Covenant Post Acute
Medicare-certified3408 EAST SHIELDS AVENUE, Fresno, CA 93726
Skilled Nursing
Medicare & Medicaid certifiedSprinkler systemsResident & family councilSkilled nursing & rehabilitation+1 more
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Prices not published
About Keystone Post-Acute
Keystone Post-Acute provides skilled nursing and rehabilitation care to Fresno, California residents recovering from surgery, illness, or injury. Our clinical team focuses on personalized treatment plans designed to help patients regain independence and return home as quickly as possible.
Community at a glance
Capacity
65 residents
Location
Fresno, CA
Status
Listed in a public registry
Care & services offered
Skilled Nursing
Contact & location
3672 NORTH FIRST STREET, Fresno, California 93726
Medicare inspection record
From CMS Care Compare, the federal record every Medicare-certified nursing home is held to. Data as of September 1, 2026. Check it on Medicare.gov
At its most recent standard inspection, on July 17, 2026, state inspectors cited 11 health deficiencies (the California average is 15.5).
Nurses and nurse aides spend 3 hours 56 minutes with each resident a day, below the California average of 4 hours 31 minutes.
Medicare fined Keystone Post-Acute once in the last three years, $42,764 in total.
Staffing
| Measure | This home |
|---|---|
| Nurse and aide time per resident, per day | 3 hours 56 minutesBelow the California average |
| Registered nurse time per resident, per day | 14 minutesBelow the California average |
| Nursing staff who left in the past year | 47%Above the California average |
Inspections
45 health citations in the last three years. Each one is a federal standard inspectors found the home was not meeting.
July 17, 2026 · Standard inspection · 9 citations
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.
Risk of harm, no one hurt, widespread (level F)Nursing and Physician ServicesCorrected Aug 14, 2026Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Risk of harm, no one hurt, a pattern (level E)EnvironmentalCorrected Aug 14, 2026Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Risk of harm, no one hurt, a few residents (level D)Nutrition and DietaryCorrected Aug 14, 2026Honor 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.
Risk of harm, no one hurt, a few residents (level D)Resident RightsCorrected Aug 14, 2026Provide care and assistance to perform activities of daily living for any resident who is unable.
Risk of harm, no one hurt, a few residents (level D)Quality of Life and CareCorrected Aug 14, 2026Provide and implement an infection prevention and control program.
Risk of harm, no one hurt, a few residents (level D)Infection ControlCorrected Aug 14, 2026Provide safe, appropriate pain management for a resident who requires such services.
Risk of harm, no one hurt, a few residents (level D)Quality of Life and CareCorrected Aug 14, 2026Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Risk of harm, no one hurt, a few residents (level D)EnvironmentalCorrected Aug 14, 2026Ensure services provided by the nursing facility meet professional standards of quality.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningCorrected Aug 14, 2026
May 8, 2026 · Complaint investigation · 1 citation
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Risk of harm, no one hurt, a few residents (level D)Quality of Life and CareFrom a complaintCorrected May 30, 2026
February 5, 2026 · Complaint investigation · 1 citation+
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Risk of harm, no one hurt, a few residents (level D)Resident RightsFrom a complaintCorrected Feb 27, 2026
May 30, 2025 · Standard inspection · 12 citations+
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Risk of harm, no one hurt, widespread (level F)Nutrition and DietaryCorrected Jun 26, 2025Ensure that residents are free from significant medication errors.
Risk of harm, no one hurt, a pattern (level E)Pharmacy ServiceCorrected Jun 26, 2025Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Risk of harm, no one hurt, a pattern (level E)Pharmacy ServiceCorrected Jun 26, 2025Ensure 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.
Risk of harm, no one hurt, a pattern (level E)Pharmacy ServiceCorrected Jun 26, 2025Make sure that a working call system is available in each resident's bathroom and bathing area.
Risk of harm, no one hurt, a few residents (level D)EnvironmentalCorrected Jun 26, 2025Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningCorrected Jun 26, 2025Give the resident's representative the ability to exercise the resident's rights.
Risk of harm, no one hurt, a few residents (level D)Resident RightsCorrected Jun 26, 2025Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Risk of harm, no one hurt, a few residents (level D)Resident RightsCorrected Jun 26, 2025Provide and implement an infection prevention and control program.
Risk of harm, no one hurt, a few residents (level D)Infection ControlCorrected Jun 26, 2025Honor 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.
Risk of harm, no one hurt, a few residents (level D)Resident RightsCorrected Jun 26, 2025Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Risk of harm, no one hurt, a few residents (level D)AdministrationCorrected Jun 26, 2025Ensure services provided by the nursing facility meet professional standards of quality.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningCorrected Jun 26, 2025
March 13, 2025 · Complaint investigation · 1 citation+
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Risk of harm, no one hurt, a few residents (level D)Quality of Life and CareFrom a complaintCorrected Apr 2, 2025
October 3, 2024 · Complaint investigation · 2 citations+
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningFrom a complaintCorrected Oct 22, 2024Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningFrom a complaintCorrected Oct 22, 2024
August 21, 2024 · Complaint investigation · 1 citation+
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.
