River City Care Center

In the surveyor’s words

From the most serious findings on record at River City Care Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF600Jul 10, 2025

  Based on interview, and record review the facility failed to ensure the resident had the right to be free from abuse, neglect, misappropriation of resident property, and exploitation for 1 out of 8 residents (Resident #12) reviewed for abuse/neglect as evidenced by:The facility failed to ensure Resident #12 was free from abuse when CNA A squirted Resident #12 with a water gun in her mouth while she slept on 5/24/25. The facility failed to ensure Resident #12 was free from abuse when Resident #12 made an allegation of abuse by CNA C. The allegation was reported to the Administrator on 05/31/2025 by CNA C and on 06/19/2025 by HHSC Surveyor L.An Immediate Jeopardy (IJ) was identified on 07/08/2025 at 4:40 p.m. The IJ template was provided to the facility on [DATE] at 5:06 p.m. […]

• Immediate jeopardy, isolatedF689Feb 28, 2025

  Based on observation, interview, and record review, the facility failed to ensure the environment was as free of accident hazards as is possible and each resident receives adequate supervision to prevent accidents for 1 of 1 resident (Resident #1) reviewed for accidents and hazards, in that: Resident #1 was able to leave the front porch of the facility on 09/09/2024 without staff's knowledge and go to a grocery store 1.7 miles away, then became confused when leaving the grocery store as to where he resided. Resident was found at the homeless shelter where he had previously lived. Resident #1 had a cognitive decline and that although staff were concerned about letting the resident sit out on the front porch, they continued to do so prior to his elopement. […]

• Immediate jeopardy, isolatedF684Sep 22, 2022

  Based on interview and record review the facility failed to ensure based on the comprehensive assessment of a resident that residents received treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan and the residents' choices for 1 of 1 residents (Residents #1) reviewed for quality of care. 1. The facility failed to ensure Resident #1 received laboratory services in accordance with professional standards of practice. 2. The facility failed to ensure Resident #1 was accurately assessed, treated, or documented with a split meatus on his penis, after his admission with a skin injury to his genitalia. An Immediate Jeopardy (IJ) situation was identified on 9/18/2022. […]

• No harm, potential for more than minimal, widespreadF812May 3, 2024

  45857 Based on observation, interview, and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for 1 of 1 kitchen. 1. The facility failed to ensure food was properly labeled. 2. The facility failed to ensure expired food products were discarded. 3. The facility failed to ensure food with freezer burn was discarded. 4. The facility failed to ensure a bag of spaghetti was not spilled on the shelf and a container of sugar was closed. 5. The facility failed to ensure staff did not keep personal drinks on the food prep tables. 6. The facility failed to ensure staff did not lick their fingers while placing dietary cards on resident food trays. […]

• No harm, potential for more than minimal, widespreadF732Sep 22, 2022

  Based on observation, interview, and record review the facility failed to ensure information was posted on a daily basis which included the facility name, the current date, the total number and the actual hours worked by licensed and unlicensed nursing staff directly responsible for resident care per shift and resident census for 1 of 1 facility, (Facility) reviewed for posting daily nurse staffing information. The facility did not post daily nurse staff information for 17 days during September 2022. This failure could place residents at risk for harm by not providing accurate nurse staffing and resident census information. […]