Keystone Post-Acute Complaints, Violations and Inspection Records
Data current as of the August 2026 CMS Care Compare release and the CDPH state enforcement dataset of August 27, 2024. State citation records cover July 1, 1997 through June 30, 2024.
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What the public record shows
If you are looking into Keystone Post-Acute in Fresno, whether a loved one lives there now or you are considering it, the public record is worth reading before you decide. It includes 3 citations in the state's two most serious classes, class A and class AA.
Here is what the record shows for this facility, drawn from CMS Care Compare and the California Department of Public Health:
- CMS overall rating: 2 of 5 stars. The health inspection rating, the most independent of the three categories, is 2 of 5.
- California state citations: 7 on record, including 3 class A and 4 class B, with $67,173 in assessed penalties.
- Staffing: 3.93 nursing hours per resident per day; registered nurse turnover 42.9%.
- Most recent standard inspection: 12 deficiencies cited on May 30, 2025. The most recent inspection since then was on May 8, 2026: 1 deficiency cited in the complaint inspection.
- Federal enforcement: 1 federal fine totaling $42,764 in the reported period.
- Ownership: Fresno Nursing and Rehab Center LLC, for-profit, part of Eduro Healthcare (34 facilities nationally).
Keystone Post-Acute ratings and staffing
Keystone Post-Acute is located at 3672 North First Street in Fresno, Fresno County. It is a for-profit facility operated by Fresno Nursing and Rehab Center LLC, part of Eduro Healthcare, with 65 certified beds and an average of 60.7 residents a day. It accepts Medicare and Medicaid.
CMS rates every certified nursing home in three separate categories, and the overall star is a blend of them:
- Health inspections, based on what state surveyors observe in person during unannounced visits. Weight this one most heavily, because it does not rely on data the facility reports about itself.
- Staffing, drawn from payroll-based records of how much nursing time each resident actually receives.
- Quality measures, built largely from data the facility submits. Read a high score here with more caution than the other two.
For Keystone Post-Acute, those scores are: health inspections 2 of 5, staffing 2 of 5, quality measures 3 of 5.
Staffing. Keystone Post-Acute reports 3.93 total nursing hours per resident per day, of which 0.23 are registered nurse hours. Over the reporting year, 47.1% of the nursing staff left. Registered nurses supervise aides, catch medication errors before they reach a resident, and notice when a person's condition is changing. Staffing is the single number that most reliably predicts whether a facility catches a problem early or lets it become a crisis.
How this home compares in the public record
CMS publishes each home's star rating and its payroll-based staffing hours, and it publishes the federal fines it has imposed. The county and California figures beside each number are the averages across those same published records.
These figures are taken from public CMS Care Compare records as of August 2026 (the August 2026 release) and public CDPH records as of June 2024 (the state enforcement dataset of August 27, 2024). They are reported as published and are not a recommendation, endorsement or assessment of any facility by this firm. How these figures were assembled.
Homes in Fresno County with a higher CMS overall rating
CMS rates each of these homes above Keystone Post-Acute on the overall star rating it publishes. The rating is one measure of a facility's record, and each page below carries that home's own inspection findings, staffing hours and citation history.
- Oakwood Gardens Care Center, Fresno: CMS overall rating 5 of 5
- Manning Gardens Care Center, Inc, Fresno: CMS overall rating 5 of 5
- North Point Healthcare & Wellness Centre LP, Fresno: CMS overall rating 5 of 5
- The Terraces at San Joaquin Gardens Village, Fresno: CMS overall rating 5 of 5
- Veterans Home of California - Fresno, Fresno: CMS overall rating 5 of 5
These figures are taken from public CMS Care Compare records as of August 2026 (the August 2026 release) and public CDPH records as of June 2024 (the state enforcement dataset of August 27, 2024). They are reported as published and are not a recommendation, endorsement or assessment of any facility by this firm. How these figures were assembled.
Federal inspection findings and penalties
Scope and severity A to C means no actual harm, with potential for minimal harm. Scope and severity D to F means no actual harm, with potential for more than minimal harm. Scope and severity G to I means actual harm that is not immediate jeopardy. Scope and severity J to L means immediate jeopardy to resident health or safety.