Risk of harm, no one hurt, a pattern (level E)Resident RightsFrom a complaintCorrected Sep 13, 2024
June 13, 2024 · Complaint investigation · 1 citation+
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Risk of harm, no one hurt, widespread (level F)Nutrition and DietaryFrom a complaintCorrected Jul 5, 2024
April 26, 2024 · Standard inspection · 16 citations+
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.
Risk of harm, no one hurt, widespread (level F)Pharmacy ServiceCorrected May 31, 2024Try 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.
Risk of harm, no one hurt, widespread (level F)Quality of Life and CareCorrected May 31, 2024Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Risk of harm, no one hurt, widespread (level F)Nutrition and DietaryCorrected May 31, 2024Have 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.
Risk of harm, no one hurt, widespread (level F)Nursing and Physician ServicesCorrected May 31, 2024Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Risk of harm, no one hurt, a pattern (level E)Resident Assessment and Care PlanningCorrected May 31, 2024Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Risk of harm, no one hurt, a pattern (level E)AdministrationCorrected May 31, 2024Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Risk of harm, no one hurt, a pattern (level E)Nursing and Physician ServicesCorrected May 31, 2024Ensure services provided by the nursing facility meet professional standards of quality.
Risk of harm, no one hurt, a pattern (level E)Resident Assessment and Care PlanningCorrected May 31, 2024Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Risk of harm, no one hurt, a pattern (level E)Resident Assessment and Care PlanningCorrected May 31, 2024Honor 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.
Risk of harm, no one hurt, a pattern (level E)Resident RightsCorrected May 31, 2024Provide and implement an infection prevention and control program.
Risk of harm, no one hurt, a pattern (level E)Infection ControlCorrected May 31, 2024Ensure that residents are fully informed and understand their health status, care and treatments.
Risk of harm, no one hurt, a pattern (level E)Resident RightsCorrected May 31, 2024Develop and implement policies and procedures for flu and pneumonia vaccinations.
Risk of harm, no one hurt, a few residents (level D)Infection ControlCorrected May 31, 2024Provide enough food/fluids to maintain a resident's health.
Risk of harm, no one hurt, a few residents (level D)Quality of Life and CareCorrected May 31, 2024Put firmly secured handrails on each side of hallways.
Risk of harm, no one hurt, a few residents (level D)EnvironmentalCorrected May 31, 2024Keep all essential equipment working safely.
Risk of harm, no one hurt, a few residents (level D)EnvironmentalCorrected May 31, 2024
November 15, 2023 · Complaint investigation · 1 citation+
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Residents were harmed, a few residents (level G)Quality of Life and CareFrom a complaintCorrected Dec 28, 2023
Fines and payment denials
1 fine totaling $42,764 and 1 Medicare payment denial in the last three years.
- November 15, 2023Fine: $42,764
- November 15, 2023Payment denial, 13 days
About the home, per Medicare
- Ownership
- For profit - Limited Liability company
- Legal business name
- Fresno Nursing and Rehab Center LLC
- Medicare-certified beds
- 65
- Average residents per day
- 61
- Accepts
- Medicare and Medicaid
- First certified
- February 25, 1971
- Part of a chain
- Eduro Healthcare, 34 homes
- Inside a hospital
- No
- Continuing care retirement community
- No
- Resident or family council
- Both
- Sprinklers in all required areas
- Yes
- CMS Certification Number
- 056266
Location
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3672 NORTH FIRST STREETFresno, CA 93726
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Questions about Keystone Post-Acute
How did Keystone Post-Acute do on its last inspection?+
State inspectors visited on July 17, 2026 and cited 11 health deficiencies, 2 of them from complaint investigations. The California average is 15.5.
How much nursing care does each resident get at Keystone Post-Acute?+
Nurses and aides spend 3 hours 56 minutes with each resident per day, including 14 minutes from registered nurses. 47% of nursing staff left over the past year.
Has Keystone Post-Acute been fined by Medicare?+
Yes. Medicare fined Keystone Post-Acute once in the last three years, totaling $42,764.
Does Medicare cover skilled nursing?+
Medicare covers up to 100 days of skilled nursing per benefit period after a qualifying 3-day hospital stay — fully for the first 20 days, then with a daily copay. Long-term custodial stays are generally not covered.
How much does a nursing home cost?+
A semi-private room averages about $7,900 per month nationally; private rooms cost more. Medicaid is the largest payer for long-term nursing home care.
What is the CMS star rating?+
Medicare rates nursing homes 1 to 5 stars on its Care Compare site. We don't repeat those stars here. Each nursing home page shows Medicare's underlying record instead: inspections, staffing and fines, with a link to check it on Medicare.gov.