River City Care Center
921 NOLAN STREET, San Antonio, TX, 78202
Federal Quality Data
Official records from CMS Care Compare — reported by the facility and audited by the Centers for Medicare & Medicaid Services. We present them unmodified. Refreshed March 2026.
CMS Abuse Flag
CMS has flagged this facility for a substantiated finding of resident abuse, neglect, or exploitation in its current or recent inspection cycle. Ask the facility for the specific citation and corrective-action plan during your visit, and consider contacting your state's long-term care ombudsman for context.
Source: CMS Care Compare.
CMS Star Ratings
Facility & Staffing
- Ownership
- For profit - Individual · Chain: Creative Solutions In Healthcare
- Certified beds
- 92 · avg 41 residents/day
- Total nursing staff turnover
- 38.7% — lower than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 20% — lower than most Texas nursing homesTexas avg: 50.5% · National avg: 43.6% · per CMS Care Compare
- Administrators who left
- 1 departed — near the Texas averageTexas avg: 0.6 · National avg: 0.5 · per CMS Care Compare
Enforcement & Citations
- Fines (past 3 years)
- 2 fines · $23,410 total
State licensing & capacity
- License number
- 307206
- Service type
- Medicare/medicaid
- Licensed capacity
- 92 beds
- Bed type breakdown
- 23 Medicare-only · 69 Medicaid/Medicare
- Current license effective
- January 1, 2026
- Current license expires
- January 1, 2029
- Initial license date
- November 1, 1973
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- San Antonio I Enterprises, Llc (Limited Liability Company (LLC))
- Operator / manager
- Creative Solutions In Healthcare, Inc
- Administrator
- Fabiana Lozano
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Chain affiliation
Part of the Creative Solutions in Healthcare chain — 149 facilities. Chain-wide average overall rating 2.7 / 5.
Disclosed owners (5 on record)
- Creative Solutions in Healthcare Inc
Operational/managerial Control · 100% · since 2019
- Gary r Blake
5% or Greater Indirect Ownership Interest · 50% · since 2019
- Honor x Enterprises, Llc
5% or Greater Direct Ownership Interest · 100% · since 2019
- Linda f Huggins
W-2 Managing Employee · since 2019
- Malisa a Blake
5% or Greater Indirect Ownership Interest · 50% · since 2019
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Chain Performance Measures, as of April 2026.
Federal inspection record
Immediate-jeopardy citations (CMS scope/severity J–L) are the most serious category federal inspectors issue — meaning a deficiency placed residents in immediate risk of serious harm. Ask the facility for the corrective-action plan filed with CMS, and consider contacting your state long-term care ombudsman for context.
Recent health-deficiency citations (most recent 8 of 32)
- J0600·Jul 10, 2025Complaint
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.
- C0912·Jul 10, 2025
Environmental Deficiencies
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
- D0880·Jul 10, 2025
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
- E0812·Jul 10, 2025
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E0761·Jul 10, 2025
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.
- J0689·Feb 28, 2025Complaint
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D0949·May 3, 2024
Administration Deficiencies
Provide behavior health training consistent with the requirements and as determined by a facility assessment.
- C0912·May 3, 2024
Environmental Deficiencies
Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Federal penalties
By year
- 20252 fines · $23K
Most recent events
- Jul 10, 2025Fine · $14K
- Feb 28, 2025Fine · $9,390
Largest single fine on record: $14K.
Fire-safety citations
9 Life-Safety-Code citations on file. Most recent: Jul 10, 2025. Fire-safety inspections cover building-level Life Safety Code compliance, separate from the resident-care health survey.
Source: CMS Provider Data Catalog — Health Deficiencies, Fire Safety Deficiencies, and Penalties datasets, snapshot Mar 1, 2026.
About this community
River City Care Center is a 92-bed nursing home in San Antonio's Bexar County, accepting Medicare and Medicaid, managed by Creative Solutions In Healthcare. CMS rates it 2 stars overall, with a substantiated abuse or neglect finding in the past 36 months. Quality-of-care outcomes rate 4 stars. Only 41 of 92 beds are occupied — a 45% occupancy rate.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates this facility 2 stars overall and 2 stars on health inspections, with a substantiated finding of resident abuse or neglect within the past 36 months. That finding is recorded in CMS data and is separate from the inspection score.
Staffing rates 3 stars — about the middle fifth of Texas nursing homes at that tier (19% of facilities share this rating). Each resident receives roughly 188 minutes of nursing care per day, about 53 minutes less than at a 4-star-staffing facility in Texas. Residents here require more hands-on care than at a typical facility — they are sicker or less mobile on average — so those 188 minutes stretch thinner than the raw number suggests.
Despite the staffing rating, nursing staff turnover is low: roughly 4 in 10 nursing staff left in the past year, below Texas's 25th-percentile cutoff — better than about three-quarters of nursing homes in the state. RN turnover is exceptionally low at about 2 in 10, meaning the registered nurses who set care plans have been largely stable.
One administrator has turned over in the past year — an elevated count, though not as disruptive as facilities with two or more changes.
Two CMS fines totaling $23,410 have been assessed; Texas's median fine total is $20,699, and about 30% of Texas facilities have no fines at all.
The facility is operating at roughly 45% of its licensed 92 beds, with an average of 41 residents per day. This is well below typical occupancy for nursing homes in the state.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
About the abuse finding
CMS records a substantiated finding of resident abuse or neglect here within the past 36 months — ask what happened, what changed, and how staff are trained and monitored now.
Why occupancy is so low
With only 41 of 92 beds filled, ask whether the facility is accepting new residents and what accounts for the low census.
How care plans are reviewed
Quality-of-care outcomes rate 4 stars despite a 3-star staffing score — ask how care plans are developed and how often they are updated by nursing or clinical staff.
Administrator continuity going forward
One administrator has left in the past year; ask how long the current administrator, Fabiana Lozano, has been in the role and whether leadership changes are expected.
What the Resident Council covers
There is a Resident Council but no Family Council — ask how family members surface concerns and who they contact when a resident cannot advocate for themselves.
Staffing on weekends
Weekend nursing hours average 2.85 hours per resident per day, lower than the weekday figure — ask how staffing levels and supervisor coverage differ on weekends and holidays.
Where this information comes from
- License, capacity, ownership, administrator: Texas HHSC licensing registry, snapshot as of April 16, 2026.
- Star ratings, staffing, fines, deficiencies: CMS Care Compare, processed March 1, 2026.
- Summary, insights, and tour questions: Written from the state licensing and CMS records above, last updated April 19, 2026.
Read our methodology for how this information is collected and verified.