May 8, 2026, complaint inspection
1 deficiency cited. Surveyors cited the facility for ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- F0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (scope and severity D)
February 5, 2026, complaint inspection
1 deficiency cited. Surveyors cited the facility for ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
- F0627Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. (scope and severity D)
May 30, 2025, standard inspection
12 deficiencies cited. Surveyors cited the facility for procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards, provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist, and ensure that residents are free from significant medication errors.
- F0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (scope and severity F)
- F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (scope and severity E)
- F0760Ensure that residents are free from significant medication errors. (scope and severity E)
- F0761Ensure 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. (scope and severity E)
- F0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (scope and severity D)
- F0551Give the resident's representative the ability to exercise the resident's rights. (scope and severity D)
- F0584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (scope and severity D)
- F0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (scope and severity D)
- F0658Ensure services provided by the nursing facility meet professional standards of quality. (scope and severity D)
- F0835Administer the facility in a manner that enables it to use its resources effectively and efficiently. (scope and severity D)
- F0880Provide and implement an infection prevention and control program. (scope and severity D)
- F0919Make sure that a working call system is available in each resident's bathroom and bathing area. (scope and severity D)
March 13, 2025, complaint inspection
1 deficiency cited. Surveyors cited the facility for ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- F0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (scope and severity D)
October 3, 2024, complaint inspection
2 deficiencies cited. Surveyors cited the facility for develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured and safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- F0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (scope and severity D)
- F0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. (scope and severity D)
August 21, 2024, complaint inspection
1 deficiency cited. Surveyors cited the facility for honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- F0584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (scope and severity E)
June 13, 2024, complaint inspection
1 deficiency cited. Surveyors cited the facility for procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (scope and severity F)
April 26, 2024, standard inspection
16 deficiencies cited. Surveyors cited the facility for try different approaches before using a bed rail. if a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) correctly install and maintain the bed rail, have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis, and implement gradual dose reductions(gdr) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and prn orders for psychotropic medications are only used when the medication is necessary and prn use is limited.
- F0700Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. (scope and severity F)
- F0727Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. (scope and severity F)
- F0758Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. (scope and severity F)
- F0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (scope and severity F)
- F0552Ensure that residents are fully informed and understand their health status, care and treatments. (scope and severity E)
- F0584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (scope and severity E)
- F0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (scope and severity E)
- F0658Ensure services provided by the nursing facility meet professional standards of quality. (scope and severity E)
- F0726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. (scope and severity E)
- F0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. (scope and severity E)
- F0880Provide and implement an infection prevention and control program. (scope and severity E)
- F0940Develop, implement, and/or maintain an effective training program for all new and existing staff members. (scope and severity E)
- F0692Provide enough food/fluids to maintain a resident's health. (scope and severity D)
- F0883Develop and implement policies and procedures for flu and pneumonia vaccinations. (scope and severity D)
- F0908Keep all essential equipment working safely. (scope and severity D)
- F0924Put firmly secured handrails on each side of hallways. (scope and severity D)
November 15, 2023, complaint inspection
1 deficiency cited. Surveyors cited the facility for ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- F0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (scope and severity G)
October 17, 2023, complaint inspection
1 deficiency cited. Surveyors cited the facility for develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- F0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (scope and severity D)
August 5, 2022, standard inspection
11 deficiencies cited. Surveyors cited the facility for develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured, ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents, and procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (scope and severity G)
- F0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (scope and severity G)
- F0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (scope and severity F)
- F0881Implement a program that monitors antibiotic use. (scope and severity F)
- F0882Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. (scope and severity F)
- F0658Ensure services provided by the nursing facility meet professional standards of quality. (scope and severity E)
- F0679Provide activities to meet all resident's needs. (scope and severity E)
- F0803Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. (scope and severity E)
- F0880Provide and implement an infection prevention and control program. (scope and severity E)
- F0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (scope and severity D)
- F0761Ensure 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. (scope and severity D)
Penalties. Over the reported period, Keystone Post-Acute received 1 federal fine totaling $42,764 and 1 payment denial. Fines are imposed when a facility is cited for a serious violation or fails to correct a prior deficiency in time.
California state citations
California inspects and cites nursing homes separately from the federal government. The Department of Public Health issues three classes of citation. A class AA citation is a class A violation that the Department of Public Health determined was a direct proximate cause of a resident's death. A class A citation is a violation the Department determined presented an imminent danger of death or serious harm to residents, or a substantial probability that death or serious physical harm would result. A class B citation is a violation the Department determined had a direct or immediate relationship to residents' health, safety or security, other than a class AA or A violation.
