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Nursing HomeMedicaid Investigative

River City Care Center

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

921 Nolan Street, Dignowity Hill · San Antonio, TX 7820292 bedsLicensed & Active
1/5
Medicare
Inspection
Quality
Staffing
Google rating
4.5/5

based on 127 Google reviews

5
4
3
2
1
River City Care Center Nursing Home in San Antonio, TX — Street View
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4/ 10
moderate Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Abuse citation on record
  • Low overall rating (2/5 stars)

Below average in Texas · Below recommended RN staffing · Below chain average · $23,410 in fines · Abuse citation

Source: Medicare data

What this means for your family

This facility is a much better option than it was in previous years, thanks to significant renovations and new leadership. The staff is currently highly praised for their compassion, but families should verify that weekend staffing levels meet their expectations and keep a close eye on the management of personal belongings.

Google Reviews

Google Reviews

127 reviews on Google
Families will find a facility that has undergone a significant transformation, with recent reviews heavily praising a beautiful, modern renovation and a much more professional, compassionate nursing staff. While historical reviews from 2020 and earlier highlight severe issues with neglect and facility conditions, the most recent feedback indicates a strong turnaround in cleanliness and care quality.

Quality Themes

Tap a score for details
Food8.0Staff9.0Clean9.0Activities8.0MedsN/AMemoryN/AComms7.0ValueN/A

Strengths

  • Extensive recent building renovations
  • Compassionate and attentive nursing staff
  • Clean and well-maintained environment
  • Engaging resident activities and events

Concerns

  • Inconsistent staffing quality on weekends (mentioned by 2 reviewers)
  • Occasional issues with personal property/clothing management (mentioned by 2 reviewers)

Rating Trends

Tap a year to see what changed

234'16(2)'18(5)'20(11)'22(63)'24(10)'26(1)

Distribution · 168 analyzed

5
137
4
9
3
3
2
2
1
17
28 reviews posted between Jul 18, 2022Jul 23, 2022 · 28 were 5-star
10 reviews posted between Jun 28, 2023Jun 28, 2023 · 10 were 5-star
10 reviews posted between Jan 24, 2022Jan 28, 2022 · 10 were 5-star

How They Respond to Reviews

13%response rate
Generic

The owner relies heavily on repetitive, templated scripts to respond to negative reviews, primarily directing users to a single Customer Care Line. While they occasionally address specific claims (like HVAC or ownership changes), the vast majority of responses use nearly identical phrasing.

Questions for Your Tour

  • 1I noticed the facility has had some extensive recent renovations; could you show me some of the newly updated areas where residents spend their time?
  • 2Since we want to ensure consistent care, how does the nursing team manage transitions and staffing levels during the weekend shifts?
  • 3What specific systems do you have in place to help residents keep track of their personal belongings and clothing to prevent anything from getting lost?
  • 4Could you tell me more about the types of engaging activities and social events planned for the residents each week?
  • 5In the event of a medical emergency during the night, what is the protocol for getting immediate physician or specialist oversight?
  • 6We appreciate how much the community values your staff's compassion; how do you support your nursing team to maintain that high level of attentive care?

Personalized based on this facility's data


Key Review Excerpts

The building is very clean and everyone is very welcoming. The new Activity Director was popping popcorn and showing the residents a retro movie which they were thoroughly enjoying.

Visitor · 2025★★★★★

My brother just became a member of the River City Care community and our experience thus far has been so positive! The staff is friendly and so kind. My brother feels respected and cared for by all who encounter him and he is in LOVE with the dining experience!!!

Long-term resident's family · 2023★★★★★

They made me work hard at getting better and turned a worst case scenerio( 1 -2 months), into 2 weeks and going home. My thanks to each and every one of you.

