Cycle 1
Health 2025-04-10 · Fire 2025-04-10
3 health deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
2 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Merced, CA
Franciscan Post-Acute Care Center
4-star overall rating with 4-star inspections with $9,110 in total fines with 3 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
3169 M Street, Merced, CA
(209) 722-6231
Overall
4 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
71
Certified beds
Average residents
60
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Avalon Health Care
Operator or chain grouping
Approved since
1969-07-31
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
13 facilities
Chain averages 4 overall / 3 health / 4 staffing / 4 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.42
Registered nurse staffing · state 0.65 · national 0.68
LPN hours / resident day
1.25
Licensed practical nurse staffing · state 1.22 · national 0.87
Aide hours / resident day
3.05
Nurse aide staffing · state 2.64 · national 2.35
Total nurse hours
4.72
All reported nurse hours · state 4.51 · national 3.89
Licensed hours
1.67
RN + LPN hours · state 1.87 · national 1.54
Weekend hours
4.31
Weekend nurse staffing · state 4.08 · national 3.43
Weekend RN hours
0.28
Weekend registered nurse coverage · state 0.50 · national 0.47
Physical therapist
0.03
Reported PT staffing · state 0.10 · national 0.07
Adjusted RN hours
0.42
CMS adjusted RN staffing hours
Adjusted total hours
4.79
CMS adjusted total nurse staffing hours
Case-mix index
1.35
Higher values indicate more complex resident acuity
RN turnover
50%
Annual RN turnover · state 42% · national 45%
Total nurse turnover
35%
Annual nurse turnover · state 38% · national 46%
SNF VBP
Value-based purchasing
Program rank
3,718
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
42.98
Composite VBP score used to determine payment impact.
Payment multiplier
0.9959
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
4.35
Baseline 18.25% · Performance 19.41% · Measure score 4.35 · Achievement 4.35 · Improvement 0
Healthcare-associated infections
0
Baseline 5.96% · Performance 9.22% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
7.11
Baseline 40.00% · Performance 34.62% · Measure score 7.11 · Achievement 7.11 · Improvement 3.05
Adjusted total nurse staffing
5.73
Baseline 4.4 hours · Performance 4.71 hours · Measure score 5.73 · Achievement 5.73 · Improvement 1.73
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.15% |
10.72%
0.6 pts better
|
No Different than the National Rate · Eligible stays 164 · Observed rate 9.76% · Lower 95% interval 7.84% |
| Discharge to community | 63.61% |
50.57%
13 pts better
|
Better than the National Rate · Eligible stays 161 · Observed rate 57.76% · Lower 95% interval 54.08% |
| Medicare spending per beneficiary | 1.14 |
1.02
0.1 pts worse
|
|
| Drug regimen review with follow-up | 90.24% |
95.27%
5 pts worse
|
Numerator 111 · Denominator 123 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 123 |
| Discharge self-care score | 41.89% |
53.69%
11.8 pts worse
|
Numerator 31 · Denominator 74 |
| Discharge mobility score | 27.03% |
50.94%
23.9 pts worse
|
Numerator 20 · Denominator 74 |
| Pressure ulcers or injuries, new or worsened | 1.63% |
2.29%
0.7 pts better
|
Numerator 2 · Denominator 123 · Adjusted rate 1.27% |
| Healthcare-associated infections requiring hospitalization | 9.22% |
7.12%
2.1 pts worse
|
No Different than the National Rate · Eligible stays 119 · Observed rate 11.76% · Lower 95% interval 6.02% |
| Staff COVID-19 vaccination coverage | 34.18% |
8.2%
26 pts better
|
Numerator 54 · Denominator 158 |
| Staff flu vaccination coverage | 78.34% |
42%
36.3 pts better
|
Numerator 123 · Denominator 157 |
| Discharge function score | 48.65% |
56.45%
7.8 pts worse
|
Numerator 36 · Denominator 74 |
| Transfer of health information to provider | 97.14% |
95.95%
1.2 pts better
|
Numerator 34 · Denominator 35 |
| Transfer of health information to patient | 98.68% |
96.28%
2.4 pts better
|
Numerator 75 · Denominator 76 |
| Resident COVID-19 vaccinations up to date | 7.94% |
25.2%
17.3 pts worse
|
Numerator 5 · Denominator 63 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.2 |
2.3
1.1 pts better
|
1.9
0.7 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.2 · Observed 0.6 · Expected 0.9 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.2 |
1.6
0.4 pts better
|
1.8
0.6 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.2 · Observed 0.9 · Expected 1.2 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
98.5%
1.5 pts better
|
93.4%
6.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 91.3% |
98.2%
6.9 pts worse
|
95.5%
4.2 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 91.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.8% |
1.6%
1.2 pts worse
|
3.3%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.3% · Q2 2.2% · Q3 4.3% · Q4 2.3% · 4Q avg 2.8% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.0% |
6.8%
6.8 pts better
|
11.4%
11.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents who lose too much weight | 3.3% |
4.1%
0.8 pts better
|
