 · report 1344579 | 2021 · report 1313920 | 2020 · report 1283904 | 2019 · report 1252390 | 2018 · report 1255993 | 2017 · report 1279306 | 2016 · report 1246483 | 2015 · report 1143035 | 2014 · report 1149283 | 2013 · report 1073753 | 2012 · report 1047219 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Period began | October 1, 2023 | October 1, 2022 | October 1, 2021 | October 1, 2020 | October 1, 2019 | October 1, 2018 | October 1, 2017 | April 1, 2017 | May 1, 2016 | January 1, 2015 | January 1, 2014 | January 1, 2013 | May 31, 2012 |
| Period ended | September 30, 2024 | September 30, 2023 | September 30, 2022 | September 30, 2021 | September 30, 2020 | September 30, 2019 | September 30, 2018 | September 30, 2017 | December 31, 2016 | December 31, 2015 | December 31, 2014 | December 31, 2013 | December 31, 2012 |
| Days, where not a full year | — | — | — | — | — | — | — | 182 | 244 | — | — | — | 214 |
| Report status | settled | settled | settled | settled | settled | settled | settled | reopened | settled | settled | settled | settled | settled |
| Processed by CMS | January 13, 2025 | March 19, 2024 | March 17, 2023 | April 21, 2022 | May 13, 2021 | March 12, 2020 | May 21, 2020 | January 29, 2021 | November 26, 2019 | September 30, 2016 | December 16, 2016 | July 28, 2014 | August 22, 2013 |
| Total patient revenue | $15,097,253 | $14,660,285 | $12,391,667 | $10,245,999 | $10,918,038 | $11,849,486 | $11,335,200 | $5,091,748 | $7,262,834 | $13,469,735 | $13,529,579 | $11,891,985 | $4,327,827 |
| Contractual allowances and discounts | $1,046,827 | $1,178,066 | $632,535 | $103,174 | $686,637 | $1,688,933 | $1,411,418 | $794,255 | $1,565,733 | $4,101,972 | $4,396,910 | $4,000,273 | $1,598,832 |
| Net patient revenue | $14,050,426 | $13,482,219 | $11,759,132 | $10,142,825 | $10,231,401 | $10,160,553 | $9,923,782 | $4,297,493 | $5,697,101 | $9,367,763 | $9,132,669 | $7,891,712 | $2,728,995 |
| Total operating expenses | $12,953,678 | $12,453,884 | $10,791,235 | $9,272,987 | $9,486,556 | $9,613,252 | $10,048,597 | $4,429,468 | $5,831,013 | $8,470,261 | $8,430,367 | $7,493,808 | $3,383,055 |
| Net income from service to patients | $1,096,748 | $1,028,335 | $967,897 | $869,838 | $744,845 | $547,301 | −$124,815 | −$131,975 | −$133,912 | $897,502 | $702,302 | $397,904 | −$654,060 |
| Total other income | $3,388 | $4,179 | $1,946 | $1,979 | $7,073 | $1,524 | $2,921 | $202 | $7,542 | $6,468 | −$14,979 | $4,221 | $310 |
| Net income after other income | $1,100,136 | $1,032,514 | $969,843 | $871,817 | $751,918 | $548,825 | −$121,894 | −$131,773 | −$126,370 | $903,970 | $687,323 | $402,125 | −$653,750 |
| Net income | $1,100,136 | $1,032,514 | $969,843 | $871,817 | $751,918 | $548,825 | −$121,894 | −$131,773 | −$126,370 | $892,116 | $687,322 | $391,475 | −$660,206 |
| Total facility beds, all components | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 | 124 |
| Bed days available, all components | 45,384 | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicare (Title XVIII) patient days | 2,638 | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicaid (Title XIX) patient days | 20,161 | — | — | — | — | — | — | — | — | — | — | — | — |
| Other-payer patient days | 16,067 | — | — | — | — | — | — | — | — | — | — | — | — |
| Total patient days, all components | 38,866 | 38,512 | 32,429 | 30,129 | 36,066 | 38,307 | 37,907 | 17,246 | 24,475 | 38,288 | 36,688 | 31,038 | 9,928 |
| Medicare discharges | 72 | — | — | — | — | — | — | — | — | — | — | — | — |
| Medicaid discharges | 22 | — | — | — | — | — | — | — | — | — | — | — | — |
| Other-payer discharges | 664 | — | — | — | — | — | — | — | — | — | — | — | — |
| Total discharges, all components | 758 | 840 | 587 | 385 | 498 | 620 | 656 | 300 | 389 | 457 | 411 | 490 | 198 |
| Average length of stay, Medicare, in days | 36.64 | 30.48 | 37.87 | 68.68 | 40.94 | 25.05 | 27.81 | 26.09 | 28.72 | 32.83 | 29.86 | 37.74 | 41.65 |
| Average length of stay, Medicaid, in days | 916.41 | 912.62 | 1,371.54 | 646.96 | 484.6 | 457.76 | 569.58 | 492.36 | 305.71 | 266.14 | 817.27 | 226.75 | 113.31 |
| Average length of stay, all patients, in days | 51.27 | 45.85 | 55.25 | 78.26 | 72.42 | 61.79 | 57.79 | 57.49 | 62.92 | 83.78 | 89.27 | 63.34 | 50.14 |
Net income, fiscal years 2024, 2023, 2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015, 2014, 2013, 2012. Checked against the form’s own arithmetic: what that check shows.
