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.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
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.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
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-day | 2.62 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.42 | 0.55–0.75 |
| Weekend hours / resident-day | 2.21 | ≈ weekday level |
| Nursing turnover / year | — | median 45% |
| Fines (3-yr window) | 2 · $23,410 |
Inspection citations (32 in the current record)
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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
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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
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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
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Potential for harm · D July 10, 2025
Provide and implement an infection prevention and control program.
Corrected July 11, 2025 · Infection Control
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Potential for harm · D May 3, 2024
Ensure medication error rates are not 5 percent or greater.
Corrected May 10, 2024 · Pharmacy Service
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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
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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
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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
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Potential for harm · E May 3, 2024
Provide and implement an infection prevention and control program.
Corrected May 4, 2024 · Infection Control
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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
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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
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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
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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
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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
| Date | Type | Amount / length |
|---|---|---|
| July 10, 2025 | Fine | $14,020 |
| February 28, 2025 | Fine | $9,390 |
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
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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.