5.4%
2.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 10.8% · Q2 2.6% · Q3 0.0% · Q4 0.0% · 4Q avg 3.3% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 28.8% |
13.7%
15.1 pts worse
|
19.6%
9.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 28.9% · Q2 31.7% · Q3 28.6% · Q4 25.6% · 4Q avg 28.8% |
| Percentage of long-stay residents who received an antipsychotic medication | 15.6% |
14.2%
1.4 pts worse
|
16.7%
1.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 16.7% · Q2 16.0% · Q3 16.7% · Q4 13.0% · 4Q avg 15.6% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.4%
0.4 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 24.4% |
11.0%
13.4 pts worse
|
16.3%
8.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q3 34.3% · 4Q avg 24.4% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 18.5% |
10.7%
7.8 pts worse
|
14.9%
3.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 14.3% · Q2 10.8% · Q3 23.7% · Q4 25.0% · 4Q avg 18.5% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.3% |
1.0%
0.7 pts better
|
1.0%
0.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 1.3% · 4Q avg 0.3% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.6% |
1.2%
0.6 pts better
|
1.7%
1.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.4% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.6% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 22.8% |
10.9%
11.9 pts worse
|
19.8%
3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.7% · Q2 23.5% · Q3 20.7% · Q4 25.5% · 4Q avg 22.8% |
| Percentage of long-stay residents with pressure ulcers | 6.4% |
4.7%
1.7 pts worse
|
5.1%
1.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.0% · Q2 12.1% · Q3 8.1% · Q4 2.2% · 4Q avg 6.4% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 99.1% |
94.0%
5.1 pts better
|
81.7%
17.4 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 98.5% · Q2 100.0% · Q3 99.2% · Q4 98.5% · 4Q avg 99.1% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 15.7% |
11.2%
4.5 pts worse
|
12.0%
3.7 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 15.7% · Observed 15.7% · Expected 11.2% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.5% |
1.5%
1 pts better
|
1.6%
1.1 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 1.1% · Q4 1.2% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 85.0% |
93.2%
8.2 pts worse
|
79.7%
5.3 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 85.0% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 26.1% |
23.2%
2.9 pts worse
|
23.9%
2.2 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 26.1% · Observed 25.9% · Expected 23.7% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2022-12-01 · Fire 2022-12-01
13 health deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
3 fire-safety deficiencies
Top issue: Emergency Preparedness (1 deficiency)
Cycle 3
Health 2019-02-15 · Fire 2019-02-15
12 health deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2 fire-safety deficiencies
Top issue: Emergency Preparedness (1 deficiency)
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2025-04-10
K325 · Smoke Deficiencies
Fire Safety
Have properly installed hallway dispensers for alcohol-based hand rub.
Corrected 2025-04-24
D · Potential for more than minimal harm
2025-04-10
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2025-04-24
D · Potential for more than minimal harm
2022-12-01
E31 · Emergency Preparedness Deficiencies
Fire Safety
Provide emergency officials' contact information.
Corrected 2023-01-05
D · Potential for more than minimal harm
2022-12-01
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-01-05
D · Potential for more than minimal harm
2022-12-01
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-01-05
D · Potential for more than minimal harm
2019-02-15
E6 · Emergency Preparedness Deficiencies
Fire Safety
Conduct risk assessment and an All-Hazards approach.
Corrected 2019-03-20
D · Potential for more than minimal harm
2019-02-15
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2019-03-20
Inspection history
Recent health citations
G · Actual harm
2025-06-12
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2025-07-04
D · Potential for more than minimal harm
2025-06-12
F806 · Nutrition and Dietary Deficiencies
Health
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Corrected 2025-07-04
D · Potential for more than minimal harm
2025-04-10
F644 · Resident Assessment and Care Planning Deficiencies
Health
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2025-05-02
G · Actual harm
2025-02-05
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-02-28
D · Potential for more than minimal harm
2025-02-05
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2025-02-28
D · Potential for more than minimal harm
2025-02-05
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2025-02-28
E · Potential for more than minimal harm
2025-01-13
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2025-02-12
D · Potential for more than minimal harm
2024-12-11
F825 · Quality of Life and Care Deficiencies
Health
Provide or get specialized rehabilitative services as required for a resident.