Legend Oaks Healthcare and Rehabilitation - West S: nurse staffing hours by quarter →
Who owns Legend Oaks Healthcare and Rehabilitation - West S, as filed with CMS
Care Compare
- 5% OR GREATER INDIRECT OWNERSHIP INTEREST: DEWITT MEDICAL DISTRICT (organization), 100%%, since 04/01/2017
- ADP OF THE SNF: BERTETTI HEALTHCARE, INC. (organization), NOT APPLICABLE, since 10/24/2025; ENSIGN SERVICES INC (organization), NOT APPLICABLE, since 05/01/2016; GRAY, ROBERT (individual), NOT APPLICABLE, since 12/15/2017; MANSOOR, SAAD (individual), NOT APPLICABLE, since 09/12/2023; NATIONAL HEALTH INVESTORS, INC. (organization), NOT APPLICABLE, since 04/01/2017; TEXAS NHI INVESTORS, LLC (organization), NOT APPLICABLE, since 04/01/2017
- CORPORATE OFFICER: ALEXANDER, ALMA (individual), NOT APPLICABLE, since 05/27/2020; BURNAM, SOON (individual), NOT APPLICABLE, since 04/01/2017; KEETCH, CHAD (individual), NOT APPLICABLE, since 03/01/2011
- MANAGING CONTROL - GOVERNING BODY: GRAY, ROBERT (individual), NOT APPLICABLE, since 12/15/2017; MANSOOR, SAAD (individual), NOT APPLICABLE, since 09/12/2023
- OPERATIONAL/MANAGERIAL CONTROL: BERTETTI HEALTHCARE, INC. (organization), NOT APPLICABLE, since 04/01/2017; GRAY, ROBERT (individual), NOT APPLICABLE, since 12/15/2017; MANSOOR, SAAD (individual), NOT APPLICABLE, since 09/12/2023
Medicare enrollment
As filed in the CMS file dated October 1, 2026 (Medicare enrollment ownership), under the enrollment of DEWITT MEDICAL DISTRICT (enrollment ID O20170601001745).
- 5% OR GREATER INDIRECT OWNERSHIP INTEREST: DEWITT MEDICAL DISTRICT (organization), 100.00%, since 04/01/2017
- ADP OF THE SNF: BERTETTI HEALTHCARE, INC. (organization), since 10/24/2025; ENSIGN SERVICES INC (organization), since 05/01/2016; NATIONAL HEALTH INVESTORS, INC. (organization), since 04/01/2017; ROBERT GRAY (individual), since 12/15/2017; SAAD MD MANSOOR (individual), since 09/12/2023; TEXAS NHI INVESTORS, LLC (organization), since 04/01/2017
- CORPORATE OFFICER: ALMA ALEXANDER (individual), since 05/27/2020; CHAD KEETCH (individual), since 03/01/2011; SOON BURNAM (individual), since 04/01/2017
- MANAGING CONTROL - GOVERNING BODY: ROBERT GRAY (individual), since 12/15/2017; SAAD MD MANSOOR (individual), since 09/12/2023
- OPERATIONAL/MANAGERIAL CONTROL: BERTETTI HEALTHCARE, INC. (organization), 100.00%, since 04/01/2017; ROBERT GRAY (individual), 0.00%, since 12/15/2017; SAAD MD MANSOOR (individual), since 09/12/2023
Paused by CMS: Form CMS-855A, December 11, 2025.
Private equity company, real estate investment trust and holding company: No: DEWITT MEDICAL DISTRICT; BERTETTI HEALTHCARE, INC.; ENSIGN SERVICES INC; NATIONAL HEALTH INVESTORS, INC.; TEXAS NHI INVESTORS, LLC; BERTETTI HEALTHCARE, INC..
Private equity company, real estate investment trust and holding company: Paused by CMS: ROBERT GRAY; SAAD MD MANSOOR; ALMA ALEXANDER; CHAD KEETCH; SOON BURNAM; ROBERT GRAY; SAAD MD MANSOOR; ROBERT GRAY; SAAD MD MANSOOR.
