1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
1/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Accepting Medicare, Medicaid, and private pay, River City Center is a 183-bed nursing home owned by Joseph Dunavant in Alabama. The facility serves longer-term residents and those seeking short-term rehabilitation following a hospital stay or recovery period. The average stay duration is nearly 147 days, reflecting that mix of care needs.
The home, clinically speaking, highlights rehabilitation services, making it a pragmatic choice for someone recovering from surgery, an injury, or illness. Total nursing care averages roughly 3 hours and 35 minutes per resident day, with registered nurses, nurse aides, and licensed vocational nurses working to support daily needs. Most errands need a vehicle because the community is in a car-dependent area of Alabama. For families living at a distance, this means visiting will generally involve driving rather than walking from a nearby station or using public transit.
Over the years, state inspections have noted deficiencies in facility maintenance, care procedures, and medication management. The home also has a history of substantiated abuse allegations.
For families considering River City Center, they must request a detailed explanation of how the facility has addressed such past findings and what safeguards are currently in place.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 120th out of 136 homes in Alabama for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 52m per day | ▲ 38% State avg: 38m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 43m per day | ▼ 8% State avg: 47m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 1h 43m per day | ▼ 32% State avg: 2h 30m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 2h 56m per day | ▼ 10% State avg: 3h 17m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 2m per day | ▲ 4% State avg: 2m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 38m per day | ▲ 72% State avg: 22m per day · National avg: 28m per day |
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
River City Center is administered by Joseph Dunavant.
In Alabama, the Department of Public Health, Bureau of Health Provider Standards conducts unannounced surveys to ensure facilities meet state licensing and federal certification safety standards.
This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Alabama state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | AL Average | vs. AL Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 12 | 17 | This facility has 29% fewer total deficiencies than a typical Alabama assisted living residence (12 vs. AL avg 17).↓ 29% better |
|
Deficiencies per year
Average deficiencies per year since 2018.
| 1.5 | 2.1 | This facility has 29% fewer deficiencies per year than a typical Alabama assisted living residence (1.5 vs. AL avg 2.1).↓ 29% better |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
Alabama average 2.9
Last Health inspection on Apr 2021
Alabama average 10.4
Alabama average 3.46
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
All 12 citations resulted from standard inspections.
100% better than Alabama averageAlabama average: 0.7
400% worse than Alabama averageAlabama average: 0.2
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
19% fewer staff per resident than Alabama average
11% better than Alabama average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
All 27 RN Staff are full-time employees. No contractors work on this role.
27
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10 hoursAssists with medical care and medications.
29 total: 19 full-time employees and 10 contractors.
29
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.6 hoursHelps with daily care and mobility.
74 total: 72 full-time employees and 2 contractors.
74
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.8 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
3,632 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 72 | 2 | 74 | 24,452 | 92 | 100% | 8.8 |
| Licensed Practical Nurse | 19 | 10 | 29 | 10,264 | 92 | 100% | 9.6 |
| Registered Nurse | 27 | 0 | 27 | 9,841 | 92 | 100% | 10 |
| Clinical Nurse Specialist | 5 | 0 | 5 | 2,153 | 66 | 72% | 7.9 |
| Physical Therapy Aide | 7 | 0 | 7 | 1,311 | 74 | 80% | 6.9 |
| Speech Language Pathologist | 4 | 0 | 4 | 1,304 | 68 | 74% | 7 |
| Other Dietary Services Staff | 5 | 0 | 5 | 1,106 | 82 | 89% | 7 |
| Mental Health Service Worker | 2 | 0 | 2 | 1,052 | 71 | 77% | 8.8 |
| Qualified Social Worker | 3 | 0 | 3 | 637 | 67 | 73% | 7.1 |
| Physical Therapy Assistant | 2 | 0 | 2 | 569 | 69 | 75% | 6.8 |
| Respiratory Therapy Technician | 3 | 0 | 3 | 494 | 64 | 70% | 7.5 |
| Nurse Practitioner | 1 | 0 | 1 | 480 | 60 | 65% | 8 |
| Other Social Services Staff | 1 | 0 | 1 | 475 | 66 | 72% | 7.2 |
| Administrator | 1 | 0 | 1 | 440 | 55 | 60% | 8 |
| Occupational Therapy Aide | 0 | 1 | 1 | 437 | 54 | 59% | 8.1 |
| Dental Services Staff | 1 | 0 | 1 | 435 | 57 | 62% | 7.6 |
| Occupational Therapy Assistant | 0 | 2 | 2 | 81 | 16 | 17% | 4.8 |
| Medical Director | 0 | 1 | 1 | 49 | 38 | 41% | 1.3 |