Corrected 2024-12-30
D · Potential for more than minimal harm
2024-09-17
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-10-10
E · Potential for more than minimal harm
2024-08-29
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Corrected 2024-09-30
D · Potential for more than minimal harm
2024-08-16
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-09-10
G · Actual harm
2024-04-17
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-05-16
D · Potential for more than minimal harm
2024-01-30
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2024-02-21
D · Potential for more than minimal harm
2023-10-02
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-10-24
D · Potential for more than minimal harm
2023-10-02
F726 · Nursing and Physician Services Deficiencies
Health
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Corrected 2023-10-24
D · Potential for more than minimal harm
2023-07-11
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2023-08-01
E · Potential for more than minimal harm
2022-12-01
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2022-12-22
E · Potential for more than minimal harm
2022-12-01
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2022-12-22
E · Potential for more than minimal harm
2022-12-01
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2022-12-22
D · Potential for more than minimal harm
2022-12-01
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2022-12-22
E · Potential for more than minimal harm
2019-02-15
F584 · Resident Rights Deficiencies
Health
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.
Corrected 2019-04-03
E · Potential for more than minimal harm
2019-02-15
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2019-04-03
E · Potential for more than minimal harm
2019-02-15
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2019-04-03
E · Potential for more than minimal harm
2019-02-15
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2019-04-03
D · Potential for more than minimal harm
2019-02-15
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2019-04-03
D · Potential for more than minimal harm
2019-02-15
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2019-04-03
D · Potential for more than minimal harm
2019-02-15
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2019-04-03
D · Potential for more than minimal harm
2019-02-15
F921 · Environmental Deficiencies
Health
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected 2019-04-03
Penalties and ownership
What sits behind the stars
$9,110
2025-01-13
Fine
Fine · fine $9,110
Fine
Ownership
Avalon Of California LLC
5% Or Greater Direct Ownership Interest · Organization
Avalon Care LLC
5% Or Greater Indirect Ownership Interest · Organization
Avalon Health Care Management, Inc.
Operational/Managerial Control · Organization
Avalon Health Care, Inc.
5% Or Greater Indirect Ownership Interest · Organization
Avalon Health Care, Inc.
Operational/Managerial Control · Organization
Avalon Holding, Inc.
5% Or Greater Indirect Ownership Interest · Organization
Borisevich, Maria
Operational/Managerial Control · Individual
Borisevich, Maria
Corporate Officer · Individual
Dangerfield, David
Corporate Director · Individual
Hash, Alan
Operational/Managerial Control · Individual
Hash, Alan
Corporate Officer · Individual
Henrie, Brian
Operational/Managerial Control · Individual
Hyrum A Kirton Individual Tr
5% Or Greater Indirect Ownership Interest · Organization
K-Team LLC
5% Or Greater Indirect Ownership Interest · Organization
Kirton, Byron
Corporate Director · Individual
Kirton, Charles
Operational/Managerial Control · Individual
Kirton, Charles
Corporate Director · Individual
Kirton, Charles
Corporate Officer · Individual
Kirton, Hyrum
5% Or Greater Indirect Ownership Interest · Individual
Kirton, Hyrum
Operational/Managerial Control · Individual
Kirton, Hyrum
Corporate Director · Individual
Kirton, Hyrum
Corporate Officer · Individual
Kirton, Spencer
Corporate Director · Individual
Paik-Tesch, John
Operational/Managerial Control · Individual
Smith, Nicole
Operational/Managerial Control · Individual
Smith, Nicole
Corporate Officer · Individual
Souza, Joanne
Operational/Managerial Control · Individual
Spencer K Kirton Individual Tr
5% Or Greater Indirect Ownership Interest · Organization
The Byron A Kirton Individual Tr
5% Or Greater Indirect Ownership Interest · Organization
Woltil, Robert
Corporate Director · Individual
Nearby options
Other facilities in reach
#1
Golden Merced Care Center
Merced, CA
2-star overall rating with 2-star inspections with $103,467 in total fines with 15 recent health deficiencies with 10 fire-safety deficiencies in the latest cycle
#2
Merced Nursing & Rehabilitation Ctr
Merced, CA
4-star overall rating with 3-star inspections with 12 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#3
La Sierra Care Center
Merced, CA
3-star overall rating with 3-star inspections with 14 recent health deficiencies with 8 fire-safety deficiencies in the latest cycle
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