Changes in ownership
- December 1, 2025, enrollment ownership file; no longer listed: SOON BURNAM (OPERATIONAL/MANAGERIAL CONTROL); TROY HENDRIKSEN (OPERATIONAL/MANAGERIAL CONTROL); ROBERT GRAY (W-2 MANAGING EMPLOYEE); ALMA ALEXANDER (CORPORATE DIRECTOR); first listed: SOON BURNAM (CORPORATE OFFICER), associated since April 1, 2017; CHAD A KEETCH (CORPORATE OFFICER), associated since March 1, 2011; ROBERT GRAY (ADP OF THE SNF), associated since December 15, 2017; ROBERT GRAY (MANAGING CONTROL - GOVERNING BODY), associated since December 15, 2017; SAAD MD MANSOOR (ADP OF THE SNF), associated since September 12, 2023; SAAD MD MANSOOR (MANAGING CONTROL - GOVERNING BODY), associated since September 12, 2023; SAAD MD MANSOOR (OPERATIONAL/MANAGERIAL CONTROL), associated since September 12, 2023; ALMA ALEXANDER (CORPORATE OFFICER), associated since May 27, 2020; ENSIGN SERVICES INC (ADP OF THE SNF), associated since May 1, 2016; TEXAS NHI INVESTORS, LLC (ADP OF THE SNF), associated since April 1, 2017; BERTETTI HEALTHCARE, INC. (ADP OF THE SNF), associated since October 24, 2025; NATIONAL HEALTH INVESTORS, INC. (ADP OF THE SNF), associated since April 1, 2017. Skilled_Nursing_Facility_All_Owners_:_2025-12-01.csv
Inspections of Legend Oaks Healthcare and Rehabilitation - West S
- Cycle 1: health January 29, 2026 (11 deficiencies), fire safety January 29, 2026 (2)
- Cycle 2: health October 31, 2024 (2 deficiencies), fire safety October 31, 2024 (1)
- Cycle 3: health September 15, 2023 (7 deficiencies), fire safety September 15, 2023 (0)
Deficiencies cited at Legend Oaks Healthcare and Rehabilitation - West S
20 deficiencies on file, by tag, newest citation first
every one from a health inspection; every one marked “Deficient, Provider has date of correction”; 7 cited from a complaint, marked below. Letter after a date: scope and severity grade.
- F 0550, resident rights: June 12, 2026 (E, from a complaint, corrected July 3, 2026).
- F 0609, freedom from abuse, neglect, and exploitation: June 12, 2026 (E, from a complaint, corrected July 3, 2026); April 12, 2024 (D, from a complaint, corrected April 15, 2024).
- F 0690, quality of life and care: April 23, 2026 (D, from a complaint, corrected May 14, 2026).
- F 0880, infection control: April 23, 2026 (D, from a complaint, corrected May 14, 2026); January 29, 2026 (E, corrected February 18, 2026); December 9, 2025 (D, from a complaint, corrected December 10, 2025).
- F 0628, resident rights: January 29, 2026 (D, corrected February 18, 2026).
- F 0641, resident assessment and care planning: January 29, 2026 (E, corrected February 18, 2026).
- F 0755, pharmacy service: January 29, 2026 (D, corrected February 18, 2026).
- F 0761, pharmacy service: January 29, 2026 (E, corrected February 18, 2026).
- F 0812, nutrition and dietary: January 29, 2026 (E, corrected February 18, 2026); September 15, 2023 (D, corrected October 12, 2023).
- F 0576, resident rights: October 31, 2024 (F, corrected November 22, 2024).
- F 0657, resident assessment and care planning: October 31, 2024 (D, corrected November 22, 2024).
- F 0689, quality of life and care: April 12, 2024 (J, from a complaint, corrected April 15, 2024); September 15, 2023 (D, corrected October 12, 2023).
- F 0638, resident assessment and care planning: September 15, 2023 (D, corrected October 12, 2023).
- F 0644, resident assessment and care planning: September 15, 2023 (D, corrected October 12, 2023).
- F 0645, resident assessment and care planning: September 15, 2023 (D, corrected October 12, 2023).
Penalties
| Penalty date | Type | Fine amount | Payment denial began | Payment denial, days | Fine ID |
|---|---|---|---|---|---|
| April 12, 2024 | Fine | $8,632 | 112687 |
From the Care Compare penalties file NH_Penalties_Oct2026.csv, processed on October 1, 2026.
Legend Oaks Healthcare and Rehabilitation - West S in Care Compare
- Ownership Type: For profit - Corporation
- Legal Business Name: DEWITT MEDICAL DISTRICT
- Date First Approved to Provide Medicare and Medicaid Services: 2012-05-31
- Provider Resides in Hospital: N
- Continuing Care Retirement Community: N
- Urban: Y
- County/Parish: Bexar
- Telephone Number: 2106731700
- Chain Name: THE ENSIGN GROUP
- Chain ID: 507
- Provider Changed Ownership in Last 12 Months: N
- With a Resident and Family Council: Resident
- Automatic Sprinkler Systems in All Required Areas: Yes
- Average Number of Residents per Day: 101.5
- Overall Rating: 3
- Health Inspection Rating: 3
- QM Rating: 4
- Long-Stay QM Rating: 5
- Short-Stay QM Rating: 4
Care Compare, October 1, 2026: provider information NH_ProviderInfo_Oct2026.csv · inspections NH_SurveySummary_Oct2026.csv · citations NH_HealthCitations_Oct2026.csv · penalties NH_Penalties_Oct2026.csv · ownership NH_Ownership_Oct2026.csv.
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