Why this was flagged
Medicare paid far more per patient than peers
In 2022 this provider was paid $32,106 per patient, against a typical $15,972 for the same kind of provider in TX. A genuinely high-need patient mix can explain some of this, but extreme per-patient billing is a classic upcoding and phantom-patient pattern.
Source Medicare Skilled Nursing Payments by Provider · record as of 11 Aug 2026 · pulled 9 Nov 2026 · version 2026-11-09 · 0c26d5
View the records behind this flag →
Owner is tied to 64 providers
An owner or managing party of this provider (PLANTE & MORAN PLLC) is listed on 64 separate Medicare enrollments. Chains are legal, and most are ordinary business — this is background context, not a fraud indicator on its own.
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
View the records behind this flag →
Owners and managing parties of record
BEXAR COUNTY HOSPITAL DISTRICT
5% OR GREATER DIRECT OWNERSHIP INTEREST · O · 100% ownership · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LUMENT REAL ESTATE CAPITAL LLC
5% OR GREATER MORTGAGE INTEREST · O · 5% ownership · since May 5, 2014
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
CHRISTOPHER REED HURLEY
CORPORATE OFFICER · I · 0% ownership · since Sep 26, 2014
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
CARVAJAL PHARMACY LTC
ADP OF THE SNF · O · since Jul 1, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LYNNEA CASTILLO
OPERATIONAL/MANAGERIAL CONTROL · I · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LYNNEA CASTILLO
ADP OF THE SNF · I · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
ALAMO ADVISORS LP
ADP OF THE SNF · O · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
PLANTE & MORAN PLLC
ADP OF THE SNF · O · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
NUTRITIOUS LIFESTYLES, INC.
ADP OF THE SNF · O · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
MARIA DUENES
OPERATIONAL/MANAGERIAL CONTROL · I · since Aug 17, 2020
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
MARIA DUENES
ADP OF THE SNF · I · since Aug 17, 2020
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
TOUCHSTONE REALTY - ATASCOSA LLC
ADP OF THE SNF · O · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
TOUCHSTONE STRATEGIES - PLEASANTON LLC
OPERATIONAL/MANAGERIAL CONTROL · O · since Mar 1, 2016
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
TOUCHSTONE STRATEGIES - PLEASANTON LLC
ADP OF THE SNF · O · since Jul 10, 2025
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
NICOLE MORRIS
OPERATIONAL/MANAGERIAL CONTROL · I · since Oct 1, 2025
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
NICOLE MORRIS
ADP OF THE SNF · I · since Oct 1, 2025
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
DARRELL D ZUROVEC
OPERATIONAL/MANAGERIAL CONTROL · I · since Aug 1, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
DARRELL D ZUROVEC
ADP OF THE SNF · I · since Aug 1, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
TOUCHSTONE COMMUNITIES INC
ADP OF THE SNF · O · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
AEGIS THERAPIES, INC.
ADP OF THE SNF · O · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
BENJAMIN S ZERTUCHE
OPERATIONAL/MANAGERIAL CONTROL · I · since Dec 1, 2014
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
BENJAMIN S ZERTUCHE
ADP OF THE SNF · I · since Dec 1, 2014
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
BRYON SEHLKE
OPERATIONAL/MANAGERIAL CONTROL · I · since Dec 16, 2016
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
BRYON SEHLKE
ADP OF THE SNF · I · since Dec 16, 2016
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LESLIE D CAMPBELL
OPERATIONAL/MANAGERIAL CONTROL · I · since Apr 1, 2020
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LESLIE D CAMPBELL
ADP OF THE SNF · I · since Apr 1, 2020
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
ERNEST C FELLBAUM
ADP OF THE SNF · I · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
TRIDENT HEALTH SERVICES INC
ADP OF THE SNF · O · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
JONATHON DEWEY CLAYTON
OPERATIONAL/MANAGERIAL CONTROL · I · since May 1, 2023
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
JONATHON DEWEY CLAYTON
ADP OF THE SNF · I · since May 1, 2023
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
STANLEY S STUDER
ADP OF THE SNF · I · since Feb 28, 2015
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
Source timeline
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Source records
Each value includes its published file, download date, and weekly version. Open a link to check the source record. Verify this lead yourself.
| Detail | Value | Published file | Record as of | Pulled | Version |
|---|---|---|---|---|---|
| Legal name | BEXAR COUNTY HOSPITAL DISTRICT | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Trading name | THE HEIGHTS OF ATASCOSA | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| NPI | 1235528506 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Medicare certification number | 676181 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| CMS associate ID | 5395722904 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Provider type | PART A PROVIDER - SKILLED NURSING FACILITY | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Organisation type | GOVERNMENT | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Street address | 1855 W GOODWIN ST | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| City | PLEASANTON | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| State | TX | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| ZIP | 78064-4502 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
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Public research history
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