State records show 7 citations against Keystone Post-Acute between February 14, 2001 and January 22, 2024: 3 class A and 4 class B, with $67,173 in assessed penalties.
- January 22, 2024, class A, Patient Care. $20,000 penalty.
- December 1, 2022, class A, Patient Care. $20,000 penalty.
- February 3, 2022, class A, Physical Environment. $18,000 penalty.
- September 27, 2019, class B, Patient Rights. $2,000 penalty.
- April 23, 2008, class B, Patient Rights. $800 penalty.
- October 10, 2002, class B, Other. $5,573 penalty. Appealed.
- February 14, 2001, class B, Patient Rights. $800 penalty.
Across Fresno County's 31 certified facilities, the average is about 5.6 state citations per facility. Keystone Post-Acute's 7 is close to that average.
A citation marked "Appealed." is under appeal, so it is not a final determination. A citation records a determination by state surveyors. A citation does not by itself establish that any particular resident was injured or that the facility is liable to anyone.
Other nursing homes in Fresno
Families comparing options in Fresno often look at these facilities as well. Each link opens that facility's full public record:
- Pacific Gardens Nursing and Rehabilitation Center, 3 stars, 2 state citations
- Horizon Health & Subacute Center, 2 stars, 3 state citations
- Healthcare Centre of Fresno, 2 stars, 5 state citations
- Covenant Post Acute, 3 stars, 3 state citations
- Veterans Home of California - Fresno, 5 stars, 5 state citations
See every facility in the Fresno County nursing home directory.
Other nursing homes in Fresno County
These are other nursing homes in Fresno County, listed by how close each home's ZIP code is to the ZIP code for Keystone Post-Acute. The public record gives a street address but no coordinates, so distance is not measured; homes in the same ZIP code appear first. No rating or inspection figure is used to order this list.
- Covenant Post Acute, Fresno
- Oakwood Gardens Care Center, Fresno
- Evergreen Care Center, Fresno
- Grace Healthcare Center, Fresno
- Manning Gardens Care Center, Inc, Fresno
This list is drawn from public CMS Care Compare records as of August 2026 (the August 2026 release) and public CDPH records as of June 2024 (the state enforcement dataset of August 27, 2024). It is ordered by location only and is not a recommendation, endorsement or assessment of any facility by this firm. How these figures were assembled.
What to do if you are worried about care at this facility
You will usually notice something is wrong before anyone official does, and you do not need proof before you act. If you are concerned about care at Keystone Post-Acute, you can take these steps:
Write down what you see. Note dates, times, and specific concerns, and photograph anything relevant. A clear, contemporaneous record matters if an investigation follows.
File a complaint with the California Department of Public Health. CDPH licenses and inspects skilled nursing facilities and investigates complaints, and a serious complaint can trigger an on-site inspection. You can file online through CDPH's Cal Health Find system, which routes your complaint to the Fresno County licensing district office.
Contact the Long-Term Care Ombudsman. The ombudsman is a free advocate who will visit your loved one, look into your concerns, and press the facility on their behalf. Fresno County's ombudsman program can be reached at (559) 224-9177. This is often the fastest first step when the issue is care quality rather than an emergency.
For the full walkthrough, see How to report nursing home abuse in California.
Injuries that most often signal neglect
The injuries below are the ones most often at issue in California nursing home cases. Any one of them at Keystone Post-Acute is a reason to ask what the facility's own records show:
- Bedsores and pressure ulcers, especially a wound that reached stage 3 or 4
- Falls and fractures in a resident who was supposed to be supervised
- Wandering and elopement from a building that was not secured
- Dehydration and malnutrition
- Sepsis and untreated infections
- Medication errors
- Wrongful death, when neglect contributed to a resident's passing
Nursing home abuse claims in Fresno County
If a loved one was harmed at Keystone Post-Acute, these pages explain how Fresno County families pursue the most common nursing home claims, each with local facility data and the county long-term care ombudsman:
- Fresno County bedsore lawyer
- Fresno County nursing home neglect lawyer
- Fresno County nursing home fall lawyer
- Fresno County nursing home wrongful death lawyer
- Fresno County nursing home sepsis lawyer
- Fresno County nursing home dehydration and malnutrition lawyer
- Fresno County nursing home medication error lawyer
You can also compare every home in the Fresno County nursing home directory.