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
9.6
8% worse than Alabama averageAlabama average: 8.9
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
16.5
14% worse than Alabama averageAlabama average: 14.5
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
15.6%
12% worse than Alabama averageAlabama average: 13.9%
Percent of long-stay residents whose ability to move independently worsened
15.6%
In line with Alabama averageAlabama average: 16.1%
Percent of low risk long-stay residents who lose control of their bowels or bladder
18.2%
34% worse than Alabama averageAlabama average: 13.6%
Percent of long-stay residents experiencing one or more falls with major injury
2.6%
22% better than Alabama averageAlabama average: 3.4%
Percent of long-stay high risk residents with pressure ulcers
8.1%
37% worse than Alabama averageAlabama average: 5.9%
Percent of long-stay residents with a urinary tract infection
1.1%
60% better than Alabama averageAlabama average: 2.7%
Percent of long-stay residents who lose too much weight
6.0%
11% worse than Alabama averageAlabama average: 5.4%
Percent of long-stay residents who have depressive symptoms
2.1%
68% worse than Alabama averageAlabama average: 1.2%
Percent of long-stay residents who received an antipsychotic medication
16.8%
19% better than Alabama averageAlabama average: 20.7%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
98.2%
7% better than Alabama averageAlabama average: 91.5%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
99.3%
5% better than Alabama averageAlabama average: 94.8%
Number of hospitalizations per 1,000 long-stay resident days.
1.42
29% better than Alabama averageAlabama average: 2.00
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.02
43% better than Alabama averageAlabama average: 1.79
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
83.2%
In line with Alabama averageAlabama average: 83.7%
Percent of short-stay residents who newly received an antipsychotic medication
1.5%
27% better than Alabama averageAlabama average: 2.1%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
90.8%
13% better than Alabama averageAlabama average: 80.3%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
27.6%
13% worse than Alabama averageAlabama average: 24.5%
Percentage of short-stay residents who had an outpatient emergency department visit.
10.1%
12% better than Alabama averageAlabama average: 11.5%
Percentage of SNF residents who experience falls with major injury during their stay.
0.9%
22% worse than Alabama averageAlabama average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
42.5%
21% worse than Alabama averageAlabama average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
54.7%
8% better than Alabama averageAlabama average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
29% of new residents, usually for short-term rehab.
45% of new residents, often for short stays.
26% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
134Residents meet regularly to discuss policies, care quality, and activities
State-approved Nurse Aide Training and Competency Evaluation Program on-site
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for River City Center from 2011–2024, based on CMS SNF Cost Reports.
Key figures below are for fiscal year ending in 06/2024.
Based on CMS SNF Cost Report for fiscal year ending in 06/2024.
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.
Rank #4 / 135Payroll — State benchmarkedThis home is ranked 4th out of 135 homes in Alabama. Shows total annual staff payroll benchmarked to the Alabama average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Rankings are based only on facilities in Alabama that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.
Rank #54 / 133Payroll % — State benchmarkedThis home is ranked 54th out of 133 homes in Alabama. Shows payroll as a percentage of revenue versus the Alabama average. Well-run Alabama facilities typically land around 54–69% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Rankings are based only on facilities in Alabama that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
Most residents stay for extended periods and receive ongoing daily care.
New residents most often arrive under private pay (45% of admissions), and a typical private pay stay runs around 1 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
3.7 miles from city center
Estimated distance in miles from Decatur's city center to River City Center's address, calculated via Google Maps.
Add your location
River City Center is located in Decatur, Alabama.
Here are the financial assistance programs available to residents in Alabama.
River City Center has a walk score of 6. Car-dependent. Most errands require a car, with limited nearby walkable options.
River City Center's occupancy is 82.9%.
River City Center is registered as a for-profit in AL.
Joseph Dunavant is the administrator of River City Center.
River City Center has 183 beds.
Yes — there are 18 photos of River City Center in the photo gallery on this page.
River City Center is located at 1350 Fourteenth Avenue, Southeast, Decatur, AL 35601.
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