River City Care Center

921 Nolan St · San Antonio, TX · 78202 · 2102266397

92 certified beds For profit - Individual Chain: Creative Solutions in Healthcare

Why this verdict

  • Carries CMS’s abuse warning icon.
  • Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
  • Inspection record is far worse than the national median (deficiency count and severity).
  • Inspection results have improved across recent cycles.

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Red flags

CMS abuse warning

CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.

1 immediate-jeopardy citation in the most recent inspection cycle

Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.

1 abuse-related citation at the actual-harm level

Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.

Total nurse staffing below 3.0 hours per resident-day

2.62 reported hours vs the 3.48 minimum CMS's own staffing study recommends.

Score breakdown

Inspection record 30% of score 39
Serious harm & abuse 20% 34
Staffing 20% 44
Federal penalties 15% 59
Trend 10% 76
Context 5% 75

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 1 of 5 Inspections: 2 of 5 Staffing: 1 of 5 Quality measures: 4 of 5

Total nurse hours / resident-day2.623.48 min · 4.1 strong
RN hours / resident-day0.420.55–0.75
Weekend hours / resident-day2.21≈ weekday level
Nursing turnover / yearmedian 45%
Fines (3-yr window)2 · $23,410

Inspection citations (32 in the current record)

  • Immediate jeopardy · J July 10, 2025 · found via complaint

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Corrected July 11, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · E July 10, 2025

    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.

    Corrected July 11, 2025 · Pharmacy Service

  • Potential for harm · E July 10, 2025

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Corrected July 11, 2025 · Nutrition and Dietary

  • Potential for harm · D July 10, 2025

    Provide and implement an infection prevention and control program.

    Corrected July 11, 2025 · Infection Control

  • No harm found · C July 10, 2025

    Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.

    No revisit needed · Environmental

  • Immediate jeopardy · J February 28, 2025 · found via complaint

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Corrected March 1, 2025 · Quality of Life and Care

  • Potential for harm · E May 3, 2024

    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Corrected May 4, 2024 · Resident Rights

  • Potential for harm · D May 3, 2024

    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.

    Corrected May 4, 2024 · Resident Rights

  • Potential for harm · D May 3, 2024

    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

    Corrected May 4, 2024 · Resident Assessment and Care Planning

  • Potential for harm · E May 3, 2024

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Corrected May 4, 2024 · Resident Assessment and Care Planning

  • Potential for harm · D May 3, 2024

    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

    Corrected May 10, 2024 · Quality of Life and Care

  • Potential for harm · D May 3, 2024

    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.

    Corrected May 10, 2024 · Quality of Life and Care

  • Potential for harm · D May 3, 2024

    Provide safe and appropriate respiratory care for a resident when needed.

    Corrected May 4, 2024 · Quality of Life and Care

  • Potential for harm · D May 3, 2024

    Provide safe, appropriate dialysis care/services for a resident who requires such services.

    Corrected May 10, 2024 · Quality of Life and Care

  • Potential for harm · E May 3, 2024

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Corrected May 4, 2024 · Pharmacy Service

  • Potential for harm · D May 3, 2024

    Ensure medication error rates are not 5 percent or greater.

    Corrected May 10, 2024 · Pharmacy Service

  • Potential for harm · D May 3, 2024

    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.

    Corrected May 4, 2024 · Pharmacy Service

  • Potential for harm · F May 3, 2024

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Corrected May 10, 2024 · Nutrition and Dietary

  • Potential for harm · D May 3, 2024

    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Corrected May 4, 2024 · Resident Assessment and Care Planning

  • Potential for harm · E May 3, 2024

    Provide and implement an infection prevention and control program.

    Corrected May 4, 2024 · Infection Control

  • Potential for harm · D May 3, 2024

    Provide behavior health training consistent with the requirements and as determined by a facility assessment.

    Corrected May 21, 2024 · Administration

  • No harm found · C May 3, 2024

    Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.

    Corrected May 4, 2024 · Environmental

  • Potential for harm · D April 12, 2024 · found via complaint

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected April 13, 2024 · Resident Assessment and Care Planning

  • Potential for harm · D April 12, 2024 · found via complaint

    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.

    Corrected April 13, 2024 · Pharmacy Service

  • Potential for harm · D December 13, 2023 · found via complaint

    Provide special eating equipment and utensils for residents who need them and appropriate assistance.

    Corrected December 14, 2023 · Nutrition and Dietary

Showing the 25 most recent. The Safety Report includes every citation with full findings.

Federal penalties

DateTypeAmount / length
July 10, 2025Fine$14,020
February 28, 2025Fine$9,390

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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 675896 · certified since November 30, 2001. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.