Are There Lawsuits Against Keystone Post-Acute?
This page reports federal and state inspection, complaint and enforcement records for Keystone Post-Acute. Those records are separate from civil lawsuits: a government citation is not a lawsuit, and a facility can be sued without ever being cited. This site does not track civil court filings. Civil cases against California skilled nursing facilities are usually filed in the Superior Court of the county where the facility is located; records for Fresno County are searchable through the Fresno County Superior Court's online case records. If your family member was injured at Keystone Post-Acute, the records that matter most are usually the resident's own: nursing notes, care plans, fall-risk assessments, wound records, medication administration records, physician orders and incident reports. Talk to us about what happened.
Frequently asked questions
- Is Keystone Post-Acute a good nursing home?
- CMS gives Keystone Post-Acute an overall rating of 2 of 5 stars, with a health inspection rating of 2 of 5 based on in-person state surveys. California has issued 7 state citations against the facility, including 3 in the state's two most serious classes, class A and class AA. A rating is a starting point, not a verdict. Read it alongside the inspection dates and what you see for yourself.
- What should I do if my loved one was injured at Keystone Post-Acute?
- Document the injury with dated photos, request the care plan and treatment records, and report your concern to the California Department of Public Health and the Fresno County Long-Term Care Ombudsman. If the injury is serious, such as a bedsore, a fall, or an untreated infection, you can also speak with a nursing home attorney about whether you have a claim.
- Has Keystone Post-Acute been fined or cited for serious violations?
- Public records show 1 federal fine totaling $42,764 and 7 California state citations with $67,173 in state penalties, including 3 class A citations.
- How many state citations does Keystone Post-Acute have?
- The California Department of Public Health has issued 7 citations against Keystone Post-Acute in Fresno between February 14, 2001 and January 22, 2024: 3 class A and 4 class B, with $67,173 in assessed penalties.
- How do I report a problem at Keystone Post-Acute?
- File a complaint with CDPH through its Cal Health Find system, or contact the Fresno County Long-Term Care Ombudsman at (559) 224-9177. In an emergency, call Adult Protective Services or 911.
If your loved one was harmed
We came to this work from the other side. We spent years defending nursing homes, which means we know how a facility builds a file to protect itself and where the gaps in that file tend to be. Under California's Elder Abuse Act (Welfare and Institutions Code sections 15600 to 15675), a family that proves, by clear and convincing evidence, that neglect was committed with recklessness, oppression, fraud or malice can recover remedies beyond an ordinary injury claim, including attorney's fees (section 15657).
If your loved one was harmed at Keystone Post-Acute, talk to our Fresno County nursing home abuse lawyers. We handle cases in Fresno and across California. The consultation is free and confidential, we are available around the clock, and you owe nothing unless we recover for you.
Call (888) 999-0169. Available 24/7. Free consultation. No fee unless we win.
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Sources
- Centers for Medicare & Medicaid Services, Care Compare: Keystone Post-Acute provider record, CCN 056266. Ratings, staffing, and federal deficiency data processed August 1, 2026.
- CMS Provider Data Catalog: Provider Information, Penalties, and Health Deficiencies datasets.
- California Department of Public Health, Cal Health Find: Keystone Post-Acute state license record, FACID 040000043, license 40000104.
- California Department of Public Health, Health Facilities State Enforcement Actions dataset (CHHS Open Data), citations July 1, 1997 through June 30, 2024.
Disclaimer
The inspection data, ratings, citations, staffing figures, and ownership information on this page come from public sources, including the Centers for Medicare & Medicaid Services (medicare.gov) and the California Department of Public Health. This information is reported as published by those sources and may not reflect the most current findings or conditions at the facility. Deficiencies and citations listed may have been corrected or appealed since the date shown. Inclusion of Keystone Post-Acute in this directory is not a statement, allegation, or suggestion that the facility has committed abuse, neglect, or any wrongdoing. This page is attorney advertising and an information resource. It is not legal advice, and using this site does not create an attorney-client relationship. Young & Wallin is not affiliated with Keystone Post-Acute, and neither the facility nor any government agency endorses this page.