Rehab patient · 2025★★★★★
Source: 127 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.42hrs
56%
Registered nurses for medical care
Total Nursing
2.62hrs
64%
All nurses + aides combined

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
4/ 5
Better Than Avg

10

measures

Worse Than Avg

3

measures

Mixed Results

4

measures

Long-Stay Residents
😔

Residents with depression symptoms

↓ Lower is better
This Facility0.0%
Better than Avg
Here
0.0%
US
12.1%
TX
2.5%
Bexar
2.0%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility13.2%
Better than Avg
Here
13.2%
US
19.5%
TX
18.4%
Bexar
21.9%
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility8.6%
Better than Avg
Here
8.6%
US
15.4%
TX
9.4%
Bexar
10.5%
💉

Residents vaccinated for the flu

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
95.5%
TX
98.0%
Bexar
98.1%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility18.3%
Mixed vs Avgs
Here
18.3%
US
19.4%
TX
14.2%
Bexar
17.2%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility97.5%
Better than Avg
Here
97.5%
US
93.4%
TX
96.9%
Bexar
94.0%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
79.7%
TX
88.0%
Bexar
84.4%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility97.1%
Better than Avg
Here
97.1%
US
81.8%
TX
89.2%
Bexar
81.0%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility2.9%
Worse than Avg
Here
2.9%
US
1.6%
TX
1.5%
Bexar
2.1%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

5deficiencies
2penalties
Near state avg (9.1)
7 complaint-triggered
$23,410 in fines

This facility shows concerning patterns with families filing complaints about serious issues including abuse protection and safety hazards, though all violations have been reported as corrected. The most recurring problems involve medication management (appearing in 5 instances), food safety and nutrition services, and facility safety issues like fire safety systems and room size requirements. While the facility addresses violations when cited, the repeated issues across multiple surveys and the fact that families have filed formal complaints about care quality suggest potential ongoing challenges with consistent safety and care standards.

Jul 10, 2025Complaint
1
0600Immediate jeopardy · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

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

Jul 10, 2025Routine
9
0761Potential for harm · PatternCorrected

Pharmacy Service Deficiencies

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.

0812Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

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

0353Potential for harm · PatternCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0355Potential for harm · PatternCorrected

Smoke Deficiencies

Properly select, install, inspect, or maintain portable fire extinguishes.

0511Potential for harm · PatternCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0923Potential for harm · PatternCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have proper medical gas storage and administration areas.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0912Minimal · Widespread

Environmental Deficiencies

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

0521Minimal · Widespread

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Feb 28, 2025Complaint
1
0689Immediate jeopardy · IsolatedCorrected

Quality of Life and Care Deficiencies

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

May 3, 2024Routine
17
0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

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

0550Potential for harm · PatternCorrected

Resident Rights Deficiencies

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

0656Potential for harm · PatternCorrected

Resident Assessment and Care Planning Deficiencies

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

0755Potential for harm · PatternCorrected

Pharmacy Service Deficiencies

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

0880Potential for harm · PatternCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0578Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

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.

0644Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

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

0690Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0693Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0698Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0759Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure medication error rates are not 5 percent or greater.

0761Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

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.

0842Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

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

0949Potential for harm · IsolatedCorrected

Administration Deficiencies

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

0521Minimal · Widespread

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

0912Minimal · WidespreadCorrected

Environmental Deficiencies

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

Apr 12, 2024Complaint
4
0657Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

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

0761Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

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.

0657Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

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

0761Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

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.

Dec 13, 2023Complaint
1
0810Potential for harm · IsolatedCorrected

Nutrition and Dietary Deficiencies

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

Federal Penalties

Fine

Jul 10, 2025

$14,020

Fine

Feb 28, 2025

$9,390

Ownership & Operations

Who Operates This Facility

Owner / Operator

San Antonio I Enterprises, LLC

Organization Type

for profit

Management Company

CREATIVE SOLUTIONS IN HEALTHCARE, INC

Administrator

FABIANA LOZANO

Chain Affiliation

Chain Name

Creative Solutions in Healthcare

Chain Size

149 facilities nationwide

Chain avg rating: 2.7/5 · Rank 100 of 148

Ownership & Management

Key personnel

Huggins, LindaW-2 Managing EmployeeCreative Solutions in Healthcare INCManagerBlake, GaryManagerBlake, MalisaManager
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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